Postnatal Exercise

Head, Shoulders, Knees and Toes

“I don’t feel in my own body anymore.” The reality of being a newly postnatal mama - and how and when we should return to exercise.

I’ve just had a catch up with one of LushTums students, who is now a friend, and we were talking about “how, when and what for exactly” does retuning to exercise look like for most women post having a baby.

The usual recommendation is to wait for 6 weeks post birth if you had a vaginal birth and a whopping 8 weeks if you had a caesarian, but what if you get to these infamous milestones and your still not ready. Wo betide!

Let’s face it. There is an awful LOT of social pressure out there to be some idealistic super mum. The pressure of perfection weighs heavily on the female kind - let’s name a few - the perfection in how we look, our attributes, personality (they want us funny and individual, but don't rise too high over the parapet or they might just decapitate you), career, how we birth our babies, how we feed them, and then how quickly or how well we get back in shape. Wow, we have a LOT to get right and a lot to balance… its tough up on this pedestal. Who put this blinking pedestal here in the first place? And it’s not that we don’t want to be the best in all that we do, and in so far as we CAN DO ANYTHING, we can, BUT we must remember we simply can’t do EVERYTHING. And that my ladies, is a rule of life. Take it, remember it and come back to it, when the pressure of trying to do and be everything to everyone becomes too much, especially when you first become a new mum. It is just impossible.

Life as a new mum, usually means we are already struggling to remember our own names, let alone remember to brush our teeth. Or make it out the house without getting an item of our clothing on inside out - and doing so without forgetting anything…. note to self: wallet, phone, keys, baby, BABY… must remember the baby!

And that’s at best. At worst we might well be struggling with depression and maybe flashbacks to the birth or any panic moments before, during or after, and that my dears is what is known as PTSD or post traumatic stress disorder. You know the awful thing war veterans experience. Well yes, here’s some news, you can actually get that from child birth. And get this, you might not be the one experiencing these last two things, your other half may well be feeling them instead.

It is, in its most literal sense, a bloody mine-field. Topped off with a good old dollop of broken sleep (which is in some countries is a method of torture)… and now on top of all that, we are expected to join an exercise class!! Talk about one final straw to really push us over the edge here.

Ok, stop!! Breathe. Slow down!! Take a moment. We get it. We really do. All us mums, in that elusive mums club, we have been there. We couldn't tell you about it before because how do you sum up this life changing event in a way that’s simply not going to freak the be-jesus out of you… we can’t. And of course it is also filled with the joys, but we will come to that in another article.

So let’s go back to our original question here - “how, when and what for exactly” - are we exercising post birth for? We hear we should, but do we know why? Let’s start with the easiest bit to answer.

WHEN? So we mentioned already the standard recommendation to safely return to exercise is after about 6 and 8 weeks. However, the actual, true answer is when you bloody feel like it. And no one on this beautiful blue and green planet can tell you otherwise! If you get to that time and you are not ready, give yourself a break (no else is going to, so start giving yourselves a break, start now) and consider all the walking around with the baby in the buggy or sling a pretty decent bit of exercise. All the lifting of increasingly heavy babies and all their paraphernalia, another bit of exercise. Chuck in running around after a toddler too (if you’e got one of those handy) and heck yeah, who needs a gym membership!

You are already doing a LOT! All this movement is getting your heart rate up and keeping you agile. So actually what you might need to consider is how and when to weave in is moments of rest. Yep! We said that. REST!!

Time to pause, put your feet up, take a nap, get in a warm bath, have an early night. Because one thing is very clear. We don’t CREATE energy by running around all the time - science will prove this - running around all the time, uses up all your energy. It does so by burning up your calories. We know this. So the only way you can create more energy -which is what many mums with children of all ages need - is by resting. So pop in moments each day to recharge. Five minutes here. Twenty minutes there. Make it part of your routine. Take for example, feeding, as a chance to sit quietly. Breathe deeply. Ground into wherever you are sitting in the moment (literally become aware of your feet on the ground and your back resting again the chair) and enjoy a very yogic practice of becoming present, becoming mindful. Just BE there. No phones, no distraction. Just BE. How many times a day do we find ourselves feeding? So this is a perfect time to develop an inner mindfulness practice and with that, you will be reducing stress and anxiety greatly helping towards your overall sense of well-being. So slow down and enjoy these moments.

