5 Most Important Steps to Postpartum Recovery by Tammy Obst

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The hardest part for most women is taking time to let their body begin to heal naturally in those first few special weeks following birth and being okay with taking things slowly. I see this the most with women who have been athletes or maintained a high level of fitness during their pregnancy and have a smooth sailing birth, they feel physically capable too jump back into everything within a couple weeks postpartum and yet your internal body is still in some chaos.  My favourite quote to put everything into perspective is:

“It took 9 months to create this little miracle bubba, it is going to take just as long, if not longer for your body to return to the way it was. Be Patient, be present and listen to what your body needs.” 


Understand how your birth can impact your recovery 

Natural Birth

  • You can usually resume low impact exercise after 6 week check up with OBGYN/GP

  • Once all tearing has healed, bleeding has stopped + 6 week check up is all okay 

C-section Recovery Tips

  • Getting up + down: roll onto side and push up to a seated position

  • Diaphragmatic breathing will begin repair of core + initiate activation of Pelvic Floor (PF)

  • Short walks with regulated diaphragmatic breathing (will naturally relax and
    activate through PF whilst walking)

  • Start scar tissue massage once healing has begun post 8+weeks

  • SRC recovery shorts to offer some support to help hold everything in
    C-section

  • Can usually resume low impact exercise after 12 week check up with OBGYN/ GP

  • C-section is major abdominal surgery, care needs to be taken getting back into exercise
    Emergency C-sections

  • A C-section cuts through 7 layers of tissue, muscle and through your nervous system. It can be very common for women to have misfiring of PF and core sequencing postnatal after an emergency c-section. Highly recommend booking into see a Pelvic Physio to have an assessment prior to commencing exercise outside your normal daily activity.


Why you should book into see a Pelvic or Womens Physio

Your body has just endured 9 months of creating a beautiful little human. During this time, it has undergone extensive physical adaptations to make way for the growing baby. The most prevalent being the severe pressure your posture, core and pelvic floor are put under during pregnancy. 

Postural changes during pregnancy can alter functioning of the diaphragm, which in turn alters your pelvic floor and core function. Unless this is addressed postpartum, these issues can lead to pain, pelvic floor dysfunction and incontinence. Post birth, a lot of women require guidance to know they are activating or lifting their pelvic floor correctly and not just clenching. Also, just because you feel okay down there doesn’t necessarily mean its okay to resume impact exercise straight away. Book in, have an assessment, feel confident with your pelvic floor + core activation and then go from there babes.


How your Postpartum Posture is so integral to your recovery

During the nine months of pregnancy, all of your organs have been pushed to the sides and back of your body, plus your diaphragm gets pushed up under your rib cage.  Therefore your breathing system (eg: your diaphragm) function has been compromised as it is getting squished under the ribs. The human body is pretty darn incredible and starts to make adaptations to compensate for all the changes and moving that needs to happen. A woman’s waist line begins to widen, her ribcage begins to flare slightly, her hips begin to tilt slightly forward to compensate for that baby bump and with that, the pelvis naturally widens (with the help of some magical relaxin) and your natural lumbar curve increases.  As you can see, a momma’s posture and figure changes drastically throughout the course of her pregnancy and this is one of the things that needs to be addressed first postpartum in order to allow the healing process to happen.

Postural Focuses:

  • Standing tall in neutral spine 

  • Weight balanced between balls and heels of feet, pelvis untucked, bottom unclenched, 

  • Deep diaphragmatic breath into belly + sides + back

  • Use this breathing method to activate deep transverse abdominis to strengthen the pelvic floor and lower core first by lifting on your exhale. 


What is a Diastasic Recti? 

Diastasis Recti is the widening of the gap between the two sides of your rectus abdominis or six-pack muscles. The separation begins at the linea alba, the middle line of the rectus which is composed of collagen and connective tissue. Separation of the rectus abdominis is due to excessive intra abdominal pressure. 

A diastasis is a whole body issue. From how you move, to carrying daily items, to the exercises of choice. Research now suggests that 99% of women have some form of separation at full term, your connective tissue is at it’s weakest because it has been under load and has undergone a lot of stretching.  This connective tissue or fascia down the mid line of your belly is incredible and 61% of women’s Diastasis naturally heals within 6 months while 39% of women require some extra assistance. Below are some simple and effective ways to begin to help this fascia recover.

How can you begin to heal your Diastasic Recti

  • Diaphragmatic Breathing

  • Diaphragmatic Breathing with PF + Core lift and wrap

  • Daily Walking

  • Phase 1 – core restore exercises

  • Avoid impact and exercises where you cannot manage the intra abdominal pressure until it has mostly healed 

Pelvic Floor healing

1/3 of women have some form of pelvic floor dysfunction.  Ladies this is a scary stat! Pelvic floor dysfunction can be describes as the inability to correctly contract (tighten) and relax the muscles in the pelvic floor to have a bowel movement. The pelvic floor is a group of muscles in the floor of the pelvic area. These muscles support the organs in the pelvis, and some form a sling around the rectum and vagina.

People with pelvic floor dysfunction contract these muscles rather than relax them. Because of this, they have difficulty in evacuating a bowel movement, they have an incomplete bowel movement, or they may leak urine or stool.

Symptoms of pelvic floor dysfunction may include:

  • The feeling that you need to have several bowel movements during a short period of time.

  • The feeling that you cannot complete a bowel movement.

  • Constipation or straining pain with bowel movements.

  • Leakage of stool/urine with or without your awareness.

  • A frequent need to urinate. When you do go, you may stop and start many times.

  • Painful urination

  • Pain in your lower back that cannot be explained by other causes.

  • Ongoing pain in your pelvic region, genitals, or rectum with or without a bowel movement.

  • Pain during intercourse (experienced by women)

Restore Your Core + Pelvic Floor Function 
Your posture can be altering the performance and restoration of these areas 

  • STOP: tucking pelvis under and hanging forward

  • START: finding your neutral pelvis and standing tall

  • START: lifting pubic bone (lifting pelvic floor + lower core vs drawing belly button in

Ladies the process of healing in the first 6 weeks postpartum doesn’t need to be complicated but the more you understand about what your body has been through with physical changes during pregnancy and birth, the easier it is to understand that there are steps to take postpartum to heal and give yourself time before jumping back into impact exercise straight away.

STEPS TO RECOVER

  1. Learn how to breathe effectively, using your diaphragm + incorporate this breathing with daily movements 

  2. Think about standing tall with your ribs stacked over your hips

  3. Start to lift your pelvic floor and lower core on your exhale, rather than clenching your pelvic floor

  4. STOP: drawing your belly button in and start lifting and engaging deep transverse

  5. Start with short daily walks as this helps the recovery process for your deep core as well :)

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