Postnatal/Postpartum Exercises

Written by : Dr.M.D.Mazumdar, MD

Regular exercise after childbirth helps the body to regain its pre-pregnancy shape and size. Decrease in weight increases energy levels, stimulates appetite and helps a new mother cope with the demands of looking after a newborn.

The exercises also help to tone up the pelvic and abdominal walls and to correct postural defects.

All women should be encouraged to do simple postnatal exercises at any time that she finds convenient. But while some exercise is a very good thing for a new mom, doing too much too soon can be harmful.

It is always best to consult the doctor or the midwife before starting an exercisse schedule. Exercises should be started only after they have declared the new mother fit to do so.

Provided that there are no medical contraindications, exercises can be started after 1 week of normal delivery and after 6 weeks of a cesarian section.

Exercises From Birth to 6 weeks Postpartum

The best exercises in the first six weeks are Kegel's exercises (also known as pelvic floor exercise), walking and gentle abdominal tightening with deep breathing.

Kegel's Exercise

The pelvic floor muscles are the muscles between the tailbone (coccyx) and the pubic bone. They support the bowel, bladder, uterus (womb) and vagina. They stretch during childbirth and may tear or sprain, weakening them. Kegel's exercises helps tone the pelvic muscles, preventing uterine prolapse and stress incontinence later on.

The pelvic muscles are those muscles that need to be tightened when a person attempts to stop urinating or hold in a bowel motion. To exercise these muscles, gradually squeeze and increase the tension in the muscles until the muscles are contracted as hard as possible. Then they should be relaxed gently.

The contraction should be held for a slow count of ten and then released slowly. Slow exercises should be performed 10 times and then quick, short and hard squeezes for another 10 times.

The advantage of Kegel's exercises are that they can be performed at any time and in any position - lying down, sitting or standing.

Gentle Abdominal Exercise with Deep breathing

Women who have undergone cesarian sections should wait till the 6 week checkup to do this exercise. Breathing in slowly and deeply, the air should be allowed to expand the lungs as far as possible. Then it is let out slowly. Even after all the air has apparently left the lungs, the chest muscles and the abdominal muscles should be contracted hard to expel as much residual air as possible from the lungs.The abdominal muscles should be kept contracted while drawing in the belly button towards the spine as far as possible. This position should be held for a slow count of 10 and then the muscles slowly relaxed. Repeat 3 times in one sitting. This exercise can be done at any time and in any position - sitting, standing or lying.

Deep breathing relaxes the muscles and releases tension and stress. It provides increased oxygen to the body and stimulates faster healing. It not only exercises the lungs but also the abdominal muscles. The abdominal exercises help to tone the muscles and decrease abdominal fat.

Walking

Walking is a low impact aerobic exercise. Walking for 30 minutes at a slow to moderate pace three times a week is best in the first 6 weeks. The rate and the duration can be gradually increased. Walking helps tone up the abdominal as well as the pelvic floor muscles. Involution of the uterus is faster. Blood flow to the reproductive organs is improved and healing stimulated.

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Exercises After 6 weeks Postpartum

Once the 6 weeks postpartum checkup has been done and you have been declared fit to exercise, the following exercises can be done:

Toe Touching

Stand up straight with the arms stretched over your head while drawing in your breath. Slowly breathing out, bend your body forward and attempt to touch your toes. Bend as far as possible until you can feel the stretch in your back muscles and behind your legs. This exercise relieves back pain from overstretched ligaments. It helps tone the back and leg muscles and improves posture.

Exercises for the Abdominal Muscles:

Lie on your back with legs flexed at the hip and knee joint. Breathing out slowly, the abdominal muscles should be drawn in as much as possible. At the same time, the back should be flattened, allowing the small of the back to touch the floor. The muscles are then released slowly in time with drawing in the breath. This exercise tones the abdominal muscles.

Exercises for the Upper Back Muscles:

Sit up straight in a chair. Cross your arms in front of your body and twist your body to the left and then to the right. Repeat 10 times each way.

Exercises for the Hips, Abdomen and Back:

Lie on your back, hands at your sides, legs stretched out. Slowly lift both legs together so that they make an angle of 30 degrees with the floor. Count till ten. Lift your legs higher so that they make an angle of 60 degrees with the floor. Count till ten. Then lower your legs slowly. Repetitions: Repeat three times twice daily. Benefits : Strengthens lower back and buttocks and stretches hip flexors at the front of the thigh.

Pelvic Tilt:

Lie on back with knees bent and feet flat on the floor with a small pillow under your head. Tighten your abdominal muscles by pulling your pelvis and ribs together in front and flattening your lower back towards the floor. Repetitions: Repeat three time twice daily.

Losing Weight:

Weight loss can be achieved and maintained with aerobic exercises like walking, swimming, running etc. One of the easiest options is using a skipping rope. Rope skipping should be done for an initial count of 100 and then gradually increased.

Signs of Over-exertion

  • Fatigue.
  • Muscle aches which do not go away on rest.
  • Breathlessness.
  • Lochia changes in color or quantity.


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