The importance of exercise post pregnancy

6 July 2015

Exercise… okay, so it's not the first thing you want to think about immediately after the birth of your new bundle of joy, but it's certainly something I'm sure most of us think about eventually.

Parenting on Female First

So, why is exercise so important post pregnancy? It's not just about losing that baby weight, more importantly, it can help prevent postpartum depression; boost your energy levels; improve your overall mood; act as a stress release; restore that muscle strength that was weakened during pregnancy and childbirth as well as improve your general cardio.

When you are well and truly sleep deprived and feel utterly exhausted though, the last thing you might feel like is exercise; however, if you can muster up the oomph to get started, exercising will actually give you more energy and help you feel less tired. Even on the days where you really don't think you can face it, a simple walk in the fresh air could do you the world of good!

Creating time for postnatal exercise:

When you have a newborn in the house and it seems your washing is coming out of your ears, it's easy to find excuses not to exercise.

However, they are usually just that - excuses. Although you should ideally aim for 30 minutes a day, you don't even need to find 30 minutes together to begin with; you could split it up into more manageable chunks. Why not try 10 minute slots three times a day? You could start simply (but very importantly) with pelvic floor exercises and slowly build up to a more vigorous activity as you feel more confident. A walk to the shops or local park or when you're ready for an hour to yourself, you could join a class.

If you lack the motivation to do things on your own, buddy up with a friend or family and exercise together - having the support could give you both the motivation to keep going.

So what exercise should you start with?

• Swimming

• Aqua aerobics

• Yoga

• Pilates

• Brisk walking

• Low impact aerobic workouts

• Cycling

Remember, you should ALWAYS consult your doctor or midwife before starting any postnatal exercise especially as pregnant women can suffer from diastasis recti. To help you out if you're at all concerned about getting back into an exercise regime, Dr Joanna Helcke has answered a few important questions for us.

Does every pregnant woman get diastasis recti?

It is generally estimated that over 60% of women will have a separation of the outer layer of abdominals occurring during pregnancy. For most women, the muscles will start to realign and come back together again once they have given birth. However, a not insignificant proportion will end up with quite a wide abdominal separation - of perhaps an inch or more - and this is referred to as diastasis recti.

Those with diastasis recti need to work on closing the gap by regularly performing a series of deep abdominal stabilising exercises, pelvic floor work, and postural strengthening movements (I have been doing something similar online with Dr Joanna Helcke and you can see what I think about her online Pilates class Here). They also need to make sure that they avoid certain traditional abdominal exercises such as sit-ups, planks, medicine ball twists, side planks and bicycle crunches as these will actively inhibit the closing of the abdominal gap.

Why should you be concerned about diastasis recti?

For many women, a mild separation of the abdominals, alongside a toned deep abdominal layer, will not be in any way problematic.

However, for those with a more severe diastasis recti, it can be quite distressing and uncomfortable on a number of fronts:

1. The abdominals wrap around the waist a bit like a corset that supports the back. As is all too well known, back pain is incredibly common amongst mothers with little children (think of all the bending, lifting and carrying that has to be done). With an abdominal separation, the corset of muscle is essentially loose and weak and therefore, the back no longer has proper support and is vulnerable. So in general, those with diastasis recti tend to also suffer from persistent lower back pain.

2. Imagine this: with diastasis recti, it is as if the outer layer of abdominals were "unzipped" from the bottom of your sternum down to your pubic bone, a bit like going round with your fitted jeans undone. The net effect of this is that the tummy bulges and protrudes outwards because there is no way of holding it in. So many women with postnatal diastasis recti find themselves on the receiving end of a most unwelcome question: "congratulations, when are you due?" - not what you want when you are not even contemplating pregnancy let alone pregnant… So not surprisingly, many women feel terribly self-conscious of their non-baby bump and find it most unsightly, especially in a swimming costume.

3. Occasionally, the actual area where the outer abdominals are separated is very sensitive, almost as if it were herniated, and it can feel painful when touched. Some of the women who have come to me for help with healing diastasis recti have particularly commented on kitchen work surfaces being a problem as they push against the abdominal gap when, for example, doing the washing up.

4. Having a significant diastasis of the abdominals is also quite limiting in terms of the physical activity you can take part in. The vast majority of organised exercise classes will have a significant proportion of exercises in them that will actively impede the healing process and so many women find themselves unable to attend these fitness sessions. Who wants to limit themselves when all other fronts they feel fit, strong and healthy?

How soon after birth should I start exercising?

Every woman will feel ready to come back to exercise in her own time and this can vary from a matter of weeks to many months. For those who feel ready to exercise from early on, it is still necessary to wait at the very least until the 6 week postnatal check-up has been done, and the GP has given the green light to exercise. However, it is important to realise that this is very much a general check-up and every new mum should also use her own gut feeling - if she doesn't feel ready at 6 weeks postpartum then so be it.

For those who have had a less straightforward birth - a caesarean section, forceps, ventouse or tearing - it is vital to wait for everything to have healed before embarking on any formal exercise programme. This normally means waiting at least 8-10 weeks after giving birth.

What is your number 1 exercise for post pregnancy?

I always say to women that it's vital to get firm postnatal fitness foundations in place: skip them and you end up with a rocky "building". So the two key aspects to initially focus on in the postnatal period are getting your core (deep abdominals) up and running again and building your pelvic floor strength through movement-based pelvic floor exercises.

I'd add a third fundamental element in too: posture. Work on strengthening your posture and your back will thank you!

Will exercise affect my ability to breastfeed?

Research has shown that exercise does not usually affect either the quality or the quantity of breast milk. It is only when exercising at an extremely high intensity - the type of exercise that is so tough you can only sustain it for a matter of seconds before needing to rest - that the taste of breast milk is altered. I wouldn't advocate taking part in extremely high intensity exercise in the first 6 months post-pregnancy but for those who choose to do so, it is best to wait at least an hour after exercising before feeding.

On a practical note for all those exercising and breastfeeding, remember to drink lots of water.

What would you say are three of the main benefits to exercising after pregnancy?

Postnatal exercise is beneficial in so very many ways that it is hard to choose only three benefits. Here are three key benefits:

1. Mental wellbeing: becoming a mother is quite a shock to the system for most of us. It may sound like a cliché but nothing can quite prepare us for how life changes. Whilst 10-15% of women will suffer from postnatal depression many more will have significant ups and downs. Regular exercise - especially outdoors and with friends - is an excellent way of lifting the spirits. It can, quite literally, be transformational: it makes you happy!

2. Staving off back pain: there is no doubt that back pain is the scourge of early motherhood. All the activities surrounding life with a baby involve repeatedly lifting, carrying, stooping, twisting and bending and this takes its toll on the back. Exercise is one of the most effective ways of managing backache, whether it be walking, swimming or -best of all - postnatal Pilates.

3. Alongside "clean eating", exercise is the perfect way to help get you back into your pre-pregnancy clothes. Following pregnancy the metabolism will need a bit of a kick start and exercise is the perfect way to fire it up again. The great thing about regular exercise is that even before a single pound has been lost you will already start to feel great about yourself - exercise is the ultimate confidence booster.

Dr Joanna Helcke is an expert in pregnancy and postnatal fitness and Pilates, winner of the UK's most prestigious fitness award - the 2014 FitPro Award for Excellence in Fitness - and creator of the UK's first online week by week pregnancy and postnatal exercise programme. www.joannahelcke.com