Congratulations on the birth of your baby.
The following advice applies to all new mothers whether you have given birth vaginally or by caesarean section.
Back Care and Posture
- Lifting – Always soften your knees, gently contract your pelvic floor muscles and abdominals and keep your baby close to your body.
- Feeding – Get comfortable in a chair or bed and place a pillow at the small of your back. Pillows on your lap will bring your baby up towards you. Rest back and make sure that your shoulders are relaxed.
- Changing – Ideally do this in standing with the changing mat at waist height.
- Bathing – Try kneeling down, avoid bending over the bath.
Pelvic Floor Dysfunction
During delivery, it is likely there will be significant and prolonged stretching of the pelvic floor muscles, fascia and nerves which may contribute to:
- Incontinence – urinary and/or faecal leakage
- Pelvic Organ Prolapse – this means that one or more of the pelvic organs (bladder, bowel or uterus) have descended downwards into the vagina.
It is therefore recommended that all women exercise the pelvic floor muscles as soon as possible after you have delivered. If you have had a perineal tear or an episiotomy, exercising your pelvic floor muscles will also help this to recover.
Pelvic Floor Exercises
Imagine you are trying to stop yourself from passing wind and urine at the same time, you should feel a lift as you contract your muscles and a drop as you relax.
- Breathe normally throughout
- Do not clench your buttocks or brace your abdominal muscles
Aim to do x10 short contractions and x10 longer holds at least x3 daily
Contract the pelvic floor muscles just before you know you might be about to leak such as when coughing, sneezing, laughing or lifting heavy objects. Do not assume that if you have had a caesarean section you should not need to exercise your pelvic floor muscles! Pregnancy both alters the anatomy in the pelvis and increases the load placed on the pelvic floor muscles.
Remember pelvic floor muscle exercises are important for life!
Your abdominal muscles stretch during pregnancy and will separate in the middle (known as DRAM). The gap should gradually reduce in size in the months after your baby is born however do not expect full closure.
It may help your abdominal muscles recover by doing some gentle abdominal activation exercises as soon as possible after your delivery.
Find a comfortable position, gently breath in allow your lower abdomen to expand, as you breathe out, draw your lower abdominal muscles in. Take one or two more breaths then relax. Do this regularly throughout the day
It is important to give your body time to recover after having a baby. Pelvic floor muscle training, basic core exercises and walking are all recommended as soon as possible after delivery. You can return to gentle, low impact exercise from 6 weeks postnatal. Guidelines recommend you wait until at least 12 weeks before gradually returning to higher impact exercise (such as running).
It may take your body slightly longer to recover after having a caesarean section. For the first 6 weeks take regular pain relief and accept all the help that is offered. Support your wound with your hands, a pillow or towel when you need to cough, sneeze or laugh. Try to avoid activity that causes strain such as heavy lifting. It is also recommended that you do not drive for the first 6 weeks.
When to Refer to Physiotherapy
We would strongly suggest you arrange a postnatal appointment with the Pelvic Health Physiotherapist team if you are having symptoms of:
- Incontinence especially if you have had any of the following:
- Baby birth weight over 4kg or 8lbs 13oz
- Second stage of labour (pushing stage) longer than 1 hour
- Forceps delivery
- Pelvic Organ Prolapse
- Abdominal Separation (DRAM) larger than 3cm
- Unresolved Pregnancy-related Back Pain / Pelvic Pain
You can self refer to pelvic health physiotherapy up until you are 6 weeks postnatal by calling 01786 434 061.
Alternatively you can complete the below online booking form and you will be contacted and offered an appointment.
If you are over 6 weeks postnatal you will need a GP referral.