What to focus on after birth?
What should I do after birth? I long should I wait until I exercise again? What sort of exercise should I do first?…These are questions I am often asked, these are some of the (many) questions on a new mum’s busy and tired mind…
And my short answer to these questions is: in the postpartum period, focus on reconnecting with your body – and by that I mean, focus on feeling your muscles and finding your alignment. And focus on regaining a health breath pattern – and by that I mean take time to breathe, and breathe well.
The long answer to these questions is below…
The first few weeks
Right after birth, your main task is to rest, eat nutritious food and enjoy cuddling your little bundle of joy.
Shortly after that, you can start trying to reconnect with your pelvic floor and belly muscles very gently. The idea here is to start feeling the pelvic floor muscles and belly muscles again, and start to regain a little bit of control – very gently, by doing gentle contractions or squeezes, on the exhale, followed by relaxation on an inhale.
If you have had a C-section, this phase might come a bit later and your belly will need time to heal. But you can start with gentle pelvic floor exercises right after birth.
In addition to that, focusing on finding a healthy breath pattern is also very helpful, not only for your body (that really needs it after pregnancy, see below to understand why) but also for your mind – as breathing is relaxing and soothing for all your systems.
And thirdly, try to start thinking about alignment. After birth is a time when you are tired and pulled out of alignment by exhaustion and your baby. Try to fight back and realign.
Keep your spine straight whenever you can, avoid slouching, rounding your shoulders and spine whenever possible – as this will help strengthen the muscles that were stretched during pregnancy and will avoid putting a lot of pressure on the muscles that got tense because of pregnancy…
Try to think about closing your ribcage, and bringing back into alignment with your pelvis; and you can also start practicing pelvic tilts. The aim here is to play around with the alignment of your pelvis, and move away from the anterior pelvic tilt you might have adopted during pregnancy, while at the same time avoiding to fall straight into a posterior pelvic, with a tucked bottom and gripped glutes.
What is the 6-week check up about?
It is important not to misunderstand what the 6-week check up is about. A lot of women think that they shouldn’t move or do anything with their muscles until that check-up, but that once they have the go ahead from their doctor, they can go back to exercising as normal. That’s not how it works.
Read on to understand what I mean.
Firstly, women, people who’ve just given birth, just like any other human beings moving around on this Earth, have to make physical efforts to live: we have to hold our babies, get out of bed, walk to the bathroom, go down and up stairs, do all sort of house chores. And all this is physical effort requiring muscle activation. So the advice to avoid movement or physical effort completely in the first 6 weeks after birth isn’t reasonable or realistic.
The key in the first 4-6 weeks is to move smartly – move mindfully, keeping proper alignment and a good breathing pattern.
Secondly, what your gyno is going to assess at the 6-week checkup is whether
– your uterus is back to a “normal” shape, size and position
– whether your birth canal and vagina are healthy
– whether any scars have healed well..
She is not going to assess
– the strength of your pelvic floor contraction
– your breathing and the position of your ribcage and diaphragm
– whether you are able to correctly contract lower, middle and upper abdominals correctly with the breath
– your alignment
– your mobility
Which means that she is not in a position to tell you what kind of postnatal exercise programme your body needs. And the problem is, there aren’t many professionals who can help you figure that out! You will either have to figure it out for yourself, or come for an assessment with me!
What if I feel great and just want to jump right back?
If you were fit before pregnancy, fit during pregnancy, and feel fit after birth – then great! You might be able to jump righ back into your old exercise routine quite quickly. A couple of things to remember though:
You are only as strong as your weakest muscle group.
Which means that, your legs and arms might feel like they can run for kilometers or lift heavy – but if your pelvic floor is not up to it, then DON’T DO IT. Do not lift heavy or run miles – yet. Bring your pelvic floor back to where it needs to be not to be your weakest link anymore. I you feel the slightest heaviness, discomfort, if you leak sometimes or have trouble holding pee – then work on your pelvic floor.
Your pelvic floor has been through trauma – treat birth as what it is: trauma, sometimes injury, for the pelvic floor. Give it time. Read this blog post if you need more information about the pelvic floor after birth.
It’s not because you CAN do something, that you should. It’s not because you can lift heavy or run or push yourself, that you should.
Parts of your body you are less aware of, like your pelvic floor, might suffer if you overdo it.
What we focus on in my classes
So: what do we focus on in my Postpartum Rehab/ Postnatal Pilates classes? And why are they so different from other Postpartum rehab / Postnatal Pilates classes in Berlin?
My classes are part pelvic floor rehab, part full body rehab, part postnatal Pilates.They focus on the following:
When you join a class with me, the first part of the class is spent doing breathing exercises to restore healthy movement to the ribcage.
Pregnancy has a dramatic impact on the ribcage and the diaphragm, as the growing baby pushes the ribcage open and the diaphragm in a stretched position. After the baby is born, it can take a while for the ribcage to find it’s natural alignment again, and for some women, this process actually needs a lot of help in the form of breathing exercises and fascial release. This is a key part of postpartum recovery, and a central part of all classes with me.
Pelvic floor connection
After the breathing, comes the connection to the pelvic floor. This is done in different positions, using different visual and verbal cues to help you feel, contract and release your pelvic floor. This is done in coordination with the breath, and eventually the belly muscles too.
Following the breath and pelvic floor connection is the abdominal connection: gently, the transversus abdominis, or TA, is woken up, engaged, challenged. Then come the obliques and lastly the rectus, in increasingly challenging abdominal exercises.
Strengthening the whole body
I take a whole-body approach to help my clients recover, whether it is from an injury, trauma or birth (which can be both injury and trauma at the same time). So mobility exercises for the whole body, and strengthening exercises for the whole body, are always part of my classes.
Postpartum is forever
Always remember that once you have been through pregnancy, your body will most certainly carry marks of that pregnancy in one way or another. And that it’s completely ok.
What’s not ok, however, is to think that pain, discomfort, dysfunction is normal part of the postpartum journey – it is not. If you are experiencing pain, discomfort or dysfunction, please come and see me, or ask another health professional you trust for help. There is help out there and no one is supposed to come out of pregnancy and birth feeling broken or dysfunctional.
For some women, postpartum recovery will take a few months, for some it will take years.
It might be hard to accept, but one thing is sure: there is no point rushing your body through it’s postpartum recovery. You will do more harm than good, it will be counterproductive. Slow and steady wins the race.