Rebooting Your Pelvic Floor After Birth: Your Postpartum Guide to Getting Back After Delivering a Human out of Your Lady Bits
Wondering how to navigate postpartum recovery and regain your strength after having a baby? Here are my recommendations on easing back into exercise, managing emotional hurdles of restarting exercise.
I just had a baby. Is there anything that I should be doing?
Oh girl I am so glad you asked.
When we are done with all the baby growing, sometimes we don’t think to ask about what we need to do for ourselves. This is because it is ALL ABOUT THE BABY, which makes sense. Babies are cute and need tons of help so they can thrive. Yes, women have been having babies forever, but no one wants to have their bodies stay postpartum forever.
So, where do we start? Like Maria in the Sound of Music, “Let’s start at the beginning because it is a very good place to start.” #musictheaternerd #rogersandhammersteinforlife
How do I know that I am ready?
Most of the time, your doctor will say six weeks, but that is such a vague answer because the questions really are: WHAT should I start doing at six weeks? Can I do anything BEFORE six weeks? Can I sign up for a ninja competition on national television at six weeks postpartum?
The answers are: I am getting to it; yes, and that is probably not a great idea. First off, we should start by saying:
Your body just went through a lot because you just grew a human. PLUS, your body continues to go through many changes right after the baby arrives.
Fluids are leaking out of your breasts. You are bleeding so much more than you thought was possible.
I personally wondered why no one told me to buy a BOX of pads and to steal all the disposable underwear I could from the hospital. P.S. To the nurse who showed me I could stuff ice in newborn diapers to ice my lady parts after birth, I still love you.
The patients who take the time for rest do simple pelvic floor exercises and short walks can do more exercise faster. But that doesn’t mean I am saying to get out there and run, play tennis, and join a competitive table tennis team. Well, actually, you probably could do the table tennis team close to the six-week mark, but let’s chat about where we all should start just in case table tennis is not your sport.
The First Six Weeks Post Baby
The first six weeks are really about reconnecting to your pelvic floor. After you have a baby, there is probably no response when you try to contract your pelvic floor. Most exercises should be done on your back so that your pelvic floor is not required to work against gravity when it is having a hard time just trying to contract.
If you have prolapse issues, starting lying down is especially important. Adding a pillow under your hips will help place your pelvic floor in a better position for strengthening to decrease your prolapse.
Check out these videos for ideas for weeks 1-3 and weeks 4-6 to get yourself going.
Weeks 1-3 Suggestions
Week 4-6 Suggestions Building from Week 1-3 Suggestions
Lifting Heavy Stuff and Running
The research shows that we want to wait 12 weeks to introduce high-impact activities back into our exercise routine. High impact are things like running and jumping. If you were doing those activities before you had a baby, then you will absolutely be able to get back to those sooner than those who were not able or had no desire to do those activities. I personally have successfully NEVER run a marathon because I have zero desire to train for a marathon.
I have been lifting or running for years. I don’t think I need to wait 12 weeks.
Let's be clear that I actually really like lifting heavy weights, unlike running for hours. I like lifting heavy weights in the CrossFit and Peloton app strength classes. I hate lifting alone and won’t do it. I am the type of person who is encouraged and pushed in a good way in the group environment. Even though I never take the Peloton classes live, I still feel very much like it is a group class mentally, so it checks my box.
If you were lifting before, I want to encourage you to get back to it and you can probably get back a couple weeks earlier than 12 weeks if you work on it. But here's the big thing.
You are rebuilding your core and your pelvic floor during the first six weeks, and you need a few more weeks to get it strong so that you don’t develop problems because you are too weak.
Your core and public floor just spent months slowly getting stretched out and having to balance strength with endurance while growing a small human who perpetually made it harder for the muscles to both stay strong and maintain endurance. You need to give your core and pelvic floor some grace. If your pelvic floor is having a hard time turning on the pelvic floor at all during week 1 post-baby, it is kind of unlikely that at week 6 it will be ready for you to deadlift 165 lbs/74.8 KG.
You are not weak for giving your pelvic floor the space it needs, allowing it to steadily regain its strength after having a full-grown baby sitting on it and stretching it. Steadily progressing your pelvic floor strengthening is crucial for the muscles to recover and reconnect. My goal is for you to gradually reintroduce these movements, like lifting, running, and jumping, without the inconvenience of urinary leakage (i.e. peeing your pants). Trust me when I say that even a minor incident of urinary incontinence during an exercise class is not an experience I'd advise. I am just glad I had spare pants for the ride home after my ‘incident.’
Did I go back too fast?
Experiencing incontinence and bleeding are common occurrences post-birth. Bleeding is a sign that your uterus and other lady parts are still in the process of healing after childbirth, regardless if you had a c-section or vaginal delivery.
