Exercising after pregnancy and birth
When is it ‘safe’ to return to exercise after giving birth?
This question doesn’t have an easy answer. It will vary for every woman and depend on many different factors such as what happened during the birth, prior fitness levels and how you are feeling after the birth.
Although things will feel far from normal straight after giving birth, in those first 6 weeks, and beyond, your body will be recovering and healing; you can help support this by eating well, including plenty of protein to help collagen regeneration, and resting when you can. Start your pelvic floor exercises and pay attention to your posture when sitting and standing as it is easy to remain in your pregnancy posture after birth.
At the 6-week check you may be suffering from any of these symptoms:
• Low back or pelvic pain
• Leakage of urine or faeces
• Pain with sex
• Feelings of heaviness/ pressure or the pelvic floor having dropped
• The stomach bulging or doming significantly during exercise.
If so, mention it to the GP and get a women’s health physio referral as these symptoms are not normal at this stage and will not usually go away on their own.
If you are not aware of any symptoms at the 6-week check then fantastic, but it is not a green light to get back to vigorous exercising. You need to remember that the foundations of your core control – your pelvic floor and abdominals – need to recover and be working correctly before you start to increase the intensity of exercise. Without strong foundations things can fall apart! And your pregnancy hormones will still be affecting your body up to 3-5 months after giving birth – longer if breast feeding.
How do you build up your core foundations and how do you know they are working?
You need to do specific exercises to target the pelvic floor and abdominals. This can be through gentle Pilates or Yoga exercises which incorporate breathing. Avoid high-impact exercise, anything which causes you to brace your tummy or breath hold and abdominal crunch or plank-type exercises. These are more advanced exercises which you should only attempt once you have your foundation back and strong.
Again, if you have any bulging, doming, leakage, pain or heaviness, or you find yourself breath holding when exercising, your core foundation is not yet fully working.
You can do a self-check: lie on your back with knees bent; tuck your chin in and slowly curl your head and shoulders off the floor; and look and see whether your abdomen is bulging or doming (see picture). Do you have any back or pelvic pain; does your pelvic floor feel like it is bearing down or bulging?
If any of the above apply you would be advised to see a postnatal fitness professional or women’s health physio, or to join my PhysioNatal Regain course which is designed to bridge the gap between birth recovery and return to full exercise. You will be given exercises to build up your core foundation and taught correct exercise techniques so you may confidently return to your previous fitness activities.
When you feel ready to start exercising again how do you pick a class that is suitable?
There are many classes out there marketed particularly at new Mums, which is great. It is a chance to get out of the house, meet new people, do some exercise and start to get back to ‘normal’. But how do you know if the class is suitable for you? Unfortunately, not every instructor leading such classes is sufficiently trained in the needs of the postpartum woman and the steps and precautions that need to be taken to return to exercise. Here is a quick checklist to help you choose:
Is there a pre-screen before starting?
A properly trained instructor will do a pre-screen before you start a class. They will ask specific questions about your birth, your recovery, your pelvic floor health including any symptoms you may be experiencing.
If you are just expected to turn up and join in with no questions asked: AVOID!
Is leaking during the class considered normal?
Any class that offers you a TENA lady, or suggests you go to the loo before you start exercising: AVOID, AVOID, AVOID! Unfortunately, I have heard reports of this happening. It is normalising stress incontinence which is NOT NORMAL, and reinforcing – and potentially worsening – a pelvic floor dysfunction that needs fixing. If you are leaking during exercise you must see a women’s health physiotherapist: either access a referral through your GP or, if it is an option, pay privately.
Do you enjoy the class?
Any exercise you choose should be something you enjoy. After 10 mins you should start to feel energised and your mood lifted. That feeling of being energised should also be with you for a couple of hours after exercising. If you feel wiped out, mentally fatigued and need to lie down (rather than feel physically tired after exercising) it is too intensive for you at present.
Are you experiencing any symptoms when exercising?
Any of these symptoms indicate that your core foundation is not fully restored or coping with the intensity of the exercise you are doing: leaking urine, heaviness or feeling of dropping in your pelvic floor, your tummy bulging outwards or doming, breath holding when exercising, aches and pains in the back, pelvis and hips.
If this is the case, again you need to see a women’s health physio or get in touch with me here at PhysioNatal for a full assessment and personalised programme to get you back to exercising.
Give yourself time!
You have been pregnant for 9 months, been through the physically and emotionally demanding process of birth and are dealing now with the enormous life change that having a baby brings. You will get your body back, but it will take time – anything up to 12-18 months after giving birth – and a bit of perseverance.