The Physiotherapist wants to see me at six weeks post-natal, what can I do before this to help my recovery?

Baby and mum

Giving birth can be an exciting and overwhelming time and leave you with questions about your postnatal recovery. Generally, it is six weeks before your doctor and/or physiotherapist will see for your review to answer your questions and address concerns.

To help with the time in between, we have put together some handy tips to get your recovery started before you see your professional for your six-week review.

Ice & compression:

  • Following a vaginal delivery or attempted vaginal birth the outside of your vaginal (vulva) may be swollen/bruised and sore. Ice can help with this. We recommend you use ice in your pads for 20-30 minutes every 2-3hours.
  • HANDY tip: fill period pads with water and freeze for a convenient ice pack or order “perineum ice packs” prior to giving birth
  • Firm supportive underwear will help support the perineum and lower abdominal and reduce pain and discomfort in those first few weeks after giving birth. Control briefs/high rise briefs or high-rise exercise tights will do the job. Just remember these should only be used in the first few weeks of giving birth to give you extra support, after this time we want your abdominal muscles to support you.

Guidelines for lifting:

  • Do not lift anything heavier than your baby for the first six weeks
  • No heavy housework (vacuuming, mopping, lifting grocery bags) until approximately 12 weeks postnatal. Your physiotherapist will access your core and pelvic floor strength and work out an individual exercise program for you to slowly return to these activities at the 6-week checkup.
  • No running or vigorous exercise (including weight training)- we need to make sure your abdominal and pelvic floor strength are sufficient to support you to avoid future injuries.
  • No crunches or sit-ups, especially if you have had a cesarean.
  • Avoid sudden and repetitive bending and twisting movements.

Supportive positions:

  • Getting in and out of bed with the log roll- Sit on the edge on your bed and then lean onto your elbow and at the same time lift both legs onto the bed. From this position, you can roll onto your back. For getting out of bed it is the opposite.
  • Make sure your working surfaces are at waist height (e.g. bathing & changing the baby).
  • Create a supportive position for feeding. If sitting, place your bottom back in the chair, make sure your feet and arms are supported while you feed.

Good bladder and bowel habits:

  • It is important to avoid constipation and stressing/straining when you are on the toilet.
  • Drink between 1.5L-2L (3L if you are breastfeeding) of fluid each day
  • Water is preferable but tea/coffee/juice is included in your total fluids
  • Avoid drinking too much caffeine and alcohol.
  • Eat plenty of high fibre foods (e.g. fruits, vegetables)
  • Don’t ignore urges to use your bladder or bowel.

The best toilet position to avoid straining:

  • Try placing your feet on a small stool so your knees are higher than your hips. Lean forward from the hips, resting your elbows on your thighs. Take a few deep breaths to relax your pelvic floor and abdominal muscles before you start.
  • Support any stitches with your hand particularly when opening your bowels

Exercises to start:

  • The pelvic floor muscles are a “sling” like muscle group that attaches to the bottom of your pelvis. Their main job is to control continence and support the pelvic organs (bladder, uterus/womb and rectum). During pregnancy and birth, these muscles are often weakened. It is important to start exercising these muscles straight away to avoid incontinence or prolapse.
  • Squeeze around your back passage and your vagina, like you are trying to stop yourself passing wind or urine, and try to lift the pelvic floor up.
  • Start slowly- 5 x reps of gentle (pain free!) pelvic floor squeezes every time you feed your baby
  • As you feel stronger, try and work both the endurance (long holds) and strength (quick squeezes) of your pelvic floor
  • Long hold: Squeeze and hold for 2–3 seconds while making sure your buttock, abdominal, and thigh muscles are relaxed. Repeat this 10 times for 3 sets, once a day. As you get stronger you may increase the holds up to 10 seconds but do not go past this.
  • Quick squeeze: Tighten the pelvic floor muscles as above, this time holding the exercise for only one second. Make sure you relax completely between repetitions. Try to repeat 10 to 20 quick strong squeezes for 3 repetitions, once a day.

At your Pelvic Health six weekly Postnatal Review

  • Will check any scarring (cesarean or vaginal)
  • Will check and correct your posture breastfeeding/baby holding or carrying
  • Address any continence concerns
  • Mobility assessments
  • Musculoskeletal assessment
  • Rectus abdominal assessment for any separation
  • An optional pelvic floor check (either internal or external, whatever if preferred if safe to complete).
  • Give you advice on resuming sexual intercourse safely
  • Give you advice on good bladder and bowel habits
  • Return to exercise advice and individually tailored exercise program to work towards your goals

Contact Proactive Physiotherapy today and organise your six-week postnatal appointment with one of our Pelvic Physiotherapists on 07 4084 0602.