If you're reading this, it's likely that you are either in your fourth trimester and trying to figure out how to best recover after giving birth, OR you're pregnant and looking ahead to prepare yourself for postpartum. Either way, congratulations! Here is a general guide on how to recover in those early days and weeks postpartum.
Horizontal rest.
If you've given birth vaginally, your pelvic floor would have stretched an incredible amount. Resting horizontally helps with giving your pelvic floor tissues a well deserved rest by taking gravity away. It can be much easier said than done, so just try to get it in as often and whenever you can for ¬15-20mins each time.
Some ways to get horizontal rest in:
During tummy time
Baby sleeping time / down time
Get yourself semi-reclined by propping yourself on some pillows on the couch or in a recliner/rocking chair
Pelvic floor connection
You can start pelvic floor exercises early and as soon as you feel up to it after giving birth.
As a general guide, try 3 rounds of these every week:
Week 1: 10 x 1sec holds
Week 2: 10 x 2sec holds
Week 3: 10 x 3sec holds
Week 4: 10 x 4sec holds
Week 5: 10 x 5sec holds
Week 6: 10 x 6sec holds
It's highly recommended to see a Pelvic Health Physiotherapist at 6 weeks for an internal examination to give more specific guidance on pelvic floor exercises. It is also encourage to see a Pelvic Health Physiotherapist prior to and/or during pregnancy so you have a baseline level and understanding of your pelvic floor, as well as to prepare for birth.
Core connection
Starting abdominal activation early will help to rebuild that connection to your abdominal wall. Yes, it is absolutely fine to start as soon as you feel comfortable, as long as you have the right technique!
Book in with a Pelvic Health Physiotherapist for guidance on core exercises that are specific and individual to you.
Bladder and bowel health
It's so important to be able to pass urine and bowel motions after giving birth.
So - what are healthy toilet habits?
Bladder:
Passing urine every 3-4 hours
You should be able to empty completely - you shouldn't need to come back to pass more urine 5 mins later
No leaking or very sudden urge to go
No pain with passing urine
Urine is a pale yellow colour
Bowels:
Passing bowel motions 1-3x per day to 3x per week
Go when you have the urge sensation to go
No straining
You feel empty after going
Type 3-4 on bristol stool scale
<5 mins to open your bowels once you are sitting on the toilet
No pain when you are passing a bowel motion
If this sounds like you, you're doing a great job! Alternatively, if the above doesn't sound like you, it might be a sign that you should see a Pelvic Health Physio and consult your medical team.
Early movement
Early movement is encouraged from early on postpartum, but it's important to take it slowly, particularly in the first six weeks. This is because the first six weeks lines up with the initial tissue healing timeframes of soft tissue/wounds. Obviously, this depends on a wide variety of factors that are specific to you.
In addition to pelvic floor and core exercises, some safe exercise to do in the first six weeks include:
Stretching: there are so many stretches that are really helpful for your first 6 weeks, especially those targeting your back and hips. Stretches that I often recommend are:
Cat cow
Thread the needle
Open book
Child's pose/puppy pose
Pidgeon stretch/figure four stretch
Couch stretch
Walking: ensure that you are monitoring how you feel during and after your walk as walking places some amount of pressure on your pelvic floor and abdominal wall. Starting small and slowly increasing time week by week is recommended, providing that you remain symptom free!
Basic upper and lower body strengthening can be really helpful to help keep your strength up, providing that they are safe for you and your body of course! These are best prescribed by your pelvic health physio to ensure you're doing them in the right way.
Some signs you need to rest and/or you've done too much:
Pain, tugging or pulling at your c-section scar site
Heaviness or dragging
Other pelvic symptoms, such as incontinence or pelvic pain
Back ache or other musculoskeletal symptoms
Scar care
If you have a c-section or episiotomy/perineal tear scar, it is vital to care for your scar. Some guidelines for your scar are:
Massage and desentisation from 6 weeks / after scar has healed
Continue to check in and monitor how you are feeling and how your scar looks - this might seem scary at first, but make sure you do! Look in the mirror if you have a c-section scar, and use a small hand held mirror if you have an episiotomy/perineal scar.
Silicone tape for c-section scar scar to keep the scar hydrated
Check in with your pelvic health physio
There are a couple of different points to check in with your pelvic health physio. These are at:
3 weeks for early rehab
6 week check for internal examination
You can also check in with a Pelvic Health Physiotherapist whenever you feel like you need it, and it doesn't have to be at these two points - it could be earlier, weeks or months later, or even years down the track.
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