In today’s blog we will be looking at Postnatal Fitness. We will ask; when is it safe for a Mum to start moving again after the birth of her baby? My job as a Pregnancy and Postnatal Trainer is to make sure that Mum respects the incredible change her body has just been through, and to show her the best way to recover. 

I’ve said it before, but I will say it again now; it took nine months to grow and nurture your baby, during which time your body underwent many amazing and complex changes. Changes that aren’t going to go away overnight.  That being said, as a new Mum you do want to avoid becoming a ‘couch potato’!

Getting Started

So what should a postnatal programme involve?

Any good programme should focus on the journey, with gradual changes and achievable goals. It should pay particular attention to lumbopelvic stability, joint stability and postural changes. All of these would have been affected during the nine months of pregnancy.  But before a fitness programme can commence, we need to address any incorrect posture. New Mums also need advice and guidance on everyday activities when they are caring for themselves and their newborn. This can be anything from nutrition, holding/feeding/changing etc, getting baby and buggy in and out of the car and so on.

Your Post-Natal Check Up

All postnatal Mums should not start formal exercise until they have been cleared by their GP at their 6-8 week postnatal check-up.  Mums that have had a caesarean delivery are usually recommended to wait a few weeks longer, usually around 12 weeks.  

So what is involved in the 6-8 week postnatal check-up? 

The whole process takes around 7 minutes during which the GP will check to make sure Mum is feeling well and recovering properly. However, not all GP surgeries offer a routine postnatal check, so make sure to request an appointment. Especially if there are any concerns.  Also some check-ups can include baby’s 6-8 week check. If this is the case, it will cut into Mum’s allocated time with the GP. So be mindful of this and if there are any other concerns, no matter how small, simply make another appointment.

The following is usually asked/offered, but may vary depending on where you live:

  • As part of mental health and wellbeing, Mum will be asked how she is feeling.
  • Mum will be asked if there is vaginal discharge and if she has had a period since the birth.
  • Blood pressure will be checked if Mum had any problems during pregnancy or straight after the birth.
  • If Mum had either an episiotomy or caesarean section she will be offered an examination to make sure the stitches have healed.
  • If a cervical screening test was due whilst Mum was expecting, then this will be rescheduled for 12 weeks after the birth.
  • Mum will be asked about contraception.
  • If overweight or obese i.e. with a BMI (Body Mass Index) of 30 or more, Mum may be weighed.  The GP should then give weight loss advice and guidance on healthy eating and exercise (I will be covering nutrition in a separate blog.)

The Pelvic Floor

In the above list no mention or check is made of the pelvic floor.  This is one area I know is lacking and should be included. But our GP surgeries are overworked and the GP only has so much time allocated to each patient. 

So why is the pelvic floor so important?

In an ideal world, all mums would be as informed about the pelvic floor as possible by the time their child is born.  Maintaining pelvic floor strength before conception, during pregnancy and after is vital to every woman’s health – not just now but years down the road! Sadly, this isn’t the case. Most women tend to only think about their pelvic floor health during pregnancy or after birth, when they experience problems. For example, issues such as leakage (and no it’s not normal as the TV ads would have us believe), pain or other strange sensations.

In my opinion, pregnancy is the perfect time to bring awareness to this hidden part of the body we cannot see. Those 45 wonderful muscles that do so much to support the body and baby during pregnancy. Having had my own two children, I know how important this awareness is. It is important that every Mum-to-be becomes familiar with her pelvic floor muscles as soon as possible.  It is important to know how to exercise and maintain them in the correct way. In cases where a Mum hasn’t done her exercises and a problem has developed, I will refer her to a Well-Women’s Health Physiotherapist.  I have the wonderful Ashling Burke, who works out of the Tonbridge Clinic. She is as passionate about Pelvic Floor health as I am – not just for women but men and children too! Yes these issues can affect anyone.

Returning to exercise after the 6-8 week check-up

So how do I help a new mum start to get back to exercise after their 6-8 week check up?

Pre-screening:

This is carried out by all Personal Trainers, no matter who their client is. A form (common amongst the industry) is called a Physical Activity Readiness Questionnaire (PAR-Q). It is an easy 2-page form that is used to track current lifestyle habits, what level of fitness a client currently has, coupled with fitness history, medical history and whether or not a potential client needs to see a doctor before starting or becoming more physically active.  The PAR-Q form I have for my Postnatal Mums has further in-depth questions to ensure that I am training my lovely clients safely and effectively, whilst achieving their goals.

I never rush this stage because it also gives me time to get to know my clients. It gives me and important insight into the best way to proceed after their all clear from the GP. If any issues arise that I am unsure of, I may recommend returning to their GP for further medical advice. Or I may refer them to my Well-Women’s Health Physiotherapist, if it relates to a pelvic floor issue.

Pelvic Floor (Kegels)

These can literally start the first week after delivery.  However, if Mum has had an episiotomy (a surgical cut to enlarge the vagina to assist birth), she may need to wait longer. I always encourage my Mums to get going on this one because they can be done anytime, anywhere. If they have trouble remembering then I always recommend the NHS Squeezy App, which is a handy reminder!

Correct Spinal Alignment & Posture

Next I check their spinal alignment and posture, to see where and how they may have been affected during pregnancy.  Those Mums that I train during pregnancy usually don’t have much of an issue. This is because I have gotten to them early with strength and stretch training. But I also have Mums who come to me after the birth. In these cases there may be things we need to address before we start training. Spinal Alignment and Posture are two of the main building blocks to Mum’s recovery, so I will always check these when a new client starts.

In my next blog I will be going through what correct spinal alignment and posture is. Plus I will look at some of the exercises I start to introduce my new Mums to for lumbopelvic support and the core. We will also address that question many Mums asks “do I have diastasis recti?”

Happy Body, Happy Mind, Happy Mum!

References: NHS UK

  • Postnatal Fitness, Judy DiFiore
  • Jenny Burrell, Burrell Education