Having a baby truly is a miracle. It takes 9 months (for some a little less and some a little more) to grow your baby and then next thing you know, your little boy or girl is here! After you have your baby it is a whirlwind of feeding, checking stitches if you have some, monitoring urine output, weighing the baby etc etc. And then you get home. This blog is just a little guide from a physiotherapist point of view as to what you need to be doing in your first 6 weeks after giving birth. These tips are some things you can implement to help optimise your recovery and some guidelines to follow.

The thing to keep in mind is that whether you have a vaginal delivery or a cesarean section delivery, the first 6 weeks are going to be similar for you. If you have a vaginal delivery, and maybe some stitches, you will be protecting these areas. If you have a c-section, you will be focused on protecting your wound and having really good healing. When I worked on the maternity ward, I saw many women with both types of deliveries. Some said their vaginal delivery was easy, others said they were so glad they had their c-section. This blog is not about the pros and cons of these deliveries – it is to simply outline that both deliveries require some TLC afterwards and do take time to recover from.

If there was any take home message from this blog it would be

“Be patient and be kind to yourself”

First few days post delivery

• Rest – I know this may sound like a joke with a newly born baby needing to be fed and the sleep deprivation sinking in. When you are able – try to rest. You do not need to be rushing around seeing visitors, you do not need to be doing heaps of walking. Some small gentle walks around the ward are good, but accept the help that people offer you and try to sit and lay and get some sleep where you can
• Get to know your baby – the first few days after delivery are really about bonding with you baby, getting the hang of feeding etc. It is not the time to be worried about getting your 6 pack muscles back or trying to get back into exercise, all your goals will come in time
• Baby blues day 3 – during pregnancy you are on a hormone rollercoaster, and it is similar after. After giving birth your hormones change dramatically, so if you are feeling teary and not sure why – that’s the answer! This is a normal feeling, but just monitor yourself and check in with how you are feeling, pos- natal depression is not something to panic about but something to keep in the back of your mind and ask for help if you need
• Log roll out of bed – when you are pregnant, often you get to a stage where you cannot just sit up in bed and you have to roll through your side. Once your bub is here – stick with this habit! Log rolling out of bed will minimise the amount of abdominals used to sit up, which will protect your c section wound if you have one, and minimise pressure on your pelvic floor as well. So it is important for both types of deliveries. For clients in general with back pain, that is the recommended way to get out of bed so keep that in mind if you back is aching.
• Gentle pelvic floor exercises can help with swelling – now we are not talking about doing really strong hard squeezes of your pelvic floor. It is more like a gentle squeeze upwards, hold for a second or so and then release. After bub this will be easiest to do laying on your back or on your side and the key word is GENTLE.
• If your stitches are sore – whether you have stitches or not, after a vaginal delivery you will be swollen and sore in your perinuem. If you are getting burning in that area when you urinate, you can try leaning forward onto your elbows to change the angle of the flow, or try pouring some luke warm water over the area whilst you urinate to dilute the urine and it will string less
• Avoid constipated – whether you have had a c section or vaginal delivery, forcing a bowel motion will not feel great and it is not ideal for your pelvic floor. Make sure you are drinking enough water and many women use a supplement at this time to help with fibre and/or motility.

Over the next 6 weeks

• Continue slowly increasing pelvic floor exercises – After you have had your baby it may feel like your pelvic floor doesn’t feel as strong. You need to remember that your pelvic floor has been carrying a baby on it for the last few months, there are alot of hormones flowing through your body making the ligaments of your pelvic floor relaxed, and it is swollen which makes it a bit hard to activate the muscle. Start with short pelvic floor holds, and each week try and build your holds by one second.
• Do the knack – the knack is when you squeeze your pelvic floor before you cough or sneeze or lift. Generally, this should be an automatic thing that happens, but you have been carrying a baby and then given birth, you need to nudge your body in the right direciton and start with doing this as a couscious thought. After a while it will become a normal habit again,
• Continue to log roll out of bed – log roll out of bed for the first 6 weeks. This may seem like quite a while but it is worth it to try and minimise how much pressure and crunching you put through your abdominals and pelvic floor.
• Careful with lifting – the general recommendation after a c section is to not lift anything heavier than your baby for 6 weeks. This sounds like a good recommendation but it is very hard to follow. From a physio point of view we want you to do as little lifting as possible, and if you do need to lift something then try and do it with the best possible technique. This involves bending your knees and keeping the load/weight as close to you as possible.
• Avoid vacuuming and heavy type cleaning – vacuuming involves twisting and flexion and is quite heavy which will put pressure on your abdominals and pelvic floor. Try and get someone else to do this if you can.
• Walking – walking is really great exercise to do right now. Start short say 15 minutes or so, and slowly build up the length of time you walk for
• Do not panic – how your body is and how your pelvic floor feels is not how it will feel forever. It took 9 months to grow this baby, give yourself time to recovery and be patient.
• Brace – if you have a brace to wear or compression shorts (eg SRC shorts) now is the time you can wear them quite often. Do not sleep in your brace or SRC shorts. If your brace is uncomfortable or digs into your legs, remove it
• Manage constipation – as above – stay on top of your constipation
• Protect wound – the skin level of your wound heals in approx 10 days, but it takes abit longer for the deeper layers to heal. So be kind to your body and let that wound heal well.

Emily Georgopolous (APAM)
Physiotherapist

Featured in the Top 50 Physical Therapy Blog

Click here to book an appointment with Emily or view our Clinical Pilates timetable here.