Keep fit and healthy after giving birth

So, you’ve had your baby…congratulations! While you’ll want to give your baby lots of attention, it is important to look after yourself too, writes Lara Maddison, a specialist physiotherapist in Women’s Health at The Forge Clinic.

This guide aims to help aid your recovery after childbirth, boost your wellbeing and get back into shape again.

Pain Relief

  • You may be given tablets if you are uncomfortable. Take these regularly as suggested. It will help you to keep mobile, which in turn helps the healing process.
  • Ice packs can help reduce swelling and discomfort after a vaginal delivery. A simple way to make one is to soak a clean sanitary towel in water. Place in a polythene bag and pop into the freezer. Once frozen, wrap the sanitary towel in a damp flannel and place on your genital area for 15 minutes.

The Pelvic Floor

As soon as you feel ready and have emptied your bladder naturally it is important for you to recommence your pelvic floor exercises.

A little reminder about this important muscle group

Your pelvic floor muscles form a support from your tailbone at the back to your pubic bone at the front. They are important for bladder and bowel control, sexual function, lower back and pelvic stability and for providing support to your pelvic organs. Weak pelvic floor muscles may not support the bladder, uterus and bowel effectively and this can contribute to pelvic organ prolapse.

When to start your pelvic floor muscle exercises

After giving birth you may have stitches or bruising to the pelvic floor area. Do not let this prevent you from doing the exercises. Gentle movement helps to reduce swelling and aids the healing process.

For the SLOW contractions

  • Take a breath in to prepare and as you exhale firmly close around your back passage as if you are stopping yourself from passing wind
  • Draw that same contraction forwards and upwards as if you are doing up a zip between your legs and trying to stop the flow of urine
  • Once you feel the pelvic floor muscles lift, hold onto this contraction, BREATH and count steadily to a maximum of 10 seconds
  • SLOWLY release all the way
  • Rest for 3 seconds
  • Repeat 10 times

For the FAST contractions

  • Lift and squeeze your pelvic floor muscles as tightly as you can
  • Hold for 1 seconds
  • Release all the way
  • Rest for 1 seconds
  • Repeat 10 times

Exercise often

You should practise both of these exercises 3 times daily. Find some regular activities to remind you to do your pelvic floor eg while you are feeding your baby. Remember – these exercises are for life and will help prevent incontinence and pelvic organ prolapse as well as aid healing.

Extra tip

Practise tightening your pelvic floor muscles before you cough. The reflex that makes you do this naturally can stop working after having a baby. Regular practice protects your pelvic floor muscles and helps to train them to work automatically with a cough or sneeze.

CORE MUSCLE EXERCISES

Your transverse abdominis muscle runs around you like a human corset. During pregnancy this muscle can get stretched and weakened. The following exercises will help to strengthen your deep abdominal muscles.

Bracing/engaging transversus

  • Place your fingertips on your lower tummy.
  • Take a breath in to prepare.
  • As you breathe out gently contract your lower tummy muscles by drawing your bump away from your fingertips.
  • Hold for 5 – 10 seconds as you continue to breathe.
  • Practise little and often throughout the day – particularly while you are walking, before lifting anything and before changing position.

Pelvic tilt

  • Lie with your knees bent and your feet flat with the support of 2 – 3 pillows behind you.
  • Gently pull in/brace your tummy muscles as above.
  • Rock your pelvis back until you feel your lower back gently press into the floor/bed.
  • Hold as you breathe in.
  • As you breathe out gently return your pelvis back to the starting position.
  • Relax.
  • Repeat 5-10 times.
  • This exercise can also be performed while sitting and standing.

Gentle twist

  • Lie on your back with your knees bent.
  • Brace your abdominals (see exercise 1).
  • Keeping your knees together, slowly move your knees a few inches to the right. Keep your hips still and your stomach muscles drawn in.
  • Bring your knees back to the middle, and then relax.
  • Repeat on the other side.
  • Repeat 5 -10 times on each side.

BACK CARE

It is important to look after your back and your posture in the first weeks after birth. This is a common time to develop back pain. Be aware that your ligaments may still be softer for some time.

  • Try to maintain good posture. Stand and walk tall, with your tummy and bottom gently tucked in.
  • When feeding your baby, sit on a firm chair with a rolled up towel in the small of your back. Place the baby on pillows so they are higher which will help to prevent you from slouching forwards.
  • You may want to use a footstool to ensure your feet can rest flat and fully.
  • When changing and bathing your baby try to do this at waist height. If you are using a lower surface it may help to kneel down.
  • In the early weeks try not carry a baby bath full of water, as it can be very heavy.
  • Avoid heavy lifting for the first six weeks. If you do have to lift, brace your abdominals, keep your back straight and bend your knees to use your strong thigh muscles.
  • Avoid carrying the car seat with your baby in it where possible, as this increases the load.
  • Choose a pushchair with handles at a comfortable height or adjustable handles.

SEX

  • Sex is not just about intercourse. Find time to be physically close to your partner.
  • Make sure you feel ready.
  • Lubrication can make intercourse more comfortable particularly as the hormonal changes can increase vaginal dryness. You can buy lubricants in pharmacies, supermarkets or online.
  • If you have stitches wait until they have healed before attempting intercourse.
  • Gently massaging your scar can make it more comfortable once your stitches have healed.
  • Try different positions for intercourse as this might make penetration easier and more comfortable.
  • Be aware that you can still get pregnant if you are breastfeeding – even if your periods have not yet returned. Speak to your GP or health visitor about contraception.
  • Be patient. Sex may be uncomfortable the first time but do not give up.
  • If you are having any problems do not feel embarrassed and do seek help from a healthcare professional.

Expert help for new mothers

The Forge Clinic in Richmond offers a range of Women’s Health specialist services to recover fully and feel fit and healthy after your baby is born. If you would like more information or advice, please call us on 020 8332 6184 or email us at info@theforgeclinic.com.

Pelvic, Obstetric and Gynaecological Physiotherapy (POGP formerly ACPWH) has produced a guide to help you recover after childbirth, which is available on their website. You can download ‘Fit for the Future’ here.