If you start to notice an increase in incontinence, bleeding, heaviness in the pelvis, or abdominal pain, you are doing more than your abdominal muscles and pelvic floor muscles can control. If you notice a weird separation in your six-pack muscles (diastasis recti), you need to back off and do an abdominal exercise that doesn’t increase the separation. The exercises in the videos above will help you with good core exercises to decrease a diastasis recti.
Emotional Hurdle of Restarting
Quote from a real-life mom and patient:
I'm currently attempting some exercises and have gone walking a few times, but I've been struggling with the emotional hurdle of returning to my pre-pregnancy activities. It's as though I've lost the desire and energy to engage in any physical activity. In fact, the thought of starting exercise fills me with dread. It's challenging for me to convince myself that household chores like laundry and dishes can be put on hold. Additionally, I have a rather negative perception of my postpartum body. I ended up gaining more weight than my doctor said was normal and more than I had hoped to gain. These thoughts tend to drag me down rather than serve as motivation for resuming exercise. I often feel that because I have so far to go before getting close to my pre-baby body, it is not worth the effort.
Bottom line, motherhood is a totally new season of life with baby number one, two, three, and number six. Each baby brings new challenges, and plus, if this is not your first, there are the other humans we are also trying to keep alive. When we think about starting to exercise or meal planning or whatever it is we want to restart, we look at other women who we believe have it going on, similar to Stacy’s mom. We see others who have already got back to their pre-baby size. We see others who have everything organized when you walk into their house. We see pictures on Instagram or Facebook of perfection, but instead of it motivating us to change, it depresses us with the mound of things we haven’t been doing.
I believe that a huge part of this is our tendency for all or none, perfection or not doing it at all. This is common, but it doesn’t need to be our normal. If you read any of my past posts, you will see a ton of quotes from Brene Brown. That is because Brene is my girl. She gets me where I am but doesn’t validate parking to stay there.
Brene says this about perfect in The Gifts of Imperfection
Perfectionism is a self-destructive and addictive belief system that fuels the primary thought: if I look perfect and do everything perfectly, I can avoid or minimize the painful feelings of shame, judgment, and blame. Perfectionism is a 20-ton shield that we log around thinking it will protect us when, in fact, it's the thing that really prevents us from taking flight.
If we expect perfection out of ourselves, we will either never start or only keep going for a short period of time before we can’t do “it” anymore. That mental outlook is not helpful, so what actually is? I am a complete nerd if you haven’t figured it out before now. I love researching and reading scholarly articles and all the books on personal development. So here is what I have found works the best for me and my clients/patients to start, take flight, and keep heading for the destination you want to go to.
You have to start now and start small.
Yes, small. Think less than five minutes. Start with doing exercises while you brush your teeth in the morning. Take back some of your in-between time* for a small win. Your in-between time is the time between your activities. Waiting for your coffee to brew. Waiting for your kids at the pickup. Don’t give up these little chunks of time to social media. They won’t help you pay for adult diapers when you are old and incontinent. My small in-between exercises is to do a plank while I wait for my tea to steep, Kegels while at stop lights, and stretch my hamstrings when I am microwaving my tea.
You need to write down what you are doing and WHY somewhere (phone, paper, back of a napkin, etc.)
The act of writing it down will make you 42% more likely actually to do it. Your why is important because you need to understand why this is important to you. Here is my example: I will exercise at least 15 minutes each day because I am the type of mom who is strong and can do push-ups.
Pre-play your day, especially when yesterday was hard.
When you don’t do your in-between time exercises or whatever you have committed to, it is easy to get down on yourself. You are going to tend to make that small slip a slide into not doing anything for yourself tomorrow and for the rest of the week. You are not perfect. Life happens, and sometimes we don’t get things in for ourselves. Don’t beat yourself up or stay in the space. Instead, when you wake up or before you go to bed, pre-play your day. Imagine your tomorrow and what is going to happen. Imagine when you are going to get in your ________ in-between exercise. This is one of the biggest applicable tips on maintaining change, which I got from Man’s Search for Meaning by Viktor Frankl.
Even if you skip every workout you could do for the rest of your life, your house won’t always be clean, dinner won’t be ready on time each night and the baby will still need to be fed. Become a recovering perfectionist and an aspiring good enoughist mom who gets those Kegels and push-ups done.
Application: Get Deliberate, Get Inspired, Get Going
I love that you read what I wrote all the way to the end. Thank you for giving up that time to learn things that will make a difference in your life. That is why I write. That is what gives me joy. But dear reader, it's time to actually write down what your in-between time something will be and your why. I don’t just want you to read my words but actually put them into use.