Postpartum exercise - why new mums need to be SO careful
Postpartum exercise is something you should approach with caution, this is why... A few weeks back I wrote the following Instagram post about getting the ‘thumbs up’ from my Obstetrician at my 6-week postnatal check-up…
“This week I finally got the all clear from my OB at our postnatal check-up! But what the F does that mean? Does it mean I’m cool to go straight back to high intensity exercise, running, heavy strength work and crunches? Nooooo actually it doesn’t! What it means is... my uterus is back where it should be and the wound from where my placenta was attached internally has closed up, plus my c-section scar has healed well and bub is thriving. But it’s a rare woman by this stage of her recovery (and note, I got my check at 7.5 weeks postpartum rather than 6 as I was out of town), no matter what way baby arrived, that doesn’t still have either some pelvic floor, deep core, or abdominal wall weakness, not to mention imbalances in other parts of her body (back, chest, glutes, hips) from the pregnancy journey and all the hours spent feeding and carrying her baby so far. It’s also important to remember that you haven’t worked out at your pre-pregnancy level for almost a year, so the starting point will be a lot less impressive than you recall! So... what’s step one? Swipe right and watch today’s little video series to find out!”
In the video that followed, I talked about the importance of having a deeper physical check up with a women’s health physio who specialises in postnatal recovery and really listening to what they have to say about your individualised rehab. Then, you need to put in the work to strengthen your body in the right way, from the inside-out, with the help of either trained professionals, or, at the very least, following your physio’s instructions at home and being religious with doing the exercises they give you. All the while keeping your body moving gently (i.e. walks with your little one) and allowing it to heal properly before even considering going back to intense exercise. I also shared my own rehab schedule, which I’ll share again in more detail at the bottom of this blog.
So here’s what made me SO sad and kinda angry too...
Immediately, I started getting private messages from women who’d recently had a baby. They were thanking me for posting this information and sharing their own experiences about how they’d thought the 6-week check was an ‘all-clear’ to return to the kind of intense workouts they were doing before they fell pregnant. Here are just a few of the stories (which I’ll leave anonymous for obvious reasons) my followers shared with me…
Mum #1
Had a natural birth with no complications and after her check-up went straight back to HIIT and cardio group classes at her local gym, which included a mix of strength and plyometric training, as well as a lot of running. Despite no signs of pelvic floor weakness immediately after the birth, two weeks into doing these classes she suffered a prolapse and now, four months later, is still trying to heal with the help of a women’s health physio.
Mum #2
Had an emergency c-section and booked in with her trainer immediately after getting the 6-week all-clear from her OB (note that her trainer was certainly experienced in fitness but was not postnatal qualified and was also male, so clearly had not experienced pregnancy himself!). He told her it “should be fine” to go back to the same style of training she performed pre-pregnancy and put her through her paces with a session involving heavy kettlebell swings, challenging weighted exercises, as well as some sprint work. Her c-section scar tore open and she was back at the OB who prescribed a further 6-week recovery period before she went back to even gentle exercise.
Mum #3
Returned to her regular CrossFit class eight weeks after her baby was born. Not thinking twice about it, she picked up similar weights to what she’d been using pre-pregnancy and really went for broke in the session. She was surprised to find she’d retained a lot of her strength and speed. However, she experienced some bladder leakage not only during the class but that afternoon, and the day after the workout she pulled up with a huge amount of back pain, which got worse not better as the week went on. It turns out she’d done some serious damage to both her back and her still-recovering pelvic floor and had to spend the next five months doing nothing but remedial core, pelvic floor and back exercises with her physio, before she could even think about going back to more challenging exercise.
These stories made me so upset! Not once had anyone, including their chosen health professionals or the trainers they trusted with their recovery, mentioned to these women that it would be a good idea to take things slowly, to consider the fact their bodies would be different both structurally and hormonally for awhile, or recommended they see a women’s health physio or do some reconstructive Pilates work.Not one of their caregivers even mentioned it might be a good idea to ease very carefully back into their old schedule, even if they did feel great.
