Post Natal Exercises
Post Natal exercises are an important part of the process of rehabilitation of pregnant women to her pre-pregnant state. It should be started as soon as possible after birth in order to improve circulation, strengthen pelvic floor and abdominal muscles and prevent transient and long term problems. In this series of articles I will discuss the various exercises which are helpful in the post natal period. I have included a separate article for women who have had a C section as they will need different exercises. You will need to read this page in conjunction with the page on antenatal exercises to understand the exercises more clearly. I hope you benefit from these articles.
Circulatory Exercises
Foot and leg exercises as described in the antenatal section must be performed very frequently in the immediate postnatal period to improve circulation and reduce oedema. Early ambulation will help prevent deep vein thrombosis (DVT). If women in the postnatal period develop oedema of legs, then elevation of legs will help reduce the swelling.
Pelvic Floor exercises (Further read the article on Kegel exercises)
The pelvic floor muscles have been under considerable pressure and strain during pregnancy and labour. So it may be both difficult and painful to contract these muscles in the postnatal period. Mothers should be encouraged to try these exercises as often as possible in order to gain full bladder control, prevent prolapsed and ensure normal sexual satisfaction for both partners in future. The exercise can be linked to and performed along with everyday activities like feeding, bathing, changing nappies and after each bladder emptying.
Mothers should be encouraged to test their pelvic floor muscles after 2-3 months of these exercises. They should jump up and down with a full bladder and be able to cough without any leak of urine. If this is not happening, then women should continue with Kegel exercises frequently for the next one month and test again. If they fail to hold their urine this time as well they should consult a gynaecologist.
Abdominal Exercises
The muscles of our abdomen play an important role in maintaining posture along with the muscles of the back. During pregnancy the muscles of abdomen are stretched a great deal and they need to regain tone as soon as possible after delivery in order to protect the spine, prevent back problems and help the mother regain her former figure.
Transversus exercise
This exercise should not be performed in the prone kneeling position post partum until all bleeding has ceased so as to reduce the remote possibility of an embolus being introduced through the placental site. Instead it can be in prone lying and supine side lying, sitting and standing positions. The toning of the transverses muscle will also assist the performance of pelvic floor muscles and both exercises can be performed together.
Pelvic tilting
This exercise can now be done in supine lying as well as side lying, sitting and standing positions. Pelvic tilting and head lifting may be performed only if there is no diastasis and peaking of abdominal muscles on lifting the head.
Knee rolling
In a back lying position with knees bent, pull in the abdomen and roll both knees to one side as far as possible. Return the knees to the upright position and relax the abdomen. Pull in again and roll your knees to the opposite side this time. Do this at least 10-15 times daily to derive benefit.
Resuming Sports Activities
Walking, cycling and swimming are good to improve general fitness, but the more strenuous of the exercises like aerobics and competitive sports are best left until 110-12 weeks after delivery. Before resuming high impact sports are competitive sports you should ensure that your pelvic muscles are strong enough. Double leg lifts and sit ups should never be performed.
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