Expert tips on postnatal exercise from a registered midwife

Getting out for a gentle walk
- 4 days postnatal
(take this as the "before"
photo -  "after" photos
coming later this summer!)

Since I gave birth I've been loving getting active and feeling like myself again. Those last few weeks of pregnancy in the boiling hot (British!) weather were hard and I felt very ready to get going and back to normal.

I was chatting with registered midwife Karina Coats* about her tips for getting back into shape safely as a new mum. Like all the Ready Steady Mums advice on postnatal exercise, Karina's is balanced, realistic and strongly grounded in medical evidence of what works and is safe.

Today Karina shares some expert tips for postnatal exercise.


Midwife Karina's expert advice on postnatal exercise
The time after your baby is born can be confusing and fraught with varying advice. When you open any glossy magazine (we know we shouldn’t, but who can help it?) there seem to be constant images and stories about celebrities who look as though they have regained their pre pregnancy figure just like that! I believe that most of the stories are quite economical with the truth, using clever clothes, flattering photography or misleading timescales to project an image of post baby perfection. If not, then the featured celebrities must be adhering to strict and too strenuous exercise regimes and diets straight after delivery which may be putting them at risk. Sensible exercise is an important aspect of the postnatal period, and there are ways to get back into shape safely without going to these celebrity extremes.

Top tip: Try not to compare yourself to other women, especially by looking at celebrity images! Everyone's pregnancy and birth experience is different. Many things can influence your post pregnancy figure and how quickly you are able to start exercising after your baby is born.

Why exercise?
According to the Royal College of Obstetricians and Gynaecologists the benefits of postnatal exercise have been shown to include reduced anxiety and depression, raised levels of energy and mood, weight loss and improved fitness. This period is also the ideal opportunity to socialise and meet with other new mums in your area. Pelvic floor exercises are extremely important to help to regain the strength of muscles which can be weakened by pregnancy and birth. Strengthening these muscles may seem tedious and not obviously beneficial but it is very important in reducing the risk of urinary leaking and other potential problems.

When is it safe to start exercising after my baby is born?
This depends on your circumstances and how your baby was born. For all types of births usually pelvic floor exercises and gentle walking are advised as soon as you feel able to do so. If you have had an uncomplicated vaginal birth you can start mild exercise when you feel able and then slowly increase this on to more strenuous exercise when you feel ready.

The Association of Chartered Physiotherapists in Women’s Health (ACPWH) recommend that more strenuous exercise should only be started 3 to 6 months after birth as laxity in the muscles especially around the joints can be a problem. If the birth was complicated or was by caesarean section gentle walking and pelvic floor exercises can usually be done.

The Royal College of Obstetricians and Gynaecologists advise that a health professional should be consulted for advice about more strenuous exercise after a complicated or caesarean section birth at the 6-8 week postnatal check up. Particularly if your baby was born by caesarean section you should avoid lifting and any strain on the abdominal area until after you have received advice at this check up.

What exercise helps postnatal recovery?
Pelvic floor exercises are a vital part of postnatal recovery, no matter how your baby was born, but they do not have the most glamorous reputation and do not get the attention they deserve. In pregnancy and birth strain is put on the pelvic floor which is the muscles and ligaments that help support your pelvic organs including the womb, bladder and bowel. The pelvic floor can weaken and cause problems in later life or sometimes soon after delivery. Pelvic floor exercises help to regain the strength in these muscles and ligaments, helping to prevent potential problems such as urinary leaking and prolapse (dropping down of the pelvic organs).

Exercise such as walking, modified Pilates or postnatal exercise classes can be a good introduction to regular exercise. Pregnancy can stretch and put pressure on the abdominal muscles and exercising these muscles will help to re-stabilise and strengthen the abdomen and flatten the tummy. If you have had a caesarean section then getting the right information on appropriate abdominal exercises is even more vital. It is important to have seen a healthcare professional at 6-8 weeks before starting abdominal exercise.

How should I do postnatal exercise?
Pelvic floor exercises should be started as soon as possible after birth and are easier than many of us think. The trick is actually doing them correctly so they work. Some useful websites are listed below which provide guidance. Don’t be afraid to ask your midwife, health visitor, or GP for advice.

Just remember don’t push yourself too hard too soon and be aware of the recommendations (again see the sites below) about when to start the different kinds of exercise. If you are not sure ask a healthcare professional.

Where should I do postnatal exercise?
You can start anywhere from your garden, front room or park, to a specialist exercise class. Essentially anywhere you feel comfortable.

If you would like to meet new people and increase your motivation exercise groups can be a great way to do this. Local Ready Steady Mums groups range from buggy walking to full exercise sessions and all are led by volunteers. Why not get some local mums together near you?

Pelvic floor exercises can be done at any time and need no special arena. A good time would be to do them each time you feed your baby or change their nappy.

Are there any postnatal problems that I should I look out for?
Be on the lookout for any increase in vaginal bleeding, headaches, dizziness, fainting, recurrent joint or back pain or anything else which is out of the ordinary. If you have any concerns please see your midwife, doctor or health visitor.

So remember:
Don’t compare yourself to other women, get advice prior to starting an exercise plan, seek help if any problems arise and take the chance to meet other mums in your area!

Useful websites:
Wellbeing of women - www.wellbeingofwomen.org.uk
Royal College of Obstetricians and Gynaecologists - www.rcog.org.uk/womens-health
Association of Charted Physiotherapists in Women’s Health - www.acpwh.csp.org.uk
Ready Steady Mums virtual personal trainer - www.readysteadymums.com

Note:
This advice is for information only and should not be a replacement for a medical consultation or advice from a healthcare professional. It is always advisable to seek advice from a qualified professional about your own particular situation.


*Karina Coats has worked as a midwife on postnatal, antenatal, transitional care wards; day assessment units; delivery suites; a home birth response team; community antenatal clinics; and community postnatal visits. Recently Karina was also Health Information Manager at Wellbeing of Women which is a women’s health (gynae and reproductive health) medical research charity.  There she developed and expanded health information on pregnancy and birth.