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Recovering from pregnancy is no easy feat.
When we constantly see Instagram stars and celebrities bouncing back from pregnancy in the blink of an eye, it’s hard to know – realistically – how long it can take to recover from pregnancy. And we’re not just talking about getting that “post-baby bod” back.
When is it ok to start exercise?
How long do I need to rest for?
What’s going on with my body?
When is it ok to have sex again?
These are questions that are best reserved for a qualified health professional, but are often topics heavily discussed by wellness bloggers and on forums like Facebook.
We thought it was high time we sought advice from a trusted professional, so we sat down with Anna Scammell, Women’s Health Physiotherapist at Accelerate Physiotherapy.
Anna, tell us a bit about yourself.
“I’m a Women’s Health Physiotherapist and I’ve done a Masters in Continence and Women’s Health, which basically involves any issue that a woman could have during any life stage. I’ve specialised in pregnancy and post-partum recovery and wellbeing, trying to optimise a woman’s health going into this life stage. I also clinically see women for a whole different range of pelvic floor dysfunction. It can be a woman of any age with bladder or bowel issues.”
“I got into the area because I was always passionate about helping women, and I found this area super interesting. I especially love the child bearing years because it’s such a vibrant time of life, but it’s also a challenging time. Being able to support a new mum is really rewarding.”
That’s so lovely. So, when women come to see you after having a baby, what are some of the issues that they’re having?
“Some of the main issues are pelvic floor related. Often it’s incontinence, which is bladder leakage. Commonly that’s in the form of what’s called stress incontinence, which is leakage when you sneeze or lift or when you get back into exercise. That might be because their pelvic floor is weak and they haven’t been doing pelvic floor exercises.”
“Another problem I see is women that have overactive pelvic floor muscles. There can be tension and tone in their pelvic floor muscles after they’ve had a baby vaginally, which can lead to incontinence or pain during intercourse.”
“Prolapse is also very common, which is when an internal organ of the pelvis, the bladder, bowel or uterus, descends because the pelvic floor is weak. Another common issue is rectus abdominis diastasis which is when your abdominal muscles separate during pregnancy and you get weakness through the core.”
Ok then, so how long after having a baby should women wait before getting back into exercise?
“It’s very individual, and it’s difficult to say. I don’t think we place enough emphasis on what the body has just done. It’s grown a baby for nine months, which is a lot of load on your body, and then it’s birthed—whether it be via caesarean or vaginally— so our body needs time to heal.”
“The body needs at least six weeks to recover. You can start to do some light activity, like gentle walking, but this time needs to be really and truly committed to healing and making sure that you’re getting adequate rest and doing your pelvic floor exercises.”
“At the six-week mark, I recommend all women have an assessment with a Women’s Health Physiotherapist to check their pelvic floor & abdominal muscles. All going well, this is the time you can start to do low impact exercise, like brisk walking (gradually increasing the distance & intensity), pilates, yoga, swimming, light weights, low impact gym classes etc.
“At the three-month mark that’s when you can be trying to get back into normal exercise, like introducing light jogging, as long as you’re not symptomatic. You need to make sure that you don’t have any vaginal heaviness or leakage.”
“From a high impact exercise point of view, it may be closer to six months. In terms of recovering completely and feeling back to normal, I generally say give yourself 12 months or until after you’ve stopped breastfeeding. That’s when your hormones get back to a normal level.”
That’s really interesting – I didn’t know it could take that long! What about women who’ve had a caesarean – is there recovery period any different?
“During a caesarean, you’ve been cut through several layers of tissue including your lower abdominal fascia. I don’t think women realise that it is major surgery. You can’t drive, you’re not supposed to lift – although you’ve just had a newborn so you have to do that. You’re supposed to do minimal activity in those six weeks. So it is different, because if you’ve had a good vaginal birth, meaning you don’t have pelvic floor injury and you don’t have symptoms like leakage, you can generally recover faster.”
I get that it’s individual, but are there certain exercises that you recommend to most women?
“Yes. One of them is pelvic floor exercises, which I teach women how to do correctly. If someone comes to me pre-childbirth, which I always recommend, I use the ultrasound machine. It’s great because I can visualise the bladder, and teach them how to contract their pelvic floor using biofeedback. To do a pelvic floor exercise, it’s as if you’re stopping the flow of a wee, or pulling up and holding in wind. It’s an isolated contraction. Every woman should be doing them, optimally before they even get pregnant.”
*Googles Kegel exercises*
“I also teach women how to contract their deep abdominal muscles (transverse abdominis). To improve your stomach separation, working your deeper layers first is really important. I’d never want any woman to do sit-ups or any exercise that’s going to put pressure on that area, as it will just make the separation worse.
What about the other activities – how long should a woman wait before having sex after childbirth?
“Again, it really depends on your recovery, but I suggest waiting eight weeks. Absolutely wait six weeks, until you’ve had a check-up with your obstetrician, and then you need to wait until you’re comfortable and ready. The eight-week mark is a safe time frame, but a lot of women generally don’t feel like it.”
“After birth, your body is really a vehicle for nutrients and everything for your child, so it can be difficult to switch into being sexual. Often you’re tired and stressed and just want to sleep! In addition to this, your hormones levels can lower your libido and cause vaginal dryness so a natural lubricant is a good idea.”
“I say to women to be open with their partner. If they’re not ready and force themselves to have sex, it can be a painful or uncomfortable experience which can then feed into a fear avoidance cycle in the future. You’re better off waiting – partners tend to be pretty understanding of this.”
Say a woman comes to you who’s thinking of having a baby. What is the ideal process that they’d have as a patient?
“As soon as you know you’re pregnant and you’re over that 12-week mark, you’d come in and learn pelvic floor exercises and I would educate you about safe exercise during pregnancy. That’s the optimal situation. Then there’d be another review throughout the pregnancy, and then before the birth we’d go through some birth strategies and preparations. Then, when they come back in after the birth, we’ll go over core exercises again and see how they’re going, chat about the birth, and take it from there.”
“I love seeing women before they have bubs, so that we can reconnect again after and they feel supported and can ask me anything. They also feel comfortable to tell me if they are feeling disconnected from their genital area, which can be common after a vaginal birth, so part of my role is really about encouraging that reconnection. It might be painful, it might feel different or look different, but that’s generally just short term because of the swelling.”
“You’re now a mum and you have a baby, and therefore your body might look different to how it was before, but you can still be healthy, strong and fit. A lot of women do get back to how they were before, and for some women they are in even better shape post-baby. It’s about tailoring the expectations they have and the pressure they put on themselves. It’s difficult, but it’s important.”
“My aim isn’t to get your body back, it’s about getting you to be the healthiest version of you that we can, within realistic and achievable parameters for you.”
Want more advice from Anna? Check out her blog at thewholemother.com.
Who: Anna Scammell, Women’s Health Physiotherapist
Where: Accelerate Physiotherapy, 9/2 Garran Pl, Garran ACT 2605
Book: Call 02 6232 4773 or visit acceleratephysio.com.au
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