A new baby in the family is a time of great change, especially if it is your first.
It is a steep learning curve for most, as families adapt to the new addition; sleep is interrupted, there are nappies to be changed, extra washing to be done, all whilst getting to know your little bundle.
Looking after a baby is very demanding, both physically and psychologically.
Caring for a new baby generally involves spending a lot of time in a flexed forward posture while feeding, changing, bathing and carrying a baby.
Many people who have had a baby are keen to return to exercise as soon as possible after the birth, but are often unsure where they should start or are simply unaware of the huge impact that pregnancy and childbirth will have had on their body and how many of the changes of pregnancy persist into the postnatal period.
There is great variability in the time taken for the body to recover from the effects of pregnancy and childbirth and this will impact on the type of exercise that should be performed in the postnatal period.
The following are important considerations for postpartum exercise:
- The many postural adaptations due to pregnancy, hormonal changes and changes to the strength and control of the muscles and joints will take some time to adapt to the post-partum state. Remember it takes approximately 40 weeks for a baby to grow to full term, so the body won’t immediately return to the pre-pregnancy state.
- The pelvic floor muscles are put under extra strain during pregnancy and vaginal delivery, and it may take some time to regain the strength and control, prevent issues with incontinence, and make it easier to start them working again after the birth.
- The pelvic floor muscles play an important role in continence and pelvic organ support, so any exercise prescription should consider the effects on the pelvic floor muscles, particularly in the early postnatal period.
- Many people will experience a rectus abdominis diastasis during pregnancy and this may persist into the postnatal period. Assessment of the abdominal wall will help determine suitable abdominal exercises.
A graduated return to exercise is recommended regardless of whether the birth was a vaginal birth or caesarean section.
A continence and pelvic health physiotherapist can assist with guidance around return to your desired sport or activity.
We recommend a post-natal assessment at six weeks postpartum with a continence and pelvic health physiotherapist for guidance on return to exercise and also for those people who are concerned that they cannot feel the pelvic floor muscles working or who may be experiencing any of the following:
- Leakage of, or difficulties controlling urine, wind or faeces. This is termed incontinence
- Internal pelvic pain, for example during sexual intercourse
- A feeling or dragging or pressure in the vaginal or perineal region, which is a common symptom of pelvic organ prolapse
- Rectus abdominis diastasis