Returning to Walking Postpartum
Q: Walking is one of the best forms of exercise after pregnancy. Women want to know; when can I begin exercising after delivery, and what can I do?
A: First, all new mothers should listen to their bodies. The message women receive from the media is that you should feel “back to normal” in six weeks. Absolutely nothing could be farther from the truth. Women are under so much pressure to “get their bodies back” that they are exercising for all of the wrong reasons. It takes the body nine months to create a baby, shouldn’t we give our bodies at least that much time to recover? Make sure you return to exercise when you feel physically and mentally ready, and not because of societal pressures.
Exercising as soon as possible after delivery is best. It helps relieve stress, boost energy, and stabilize mood. Exercise after pregnancy also helps alleviate postpartum depression. The increased serotonin and endorphins help the body and mind cope with the demands of new motherhood.
Walking is the best, safest, and easiest form of exercise for new mothers. It gets you out of the house, you can bring the baby, and it requires no special equipment. For a woman who had an uncomplicated vaginal delivery, walking can begin within a few days of the birth. Mothers with a cesarean birth, or significant perineal tearing, benefit from the increased circulation from walking, but should allow more time for their bodies to heal.
To begin your walking program, make sure you have comfortable supportive shoes. Wear a comfortable bra that offers good support and try to nurse the baby before you go to avoid feeling overly full. To cope with leakage, wool nursing pads help keep your nipples more comfortable during workouts than cotton or disposables. Wool’s natural fibers allow skin to breathe, and wicks moisture away from your skin, keeping it dry. Pads that retain moisture when wet, such as cotton, cause nipple irritation and can promote yeast overgrowth.
Another helpful product for new mothers returning to walking is an abdominal binder. This is a wide elastic support that wraps around the tummy. It supports the abdominal muscles that have stretched out and may have separated during pregnancy. Also, it reduces bloating, supports the abdomen, and gives additional support to the legs and back. Wearing such a support while walking will help new moms feel more comfortable, and is crucial for anyone who has had a cesarean birth. If you are planning on bringing baby, make sure you have a comfortable carrier, or stroller that you can push without stooping forward. If you have had sutures, walk with a stroller rather than a front pack or sling, which can increase abdominal pressure and cause discomfort.
Initially begin your walking routine by trying to walk for a short time. Start with 10-to-15 minutes daily. Slowly increase the amount of time walked by five minutes, building up to where you can walk for 30 minutes a day without undo fatigue. The most important thing to remember is to listen to your body. If you were very active through your entire pregnancy, you will probably be able to walk longer distances initially.
Women are tired in the first months after having a baby. This can be due to interrupted sleep, the extra demands of motherhood, and breast-feeding. It is important to listen to your body and how you are feeling. Due to fatigue, you are more likely to become injured if you push yourself too much during exercise. In the first months postpartum, mom’s joints and ligaments are still under the effects of relaxing. This hormone keeps joints lax and can lead to injury. Too much physical activity during the first few weeks after delivery can also cause your vaginal flow, called lochia, to become pink or red and to flow more heavily. This is a signal to slow down. Notify your doctor or midwife if vaginal bleeding or lochia increases, restarts after you thought it had stopped, or if you experience any pain when you exercise. This is not the time to “push through the pain.”
The most common complaint from new mothers returning to exercise is stress incontinence. They are told it is normal to have some urine leakage when coughing, sneezing, or exercising and are prescribed Kegel exercises to restore pelvic muscle tone. If you have been doing your pelvic floor exercises properly and are still having issues two months after delivery, this is very common. However, it is not normal!
Many women deal with postpartum stress incontinence and pain from cesarean and perineal sutures. They are told, and hope it will eventually go away. In my practice, it is the number one barrier to new mothers resuming regular exercise. I have treated many women who put up with pelvic pain or stress incontinence for years and we are often able to resolve it within 4-6 weeks. They didn’t realize that it wasn’t normal and were told that it would go away; they were too embarrassed to come in for treatment and just hoped that the problem would go away by itself. Many women don’t know that non-drug, non-surgical manual therapy treatment is available. Seeking out treatment from a provider who specializes in conservative, non-surgical pelvic care can speed healing time and resolve most pelvic pain and stress incontinence issues.
A regular walking routine will help a mother physically and emotionally cope with all the demands of new motherhood. If you are a new mother, try to connect with other moms and form a walking group. If you know a new mother, do her a favor and invite her out of for a walk.
— Michelle Gerbi
This Issue’s Expert
Michelle Gerbi, DC, is a chiropractic physician at Clearwater Clinic with a practice focusing on the needs of pregnant women, post partum pelvic pain and infant care. She can be reached at 503-279-0205. |
