The postpartum period comes with a lot of changes and challenges-- learning how to take care of your newborn, prolonged sitting for breastfeeding or bottle feeding, long periods of holding baby, sleep deprivation, adjusting to life with a new baby, stress, your body healing and recovering from labor/delivery, and so much more!
You may feel pressure to “bounce back” after pregnancy and birth to your “pre-baby size” or “pre-baby body.” But, friend, this is not the case and this is not the time to focus on those things as tough as it may be. Your body went through so many changes during pregnancy and birth that it will take time to allow your body to heal and recover postpartum. I want to challenge you to turn your focus from “bouncing back” or “getting your body back” to a focus on reconnecting to the muscles of your deep core and gradually and specifically strengthening your entire body so you can be the best version of yourself and the best mom!
Let’s talk about some of the things to expect postpartum and what is normal or not normal!
WHAT IS NORMAL??
0-8 Weeks After Delivery:
You may feel like you don’t know how to stand or sit
You may experience pain in your back, hips, or pelvic region
You may have difficulty controlling urine or gas
Your neck, arms, back, and hips may be sore as you adjust to lifting and feeding your baby
8+ Weeks After Delivery:
Your bleeding should have stopped
Any incisions/tears should have healed -- Consult your OB-GYN or midwife with questions
You should have control over your bladder and bowel movements
You should be mostly pain-free
You may begin to gradually increase activity level (Keep reading below to find out why you need to make sure you reconnect to your deep core before jumping right back into exercise after you get the “green light” at your 6-week check-up!)
WHAT IS NOT NORMAL??
Ongoing back, pelvic, groin, or abdominal pain
Leaking urine, gas, or stool with laughing, coughing, sneezing, jumping, lifting, walking, running, etc.
Leaking urine when you feel a strong urge to go to the bathroom
Urinating > 8 times/day or waking >2 times/night to urinate
Pressure or bulging in the vagina or rectum
Bulging/doming of your abdomen during any exercise
Difficulty doing any of your every day activities because of pain, leakage, pressure, or any other symptoms
While these symptoms listed above are very common in the postpartum period, they are NOT normal and they are not just your “new normal” after having a baby! There is help for these symptoms!
If reading through those symptoms above and 1 or more of them apply to you, see a physical therapist specializing in women’s health or postpartum rehab to assess you as these symptoms typically do not just go away on their own! I love helping postpartum women heal and recover so they can feel strong, take care of their kid(s) without worrying about these symptoms, and get back to doing exercise that they love!
WHY YOU SHOULDN’T JUMP RIGHT BACK INTO PRE-PREGNANCY EXERCISE AFTER YOUR 6-WEEK CHECK-UP:
So, you just went to your 6-week check-up and your OB-GYN or midwife gave you the “green light” to return to exercise and sex, etc. Their job is to make sure from a symptom and healing standpoint that there is no specific reason you should not begin these activities.
However, what they don’t assess is:
How are your pelvic floor muscles working? Can you even feel your pelvic floor during exercises? Can you coordinate your pelvic floor with your breath?
How are your deep abdominals working?
Do you have diastasis recti/abdominal separation? Do you have doming/bulging that occurs during exercises or sitting up off the couch?
Is your C-section scar moving like it should or are there adhesions forming that could cause further issues down the road??
This is where our job as physical therapists come in! This is why ALL women (no matter if you have symptoms or not) need to be assessed by a physical therapist after having a baby! These are some of the things that are assessed at an initial evaluation by a physical therapist postpartum.
Jumping right into an exercise program after delivery isn’t ideal for everyone and just because you are cleared to exercise doesn’t mean you are ready for any and all exercise! It is crucial to learn how to reconnect with your deepest layers to facilitate healing and recovery physically and mentally postpartum. Whether you had a vaginal delivery or C-section, your abdominals and pelvic floor were stretched, weakened, and may have experienced some damage!
You need to:
RECONNECT -- Your core canister is made up of your diaphragm (main breathing muscle), deep abdominals (transverse abdominis that acts like a corset), multifidi (small stabilizing muscles of your low back), and pelvic floor (muscles that sit at the base of your pelvis). It is a crucial part of your recovery process to learn how to reconnect with these muscles. One of the best ways to start connecting with your deep core is to work on diaphragmatic or 360 breathing. Check out this video to learn more!
REHAB -- You cannot strength a muscle you cannot ‘find.’ Once we ‘find’ the muscles, we work on rehabbing them and creating a proper balance in your core system. Building strength requires progressive loading of the tissue/muscles and this comes with progressive strengthening and creating more challenge to the muscles.
RESTORE -- Reconnecting and rehabbing the core and your entire body will help you restore confidence, strength, and function in your body!
I offer in-person physical therapy consultations to local Columbus, OH women and online/video sessions as well for those in the state of Ohio! I love helping pregnant women and postpartum women (at any stage -- even years after having your last baby!) to restore their core and finally feel like themselves again!
Let me know how I can help you!!
Kaitlin Hartley, PT, DPT, PPCES
