Part Two: Post-Partum Exercise

Behaviour change before and during pregnancy has been known to be a major impact on a women’s health for the rest of her life. Most women prior to falling pregnant will opt to change their health for the better, whether that means changing diet, starting an exercise regime, meditation or supplementation. This will allow the soon-to-be mother to be at her optimum health prior to conception then following that throughout the post-partum experience. This blog is following on from my previous article on exercising while pregnant - hopefully that inspired a few women to maintain or begin an exercise regime through pregnancy. This article touches on post-partum exercising and things to consider once you have given birth.

Exercising

Many of the physiological responses your body experienced during pregnancy can follow on anywhere up to 4-6 weeks post-partum; with this said exercise regimes should be gradually reincorporated into your daily routine. This is similar to any other deconditioning phase of an exercise program; you have to ease back into your program. Everyone’s return to activity will differ; some women will be able to return to some form of exercise within days of delivery however, others may take longer for their body to recovery and to be medically cleared for exercise.

Breast feeding

Many women chose to breastfeed their new born - breastfeeding isn’t as easy. Some handy tips for women who are breast feeding and exercising:

- Nursing prior to exercise to avoid discomfort with inflamed breast tissues.

- It avoids the potential problems related to an increase acidity of the milk due to build-up of lactic acid.

- Moderated exercise during lactation does not affect the quantity or composition of the breast milk and will not impact the infant growth.

Urinary Incontinence

Women who exercise post pregnancy may sometime report of wetting themselves during impact exercises. Urinary incontinence has been found to rise during pregnancy and decrease post-partum, however, it still is a very common concern. Pressure from the growing foetus may cause incontinence during gestation, with weak pelvic floor muscles being the main culprit post-partum. To help avoid these unpleasant situations complete simple pelvic floor exercises both during and post pregnancy to help reduce your chances of developing incontinence problems.

Post natal depression

Post-natal depression (PND) affects about 10-15% of women after giving birth in their first year of motherhood. The research has shown that women that suffer from PND are more likely to suffer from general depressive symptoms later in life. Exercise is used widely in the general depressive population, and has been proven to work well as an intervention or in conjunction with other interventions i.e. social support, medications and counselling. Exercise following child birth should only be attempted with medical clearance and professional advice.

Rectus diastasis (separation of the rectus abdominis or “six pack” muscles)

Rectus diastasis is the separation of the linea alba (the sheath of fascia that connects both sides of the rectus abdominis). This can occur during pregnancy or post-partum and most commonly found in the umbilicus region. A study published in the Journal of Women’s Health Physical therapy in December 2012 has shown that women who complete specific transverse abdominis (TA) exercises reported less pain with a diagnosed rectus diastasis. Ninety percent of non-exercising pregnant women develop rectus diastasis while only 12.5% of exercising women had the condition.

References:

http://bjsm.bmj.com/content/37/1/6.full https://www.sciencedirect.com/science/article/pii/S1356689X14001817https://journals.lww.com/jwhpt/Fulltext/2005/29010/The_Effects_of_an_Exercise_Program_on_Diastasis.3.aspx https://watermark.silverchair.com/cmn101.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAAacwggGjBgkqhkiG9w0BBwagggGUMIIBkAIBADCCAYkGCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQMdq_1i3kYbnmTWW9VAgEQgIIBWqgYWfRNfL0N3uJMyd0pWAYYUM57w2KmlshAwZa3gWeHTlMaHjF-hptSTNj9-Z77z_kx3U2roqHcRNUQweVWB5Ow4D8utup5oqQvHxXRE3AeeySTzptEk869ceV4roUJLwo7kc0PW3sLZnCSXKsYCl_D_XPmwKy8RnfHGUnkmIBa3zFsx1-SnMNLFr5sEycy1MnzetRpDVQ5Ngcn52EPb4LL1HycslwV5lzqzHJ0_XauuByLPKc2_JOfubp6BeFH5ABsltXdsmjwT6uL7fqLeAHrLA058mZUuAPro1KVvW5WCF8j_fMtnVwGSzdL_WUsU-cmtGTzeG1xBN6TWKQdRt_q0b55ZpawkolznoJqHLJ_MHARfIsIk4oJR-67dDwWh53rEMgDs18m0GMzrehBEfRL_9Shok_zs0fdIiuEOTYss5RgQ0OwdsigKtNfttNwgYgf5kpbw-OhLLQ https://link.springer.com/article/10.1007/s001920050067 http://europepmc.org/abstract/med/12806453 https://journals.lww.com/jwhpt/Abstract/2012/09000/Diastasis_Recti_Abdominis___A_Survey_of_Women_s.4.aspx