On the other hand some of us will want to return to exercise pretty fast after we have had our babies. Maybe it’s something we have done a lot of in the past, in which case we will (or our ego will) identify ourselves with that activity. If you enjoy it, do it. The body LOVES to move in ways that brings JOY to our hearts. We will come on to notes of caution and how to progress safely shortly. And of course when we move and groove (or exercise) we do release endorphins and feel that lovely after-glow high, so if this is something that contributes to your overall mental and emotional health (as well as of course physical fitness), go for it! Just be mindful of what we mention next…

HOW? So the early days of having a baby is such a massive adjustment, often called ‘the fog’ by the women I work with. A complete blur of adjustment and figuring out how all this is going to work. So roll with that. There is no big rush back to anything. In fact stay in your pyjamas for as long as possible!!! But saying that when you are ready it is most useful to start your postnatal exercise routine by building your foundations first - and what I mean by that is you need to start with those muscles that have taken most of the load of pregnancy and stretched and stretched. You know what I’m going to say, ah yes, those old friends, the pelvic floor muscles.

These (I was going to say bad-boys!! Ha!!) but I’ll say good-girls, are part of a group of muscles that provide our deepest core support. And when that is all engaged and functioning we don’t have achy backs or shoulders; we don’t wee ourselves when we laugh, cough or sneeze (or heaven forbid jump on a trampoline!!!); we feel supported inside and out AND that not only helps us physically but it actually contributes to a greater sense of grounding and wellbeing generally. Strong on the inside, means strong on the outside. However, strong on the outside, doesn’t necessarily mean strong on the inside… we will come on to this…

Even just a week after giving birth, you can begin with some super gentle pelvic floor exercises - to start to feel into finding these muscles again. That is enough. This can be easy for some women or feel like a foreign language for others who can’t seem to find them at all. Do not worry, if this is you, keep at it, you will find it. The connection will come back to these muscles with practice - and maybe you’ve never had to think about them before, in which case you are creating a new neuro-pathway to these muscles and that can take a little time.

Give this a go in a seated position (perhaps while feeding) or if you are in the bath or resting in bed, start by exhaling. Easier to imagine you are blowing out a candle. Start exhaling and after a couple of seconds, gentle lift your pelvic floor in and up. It feels as if you are trying not to wee or break wind, and ideally you can also feel the walls of the vagina drawing together. Once you get to the end of the exhalation, and you’ve drawn these muscles in and up gently (only using about 3 out of 10 strength wise), then release, relax completely and inhale into a nice soft belly. Repeat. Be cautious, not to over egg and do 10 out 10 strength wise, as you’ll actually by-pass the all important pelvic floor and go straight to your 6 pack. So don’t do that. REMEMBER at this time, until you get this right and functioning and responding again, less is actually more.

Once you have mastered this, you can work several rounds of repetitions into your day. Then you can practice doing this breath and holding your pelvic floor to gently brace your core BEFORE you lift anything up at all, be that your baby, their bag of necessities, the car seat, the buggy, shopping, anything. Think to yourself this helpful mantra, “Lift on the inside first, then lift on the outside” any of these things listed above. You can even start to maintain your ‘exhale - and squeeze’ while pushing the buggy out on a walk. Just build it into your normal day and rhythm.

If you do this practice before lifting anything or when out walking, not only will you be helping restore you pelvic floor and your inner core (transverse abs too, so you may feel your tummy gently drawing in to) you will also be helping prevent much more serious issues such as incontinence and even prolapse. If either of these are happening for you, and persists beyond working on your core with these exercises or from attending specialist classes such as postnatal yoga or postnatal pilates which will whole heartily focus on this (as it should!) then consult your local Women’s Health experts/physiotherapists/osteopaths. We are all super passionate about helping women and not letting these subjects adding to the ever increasing library of subjects we are not allowed to talk about. It’s not taboo - loads of women suffer with this - so speak out and go get help!

