Post-Natal Pelvic Care and Return to Exercise


Congratulations on your new baby and welcome to a whole new world that revolves around that one tiny bundle of joy! In the wonderful mayhem of new motherhood, it can be easy to forget about you and the amazing feat that your body recently performed. 

In the interest of your immediate and longterm pelvic health, here are some helpful tips for after you've had your baby:

Early Post-Natal 0 - 10 days
  • Rest and get sleep when your baby does!
  • Cooling ice to perineum can help with healing and discomfort. This should be used with layer of cloth between skin and cold for a maximum of 10-12mins on and at least 20mins off before re-applying. (You can also use a wet pad that has been put in the fridge/freezer).
  • Gentle pelvic floor contractions can help decrease perineal swelling. These do not have to be super-strong and are safe to do even if you have stitches. Even if you don’t initially feel the contraction, still try to visualise the muscles working. Ensure you ask focus on relaxing the muscles and not clenching the bum or abdomen.
  • Start walking as you are able, gradually increasing time or distance eg. 5mins – 10mins at a time, even if it is just around house to start with.

Continuing post natal weeks 0-6 and onwards
  • Try to avoid lifting anything heavier than your new baby - this allows you to gradually increase the weight as your body recovers
  • Aim to return to good bladder and bowel habits as soon as possible by minimizing straining and constipation. Abdominal massage can help to improve digestion and motility if you are feeling bloated or having difficulty with bowel movements - this is also great to do for your baby!
  • It is highly recommended to avoid high impact activities such as running, jogging or jumping early post-natal. There is no set time to return to these activities, rather it is important to allow the muscles to return to full function. Additionally, the ligaments around your pelvis and internal organs are still more stretchy than usual and will continue to be so whilst you are breastfeeding.
  • There is no need to do crunches or sit-ups to tone your stomach. Ever. This actually creates large amount of increased pressure in the intra-abdominal space which can either push down on your pelvic organs (think prolapse) or push out into the abdominal muscles (rectus diastasis). The repetitive flexion can also cause the spinal discs to bulge out backwards and push on to your spinal cord and nerves. 
  • Gradually increase your walking distance to 5-8kms over the course of a day (doesn't have to be all at once). 
  • Practice holding your baby with your arms, rather than just resting on your hip/rib. Try holding centrally with two hands or on your side with one arm, alternating sides frequently. This is a great way build up your upper body and core strength. 
  • Try some of these stretches to reverse some of the tightness that comes with baby-feeding postures 
Opening the Windows (a)
Opening the Windows (b)

Thoracic Stretch on ball or chair
  • A specific post-natal core strengthening exercise class can also be great to ease back into your pre baby routine. Look for something that is low-impact and either run by a Physiotherapist or Restorative Exercise Specialist (RES) eg. PhysioFit 
  • With any exercise, particularly 'core' or resistance training, keep an eye on your abdomen - if you see any outward movement or bulging, this is an indication that your deep core and pelvic floor are not functioning efficiently and can be causing more harm than good. See if you can take the exercise down a level or see your Physio/RES to help you safely return to your previous level of activity. 
Finally, if you notice any of the below symptoms, a visit to your nearest Pelvic Health Physiotherapist is warranted for a prompt assessment. 

Post-Natally – What is Normal or Not?
  1. A feeling of heaviness in the vagina or noticing anything protruding can indicate a possible prolapse. This may be more evident after lots of walking and lifting.
  2. Traction or trauma to nerves and muscles during childbirth can lead to loss of or changes in sensation. This should gradually improve as swelling decreases and nerves and muscles heal. This can take a few months (or longer) to improve.
  3. Ongoing pain with intercourse. If you continue to notice a burning sensation, tightness, or any deeper discomfort with intercourse, this is not normal and can be treated.
  4. Leaking of urine or decreased bladder and bowel control is definitely not a normal part of life after having a baby, or even part of aging.
  5. Increased urinary frequency - as soon as possible, try to get back into the habit of voiding every 2 ½ to 4 hours and only once or not at all during the night, even though you may be waking up for your baby. This includes ‘just in case’ visits.
  6. Abdominal separation - Rectus Diastasis can be seen as bulging between the muscles of the 6-pack abs and can be tested with your fingers.
  7. Ongoing abdominal, back or pelvic pain, including pain radiating down the leg(s). 

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