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Pelvic Health After Birth
Pregnancy and childbirth cause a lot of physical and emotional changes. You may have been able to maintain or improve your fitness during pregnancy or it may have been more difficult for you. You may have had a straightforward birth and recovered quickly, or it may have been more complicated and taken longer.
After your baby is born it will take some time for your body to recover. It is important not to put pressure on yourself. Whatever your birth experience, getting to know your new baby/babies and resting when you can is important.
The pelvic health physiotherapy team in Suffolk and north east Essex have produced this postnatal information video which provides advice and strategies for the postnatal period and answers to any questions you may have.
Returning to exercise
When you feel ready, beginning very gentle exercise at your own pace is good for your physical and mental health.
Most women can gradually increase their exercise and build up their fitness over time, getting stronger and helping to prevent health problems in the future. Our physiotherapists have created a series post birth exercise videos to help aid your recovery at home.
Post-natal Exercise Class A: Warm up and Posture Education
Post-natal Exercise Class B: Pelvic Floor and Core Strengthening
Post-natal Exercise Class C: Cardio, Stretches & Relaxation
Post-natal Exercise Class D: Relaxation
Recovery Advice After Birth
Bladder Care
During labour and after birth it is recommended you:
Have a wee regularly every 2-3 hours. If you have any concerns please speak to your midwife.
Drink small amounts of water regularly rather than having a large amount all at once.
After birth:
You should have managed to wee within the first 3-4 hours after giving birth, or once you have had your catheter removed. It is important that the first time you wee is measured by the midwife.
Sit on the toilet seat and relax. It may help to run some water or gently tap with your fingers over the bladder area.
Some have difficulty fully emptying their bladder after giving birth, which can lead to long-term issues if not identified. In this case, your healthcare provider might recommend you have a catheter for a short period of time to allow your bladder to rest and recover.
It is important to tell your midwife if:
- The sensation of wanting to have a wee is reduced. You can set a reminder to try every 2-3 hours to help with this.
- If you can wee but have difficulty emptying your bladder.
- If you have not been able to wee for 4 hours after birth or catheter removal.
- If you have been leaking wee, particularly when standing or moving around.
This video explains more about bladder care in the first week post birth.
Pain Management and Wound Care
Pain and swelling around your vagina is common for up to 7 days after birth.
Taking regular pain medication or placing a cold pack or maternity pad between layers of underwear for periods of 10-15 minutes may help with this.
You may find some positions more comfortable than others, for example lying on your side with a pillow between your legs, or when sitting placing a rolled up towel in a ‘U’ shape under your thighs.
If you have a caesarean wound, support it when getting in and out of bed, coughing or when having a poo, by using a rolled towel to apply gentle pressure. You may also find it more comfortable to get out of bed by rolling onto your side first and using your arms to push up. It’s also helpful to gently massage your scar once it has fully healed.
It’s important to keep stitches after either vaginal or caesarean birth clean and dry.
Avoid long, hot baths in the first two weeks. Only have short baths or showers.
You should also avoid using any soaps or perfumed products directly on the area. Plain water is best. Pat the area dry rather than rubbing.
If you notice any signs of infection like a foul smelling discharge, excessive itching, increasing pain or swelling, you should contact your midwife or GP.
It is safe to return to sex approximately six weeks after birth as long as the wound has healed, although you should only return to sex when you feel ready. It can be helpful to use a water based lubricant.
This video explains more about pain management and wound care
Posture and Positioning Following Birth
Following birth: it’s important to look after your back.
When changing your baby’s nappy try to use a surface at waist height. If you are using the floor or a bed to bath or change your baby, then kneel down. This will prevent you stooping.
When feeding your baby use a chair with good support or sit well in the bed. If breastfeeding, bring the baby to your breast and use pillows so that you are not bending forward. If sitting in a chair, make sure your feet are well supported on the floor and the baby is well supported and can’t fall.
Pelvic Floor Exercises
It is recommended to do daily pelvic floor exercises during pregnancy and after birth. This will help prevent symptoms of Pelvic Floor Dysfunction such as bladder and bowel leakage or prolapse.
Your Stomach Muscles
Your stomach muscles run from the bottom of your ribcage up to your pubic bone and are connected by ligaments.
These ligaments increase in width during pregnancy to accommodate your growing baby. They may remain stretched and weak for some time after birth.
You may get the feeling of a gap between your stomach muscles. For most people, this will improve within 6 weeks after birth.
However, if after six weeks you can fit more than two fingers in-between the stomach muscles and you experience a visible bulge, especially when going from lying to sitting, this is called ‘diastasis recti’ of the abdominal muscles.
If you have diastasis recti of the abdominal muscles you should take care to reduce the bulging of your abdominal muscles when moving, lifting or carrying heavy objects or when exercising.
- Avoid sit-ups and abdominal exercises that make the abdominal muscles bulge.
- Avoid straining with constipation.
- When getting in and out of bed roll on to your side first and push through your hands.
- Start gentle core – core-strengthening exercises
Should these symptoms continue beyond six weeks after birth you can self-refer to physiotherapy for support.
This video explains more about your stomach muscles post birth
Take A Look At The ‘Fit for the Future’ Booklet
Acknowledgments:
- The content of these pelvic health web pages has been adapted from the Norfolk & Waveney NHS Integrated Care System (Just One Norfolk) who have kindly given permission for this.
- Some of the video content on our pelvic health web pages is from the MyHealthLondon team, who have kindly given permission for us to share. The London Maternity Clinical Network worked in collaboration with Imperial College Healthcare Trust, alongside service-user representatives, Maternity Voices Partnership and other NHS professionals to create a series of videos about the changes of the body before, during and after birth and will provide information and useful advice about supporting your body’s journey through pregnancy and beyond.