SO!! Until you are 100% sure you have regained connection, control and then automatic function of your deep core (including your pelvic floor and transverse abs) and probably worked a bit on your glutes too), then and only then should you consider returning to any semblance of activity that you used to do pre-birth. WOW. That is some statement. Read it again. Share it with others. It is of paramount importance for women’s health post birth.

Now, some of us will get there much sooner than others. It is not a competition, ladies. If you did lots of activity before, it will usually be quicker for you after. But it is always worth spending a few months doing this inner practice, with a qualified postnatal exercise teacher to, as I mentioned, lay the correct foundations.

WHY? Well simply put, I have worked with so many women who launched back into their old fitness routine, which might have included running, HIIT, some kind of buggy fitness in the park, aerobics, etc… and while they do get fit and strong on the ‘outside’ of their bodies, many of these classes or practices, totally miss the ‘inner’ work, i.e all the stuff we have been highlighting here.

I will often see women who are fit, have a 3 year old, run, do marathons, looked ripped, have a six-pack, AND distressingly, endure incontinence or still have separated tummy muscles so far apart you could park a bike wheel in there.

And that is such a shame, such a missed opportunity to get it right from the ground up. Instead of building the foundations first, they've gone straight for the walls and the roof, and low and behold, with no foundations, nothing to actually offer proper structural support, to take their load and hold their bodies up, they are simply peeing their way around the marathons and would never bounce with their child on the trampoline. So sad.

In France all women after having a baby are offered a very specific women’s health programme to help with all this. This kind of education and awareness is needed here too. And the exercises, can look very slow and be boring, but they are very deep and challenging, if you do them properly. So if you have EVER had a baby and feel like this speaks to you, reach out and let us know about it and we can help signpost you to a professional in your area who specialises in this kind of exercise and not to put too fine a point on it, rehabilitation. And together we can start putting you all back together all over again from the ground up.

Once this is all ticketty-boo THEN we know we can move forward safely. We can easily reach for and lift a load (whatever that might be) and these deep inner muscles are recruited appropriately to take that weight and support ourselves. Then, and ONLY then, is it advisable to start a stronger form of exercise - including any running, jumping, sit ups, crunches, planks or squats - all of this needs to come later, as they create extra load and extra pressure downward, which if the support isn't there, will perpetuate your incontinent or even at worse give yourself a prolapse.

So the mantra is return to exercise as soon as you feel you comfortably can - the earlier you do, the better it is really as all this takes time. But if that’s 6 weeks, 8 weeks, 2 years or 5 years for you, then you do need to start with a specialised postnatal or women’s health focused exercise routine to ensure you get this ground work in first. Then progress with caution, back to a more regular exercise routine.

And lastly, we answer the WHAT FOR EXACTLY part of the question. You are doing this for YOU! No one else. Not for your partner. Not for your ego. Not for the bit of you that identifies as the gym-goer, or the runner, or the dancer or the ‘because I used to, I should be able to now’ part. Not for the comparison with celebrities back in their size 8s, 1 minute past the birth. Not for any of that. But for YOU. The bit of you that knows deep down she needs to honour herself. Provide yourself with some self care - an early night today, a brisk walk with some pelvic floor exercises tomorrow.  Create some self respect around it. Create an aware practice around this. Give yourself time to do it properly. It is easier to get this so wrong (too much, too fast, too hard, too soon) and regret it later (prolapse, still incontinent, still with separated tummy muscles). Make this a priority and seek expert (fully trained and insured) advise. It is your body. It is a temple. It has done so much in providing a space to nurture and be a life support to your growing baby. And it has birthed your baby, in one way or another, so treat it gently, kindly and with compassion. Eat well, MOVE WELL and remember to REST well. It all goes into the mix of helping us feel more whole and complete,  and that my lovelies, is the whole point!

Clare Maddalena,

LushTums founder, senior yoga teacher, doula, mother of two, passionate about helping others .