Three Things I Wish All People Knew Heading Into Postpartum
This month I have been thinking a lot about the education (or lack of education insert eye roll emoji here) people get with respect to their postpartum journey. For the most part when our bodies experience major trauma or we have major surgery there are doctors or PTs who tell us what we may experience and best practices to allow our bodies to heal. So why in the world do we let women have babies and then send them home with no information on what is normal healing??
To help combat the unfortunate information deficit we're in, I wanted to share three things I always tell my pregnant friends/patients:
Your abdominals and pelvic floor muscles lengthen up to 115% during pregnancy and labor!
This number has more significance than just being a ‘fun fact’ or used for shock value. When our muscles stretch out this much, they lose their length-tension relationship: aka they lose the ability to contract well under load. What does this mean? It means we need to allow time for natural healing to occur before we challenge our core system. Every human is different but on average it takes anywhere from 4 weeks to a few months for your muscles to be back to their optimal length. Too much load on your pelvic floor or abs too soon postpartum can lead to several issues like worsening diastasis or prolapse.
GOOD NEWS- your body is really smart and for the most part will tell you if you're doing too much. Watch for pelvic floor heaviness, worsening of spotting/bleeding, low back/hip/pelvic pain, or incontinence as signs you may be pushing things too quickly. I know being limited physically sucks, but it's not forever and if you can take the time to heal properly now you're going to thank yourself one year from now. REMEMBER- you just brought a new soul into this world (literally amazing) so it's ok to give your body grace and yourself time to heal
Even though you're not “exercising” immediately postpartum, you're doing a lot of “exercise” living your normal life.
Let's think about it. When you're bending down to pick up your baby or grab your dirty socks off the floor, what are you doing?? That's right a hip hinge aka a body weight dead lift. When you're picking up the car seat, what are you doing?? A bicep curl (with 10-15 pounds of resistance)! You need to be STRONG to be a mom (one reason I really emphasize strength training during pregnancy)
There are two take aways from this-
One- make sure you're not overdoing things by just living life in the first ~3 weeks postpartum (pay attention to how your body feels lifting your baby, don't pick up your toddler yet, have your partner push the stroller, etc)
Two- take advantage of this built in exercise and use it to your advantage! Make sure you're getting a good core brace before lifting (think exhale with effort) and not bearing down on your pelvic floor.
The 6 week check in with your doctor is not the end all be all for recovery.
So many people are still getting cleared to exercise (with no guidance or instruction thumbs down) at 6 weeks with minimal physical exam. If you're not checking in with a pelvic floor PT at this point there are so many compensatory patterns your body may be doing that can lead to dysfunction down the road. Checking on pelvic floor strength, looking for prolapse, monitoring healing of diastasis, working on scar tissue (vaginal or abdominal) are just some of the things we do at PT during this time.
Blanket clearance without personalized physical exams postpartum is a thing of the past- spread the word, tell your friends, scream it from the rooftops!!!
Kayla Litwin, DPT, PCES
Kayla obtained her doctorate of physical therapy from the University of Wisconsin- La Crosse. She currently lives in San Francisco and is the owner of Apricity Physical Therapy & Wellness- a pelvic floor PT clinic that focuses on holistic care diving into root cause issues of pelvic floor dysfunction. She loves to help people get back to doing all the things they love to do with an empowered sense of how to best take care of their bodies!