Written by Dr. Lindsay Massumi, PT, DPT
The pressure to “bounce back” after having a baby seems to be at an all time high. People tell us that by 6 weeks you should be back to your pre-pregnancy weight, wearing your favorite pair of jeans, and ready to jump back into your high intensity workout classes. So, people give birth, take a few days to “recover”, and then at barely a week postpartum are out walking their baby in the stroller as if they didn’t just undergo a massive physical (and emotional!) shift 7 days ago. For a lot of people, they feel like they NEED this. They need the mental and physical benefits of movement and exercise and they’re eager to feel like themselves again. And resting, especially when you’re used to being active, can make you feel like you’re losing strength by the minute.
But what if I told you that what you do in those first 6 weeks can either speed up or slow down your recovery? It’s true! Not taking the time to allow your body (and your core) to heal may be setting you up for bigger issues down the road. So from a pelvic health perspective, here’s everything you need to know about rest, recovery, and rehab in the initial postpartum period.
Why is rest crucial during the first 6 weeks postpartum, and how does it contribute to overall recovery?
Giving birth is one of the most significant changes your body will ever go through. Immediately after, your muscles and joints are adjusting to no longer being pregnant, your hormones are dramatically shifting, and your uterus has a wound about the size of a dinner plate. If you gave birth vaginally, you may have experienced some tearing in your pelvic floor, and if you gave birth via c-section, you’re now recovering from a major abdominal surgery. By resting in those first 6 weeks, you allow your body to focus on healing and nourishing your baby. Too much activity and not enough rest can slow the natural healing process.
What are the potential consequences of not prioritizing rest in the immediate postpartum period, especially concerning pelvic health?
When you don’t prioritize rest in the immediate postpartum period, it can put a lot of additional stress on your body and may slow your recovery. High levels of stress make it harder to reduce inflammation, heal tissue, stabilize hormones, sleep, lactate and manage pain. Additionally, after birth, your pelvic floor and core muscles are at their weakest, so things like standing, walking, and going up and down the stairs are extra challenging for the body. Making these muscles work harder when they’re already weak can lead to problems like over tightening or pain. So, when we don’t prioritize rest immediately postpartum we tend to see more pain (perineum, abdomen, or back), difficulties with bladder control, hemorrhoids, constipation, increased bleeding, and even challenges with maintaining milk supply.
Are there specific exercises or practices that can be done during the first 6 weeks to support pelvic floor healing and overall well-being?
Absolutely! Although rest is part of the equation, we also want to be sure we are protecting our pelvic floor and core when moving and doing things to encourage healing. As soon as you feel up for it, you can begin gentle diaphragmatic breathing and deep core contractions to help reconnect with the muscles in your pelvis. This also can bring blood flow to the area which helps with healing. You can practice these exercises in various positions such as lying down, seated, or in a hands and knees position to help your body readjust postpartum.
In what ways does prioritizing rest and pelvic health in the early weeks postpartum contribute to the prevention of long-term issues, such as pelvic organ prolapse or incontinence?
When you prioritize rest in those early weeks postpartum, your pelvic floor muscles and core have the chance to heal and set the foundation to return to exercise and higher level activity. As you progress with your activities, your body will have the strength, endurance, and coordination to adapt without running into problems. People typically experience more issues the longer postpartum they are, indicating that early postpartum rehab may be essential to long term outcomes. So, by prioritizing rest early on, you can prevent long-term issues that many women deal with for years (if not decades) like continued leakage, pelvic organ prolapse, or pain with intercourse.
Are there specific lifestyle adjustments or habits that can complement rest and aid in the healing process for optimal pelvic health postpartum?
There is so much you can do to complement rest and aid in your postpartum healing. In addition to taking plenty of time to rest and relax, make an effort to drink plenty of water, eat nutritious foods, get outside for fresh air and sunlight, and pay attention to your postures and positions. How you fuel your body as well as how you position yourself when holding or feeding can greatly impact your timeline for healing. Ideally, you want to be sure that any time you are sitting or holding your baby, you are upright and supported, all the way back in your chair, with feet flat or on an ottoman. Other habits that make a big difference include emptying your bladder every 2-4 hours and proactively taking a stool softener to prevent constipation (my pelvic PT recommendation is magnesium glycinate).
How can mothers strike a balance between rest and gentle movement in the first 6 weeks to support overall recovery and pelvic health?
The biggest advice I have is listen to your body! There are several signs and symptoms we can watch for that indicate we may be doing too much in those early weeks postpartum or that the body is stressed and not healing well. Once you feel up for it (no rush here!), start with 5-10 minutes of gentle movement at a time, making sure to take frequent breaks so you can monitor how your body feels. This could be lying on the bed doing some breathing and stretching, walking around your house, or playing with your toddler. Remember, even if you feel good with activity, frequent breaks sitting or lying down are highly encouraged in the first 6 weeks to allow your pelvic floor muscles time to heal and rest.
Are there any specific warning signs that indicate a woman may be pushing herself too hard in terms of activity levels during the early postpartum period?
Typical warning signs that you’re doing too much activity in the early postpartum period include: increased bleeding, increased pain, pressure, or heaviness in your pelvis, bladder urgency or leakage, and decreased milk supply. If you are on any pain medications, be extra mindful of your activity as it can make it harder to monitor changes in your symptoms.
When it comes to the first 6 weeks postpartum, we understand it’s not always possible to take the time to rest and recover. Some of us may have older kids, responsibilities around the house, or just need to be up and moving around. As with anything, but especially postpartum, I encourage you to take the perspective that every little bit counts! Every minute you can take a seat, lie down, breathe, and give your body a break allows your body time to heal. And sometimes, that’s exactly what you need to find your best and strongest self postpartum.
But what happens when you get to six weeks? Are you ready to jump back to everything like you did before since you took the time to rest and recover? Not quite! Stay tuned for our next blog piece on how to return to exercise progressively and comfortably after you get the “all clear” from your provider.
For more information on the benefits of pelvic health physical therapy prenatally or postpartum, check out our upcoming workshops or schedule a FREE Consult with our team.
