This article on postnatal exercise is written by Rebecca Bennett of Natus Physiotherapy. She currently offers Postnatal Return to Fitness sessions (see link below).

Early postnatal exercise has many positive effects on our bodies including: increasing confidence, toning weakened muscles like abdominals and pelvic floor, giving you more energy and releasing feel-good hormones. For a lot of new mums, after looking after baby and getting some sleep, returning to exercise is often high on the agenda, but when is it safe to re-start exercise? How often should you be exercising?

Often your doctor, midwife or health care professional may ask you to wait until your 6 weeks postnatal to resume exercise. This can be for a few reasons which include: you will have your 6 week check where they can ask how you are feeling and check your blood pressure, lochia (breakthrough postnatal bleeding) has often stopped by this point, you may have got into a good routine with baby so you can fit in exercise in a more structured way and numerous other reasons. However, The American College of Obstetricians and Gynecologists suggest gradually resuming exercising when you feel up to it, which may be before or well after the 6 week mark.

Here are some things to consider when or before resuming exercise:

·         You can start your pelvic floor exercises very soon after giving birth and even though they may feel very difficult to contract or have reduced sensation, persevere, they will help support your bladder when you are exercising and help with healing of any stitches.

·         Starting some gentle abdominal exercises as soon as you can is important to give tone to your stomach. At your 10 day health visitor visit, ask them to check for any ‘stomach gap’, formally known as divarication of recti, if the gap is more than 2 fingers widths wide at this check it means some postnatal exercise like sit-ups will be restricted and you should see a women’s health physiotherapist. Some examples of basic abdominal exercises that are safe for everyone include pelvic tilts and static abdominal contractions.

·         The type of delivery you have had may restrict how quickly you return to exercise, especially if you have had a c-section, allow your body to recovery for 6 weeks but you can still do pelvic floor exercises, gentle abdominal exercises and walking.

·         Try not to start a completely new exercise immediately postnatally, re-start something you have done in the past and gradually increase the intensity of the workout. Listen to your body, if you need to slow down or stop, do so. A good exercise early postnatally is a slow walk which can then be increased to a power-walk and then a jog over time.

·         If you would like to go swimming, make sure your breakthrough bleeding has stopped for at least one week, this reduces any infection risk, and in the early stages avoid breast stroke movements as this often puts a strain on your abdominals.

·         Always warm up the body before doing exercises with some gentle stretches, and always stop when you feel your body has had enough.

·         Have water handy when you are exercising and you may need to drink quite a bit more than usual if you are breast feeding. Sometimes breast feeding before exercise means your breasts are not quite so heavy. Do not forget a well fitting, supportive sports bra!

·         The hormone ‘Relaxin’ is released in your blood stream in early pregnancy and affects all of your ligaments by softening them in order to help your pelvis expand. Even though this hormone leaves your system very soon after birth, the effects of this hormone can stay in your system for months. This leaves your body  more susceptible to strains and sprains as your ligaments will be looser. Try and keep to flat, even ground and wear good quality, supportive trainers.

·         A postnatal exercise class run by a professional will provide safe guided exercises as well as advice and support. An exercise buddy can help keep you motivated.

 
In conclusion, when to return to exercise postnatally will depend on the individual, what sort of delivery they have had, how easily baby gets into a routine and how you are feeling physically and mentally. In general in the first few days postnatal commence pelvic floor exercises, gentle abdominal exercises and some stretches daily. After a few weeks, either when you feel ready or you have had your 6 week check you can re-start some gentle low impact exercises, listen to your body and then gradually increase as you feel able.


Rebecca Bennett (Natus Physiotherapy)

www.natus-physiotherapy.co.uk

For details of Rebecca’s assessments and treatment sessions, please click here