Recovery after birth - the first 48 hours
‘How long does it take to get my body back after having a baby?’
New mums often ask me this question, and the answer in my head is often ‘how long is a piece of string?’ but I know that’s not very helpful. So my second answer is ‘it took 9 months to make your baby, so expect something similar to bounce back’. However, I know that many women continue to see bodily changes for a long time after the 9-month post-natal mark. So most of all, I just want to give them a big hug and say ‘Babe, I know your body feels pretty alien right now. Don’t worry, it will take time, but you WILL feel normal again. Just get some sleep, do some regular exercise, preferably with other people (to help prevent post natal depression) and eat sensibly.’ At least 48 hours of rest and recovery is critical after childbirth so read on for info on how to recover best.
The postnatal body
Many of your body’s tissues have undergone a large amount of stretch, in a short amount of time (9 months feels like yonks, but it really isn’t in the range of a lifetime), due to your growing baby and all the hormones that go along with pregnancy. So, even if you've had a caesar, your pelvic and abdominal tissues will be stretched and probably weak. A vaginal birth causes extra stretch to the pelvic floor muscles and ligaments around the vagina, and pelvic joints. Then, add to that the lack of oestrogen during breastfeeding, and you have a recipe for some very significant body changes.
Your pelvic floor
During a vaginal birth, the pelvic floor muscles can stretch about 2.5 times their resting length, which is pretty amazing actually, as other skeletal muscle can only stretch 1.5 times their resting length before failing. There may also be some tearing of the muscles and tissues around the vagina (which is common, relatively normal, and not the end of the world. Or your sex life BTW). Therefore, it is important to apply basic first aid to the vaginal area in the first 2-3 days after delivery: RICE. No, I don’t recommend eating lots of asian food, but:
R – horizontal REST: lying down is the only position where gravity isn’t acting detrimentally on the pelvic floor region. So lie down as much as possible to allow your pelvic floor to recoil back into place.
I – ICE to the perineum: use icepacks to help decrease inflammation and swelling around the vagina. Put a perineal ice pack, wrapped in gauze, on the perineum (where you’re sore) for 20 minutes, every 2 hours for the first 3 days after birth.
C- COMPRESSION: put 2-3 large pads in your (large, not sexy) underwear, and wear some supportive bike shorts or leggings to help reduce swelling around perineum/vagina
E – EXERCISE: start your pelvic floor exercises 24 hours after birth – Get the ‘Continence Foundation of Australia’ app or the ‘Squeezy’ app for more information
Yes you probably still look pregnant after you deliver, that’s normal! Your uterus is still pretty big and there’s probably some swelling around it. Plus, your abdominals have been stretched over the baby growing underneath it, and you may have some separation of the ‘six pack’ muscle. It takes 12 weeks for relaxin, the ‘stretchy hormone’, to leave your body after childbirth, therefore you should avoid abdominal exercises such as sit ups, planks and double leg lowers for that time. The following advice applies for both caesarian and vaginal birth.
To help your abdominals recover:
·Roll out of bed, and use your arms to push yourself up out of bed, rather than doing the ‘sit up’ movement from lying to sitting
·A helpful garment for abdominal recovery is a compression garment, worn over the area from underneath the boobs, down to your pubic bone. There are many post-natal recovery shorts on the market now. Anecdotally, I see a faster recovery in women who where support garments every day for about 4-6 weeks after childbirth, even though there is a lack of evidence to support them. As to which one is best, it’s all about personal preference. Have a look at Solidea Maman shorts, SRC recovery shorts or 2XU recovery shorts. They can be pricey, but they are worth it.
·Start to activate your lower and deepest part of your abdominals (transversus abdominis muscle). Do this by adopting a 4-point kneeling position, with a flat back. Without moving your spine, gently draw your lower tummy towards your back and hold for 10 seconds whilst breathing normally. Repeat this 10 times in a row, 1-2 x a day.
This muscle gives you your waist shape, and gives you a flatter tummy (NB sit ups do not give you a flat tummy! In fact they often shorten your upper tummy, and bulge out the lower tummy). See your women’s health physio for abdominal exercises to help.
In summary, remember RICE, and to pack the following into your hospital bag:
Big, granny panties
Supportive bike shorts or leggings
Perineal ice packs
Abdominal support garment (tubigrip or post natal recovery shorts)
Heavy duty menstrual pads
Here's to putting yourself first every once in a while!
- the vagina physio