caring for you after having a baby
If this sounds disconcerting to you, it’s because it is. Becoming a parent is considered a major life stressor and research has shown that for some parents there is a major decrease in life satisfaction following the birth of a child that is greater than that following divorce, as well as the loss of a job and partner.
As a new parent, I know and understand the difficulty of making time for yourself and your body. The guilt that you can sometimes feel in stepping away from being with your child to make time for medical appointments and exercise. And also how freaking hard it is to find childcare and struggle between the balance of wanting time to yourself but also missing your child when you’re away from them.
Below are four tips and tricks that I recommend to all clients after having a baby:
Regardless of how you are feeding your baby, make sure that you are using good posture and appropriate body mechanics. It is so common to lean forward bringing your bottle or breast to your baby (not to mention they’re so dang cute and you get to see their face when you lean in close), but this can put tremendous strain on your neck and back. You always want to have good lumbar support by sitting upright in a chair with your feet fully supported. Sometimes it can be helpful to put a step stool underneath your feet if your chair sits high enough to where your feet don’t fully touch the floor. You also will want to use tons of pillows to put underneath your arms to help support baby and bring them closer to your body (and chest if you are chestfeeding) or you can use a supportive device like a My Brest Friend or Boppy instead. Make sure you always bring baby close to your body (and breast) instead of the other way around!
Begin scar tissue mobilization early! It is incredibly common to tear during vaginal deliveries and both scar tissue from a tear as well as scar tissue from a cesarean delivery can become incredibly sensitive and painful to the touch if it is not mobilized early on. If your incision is not fully healed over, you can start by gently working on the sides of your incision. If your incision is healed over with scabbing and sutures gone, you can start working directly over the scar tissue. You will want to work around or over your scar using the pads of your fingertips for 5-10 minutes daily starting with what you can comfortably tolerate and gradually increase your time. Try to visualize your incision in four parts, working at each quadrant with the following movements. Begin by gently moving the tissue to the left, right, up, and down holding for 30-60 seconds in each direction. You can then gently rub clockwise and then counterclockwise circles around or over the scar tissue for 30-60 seconds each direction. After working closer to the surface of the skin, gently sink your fingertips deeper into the tissue and repeat the above movements at this deeper level. Working daily over and around your scar tissue should help to improve any sensitivity and to prevent neuromas from forming.
Begin doing pain-free, symptom-free exercise early on. Don’t wait until your 6-week postpartum checkup to begin exercise. There are safe activities you can go ahead and get started on like:
Pelvic floor contractions: Pretend as though you are using the muscles at the vaginal and anal openings to suck fluid up and in through a straw. Try to hold these contractions for a longer contraction, up to 10 seconds, and release completely before repeating again. You should also try to do quicker pelvic floor contractions where you squeeze for a second and then rest for a second before repeating again. The key with pelvic floor contractions is that you should be able to isolate the contraction at your pelvic floor instead of compensating using surrounding hip and abdominal musculature. A good way to tell if you are doing these contractions correctly? No one else should know that you are doing these contractions but YOU (unless you are having a pelvic floor exam completed by a medical care provider or sex!). *Important note: Pelvic floor contractions should never be painful. If they are, please discontinue and see below.
Active breathing: Breathe in through your nose allowing your rib cage in your abdomen and chest to expand as you exhale through your mouth while pairing a pelvic floor contraction with your exhalation. Practice this type of breathing in all positions like laying on your back, laying on your side, sitting, and standing.
Walking: You can begin walking at an easy pace where your level of exertion while walking feels very light, it is easy to breathe and talk with a friend, and you feel like you could maintain your pace for hours. Be sure to begin walking after having a baby by walking on flat surfaces and avoid hills. It is fine to bring baby along on your walk, but try to do so by pushing them in a stroller instead of baby wearing. Make sure that you do a warm up and cool down immediately before and after your walk. I usually recommend with starting walking at 5 minutes and gradually increasing each subsequent week by 2 minutes until you are able to walk 30 minutes at a time.
Abdominal activation/bracing: As you are breathing and while laying on your back, gently bring your belly button inwards towards your spine as you exhale through your mouth. You should feel a gentle activation of the abdominal muscles right at the inside of your hip bones as though you are trying to zip up a tight pair of pants (but gently!). On your next exhale paired with the contraction of these muscles make a shushing noise. Then during your subsequent exhale try to also pair the contraction and shushing noise with a pelvic floor contraction. Repeat 10 in a row 1-2 times per day.
*You want to make sure that all exercise you incorporate postpartum does not create pelvic floor symptoms during or immediately following your exercise, such as pelvic pressure or heaviness, leaking of urine/stool/gas, pelvic pain, coning inwards or doming outwards of your abdominal muscles, or an increase in your postpartum bleeding. If it does, this is your body’s way of telling you it is too much too soon. I would also recommend working with a pelvic floor physical therapist to have more 1:1 direction on how to get back into exercise after having a baby.
Work with a mental health professional. 3 out of 4 people will experience the baby blues after having a baby. 15% of those people will go on to develop postpartum depression. Literally everything about your life changes after you have a baby. Your body, your role as a partner, your identity, your career. You are likely not getting much sleep and your amount of time to invest in yourself can look extremely different and can definitely take a toll on your mental well-being. I know it did for me. I cannot recommend working with a mental health provider enough. Not sure where to start? BetterHelp is a great resource for virtual treatment options. If you are thinking about hurting yourself, your baby, or your partner please call 911 or the 988 Suicide and Crisis Hotline.
Still not sure where to start after having your baby? Or know someone that just had a baby and would benefit from postpartum pelvic floor care? Reach out to schedule a pelvic floor physical therapy appointment with me today. At Flora Physical Therapy I am passionate about providing accessible options to parents including in-home, in-clinic, and virtual appointment options to help meet you where you are.