I can remember whisking my mother aside as she scolded, “You shouldn’t be exerting yourself. You need to heal” as I lifted a laundry basket just days after delivering my first son. I hoisted the laundry basket and also attempted to walk a mile just days after delivering my son and sustained a 3rd degree tear in my perineum. It was important to me as a fitness pro to show that I still had it, and being sedentary would only slow my ability to bounce back into shape, right? Wrong on both accounts.
I learned from mistakes I made, and I endeavor to share my wisdom so that moms can use the sacred postpartum recovery period as a time to bond with her newborn and restore her body back to balance.
Here are 3 mistakes many women in American culture make during the postpartum period:
Doing Too Much:
Despite the fact that my two previous children had been born well after their due dates, my overly eager parents arrived on my third child’s due date. They pitched in and helped out for the next 8 days, leading up to his birth, but by the time I arrived home from the hospital, it was time for them to return to their lives at home. I panicked as I imagined myself caring for 2 children home from school for summer and a newborn. I was cooking dinner, going to the pool and doing household chores within days of my son’s birth. What ensued was a difficult bout with Postpartum Depression.
American mothers internalize the prevailing attitude—‘I should be able to handle this myself; women have babies every day’—and if they’re not up and functioning, they feel like there’s something wrong with them,” says Dr. Margaret Dr. Margaret Howard, the director of the Day Hospital for Postpartum Depression in Providence, Rhode Island.
In France, women spend a week in the hospital post-partum. In Balinese tradition, a woman cannot enter the kitchen until baby’s cord stump falls off. Many European countries offer generous 6 month maternity leaves.
Contrast that with American postpartum care where a woman leaves the hospital within 24 -48 hours of a normal, healthy birth. And then 6 weeks later, she visits the health care provider. In some cases, insurance offers lactation consultation and one in home visit with a nurse. Heck the baby has seen the pediatrician 3 times before mom finally checks in about her postpartum health.
Returning to Exercise Too Soon:
Here’s another story of the overly ambitious new mom. Two weeks after my first son’s birth, my bleeding had slowed so I figured it was safe to run. I wrapped my huge bosom with an ACE wrap to keep them from flopping around and went on my way. Afterward, I was faced with very heavy bleeding and a bad case of mastitis.
Doctors will typically tell a woman to wait until bleeding stops or six weeks to resume regular activity. What they don’t anticipate is that if you tell an already active woman this, she will consider this advice is only for the deconditioned and resume activity anyways.
The fact is, pregnancy and childbirth are quite traumatizing to the pelvic floor and lower back. Common side effects of pelvic floor dysfunction include incontinence, pelvic pain, and pain with intercourse.
Additionally many women suffer from low back and hip pain postpartum. Women may dismiss these as something to be expected after pregnancy.
Kegels can be a good exercise for restoring pelvic health but, in some cases, doing Kegels can exacerbate the condition. The best step to take is to contact your health care provider about finding a Women’s Health Physical Therapist. These physical therapists specialize in postpartum rehabilitation.
Performing the Wrong Exercises:
Of paramount concern to many women during the postpartum period is getting her body back. What many women might not know is that nature programmed its own method of postpartum recovery—breastfeeding. Breastfeeding actually helps speed up the recovery of the uterus, it accelerates metabolism and mobilizes fat cells. I found myself dropping 5-8 pounds below my normal set weight with all of my children within weeks of delivery. Mostly, I attribute that to never having my hands free long enough to eat much and breastfeeding certainly helped.
Physical therapist Blandine Calais-Germain, in her book The Female Pelvis, advises to attempt no abdominal strengthening exercises for 6 weeks post delivery and “avoid situations that could create too much abdominal pressure,” such as lifting or carrying. Of course, lifting the baby and stroller are necessities but should be avoided if at all possible.
This advice sounds like something from the colonial era, but when you look into her reasoning, it really makes sense. “The abdominal organs gradually fall back into place postpartum just as the muscles regain their tonicity. However the overall balance is fragile.”
In essence, if you start pressuring the abdominal area as it is reorganizing itself, you will disrupt the natural cycle of recovery. What can result is a pelvic organ prolapse, or drooping of one or more of the pelvic organs, which can lead to symptoms such as incontinence, painful intercourse and back pain.
So what type of exercises should women be doing during that fragile post partum period?
In her book, Calais maps out a sequence of breathing exercises that aid in decompression. These exercises are safe to do and encourage healthy recovery. An example of one of these exercises appears below excerpted from The Female Pelvis, pp. 135-136.
1. Costal Inspiration:
Lie down with your back on a comfortable surface with knees flexed and feet flat. Spread out your arms and place them so that they are spread open like a starfish. Take a deep breath to open the ribs in the front and back. Then relax, as you exhale, giving an easy sigh. Do you feel the ribs spontaneously return to their original positions? It is because the lungs have retracted, emptied the air and drawn the ribs inward.
2. Decompressing the abdomen:
Expand the ribs once more with an inhale. During the exhalation, try to keep the ribs expanded. This is not normal and may seem almost impossible to do. You can help yourself by making the “SSSSSS” sound or the “HHHHHHH” sound. Then try not only to keep the ribs open, but to push them open as well. Do not be surprised if the movements seem a bit forced. Little by little, they become easier.
Do you feel as though the abdomen is being pulled toward the thorax? Because the lungs are no longer able to pull the ribs in with them, they now pull the abdominal mass itself upward. This creates a kind of abdominal vacuum that decompresses the lower organs.
I certainly wish I had this information when I left the hospital with each of my babies. I definitely fell into the category of “why shouldn’t I be able to resume normal activity? I’m in good shape.” Turns out my mom was right. Don’t lift the laundry basket after giving birth.
– Gina Fontaine
Pre/post natal exercise specialist and amazing mama of 3!