The early weeks of postpartum are an overwhelming time of sleep deprivation, baby cuddles, feeds, and physically recovering from pregnancy and delivery. I feel like the thing no one really talks about is how important recovery really is, whether its from a vaginal delivery or a c-section. Both vaginal and cesarean births carry significant recovery processes and have physical, mental and emotional considerations. We often hear that women are ready to begin exercising again at the infamous 6 week check up. And although at 6 weeks postpartum, many things have changed, such as your organs shifting back into their original place and healing of any stitches or incisions, your body still needs to ramp up slowly. The first 6 weeks are a time to move with intention and restoration. Stretch carefully, begin to activate your pelvic floor and core, work on breathing, go for short walks. And be patient! Keep in mind that connective tissue, muscle tone and hormones are not back to their pre-pregnant state until at least 6 months postpartum. That means that your joints are still loosey-goosey, your muscles may not have adjusted back to a non-pregnant body, and your ligaments may still have more laxity than usual.
Recovering from pregnancy and birth is a big deal and it’s important for your long term function and athleticism. This phase is about building a strong foundation for rehabilitation. What I recommend in those early weeks postpartum is breathing, pelvic floor exercises and patience. Learn how to link your core and pelvic floor to your breathing. Sleep as much as you can. Get to know your adorable new baby, and your new identity as a mom. Drink plenty of water. Go for short walks to get out of the house and for movement, not for exercise. On the grand scheme of the seasons of life, this is a short one, and your body will thank you later (I'm talking like 30 years later...) for taking the time to recover.
Here are my favourite 6 exercises to do during the first 6 weeks postpartum to prep your body for the next phase of postpartum rehab. These exercises go from easy to more challenging, and I encourage you to only try them when you feel ready, and if it doesn't feel great just yet, that's okay.
The Core Breath
The core breath links proper breathing mechanics to the pelvic floor and core musculature in order to optimize the internal pressure system. It is the foundation of all movement, whether it be lifting baby out of the crib, or performing a core exercise. During an inhale, relax your pelvic floor, let your belly go, and visualize the breath flowing to expand your belly, ribs, and the space between your sit bones. On the exhale, gently squeeze and lift the pelvic floor as if you are picking up a blueberry with the muscle around your anus (sorry for the visual...). Ensure no other muscles are kicking in to help out (I'm looking at you glutes...). As you become proficient at this, start to incorporate turning on the deep core (transverse abdominus) as well by gently pulling the lower belly up and in, still on the exhale of the breath.
Glute Bridge
Tilt your pelvis posteriorly, as if you are rolling a ball down your pelvis to your face. Exhale and engage the core breath, push through your heels and raise up into a bridge. As you lower your hips to the ground, let your stomach, glutes and pelvic floor reset as you inhale. Remember, pelvic floor contractions are only helpful when they are also able to relax and lengthen.
Doorframe Chest Stretch
With a new baby, comes a slew of horrible postures. Before I had Keira, I used to advise new moms on the best posture when it came to everything with a new baby, and oh wow do I laugh now at what I used to say! Although everything I said wasn't wrong, it just wasn't practical. Babies are awkward. The chest stretch counterbalances all those forward postures we inevitably find ourselves in feeding, cuddling, lifting...
Bird Dog
Start on all fours, with proper alignment and a neutral spine. Engage the pelvic floor muscles and bring belly button up toward the spine on the exhale. Slowly and controlled, reach with one arm and kick back with the opposite arm. This exercise is all about keeping the torso stable as you transition and switch sides. Imagine you are balancing a glass of water on your back as you move.
Heel Taps
This exercise seems simple, but can take a lot of control to do it properly. Lay on your back, hands on your stomach and legs in a table top position. As you exhale, gently engage your pelvic floor muscles and slowly lower one heel to the ground without letting your pelvis shift/rock to the side. Rest and relax on the inhale before switching legs.
Side Lying Hip Abduction
Lay on your side with your hips stacked, and back and shoulder against the wall. Exhale, engage your deep core and slowly raise your leg up the way, maintaining contact with your heel on the way the entire time. Raise your leg only about 30 degrees, and slowly lower on the inhale. This exercise is working the gluteus medius, a major pelvis stabilizer which is very important for returning to running.
Book an appointment with a pelvic floor physiotherapist around 6 weeks postpartum for an individualized assessment of strength, function, posture, tissue integrity and advice on what to do for the next phase of postpartum rehab depending on your fitness/lifestyle goals.
Claire McDonald
Registered Physiotherapist