Pregnancy column: Regression in the postnatal period
When is a mother allowed to become active again after giving birth and what does this sporty entry look like? How long does the regression take and which exercises can help? Birte Glang, actress, fitness expert and app developer of “Move it Mama”, gives answers about the postnatal phase.
As at the beginning of pregnancy, new moms are again faced with countless questions: Many will sooner or later fight their way through the jungle of myths, half-truths and well-intentioned advice on fitness and re-entry into sports after birth.
There are terms such as gymnastics, pelvic floor stimulation andregression. Again and again one hears about the “puerperium” and the “postpartum phase”.
Does “puerperium” really only mean the first week and should the new mom stay completely in bed? Is she allowed, willing or should she do gymnastic exercises in this phase?
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ToggleHow long does the postpartum phase last?
Worldwide, there are countless customs and traditions around the topic of birth and behavior in the first weeks afterwards.
In western regions, it is customary to refer to the first weeks – such as the first six – as the so-called postpartum phase. Depending on whether you had a complication-free vaginal birth or acaesarean section, this time can vary between four and eight weeks.
During this time, the main thing is to build a bond with the child, to find one’s way as a mother in the new situation and to give the body time to regenerate. That means plenty of rest, relaxation, good nutrient-dense nutrition, sleep – if the baby lets you – and fresh air.
In Germany, it is customary for amidwifeto come to your home and show you the first steps in dealing with the baby, weigh the child and take care of the well-being of your child and you.
In China, the custom is known as “sitting of the month”. However, this “month” can last 28 to 42 days and the mother should recover from the childbirth strains and must not leave the house. Japanese women know it as “sango no hidachi” and Korean women as “sanhujori”, which means “recovery after childbirth”.
In Latin American countries it is called “la cuarentena”, in German: “forty days”. In India it is called “jaappa” (also translated japa), in Pakistan “sawa mahina”, meaning “five weeks”. In the Persian culture it is called “chilla”, which means “forty days”.
Breathing exercises for body and soul
No matter which traditions and rituals women follow after giving birth, it is probably uniform that they must not overexert their bodies so soon after.
Now it is important to support the regression of the uterus, stimulate the weekly flow, stimulate thepelvic floor musclesand activate the abdominal muscles. In addition, the soul must first get used to “being a mother” or perhaps “being a multiple mother”.
I actually felt like I was in a soap bubble, had no emotions at times and just functioned. Then again I felt pure happiness, coupled with fears as to whether I was up to this role.
In short: It is a special time and the fewer nagging questions circulate around in the head, the more energy the body has for everything it has to do.
What really helped me were meditations and breathing exercises, which on the one hand stimulated the pelvic floor and the abdominal muscles and on the other hand promoted my personal well-being. In addition to “breath work”, a few very simple movements that midwives often do with you at home in the first few days after birth also help.
Gentle gymnastics for regression
Many are not aware that in the first weeks after birth, very gentle mommy exercises can speed up healing. No wonder, with all the advice and half-truths, I would have been completely insecure myself if I hadn’t already gathered a team of experts to develop my app fitness courses for pregnant women and mothers to develop the optimal courses for exactly this time.
Too much and wrong gymnastics can be harmful, but too little too! For the sports freaks: This does not mean that you have the free ticket for challenging workouts in the first weeks and months – these are absolutely taboo, no matter how fit you were before.
Even if you feel relatively fit again after a few weeks, you can overpromote your body and will feel the consequences months later. This manifests itself in a variety of ways, ranging from mental depression to total physical exhaustion.
Such effects can be long-lasting and very uncomfortable for you, your baby and everyone involved. Therefore, do yourself the favor and take the necessary time to regenerate.
Exercises for postnatal phase 0
It is customary for midwives or physiotherapists in clinics to start their first gymnastic exercises just one day after birth – two to three days later in the case of caesarean sections. These help to stimulate your blood circulation and thus support and accelerate the regeneration process.
You can do all exercises sitting and lying down in bed, which means that even in cultures where you should not leave bed and house, these exercises would often not be taboo, but are even advocated.
1. Pelvic floor and abdominal breathing
The abdominal muscles are directly linked to the pelvic floor and many breathing exercises activate both abdominal and pelvic floor muscles.
Breathing exercise:
- Sitting upright cross-legged or on a meditation cushion.
- The vertex pulls upwards, while the pubic and coccyx gently press down into the ground.
- Inhale through the nose, bulge your stomach: It may and should be really round, just do not pull in the belly now.
- Exhalation: closing body orifices and vllt. imagine that you are pulling something, such as a tampon, inwards. Even if you don’t feel it again, you’re causing the pelvic floor to slowly tense up again.
- At the next exhalation you bring the sitbone humps to each other and towards the coccyx.
- For the third breath you pull belly button and coccyx upwards inwards.
- When inhaling through the nose, please relax the pelvic floor completely.
More advanced, you can try to keep the layers tense until all three pelvic floor layers are tense. Only then do you relax completely at the next inhaler.
Especially the static holding of tension also affects the abdominal muscles.
2. Postural exercises
In addition to breathing exercises, I recommend working with posture exercises, as an upright posture also has inseparable from the pelvic floor and the abdominal muscles.
On all fours:
- Come into the quadruped stand.
- Vertex pulls forward, while pubic and coccyx gently pull backwards.
- Lift one knee slightly off the floor and make tiny circular movements – inhaling and exhaling deeply.
