Postpartum Recovery

Summary of the medical recommendations on postnatal exercise as found in scientific literature and on various public health websites

First and foremost: REST. The University College London Hospitals recommend lying flat for 30 minutes, twice a day, during the first 1-2 weeks postpartum. This practice helps alleviate the strain on the pelvic floor and abdominal muscles. To alleviate discomfort from vaginal birth, reducing swelling through the application of ice or a damp towel within the first 72 hours after delivery may enhance recovery (1).

Avoid lifting any objects heavier than your baby for the first six weeks (4).

When lifting, bend your knees, keep your back straight, engage your pelvic floor and lower abdominal muscles, and hold the object close to your body. Avoid lifting while twisting (4).

Walking—beginning at a comfortable pace and gradually increasing intensity, duration, and other factors as you feel better and become stronger (2).

Deep breathing with abdominal contraction: While seated, breathe deeply, drawing air upward from the diaphragm. As you inhale, contract and hold your abdominal muscles tightly, and as you exhale, relax them. The duration of the contraction and holding of the abdominal muscles can be gradually increased (2).

Strengthening the pelvic floor: The pelvic floor consists of various muscles and ligaments that may become strained during pregnancy due to the weight of the uterus, as well as softened by hormonal changes. These muscles are essential for preventing urinary and gas leakage and are also involved in sexual function. As with all muscles, regular exercise is necessary for them to function optimally. A set of simple exercises can effectively strengthen the pelvic floor without causing strain or damage to other parts of the body. This is especially important as the abdominal muscles require additional time to heal and should not be exercised until fully recovered. A list of these exercises, along with references to useful websites and apps, will be provided below.

Diastasis recti is a condition that affects approximately two-thirds of pregnant women due to the pressure exerted on the abdominal muscles during pregnancy. 'Diastasis' refers to separation, indicating a wider-than-normal gap between the abdominal muscles, which may cause the abdomen to protrude. Although some sources suggest that factors such as being over 35, carrying twins or a large baby, having multiple children, or having closely spaced pregnancies may increase the risk of diastasis recti, scientific research remains inconclusive regarding its etiology. Some studies have found that this separation may persist up to a year after childbirth. Diastasis recti has been associated with health issues such as constipation, lower back pain, and urinary incontinence. In rare cases, extreme strain can lead to tissue tears and herniation, where organs protrude through the abdominal wall. A physician can measure the extent of the abdominal separation, and there are also methods to assess it independently, although caution is advised. A quick online search for 'how to measure your diastasis recti' will yield resources, including websites and YouTube videos, that can guide you. You may also measure your own linea alba, comparing it to the following parameters: 15 mm at the xiphoid process, 22 mm at 3 cm above the umbilicus, and 16 mm at 2 cm below the umbilicus.

WebMD advises caution when exercising, as certain routine fitness activities—such as crunches, sit-ups, push-ups, press-ups, front planks, swimming, and some yoga poses like downward dog—can exacerbate abdominal separation. This caution extends to exercises performed on hands and knees, as some trainers may inadvertently recommend these for women with diastasis recti, unaware of the potential risks.

It is recommended to avoid contact sports and high-impact activities, such as running, heavy weightlifting, and aerobics, for the first 3-6 months postpartum. Brisk walking and swimming may be initiated when you feel comfortable.

Crunches, sit-ups, and similar exercises are not recommended for the first 6-8 weeks after childbirth.

The World Health Organization (WHO), the American Academy of Pediatrics, and Health Canada recommend exclusive breastfeeding for the first 6 months of life. Thereafter, breastfeeding should continue in combination with solid foods for the first 12-24 months.

Women who breastfeed require approximately 500 additional calories per day. Postpartum weight loss of up to 900 grams per month will not compromise the nutritional quality of breast milk. It is important to note that if you breastfeed, you may observe natural and gradual weight loss without the need for additional effort beyond breastfeeding itself.

Survey on Women's Health Postpartum

Through conversations with fellow pregnant women and mothers, I have come to realize that what is often considered a "common experience," such as pregnancy and childbirth, can be quite challenging for many. Influenced by my studies and a growing interest in understanding how the body functions, I was prompted by these stories to explore the topic further. How are the conditions truly for pregnant and postpartum women in 2023? How prevalent are the various "common health issues" among these women? Given that such a widespread experience as pregnancy and childbirth is associated with numerous potential health issues and even permanent damage, it is paradoxical that information on the topic is not more readily available.

To address this, I conducted a survey. Although informal and without any specific agenda beyond gathering data on various issues related to pregnancy and childbirth—particularly maternal health—the survey highlighted the need for a large number of participants to yield meaningful results. Unfortunately, the sample size in this study was insufficient to draw definitive conclusions. However, the hope is that the data collected may inspire future research on the subject, leading to greater attention to postpartum women's health. Some of the findings have been shared in the Spond group mentioned below.

For Scandinavian-speaking mothers, there is a group called "Sydlandsk MammaYoga & Hnas" on Spond, which you can join using this code: https://group.spond.com/SAHHU. This group focuses on "mammayoga," or yoga during pregnancy and postpartum. In addition to announcing yoga classes and workshops, information on postpartum health will also be shared.

Although I am not a native English speaker, I chose to write this page in English to make the content accessible to a broader audience. As a result, you may encounter some awkward phrasing and grammatical errors. I apologize in advance for any such issues and hope that the content remains helpful.

The creation of this page was born out of frustration during my search for the information presented here. I spent days searching online for guidance on how to safely and effectively restore the body after childbirth. Most of what I found focused on abdominal exercises, with little or no information on when it is appropriate to start these activities post-birth. Consequently, I turned to gynecology textbooks and other medical and scientific literature to understand how long it takes for the body's physiological processes and structures, affected by pregnancy, to return to their normal state after childbirth. This research helped me determine the appropriate timeline for resuming various exercises.

I hope the information gathered here will be useful for your recovery after birth. Below the listed exercises and facts, you will find a few apps and websites that might also be of assistance.

Please feel free to contact me if you have any questions or comments. I hold a Bachelor's Degree in Pre-Clinical Medicine and am currently in my fourth year of clinical studies, working toward an MD license. In addition, I am a certified Pregnancy & Postpartum Yoga Instructor, a certified instructor in the Postpartum Rehabilitation Hipopressive Method by Marcel Caufriez, and have completed the Maternity Health Theory Part through Woxnerud's mammamage.se.

I also offer consultations on these topics—whether you have questions you feel are not serious enough to warrant a doctor's appointment or simply want a broader perspective. For more information, you can reach me at yoga@pelvicsolution.info.

If you find this site useful and believe my efforts are worth supporting, I welcome contributions through the Norwegian Vipps number 737403. This work is done in my spare time, and the site is funded out of my own pocket. Attempts to secure partial funding through ads have been unsuccessful, as women's health sites are not a popular platform for advertisers.

Disclaimer

Before beginning any new exercise program, it is strongly advised to consult your physician or healthcare provider.

We disclaim all liability related to the use of the information provided on this website.

The exercises and information presented here are not original creations but have been compiled from credible sources, including scientific literature, medical publications, public health resources, and reputable sites addressing postpartum health and recovery. References to all sources are provided for your convenience.

If you experience any discomfort while performing the exercises mentioned on this site, cease the activity immediately and consult your doctor.

If you are uncertain about the correct performance of any exercise, please seek guidance from a qualified healthcare professional or physiotherapist.