When to return to exercise after having a baby
This is a guest blog from Grace Lillywhite Pilates instructor and founder of Centred Mums. During lockdown she has created exciting and innovative pregnancy and postnatal wellbeing online programmes to support women throughout their motherhood journey. Find out more on their website.
When you’ve just had a baby you are often given a leaflet by the midwives that explains how to do pelvic floor exercise or ‘kegels’. Many women put it in the pile of ‘things to do’ on the side in the kitchen and never think about it again until a few months/years later when they realise they still don’t feel quite right ‘down there’. I truly believe that when we don’t invest time and energy into our postnatal recovery we deal with the consequences for MANY years as a result. In fact, many women don’t realise there is an issue with their pelvic floor until they hit the menopause, their oestrogen levels drop and their pelvic floor ‘drops’ too!! 50% of women over 50 have a prolapse but only 15% are symptomatic. By looking after your pelvic floor in the early days you give yourself a much higher chance of not being part of that 50%.
Pelvic floor health isn’t just about doing kegels. Our pelvic floor is part of our whole system and needs to be looked at as such. We need to consider what is happening above it in our spine, ribcage, neck and head as well as what is happening below in our legs and feet. It isn’t just an isolated muscle and it works closely with the glutes and abdominal muscles when we move. All movement is pelvic floor exercise but when you have just had a baby it is important to be mindful of how you return to movement and when.
Weeks 1- 3
Ideally you are pretty much in bed! This will give your pelvic floor a chance to rest after the marathon that is birth (and this applies whether you had a vaginal or caesarean birth - the impact of cutting the connective tissue of your abdominals is felt in the pelvic floor and so is the weight of carrying a baby around for 9 months so you aren’t off the hook if you had a caesarean birth.) You can be working on your breathing, making sure your ribcage is moving with your breath, as this will help you to find the right core connections when you are ready. You can start to coordinate your pelvic floor contractions with your breath - we inhale to release the pelvic floor and exhale to let it naturally lift back up and then add in a contraction at the end of the exhale. You can also do lovely gentle mobilising exercises such as shoulder circles, ankle circles, gentle side bends to keep things from getting too stiff.
Weeks 4- 6
Gentle movement is good, continue with pelvic floor ‘contraction & release’, movements like calf stretches can feel really good. You may start feeling like you want to get up and about going for walks and getting out into nature. This might feel great but don’t feel any pressure to get up and out if you are still recovering. Rest is really key.
Weeks 6 - 12
You can now start more formal exercise that should come in the form of a core rehabilitation programme if you had a straightforward vaginal birth. Any complications or a caesarean birth mean the recommendation is 8-12 weeks. Listen to your body and remember there is plenty of time. Forget any high impact work for now and focus on reconnecting to your pelvic floor and abdominals with gentle specialist postnatal exercise like Pilates, swimming and walking (ideally not while holding a baby!).
Week 12 - 6 months
Depending on when you start your rehabilitation will depend on when you are ready to return to high impact exercise but the absolute soonest to do anything other than core rehab is 12 weeks. For many people this will be too soon and my general recommendation is to wait until around 6 months postnatal when, having rehabilitated and strengthened your core, you may be ready to start
The rest of your life
You can be 10 years postnatal but if you haven’t yet had the time to put into restoring your pelvic floor and your core function then this needs to happen before you start adding more pressure into the equation. EVERY. SINGLE. WOMAN. needs a core rehab programme whether it is 10 weeks or 10 years postnatally. It is never too late!
Grace Lillywhite has been teaching pre and postnatal Pilates for 10 years and founded Centred Mums 2 years ago. The sole intention of Centred Mums to spread the word to all women that pregnancy and postnatal exercise, wellness and nutrition is VITAL and LIFE CHANGING. With Centred Mums classes we want to teach as many women as possible how to look after their pregnant and postnatal bodies and how to exercise safely, effectively and in a way that is sustainable for the rest of their lives.