Beyond rest: What to focus on in the first 6 weeks postpartum to feel better, faster.
The first few weeks postpartum can be a whirlwind. It's an exciting time getting to know your new little one and soaking up the newborn snuggles. However, those who have been through it also know it comes with some unique challenges. One of the most common concerns we hear from our pregnant patients is how they are going to physically recover from pregnancy and childbirth.
While the first 6-8 weeks postpartum is an important time to let your body rest and recover, there are also things you can be doing to begin your rehabilitation during this phase that will set you up for success in your postpartum recovery. It can often feel like a gray area of how much physical activity you should or shouldn't be doing. You're not exercising, but you are carrying a 15-pound car seat in and out of the house. You know you need to rest, but you still need to pick up your toddler. You feel a little different each day and may have a hard time knowing how much is too much.
The reason this is such a gray area is that everyone has a different experience with pregnancy, delivery, and postpartum recovery. Women have different fitness levels going into pregnancy, are able to stay more or less active during pregnancy, have varying amounts of physical injury during birth, and have unique activities they want to get back to postpartum. Because of this, it's impossible to give one recommendation that will work for every woman. Based on these factors, everyone will progress through their rehabilitation and recovery at a different pace, and that's okay!
While many of the factors that will determine the course of your recovery may seem out of your control, there are some key things you can be doing during the initial weeks postpartum to promote healing and lay a foundation for building back strength and fitness. Here are the things we recommend to our postpartum patients during this phase:
Rest
Your body has been through a lot, and it is important to take the time to let it rest. Unfortunately, this isn't always so simple! It can feel like there is a lot of pressure to "bounce back" and get back to your routine after the baby is born. You may also have many things to have to do such as taking care of older children. For most people, 5-10 days is a good amount of time to spend focusing on resting as much as possible. This should look like laying down, sitting and sleeping whenever you have the chance and focusing on good nutrient intake and hydration. You may need or want to increase this timeline depending on your specific circumstances. There is no magic point in recovery where you need to stop resting so listen to your body by paying attention to the symptoms listed below to decide how much time you need. Plan ahead to have as much help as possible during this time to make sure you can take it easy and let your body heal.
Know the signs that you might be doing too much
Adding in gentle movement and activity, such as going for walks, easy mobility and core retraining, will look different for everyone. Your activity progress should be based on your symptoms during this phase. Symptoms to keep an eye on to inform your activity level include:
Increased pain (low back, pelvis, hip, abdomen, etc.)
Increased uterine cramping
Increase in vaginal bleeding/discharge
Increase in urinary incontinence
Feeling of heaviness or pressure in the vaginal area
These are signs you may be doing too much too quickly and need to take a step back and give your body more time to rest. On the other hand, if you are feeling good and not experiencing any of these symptoms, your body is likely ready to start gradually increasing physical activity.
Reconnect with your deep core muscles
One of the first and most important steps in postpartum rehabilitation is reconnecting with your deep core muscles. This includes your pelvic floor, deep abdominal and low back muscles, and your diaphragm. These are the muscles that were put through the most stress and strain during pregnancy and likely had the most injury during childbirth.
Start by lying down and focusing on gently contracting your pelvic floor and drawing your belly button in towards your spine as you exhale. On the inhale, focus on breathing in with your diaphragm and letting your abdominal and pelvic floor muscles relax and lengthen. Do not contract your muscles as hard as you can; instead, focus on gentle activation and coordination of your deep core system. As you feel comfortable, start trying this in different positions and holding the engagement for longer periods (10, 30, 60 seconds) before you relax.
Pay attention to your body mechanics
Avoiding big increases in your intra-abdominal pressure will help your core muscles recover. Be mindful of how you move in your day-to-day activities such as getting in and out of bed, how you're sitting, and mechanics when you go to lift your baby, groceries, etc. Think about trying to avoid bending, crunching, and twisting through your spine with these movements as this can increase pressure on your pelvic floor and core muscles. Instead, focus on bending through your hips and knees and try to gently engage your deep core and exhale through these movements. This takes some practice and requires you to move more slowly than you may be used to but will pay off in the long run!