I also wondered, if anyone had told them, without giving examples of what the negative outcomes might be… would they have listened? The drive to ‘bounce back’ and ‘look great’ after pregnancy can be hard to resist. It’s even difficult for me: a female trainer with a really healthy body image, who’s passionate about helping women to embrace their bodies at every life stage! It’s a constant mental battle to take it slow, accept my body as it is, focus on function not aesthetics or performance, think long-term not short-term, not race back into instructing (even though I love and miss it), move slowly and with focus in class and to book that next physio check-up, despite a busy schedule and a demanding infant. As the wonderful Taryn Brumfitt of Body Image Movement would say, your body is not an ornament, but the vehicle that helps you embrace and enjoy this life, chase your dreams and look after your family… so why prioritise short-term aesthetics over long-term function? Watch her documentary Embrace if you need a little perspective shift, it’s a wonderful watch.
For those of you who are curious…
My personal post-baby return to exercise schedule
September 14th – Izzy is born!
0-2 weeks after birth – learn to look after my baby, eat well, catch up on sleep!
2-7 weeks after birth - gentle walks with bub, a little light stretching, pelvic floor and deep core activation work with The Postnatal App which you can use from the day after you give birth and can select whether you gave birth naturally or via c-section.
7 weeks after birth – I got the all-clear from my OB to go back to exercise. Instead, I headed straight to Women In Focus Physiotherapy for a check-up with my girl Sarah, who did a real-time ultrasound with me, so as she was checking what parts of my pelvic floor and core had become less functional throughout my pregnancy, I could literally see where things were at, what was activating and where imbalances had been created, as well as how to activate correctly and start to rehabilitate my body. I started practising these at home… and kept walking!
8 weeks after birth – because I’m in the fitness industry and my job is quite physically demanding, any weakness or imbalance in my body is an issue long-term, so I sought out incredible postnatal Pilates guru Kirsten King, from Fluid Form Pilates (any of her team are incredible) for one-on-one clinical Pilates sessions. I learned SO much about my body and the work I needed to put in to rehab it properly in just one session, so have committed to a few months of sessions once a week to get back to excellent function. Fluid Form also do group classes and I love the fabulous Peaches Pilates in Bondi for postnatal mat classes too. If tailored sessions are out of your budget, a great App for safe workouts from your phone, no matter your postnatal diagnosis, is 4th Trimester.
9 weeks after birth – I started back at our Mums ‘n’ Bubs group classes at the studio, keeping in mind the prescribed exercises I could sub in for my personal rehab at any time. These classes are AMAZING, they’re like an active mums group, you bring bub and have them with you throughout the session, the vibe is high and it’s an incredible way to safely return to a group exercise environment that’s fun and upbeat, with great music and fabulous women by your side. You could also try postnatal yoga now if that’s your thing!
12 weeks after birth – time for another check-up at Women In Focus Physiotherapy to see where things are at!
12-16 weeks after birth – I’ll be on a break over Christmas and am planning to progress my workouts a little at the home gym at my parents house, with a focus on strength training and a few intervals, no jumping or sprinting yet though! I’ll also take some longer hikes and continue my core and body balance work. If I get cleared for it, I might even pick up a surfboard over the break!
4 months after birth – another check-in with my physio and Pilates instructors one-on-one, then I’m hoping to return to instructing, continue with the classes and group Pilates, as well as experimenting with how my body responds with a few of the more strength-focused/lower impact classes at our studios. I’ll come armed with swaps, just in case I need them, and of course will continue walking, walking, walking.
6 months after birth – this is the point at which I hope to be back to doing all the things I love, stepping back into higher intensity instructing at our Signature studio and participating in my favourite group classes, doing a little yoga and Pilates on the side. It will be important at this point to really pay attention to how my body pulls up, and keep doing deeper activation and balance work in between sessions.
12 months after birth – this is the point at which I hope to be as (or more!) fit as pre-pregnancy. I mean… why not right ;)
Please share this blog ladies so we can spread the word! I hope this blog helps more women understand that patience and long-term health are so important - if there’s any time you have permission to take things slowly and not put a deadline on your comeback, this is it. And... for all the new mamas reading this, just know you’re a total Goddess and you’re doing a great job, even if you don’t always feel like it when you’re sleep deprived and that beautiful baby of yours is screaming its cute head off?