- Pull the navel and coccyx upwards inwards, then relax again and take two or three such deep breaths again.
- Now switch sides.
3. Vein gymnastics
This gymnastics helps with complaints such as swollen feet, because the gentle circling of the feet activates the venous and lymph flow and thus transports excess water.
Vein pump:
- You lie on your back and have your feet upright.
- From here you bring one foot up, the leg is stretched.
- Circle the foot in one direction for one breath, then in the other direction for the next inhale/exhale.
- Drop down and change sides.
4. Gentle stretching exercises
Stretching your upper body raises awareness of relieving the shoulders. These exercises help in particular against possible postural damage due to frequent prevention when breastfeeding, changing diapers and weighing the child.
Triangular strain:
- Sit upright, like to sit cross-legged on a cushion – depending on how comfortable it is for you.
- The vertex pulls upwards, while the pubic and coccyx gently press down towards the ground.
- You fold your hands over your head.
- Elbows press backwards, shoulder blades contract.
- From here, pull one elbow to the side, while the other points as straight as possible in the air.
- In this posture, pull the elbows as far apart as possible and hold three to five deep breaths, then change sides.
As you can see, in the postpartum phase, which I like to call “postnatal phase 0”, the smallest impulses are enough to achieve great effects in your body.
I myself would not have believed before how effective individual breathing exercises, leg movements and upper body stretches can be.
Walks: Getting the circulation going
A midwife personally recommended that I stay in bed for a week. Others, however, already recommend, depending on the condition, to take 15-minute walks from the first day after birth, as long as the birth injuries allow.
I followed the latter and was able to enjoy a short walk in the sunshine on the beach of Santa Monica just two days after the birth. Now, not everyone may be lucky enough to give birth in sunny California, but short walks, wrapped up warmly, make sense as long as your doctor says nothing to the contrary.
Fresh air also strengthens your defenses and does your body good. And if it’s only five minutes, it helps to get your circulation going.
If such walks are not for you, then you should definitely do the gentle breathing and gymnastic exercises for the first weeks after birth.
Vaginal birth vs. caesarean section
Both a vaginal birth and a caesarean section are referred to as an average of six weeks of postpartum phase. This period varies depending on birth injuries, predispositions, and behavior during this time.
Even though you may not really feel the pelvic floor after a vaginal birth, small exercises help to stimulate it gently.
After an abdominal birth, or rather known as a caesarean section, the regeneration of the pelvic floor seems secondary at first, as the child takes your full attention. But even with a caesarean section, your pelvic floor was extremely stressed and stretched by pregnancy, so that even a mother with a caesarean section should do the exercises for pelvic floor stimulation.
Otherwise, you will be reminded for many months, years or even throughout your life when sneezing, coughing, laughing and jumping that you have not paid sufficient attention to your pelvic floor.
Other postnatal phases
After about six weeks, you will have the official “okay” of your doctor and can now start with the postnatal training. That’s why I like to call this phase postnatal phase 1, because now your fitness training begins tailored to your body.
Now is also generally the best time for a regression course. Of course, the exact timing can vary depending on your predisposition, personal condition and birth injuries.
You have completed the regression phase – if it has been consistently adhered to with regular small training – about three months after birth. This is the end of the so-called fourth trimester and most postnatal fitness programs end here.
Many mothers can probably agree with me that you are far from fully recovered. And I’m not talking about the excess baby pounds that often don’t want to say goodbye.
According to theSport University Cologne,you should always start with postnatal training under the targeted guidance of specialized midwives or physiotherapists and give the pelvic floor a period of six to nine months for regeneration until it reaches full capacity.
How long does the regression take?
The same applies to the well-being of your entire body and soul. It is not for nothing that there is a general assumption that the body’s recovery takes another 40 weeks, i.e. the same time as your body needed for pregnancy.
This has also led me personally to divide postnatal training into phases 0 to 4 and to develop it for another 40 weeks after birth.
The postnatal courses are part of this, which of course relate in particular to healing and strengthening the pelvic floor, abdomen and body center in general – but overall are not sufficient to reach a pre-pregnancy fitness level. Body and soul simply need longer!
Beware of yoga and Pilates
For the first weeks after birth, your postpartum period, I recommend midwife-proven exercises for exactly this time. These weeks are not the time for sporting experiments. And that also means that yoga and Pilates are basically taboo.
Yoga and exercises from Pilates are then a great way to strengthen the muscles, the whole body and especially the core of the body with the beginning of the regression. But not all yoga is the same and an extremely experienced yogi knows that yoga exercises can be very challenging.
With the official okay of your doctor, suitable yoga and Pilates exercises are suitable to strengthen your powerhouse, the core of your body. However, these exercises should be clarified with an expert.
Conclusion: Take time for yourself – with patience and discipline
In the puerperium, self-care should be the top priority. That alone will be challenging enough, because a newborn baby demands your full attention and leaves you hardly any time to take care of yourself.
But only if your body and soul also get time for recovery and regeneration, you will be ready with full energy and joy for yourself, your baby and everything that comes.
Even during this time, it takes all the more patience and discipline to move and incorporate the small but fine gymnastic exercises into everyday life. If you also plan short walks in the fresh air, you will create the best conditions for a quick recovery.
Next time it will be about the classic postnatal phase 1, as I personally like to call it.
Until then, I say goodbye as usual with the words: Keep it Moving – even if in this case much more cautiously than usual.