Walk
Walking is a wonderful way to start building back fitness. It promotes increased circulation which out body needs for healing and is a good stepping stone to reintroducing more vigorous or higher impact activities. When you feel ready, begin easy walking for about 5 minutes at a time. If this feels good and you do not experience any of the symptoms listed above, try multiple 5-minute walks throughout your day. Slowly increase by 5 minutes every few days as long as you continue to be symptom-free!
See a pelvic floor physical therapist
Seeing a physical therapist who specializes in pelvic health within the first 6 weeks postpartum offers numerous benefits. Early intervention can help identify and address potential issues like diastasis recti (abdominal separation), pelvic floor weakness or tension, and incontinence that may arise after childbirth. By getting to know your unique circumstances, a therapist can provide personalized guidance on core strengthening exercises, pelvic floor muscle training, and proper body mechanics for activities like lifting and carrying your baby. Having a proactive approach to your recovery can help you heal effectively, regain strength and function, and prevent long-term pelvic floor dysfunction.
Special considerations for C-section moms
The topics above apply to all moms during their postpartum recovery period regardless of the type of delivery you had. For women who have had a cesarean delivery, there are some additional things to keep in mind:
Lay flat
When you can, try to lay flat rather than sit. This is especially important in the first few days and weeks after your c-section. When we sit, we slacken our abdominal wall, which can result in your incision healing with scar tissue that can be tight and uncomfortable when we go to straighten out our trunk. You do not need to be flat constantly, but when you have the option, try to choose lying down over sitting or being propped or reclined. Try to keep the hospital bed flat rather than at an incline during your initial recovery, and if you are breastfeeding, try to breastfeed in a side-lying position rather than sitting up when possible. Even if you are only able to do this for a few minutes each day it will make a difference!
Monitor your incision
For some women, it can be difficult to look at their incision. Initially, you need to be monitoring your incision to make sure that it is healing well. If you do not like looking at it, make sure your partner or another caregiver is monitoring it. If something is off, you will spot and be able to get assistance sooner than waiting for someone else to get eyes on it at your next check-up. Watch for signs of infection such as increased pain or drainage, redness or swelling around the incision.
Begin desensitizing your scar
As your incision heals, begin performing desensitization techniques to reduce pain and sensitivity as the scar forms. If there are still any open or scabbed-over parts of the incision, avoid touching the incision itself until it has closed entirely. Begin by rubbing the surrounding area with something soft such as a cotton ball. Over time, progress to rubbing directly over the scar with more textured materials such as a washcloth. While you might have some sensitivity while touching the incision, if you are experiencing any pain following this, you are doing too much!
While we hope that this information helps you feel informed and prepared for your postpartum recovery, we cannot remind you enough that everyone's postpartum experience will be different. We highly recommend having an in-person evaluation by a pelvic floor physical therapist to help you understand the unique needs of your body during this period. A pelvic floor physical therapist can help make sure you are healing appropriately, engaging your core correctly, and determine the right pace to progress your activity.
At Pelvic Wellness Physical Therapy, we are experts in pelvic floor therapy in Omaha, NE. We have extensive experience working with moms recovering from challenging deliveries. We make it simple for you to connect with us and begin your recovery journey. You can get in touch with us through a variety of convenient methods:
Visit Our Website: Explore more about our services, read patient testimonials, and learn more about us on our website.
Schedule Online: Ready to book your appointment or consultation? Use our easy online scheduling tool to find a time that works for you.
Call Us: Prefer to speak with someone directly? We are happy to answer your questions and help you book your first appointment. Give us a call at 402-625-0313
Email Us: Have more detailed questions? Send us an email at nicole@pelvicwellnessomaha.com and we’ll get back to you promptly.
About Pelvic Wellness Physical Therapy
Pelvic Wellness Physical Therapy is a pelvic health specialty physical therapy clinic in Omaha, NE that focuses on individualized treatment of pelvic floor conditions to determine the root cause of the symptoms. Our goal is to evaluate every patient in a holistic manner to determine the best treatment methods to help return patients to what they love.
Pelvic floor symptoms can be embarrassing and lonely. When pee, poop and sex are not functioning the way we expect, our life is significantly impacted. Pelvic Wellness is here to listen and be your guide in eliminating these symptoms and regaining your life back.
If you are dealing with pelvic floor dysfunction or are wondering if you might be a good fit for an evaluation, schedule a free online consultation here, or call us (402)-625-0313.
