Looking forward to shedding the pregnancy pounds? Maintaining a safe postnatal recovery takes time, and be weary about programs that promises results in a few weeks after birth. It’s important to protect the body and avoid discomforts related to pelvic floor disorders such as urine incontinence, prolapse, sexual disorders or abdominal diastasis.
The First 6 weeks
The first days and weeks after birth your body will change to return to its non-pregnant condition. Giving the time for your body to heal is important but this doesn’t mean you should do nothing!
During pregnancy, your abdominal muscles have been stretched about 15 cm, your core is larger and your abs may be separated (diastasis). Your pelvic floor muscles are weak. Your uterus floats in the abdominal cavity suspended by distended ligaments therefore, even after delivery it is normal if you still look pregnant!
Everything should come back to the normal if you do not bungle this natural recovery with non-correct exercises or postures, running the risk of prolapse, incontinence, sexual disorders or abdominal damages…
Here are 3 things to remember for a good recovery during the first 6 weeks after delivery:
1. Keep your organs up
2. Avoid pressure on your pelvic floor
3. Minimize the abdominal deformation
For that to happen, you should do these 8 things:
1. LIE DOWN
In our modern medical world, we give birth lying and stand as soon as possible. In traditional cultures, women deliver standing or squatting and lie during postpartum to protect their pelvic floor against gravity, which is essential.
2. DO NOT LIFT/CARRY HEAVY THINGS
Holding something heavy can increase the pressure in the abdominal cavity, through the activation of superficial abdominal muscles, affecting the pelvic floor.
3. WATCH YOUR POSTURE
Keep a good distance between your thorax and your pelvis. It will protect your back and avoid the pressure!
4. BREATHING EXERCISES
Some breathing exercises can activate your TVA (transverse abdominal muscle). This will naturally help to reduce the diastasis and your waist size without any pressure to your pelvic floor!
5. DO NOT RUSH BACK TO YOUR REGULAR FITNESS ROUTINE
Running, gym classes, spinning should be avoided during the first weeks after birth…and even after 6 weeks. But before you do anything, you should:
– Have a correct and complete evaluation of your pelvic floor and abdominal wall
– Reinforce your deep muscles and your pelvic floor first
6. THE PROPER EXERCISES
Focus on exercises that will reinforce your deep muscles without any pressure on your pelvic floor. Hypopressive abdominal gymnastics are the most effective ones.
The aim of this method is to pull your organs up using the diaphragmatic suction to work on your deep abdominal and pelvic floor muscles. Pilates based breathing exercises could also help reinforce your transverse muscle and strengthen your pelvic floor.
7. WHAT ABOUT KEGEL EXERCISES?
They can be effective if you know how to do them correctly: according to recent research, 51% of women could not perform a Kegel properly and 25% of the women in the study were actually performing them in a manner that could promote incontinence. Don’t do them if you are not sure about what you are doing. Ask a specialist to explain you how to do them properly.
Engage other muscles at the same time. A kegel by itself can’t do very much, but if you activate other muscles correctly, it can help facilitate a full pelvic floor and core recruitment.
7. WHAT ABOUT A POSTNATAL ABDOMINAL BELT?
Doing specific breathing exercises will be much more effective than wearing an external belt. Also, some postnatal belts increase the pressure on the pelvic floor!
8. CLOSE YOUR PELVIS BONES WITH A PROPER PELVIS BELT
The belt to be used is not the one for your abdomen but the one for your pelvis! It doesn’t cover your belly, it is placed only on your pelvis bone.
After 6 Weeks
Most women believe they can go back to their regular fitness routine after their 6-week doctor’s check up, but that is not always the case.
After 12 weeks of postnatal recovery, it is highly recommended to first see a postnatal therapist in order to advise you which sports are suitable for your condition and evaluate the necessity of a postnatal rehabilitation (pelvic and abdominal rehabilitation).
In fact it is very important to prepare your muscles to the gradual resuming normal sport activities with customized follow-up rehabilitation.
Is pelvic floor and abdominal rehabilitation systematic for everybody?
NO. It depends on the type of birth you had, your previous condition, the weight of your baby… Some women may need between 3-10 sessions some women none, only a proper evaluation by a postnatal therapist can tell you whether you need it or not.
I don’t need a postnatal rehabilitation if I had a C-section.
WRONG. Even if you didn’t deliver vaginally, you carried your baby for 9 months! Your pelvic floor is probably weaker and your deep abdominal muscles have been stretched!
I don’t need any postnatal rehabilitation if I don’t have any symptoms of pelvic floor/abdominal dysfunction.
WRONG. Some damages can be symptomatic years later! Postnatal rehabilitation is also about prevention!
It is usually recommended starting with sports focusing on your deep muscles first such as postnatal pilates, postnatal yoga, swimming…
Where to go?
Pelvic Floor Rehabilitation
Juke Van Der Scheer
Postnatal Physiotherapist, Ferguson Women’s Health at American Sino
Address: 800 Huashan Rd, 3FL
Postnatal Physiotherapist & Pilates instructor, Body Concept
Address: 5F, NO.118 Qinghai Lu, by Wujiang Lu
Tel: 21 6218 6236
Address: Room 508, NO.3211, Hongmei
Tel: 3468 1328
Address: 666 Xinhua Rd, Building 1 (near Dingxi Rd)
Address: SOHO Tianshan, 1737 Tianshan Rd, T3-220
Tel: 21 6226 0500
Address: Songlin Rd, Lane 97, No. 3
Tel: 21 5047 9255
Founder, Dragon Space
Address: 516 Julu Rd, No. 5
Contributed by: Sarah Calestroupat, The Midwifery Center