Post natal exercises

Post natal exercises are vital to the health of new mums. Mothers matter too and post natal exercise holds many benefits for the whole family.

What are post natal exercises?

Post natal exercises mean different things to different people.

Often your midwife/LMC will have discussed post natal exercises with you after the birth. This may have included a leaflet, or the midwife talking you through as you practised the exercises. If there were complications around the pregnancy or birth you may even have seen a physiotherapist and been given specific exercises to ease your symptoms. This article is not intended to contradict any individual advice that you have received – indeed nothing can replace the benefits of individualised advice around the birth.

This article does intend to give some general advice around exercises and health to post natal women, but please contact your own health professionals if you are in any doubt at all.

For some women post natal exercises would entail a regime of specifically prepared exercises. For others it would entail gentle exercise, such as a short walk. Some women train and play competitive sport regularly and are keen to resume this after the birth.

Post natal exercise is therefore an individual concept. However, in practically all circumstance it is advisable for women to exercise as soon after the birth as possible, within their own limits and capabilities. The majority of women who have given birth are not ill. They have endured physical stress, however, from childbirth, possible surgery, lack of sleep, the demands of breastfeeding and new parenthood.

Who should do post natal exercises?

Absolutely everyone should do postnatal exercises, within the limits of where they are at. Immobility is one of the greatest risks to pregnant and new mothers, due to the effects of the pregnancy hormone progesterone. This hormone relaxes the muscles of the body, including the muscles in the veins of the legs, making pregnant women susceptible to varicose veins and deep vein thrombosis. A DVT can have fatal consequences if it detaches from the leg vein to become an embolism – a blood clot in a vein. In addition lack of movement can causes pressure area problems and chest infections.

Clearly if a woman is bed bound or has had a serious complication of pregnancy/birth, she will not be racing off to the local exercise class. Post natal exercises in such a case would include:

• Deep breathing exercises
• Pelvic floor exercises
• Gentle leg exercises – try writing the alphabet with your toes and feel the calf muscles working!

The majority of women are up and about – albeit painfully – the day after the birth. Post natal exercises in the first week could include:

• Gentle walking around the house
• Lifting the baby (no toddlers to begin with, give your abdominal muscles a chance to recover!)
• Leg exercises if resting on the bed
• Pelvic floor exercises.

By the end of the first week a walk with the pram would usually be possible for the majority of mums, although after a caesarean section this may take another week.

How soon can I start exercising after the birth?

The sooner we get up and about after the birth, the better. Just walking to the toilet every couple of hours will improve your circulation and reduce your risks of complications from being immobile. The midwives will encourage you to be as independent as possible in order to ensure that you have a good blood flow through your body.

Pelvic floor muscle exercises can start in the first week, but don’t be shocked if you can’t feel much to begin with. Often this hammock of muscles, which reaches from your pubic bone at the front to the coccyx of your spine at the back, can be pretty weakened by childbirth.

Follow these exercises and you’ll usually notice a difference within a few weeks:

• Sit on a chair with your feet flat on the floor
• Lean forward until your elbows are resting on your knees
• Tighten your anal muscles, or back passage, as though you were preventing yourself from passing wind. These are the easiest muscles ‘to find’.
• Pull those muscles up towards your belly button until you feel your vagina tighten too and you will then feel a pull in your lower abdominal muscles too (all good!)
• Aim to hold to 10 then SLOWLY relax the muscles
• Repeat 10 times
• Repeat 10 times a day!!!
• If you were trying to build up arm and leg muscles you would honestly know that you had to keep repeating those exercises. Your pelvic floor is no different!

If at first you cannot hold for the count of 10, just hold for a few seconds then slowly let go.

You will soon feel a difference:

• During sexual intercourse, which will be more enjoyable (possibly not your first priority right now admittedly)
• When jumping up and down, or sneezing, you are much less likely to leak urine
• Your lower abdomen will feel flatter and firmer! Honest!

If you wish to resume vigorous exercise, such as team sport or an exercise class then speak to your LMC to decide whether this is beneficial to you, or whether you should wait a while longer and do more moderate exercise meanwhile.

What are the advantages of post natal exercises?

The advantages of post natal exercises spread out across the whole family:

• The sense of well being that women get from exercising affects their confidence and their relationships with their whanau and friends.
• The physical benefits include improved circulation, weight control, improved digestion and less constipation, reduced risk of complications such as DVT.
• Energy breeds energy! The more we do, within reason, the more we have the energy to do. A baby a toddler or two can be pretty exhausting. By getting them out to the park for an hour, or for a swim after a couple of months, we use up some of their endless energy – allowing time for a deserved break later while they catch up in front of a DVD or with a good story.
• Fitness for the mother usually has a knock on effect for the whole family, leading to improved fitness and reduced obesity in families.
• There’s nothing quite like the joy of walking out with your pram (don’t forget the baby!)

Are there any risks or complications associated with post natal exercises?

Although the vast majority of women are advised to exercise after the birth, within their own capabilities, occasionally exercise could be potentially risky. If this is the case then your doctor will advise you accordingly and meanwhile it is advisable to see a physiotherapist for individual advice, to avoid the risks of complications.

Remember that if you are breastfeeding you need extra calories in order to make good quality breast milk. Ensure that you eat well prior to and after sport or exercise, taking plenty of water and nutritious snacks such as fruit, bread rolls, crackers or yogurt.

Useful articles

Exercise in Pregnancy gives some great tips for mums to be on how to stay healthy in those vital nine months.

Exercising for the Birth explains how simple exercises and posture can help mothers during labour and birth.

For further advice on care of the pelvic floor muscles visit Tips for a Healthy Perineum