By Dr. Abby
Pelvic Rest is an important part of postpartum recovery. No matter how your birth went, cesarean or vaginal, it is important to give yourself this time to rest and heal because you’re also recovering from the pregnancy and all the changes your body went through the last 9-10 months. You may feel really good in 1 or 2 weeks post birth, however, you need to prioritize rest and slowly reintroduce activity and exercise. So how do you know what is too much?
There’s an old saying: “2 weeks in bed, 2 weeks around the house, 2 weeks around the community.” Now, you don’t need to be strict about this, but try to follow it as a general guideline. In some cultures, women have a confinement period after birth for 40 days, so that their healing and bonding with the baby can be prioritized.
The main reason is your uterus is healing. There’s a placenta sized wound on your uterus that your body is still pumping blood to until it scabs over, which is the reason for postpartum bleeding. This can heal in 2-4 weeks just like scars and scabs on other body parts heal. You may notice if you have an overly active day that your bleeding worsens or starts again if it had stopped and this is a sign you overdid it.
For the first 1-2 weeks, walk for 5 min continuously around your house. If you have to go out for appointments, make sure you have someone with you to carry the car seat, bags etc
By the 3rd week, you can increase your walk to 15 minutes. Increase by 5 minutes each week after to work up to 30 minutes by about 6 weeks postpartum.
Your abdominal and pelvic floor muscles are healing too. These are key components of your core health. Other initial exercises to focus on in the first 6 weeks:
Gentle, deep abdominal belly breathing
Now on an exhale, add gentle activation of deepest abdominal muscle called the transverse abdominus. Think “ bring pubic bone to belly button”, “belly back”, “flattening of the belly”, gently drawing your belly button toward your spine.
Next, add a gentle pelvic floor muscle contraction (Kegel), and do all three muscles at the same time.
Imagine you are zipping up a tight pair of pants
Do 5-10 repetitions a few times when you are feeding your baby throughout the day.
Ideally, try to coordinate a PT evaluation around the same time as your 6 week postpartum follow up with your OB. This should be with a PT who had specialized training in pregnancy, postpartum and pelvic health. You do not have to wait until your 6 week visit to schedule a PT appointment. At this appointment your PT can help you progress your activity level, discuss your goals for returning fully to exercise, sex, and address any other issues you may be experiencing related to bladder and bowel function or pain. Fortunately, Milwaukee has many excellent pelvic health PTs.