The First 6 Weeks
Things to have on your radar:
Are you experiencing any symptoms? Picture that you had a knee surgery very recently. You would be using symptoms like pain and swelling to determine whether or not you are over-doing it and post vaginal birth is no different. Pay attention to symptoms like pain, pressure, bowel and/or bladder leakage, fatigue, increased bleeding and consider them a threshold that you don’t necessarily want to push through.
Do you notice tension in your body? Maybe you notice that you hold your breath and brace when you move? Is it because you are overdoing it or because you need to use something like a compression garment or more pain meds?
At any point in time that you wish you had some guidance or someone to talk through recovery with, reach out to a pelvic health physiotherapist that is comfortable working with moms early after birth. It is not true that you have to wait 6 weeks to work with a physiotherapist. Any time you are ready is the best time to schedule an in person or online appointment.
Suggestions to promote recovery of your pelvic floor:
1
2
3
4
Most of you will have heard of sitz baths and padsicles to help manage early stage swelling. Consider using a compression garment as well. I like recommend a supportive compression garment to moms post birth because research shows they can help decrease pain and fear of movement as well as improve mobility. I have included some examples of different types of support garments to consider.
Here are some examples of compression garments:
SRC Health Recovery Shorts: code: THEPELVICFLOORPROJECT
Many women post vaginal birth are nervous and/or feel pain in the ‘under carriage’ which tends to make them hold their breath and brace when they do things like stand, sit out of bed/chair, or lift their baby. This breath hold and brace increases internal pressure which may be directed down to this vulnerable area and can actually create more pain. Instead, try letting pressure out by exhaling when you do the above movements.
Start gently touching around your area of healing. Many women struggle with the emotions tied to their episiotomy or tearing and with the idea of what it may look like. I encourage new moms to meet themselves where they are at and touch as close to the area as they feel comfortable with light soft touch in different directions. You may feel at this point that the closest you feel comfortable is your inner/upper thigh and that’s ok. If you feel ready, take a mirror and look.
Most new moms spend a significant amount of time sitting to rest. Although no position is considered “bad”, keep in mind that in sitting, gravity can’t assist with swelling as well. Spend time laying horizontal when you can for example after you walk around the house, when visiting with a friend, or talking on the phone.
Exercises
REST is the best thing you can do in the early days. However, there is a gentle exercise that can have a huge impact on your recovery that I always suggest to my clients after birth.
Find yourself in a comfortable position (sitting to feed or cuddle baby, lying down on your back or side etc)
INHALE - feel your body relax, let your tummy muscles go and your pelvic floor soften.
EXHALE - let your air out completely while you encourage your pelvic floor to squeeze and lift softly and notice how this gently pulls your tummy inwards.
Here is a demonstration of how this may look newly postpartum. I tend to suggest to work on this in various resting positions (lying down on your back, on your side, while you stand, while you feed or cuddle your baby) :
Take your time with this, the goal is not strength or how many times you do it but rather gentle coordination of muscles and should stay within your limits of pain.
*NOTE**
If you have a belly band, notice the difference between doing this exercise with it on vs. off. Do you notice that it feels easier to to coordinate the core muscles? Remember that the band won't make your muscles stronger or bring your diastasis together but it may help your muscles feel more supported and therefore have an easier time engaging.
This video demonstrates how learning to coordinate your muscles can help early on with diastasis. You can see the first 2 times she sits forward, she holds her breath making the internal pressure push out into the stretched midline tissue. The 3rd time she sits forward, she exhales gently and feels less pressure/coning out the front:
Here are some other ideas of how to incorporate the core and pelvic floor coordination into movements that involve different areas of the body that you can use as exercise ideas:
WALKING
If you are eager to get outside for a walk, first check in with your symptoms? Are you hitting a threshold of fatigue, pain etc before even going? If so, I encourage you to rest first before adding more. When you do go out walking early on, stick with very short distances like to the end of the driveway and back to see how this feels before progressing.
When you are ready to progress, do so slowly and always using your symptoms as a guide before knowing whether or not to progress.
Many new moms will describe that walking is important for their mental health and I couldn’t agree more. However, pushing past symptoms that your body is giving you can mean that you are compromising healing. In order to priorizie having enough energy to go for a short walk, perhaps there are things within the house like laundry, cooking, making the bed that someone else can help you with so that you have enough energy in the tank to get that walk in that is important to you.
