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Postnatal
Exercise: When and How
Sara Shelley, M.A., A.D.T.R.
So,
you've just had a baby! After nine months of dramatic body changes,
and the final culmination of childbirth, a new person came into your
life. You are captivated. Every breath, movement and gesture pulls you
in. Gazing at your baby may be the closest you've ever come to spiritual
bliss, but admit it: What you really want to know is when you'll get
a full night of uninterrupted sleep. Although it is amazing how little
sleep you now can get by on, this brand new 24-hour 'round the clock'
unpaid job makes whatever you were getting paid to do before seem like
a piece of cake.
Bringing a baby home can be a shocking experience, especially for the
first-time mother. Without a doubt, it is a most significant life change.
It's no wonder then, no matter how much you were walking, swimming or
participating in any exercise program during your pregnancy, that it
is hard to imagine how or when you'll begin again. Exercising could
very well be the last thing on your mind.
New moms might find it comforting to know that, for a while, it's not
at all unusual to feel disconnected from your former pre-pregnancy body,
and, let's face it, from sex too. Your breasts, and their ever-changing
size and assortment of subtle and obvious sensations, now seem to have
a life all their own. You know that exercise would give you energy,
help drop a few pounds and perhaps even jump-start your libido, but
you're too drained and too busy to care.
Want to know how to get started? The first step: Hide that scale and,
while you're at it, that favorite pair of jeans and anything else that
fits into the unfittable category. Trust me, now is the time to be good
to yourself, and whatever fits into that category, do it! If
you haven't already, indulge and let go a bit without guilt. Take bubble
baths, make a date with a girlfriend, go for a walk in the woods, shop
if you wish, but let Dad have a turn with the baby. Please remember
your well-being and your need to refuel are now, more than ever before,
a priority. It is the best lift you can give yourself and your new baby.
Once you feel ready to begin any exercise program that involves sustained
aerobic activity, consider these important issues:
1. your prior fitness level,
2. the ease or difficulty of your delivery,
3. your baby's disposition, and
4. your physical recovery.
Each of these factors will vary greatly with each woman, yet should
be considered together when determining the safe and appropriate time
to begin.
Prior fitness level: In general, the rule is the more fit a woman
is going into the birth, the easier her recovery and the faster her
return to activity. For example, those of you who had to be pulled off
the tennis courts during your third trimester may be ready to volley
again weeks, even months earlier than those of you who consider hammock
swinging a competitive sport. All things being equal, try not to be
hard on yourself. Where you happen to fall on the more-to-less scale
does not in any way mean that you are more or less, regardless
of your weight, shape, bust size or hair color. So get that straight
right now!
The ease or difficulty of your labor and delivery will be a critical
element to consider as well. Factors such as length of labor, type of
birth, health of the baby and complications are but a few. Do not underestimate
the amount of time you need. Jumping back into high intensity activity
too early can have serious consequences that only tend to postpone full
recovery. Typically, women wait until their six- week postpartum checkup
to receive a go-ahead from their doctor or midwife. However, if you
are feeling well enough, many practitioners will advocate an earlier
return to moderate exercise.
In addition, your baby's disposition will have a significant
role in when you begin exercising again. If you're lucky and have been
blessed with a baby who seems to know how to sleep and you are able
to get some regular periods of sleep as well, you will find your energy
and motivation returning earlier. A fussy or colicky baby will most
likely delay a mother's readjustment and possibly prolong complete physical
recovery. Hang in there! Parenting a high-maintenance baby can be one
of the biggest challenges you'll ever face, but I promise, this too
shall pass.
Finally, prior to grabbing your gym bag and heading out, it is critical
that your body has sufficiently healed. Locia or bloody discharge
should be completed or be very dark and nearly ceased. Walking a mile
should not cause an increase in red bleeding. If you see red blood,
stop activity for a few days and then consult your physician or midwife
if it continues. If you had a C-section you should be healed to the
point that even with your hands raised overhead, you feel little or
no discomfort. Episiotomies should also be healed sufficiently. Pelvic
relaxation should have lessened, and there should be no incontinence
resulting from exertion. If you are nursing, milk production should
also be satisfactory.
Starting gradually and working up to sustained activity will produce
the best results. Keep in mind that your body expanded slowly, undergoing
extraordinary transformations from conception to birth. Full recovery
will take anywhere from 9 to 12 months.
If you had a "normal" vaginal birth without complications, you may try
to tighten kegel muscles within a few hours of birth. Regaining control
of these muscles is a significant activity and can actually encourage
blood flow to the whole pelvic floor. Pelvic tilts can be added during
the first week or so. If you feel up to it, you can begin walking 10-20
minutes every other day, a week or two after delivery--providing your
practitioner approves. Often this gentle increase in activity creates
the additional energy necessary to complete the healing process and
get you started. Finally, joining a postnatal, bring-your-own-baby exercise
class is a safe and convenient way to ease back into aerobic activity.
Plus, it's a great way to connect with other new moms and do something
good for yourself and your baby too.
With the unceasing and ever-changing demands of motherhood, the challenge
will always be to find the time to fit exercise into your life. Those
who say "just do it" clearly have not recently experienced a childbirth,
been up all night with a howling baby or spent timeless hours feeding,
wiping and consoling. Finding ways to keep your humor, to be creative
and flexible and to have fun with fitness is a must! Do what you can,
and remember that whatever you do will always be good enough.
Sara Shelley is the mother of two young boys. She currently teaches
"Dancing Thru Pregnancy" and "Afterdance," and is a registered movement
therapist and licensed pre-/postnatal fitness instructor. She also leads
support groups for new parents with P.A.C.E.
July 1999
Reproduced with permission from the Washington
Parent
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