Most of the time after giving birth, the advice that’s given regarding returning to movement and exercise is this: wait until your six-week checkups, then listen to your body and gradually return to what you were previously doing.
Why does this not sit right with us?
Well, firstly, six weeks is actually a really long time. To expect a woman to do nothing with regard to exercise and movement over that time is unreasonable and also unhealthy.
Muscle deconditioning can happen quickly, and new mothers need to stay strong and fit to ensure that they can keep up with the physical demands of looking after a baby – and possibly also one or more older children too.
We are not saying that brand-new mothers should return to the gym in the early weeks after giving birth. I’m also not saying that hour-long workouts should be factored into their sleep-deprived lives.
But what we are saying is that there are so many things to do with movement that can and should, be incorporated into daily life with a newborn rather than waiting until the magical six-week mark.
This brings us to our second point. Those six-week checkups are not a magical all-clear to return to exercise. Very commonly, no physical assessment is done for the mother, and it is simply an ‘all clear’ that the mother is medically well, rather than an individual assessment of birth injuries, abdominal muscle separation or musculoskeletal health.
Simply ‘listening to your body’ and returning gradually to the exercise you were previously doing, in my opinion, is flying blind. Many birth injuries are asymptomatic at first, so there wouldn’t be anything to ‘listen to’ with regard to knowing how and when to progress your load and intensity.
READ MORE here if you don’t already know about the importance of including a postnatal assessment with a physiotherapist who specialises in Women’s Health and why it is so essential to get an individualised management plan in place for your return to exercise.
The first six weeks. What can you do?
We usually break it down into the following categories of return to movement and exercise:
Pelvic Floor and Core
Strength & Resistance
READ MORE here about the importance of starting early pelvic floor exercises, stretching and gentle cardio in the early weeks.
If you would like some more in-depth information, we have a whole series of videos in The FitRight Membership group called ‘The First Six Weeks’, in which we talk about all of these categories of movement, plus extra specific information about recovery from the potential swelling and pain in and around the vagina after vaginal birth.
READ MORE here if you have given birth via a Caesarean Section, as there are extra things to take into consideration to do with recovery from abdominal surgery and scar healing.
We want to focus on the gentle way that you can return to some resistance work. This doesn’t necessarily have to involve weights or resistance bands at first; it can simply involve your body weight and the baby’s weight.
A gentle return to Resistance Exercise
You will no doubt spend a lot of time in these early weeks holding the baby in your arms, or in a carrier, while you walk around with them. Babies tend to love your movement and love being close to you.
So why not use this time to not only walk and jiggle, and instead make it into a form of resistance exercise?
As long as you are medically well and follow these two principles, adding in some gentle strength work is safe:
Use vaginal heaviness and/or pain as a guide.
Don’t push through this feeling of heaviness; it is likely to be an indicator that the pelvic floor muscles and connective tissue are not recovered sufficiently to support the pelvic organs under the load that you’ve asked of them. Pushing through this feeling could cause or worsen vaginal prolapse.
Start gently and work up.
Even if you think a movement seems very easy, in the early days or weeks after giving birth, ensure that you start with the lowest load and intensity option and check how you pull up later before increasing to harder options next time. You may be surprised that something relatively easy might actually be too much load on the pelvic structures this soon after birth.
Here are some examples of standing bodyweight movements that you could start with, that can be done while holding your baby:
Calf Raises (up on tiptoes)
Would you like some more ideas and information?
Here are some example of movements that you could do on the floor while your baby is having a play on the mat…
Modified push-ups from four-point kneeling
Arm and leg lifts in four-point kneeling
Bridging (this is also a great ‘anti-gravity’ exercise to prevent or manage vaginal heaviness symptoms)
There are so many more, and the general rule should be that if it is safe and achievable in late pregnancy, then a similar exercise probably is safe to try in the early postnatal period.
A good way to structure this is to choose 2-4 movements, do 8-10 repetitions of each, rest, and then repeat everything 2 or 3 times depending on symptoms.
Here are some sneak peek video examples from the FitRight Membership Group:
Pelvic Tilts, Squats and Calf Raises
Squat Twist and Leg Lifts
Squat Twist and Leg Lifts
The FitRight Membership has a huge library of low-impact, pelvic floor-friendly workouts to follow, and The First Six Weeks video series is also available in there.
Join us here if you’d like to explore more!
Remember – you don’t have to spend the first six weeks wrapped in cotton wool doing nothing. There are so many tasks, such as getting a capsule in and out of the car, lifting a baby from the floor, and getting in and out of bed, that would become so much harder on your body if you are deconditioned, stiff or with a lower level of fitness.
If you are medically well in those early weeks, there is actually a lot that you can do to set yourself up for an easier, quicker return to your normal levels of activity and exercise. And yes, it can be done around your baby in little bite-sized pieces rather than structuring any specific exercise into your day.
READ MORE here about recovering from a vaginal birth and what no body else is going to tell you!
At FitRight HQ all of our womens health physios specialise in exercise and education following birth. If you would like to make an appointment at FitRight HQ click here.