I sat in the doctor’s office, anxiously looking down at my newborn baby. I could feel my breasts growing hot and painful, reminding me that he needed to be fed soon. My back had started hurting from slouching over him constantly: to change diapers, give him baths or coax him to eat. Instinctively, I straightened, tried to stretch my back and yawned.I don’t remember ever being this tired; exhaustion seeped into my bones, making me want to fall asleep at any available opportunity. Ever since giving birth, everything about my body felt wrong. I felt like I was living in an ill-fitted suit that was too hot, too big in places, and too tight in others. I just wanted out of it and back into a body that felt familiar to me again.
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I had come here for my post-delivery check-up to determine if I could return to exercise. This was the day I had been waiting for, ever since my delivery. I was desperate to feel some sense of normality in my life. I just wanted to move my body in a way that felt familiar in a world of complete unfamiliarity.
It is this unfamiliar feeling that makes it so hard for women to deal with the post-natal body. The physiological change that occurs through the abdominal expansion, postural changes, tissue damage, and medical intervention during labour can be substantial, and blase “return to exercise” recommendations don’t even hint at the progressive strengthening required to rebuild a woman’s foundational strength.
When told they can return to exercise, most women are left marooned in the gym, wondering what’s best for their bodies. As a result, they jump in where they left off, regardless of the profound internal changes that have occurred.
It, therefore, makes no sense for women to turn to generic programmes that might advocate ill-suited exercises that don’t encourage rehabilitation or progressive strengthening. Just as a personal trainer wouldn’t prescribe box jumps to ACL tear patients, for example, you wouldn’t prescribe potentially risky exercises to a woman before her body has adequately healed after the birth of her child. And yes, we, as a society, are often dismissive of the importance of maternal health, assuming that bodies will naturally “sort themselves out”. And if they don’t, many women are left wondering if the physical changes they are currently experiencing, such as urinary incontinence when one laughs, unhealed diastasis recti (the mid-line that runs the length of your abdomen widens during pregnancy), pelvic floor dysfunction or persistent back pain, are permanent.
In most cases, these physical reminders of the stress placed on a woman’s body can be healed so that she can live a vibrant, confident life.
All of these can be addressed through appropriate training programmes and adhering to specific physical milestones.
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Thankfully, a movement is developing in the maternal community to address education and proactive exercise planning for new mothers. After all, an athlete suffering from an ACL injury or another medical intervention such as surgery would have rehabilitation milestones to accomplish before returning to their regular lives. Why shouldn’t there be rehabilitation milestones for a woman’s body after the Olympic event of giving birth?
1. Rest and recover
While complete rest and recovery are advised for the first two weeks, that doesn’t mean a new mother can’t do anything. During pregnancy and labour, your core and pelvic floor muscles would have stretched like an elastic band. It takes time for them to re-engage and strengthen to support your daily movements after delivery. Training your core post-birth can be gentle yet effective. The first exercise you can start is the “core connection breath,” a breathing technique that helps connect your core and strengthen those muscles simply through breathing.
2. Gently begin to move
The next 2-4 weeks will vary from woman to woman. Some women feel up to going for walks at this time. Walking is a great activity to start building their connection to their bodies through movement. It also does wonders for a woman’s mental and emotional state; fresh air can do wonders for someone’s sense of self.
Start small and slowly build your capacity, beginning with a 10-minute stroll twice a day and gradually increasing your time each week. If you’ve had a c-section, your doctor may suggest waiting until four weeks before commencing a walking program, and this is because there is internal healing that needs to happen first.
During your stroll, you can work on your posture. This goal is to slowly correct the hunched position your body has adapted to during pregnancy due to your growing belly. By slowly drawing your spine tall by imaging a string pulling your head to the ceiling, you are better able to “stack” your rib cage over your hips. This puts your abdominals in the prime position to be able to engage should you need them. You’ll also be able to relish those deep breaths you’ll be able to take again, unencumbered by slouching or having a baby belly!
Continue your core connection breathing throughout this time, gradually strengthening your pelvic floor and core. You can also include stretching movements to alleviate back pain, such as a child’s pose.
3. Stretch and strengthen
After you’ve planned some movement for your first couple of weeks, you can add some more movements, such as heel slides, glute bridges, and clam shells, into your routine to build on your core and glute strength over the next 4-8 weeks.
4. Consult your doctor
By this time, you’ll have your opportunity to meet with your primary care physician to have your healing monitored. If your doctor gives you the go-ahead to resume exercise, you can start on a light bodyweight program, eventually adding minimal resistance as your body adapts.
The goal is not to get “fit” immediately. The first few weeks of exercise are all about learning how to engage your core with your daily movements like squatting, lunging, pushing, pulling, and walking. Syncing your core engagement to your movements is key to developing a strong body from the inside out.
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5. Return to the gym
When you are approximately 12+ weeks past delivery and have created a strong foundational set of movements, you can slowly add in weights and resistance bands. As impatient as you may be throughout the process of returning to your previous activity level, it’s worth knowing that an injured athlete must rest and rehabilitate. We should treat women with the same care and consideration. That way, when you finally re-enter your favourite gym, you can be confident and self-assured that you’re ready to begin.
Jen Thomas is a Chennai-based weight-loss coach
