It’s going to take some time for your body to recover after birth. It took about 10 months to make your baby, so expect something similar to recover. However, many women continue to see bodily changes for a long time after the 10-month post-natal mark. Your body probably feels a bit alien to you in the early days, and you may be a bit sore. My advice? Try to get some sleep when you can, do some regular exercise, preferably with other people (to help prevent post natal depression) and eat sensibly. The first few days after childbirth is critical for rest and rehabilitation. Most of the healing happens in the first 6 weeks so take it easy for that time, and read on for info on how to recover best.
The postnatal body
Many of your body’s tissues have undergone a large amount of stretch, in a short amount of time (10 months feels like yonks, but it really isn’t in the range of a lifetime), due to your growing baby and all the hormones that go along with pregnancy. A vaginal birth causes extra stretch to the pelvic floor muscles and ligaments around the vagina, and pelvic joints. Then, add to that the lack of estrogen during breastfeeding, and you have a recipe for some very significant body changes.
Your pelvic floor
During a vaginal birth, the pelvic floor muscles (the ones at the base of your pelvis, surrounding your vagina, urine tube and anus) can stretch about 2.5 times their resting length. There may also be some tearing of the muscles and tissues around the vagina (which is relatively common). Therefore, it is important to apply basic first aid to the vaginal area in the first 2-3 days after delivery: Use RICE:
R – horizontal REST: lying down is the only position where gravity isn’t acting detrimentally on the pelvic floor region. So lie down as much as possible to allow your pelvic floor to recoil back into place. You may even like to elevate your pelvis to decrease swelling, by placing a pillow under your hips whilst lying down.
I – ICE to the perineum: use icepacks to help decrease inflammation and swelling around the vagina. Put an ice pack, wrapped in gauze/thin material, on the perineum (where you’re sore) for 20 minutes, every 2 hours for the first 3 days after birth.
C– COMPRESSION: put 2-3 large pads in your (large, not sexy) underwear, and wear some supportive bike shorts or leggings to help reduce swelling around perineum/vagina
E – EXERCISE: start your pelvic floor exercises 24 hours after birth – Get the ‘pregnancy pelvic floor plan’ app or the ‘Squeezy’ app and refer to my ‘pelvic floor’ videos for technique.
Start in lying, and co-ordinating your pelvic floor contraction with breath: Breath in and relax your pelvic floor, breath out and squeeze your pelvic floor. Difficult huh? Once you’ve mastered this, you can start to hold a little longer, whilst you breathe normally:
*This number is however many weeks old your baby is. i.e. if your baby is 1 week old, hold for 1 second. When your baby is 2 weeks old, hold for 2 seconds. And so on. You’re aiming for 10 x 10 second holds.
For the first few weeks, perform these exercises in lying i.e. when chilling out with your baby, when you go back to bed after a feed etc. Then progress to sitting, and eventually standing.
Also, remember to squeeze your pelvic floor before you cough/sneeze, lift your baby or weights, or change positions.
Yes you probably still look pregnant after you deliver, that’s normal! Your uterus is still pretty big and there’s probably some swelling around it. Plus, your abdominals have been stretched over the baby growing underneath it, and you may have some separation of the ‘six pack’ muscle. It takes 12 weeks for relaxin, the ‘stretchy hormone’, to leave your body after childbirth, therefore you should avoid abdominal exercises such as sit ups, planks and double leg lowers (when lying on your back) for that time. The following advice applies for both caesarian and vaginal birth.
To help your abdominals recover:
- Roll out of bed, and use your arms to push yourself up out of bed, rather than doing the ‘sit up’ movement from lying to sitting
- A helpful garment for abdominal recovery is a compression support garment, worn over the area from underneath the boobs, down to your pubic bone. You can wear some tubi-grip or post-natal recovery shorts daily for about 4-6 weeks after childbirth, slowly weaning off it in the final couple of weeks to allow your muscles to support you. As to which one is best, it’s all about personal preference, but avoid the tie-up, restrictive, corset style garments.
- Start to activate your lower and deepest part of your abdominals (transversus abdominis muscle) along with your pelvic floor. Your deepest layer, transversus abdominus (TA), attaches all the way around your ribcage, down your lower back vertebrae on either side, and all the way around the rim of your pelvis. It acts like a corset, stabalises your spine, and works with your pelvic floor muscles for bladder and bowel control, low back and pelvic stability, and it gives you your waist shape.
- Get onto your hands and knees, with your wrists under your shoulders and knees under your hips. Aim to do this infront of a mirror to find a long, flat spine, with a gentle arc in your lower back.
- Without moving your spine from this position, let your belly relax by gently bulging it towards the floor
- Then, squeeze your pelvic floor and gently draw in your lower tummy up towards your spine, without moving your back position.
- Keep breathing, and hold this muscle contraction for approx. 5 seconds
- Relax this muscle gently towards the ground and rest for 5 seconds
- Repeat 10 times, holding your back, chest and shoulder position
- Progress this by aiming to hold 1 second longer each week, and try doing this in different positions, ie sitting up tall when you are feeding your baby, or standing
Most importantly, activate your pelvic floor and lower tummy muscles just before you change positions, and lift your baby throughout the day. Practice this by standing up from your chair now:
- Sit up tall and bring your knees just wider than your hips.
- Lean forward from your hips, keeping your spine tall
- Squeeze and lift your pelvic floor muscles, and gently draw your tummy in towards your spine.
- Hold these muscles contracted whilst you stand up from your chair, using your legs to drive up and your spine long
- Gently let go of these muscles when you are standing, then contract them as you sit back down in your chair.
So, if you are preparing for birth, remember to pack the following into your hospital bag:
- Big, granny panties
- Supportive bike shorts or leggings
- Perineal ice packs
- Abdominal support garment (tubigrip or post-natal recovery shorts)
- Heavy duty menstrual pads
After the first few days:
Listen to your body, if you are feeling fatigued, your body needs rest! When your baby goes down for a sleep, ignore the pile of laundry and lie down yourself. Even if you don’t sleep then, it is a great time to practice your pelvic floor and deep abdominal exercises and get some horizontal rest. For pelvic floor healing, you should be spending just as much time horizontally as you are spending upright in the first week of being home. From then, you can slowly start to increase your upright time each day, but make sure you are factoring in daily horizontal rest each day for 6 weeks. Doing too much in the early days, may cause long term damage to your pelvic floor and you may end up leaking urine or faeces, prolapse, sexual dysfunction or joint pain. If you have any of these symptoms, seek help from you doctor and pelvic floor physio.
Finally, exercise is good! But take it easy initially. Refer to my ‘Returning to exercise article’ for more info.