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Postpartum and Physical Changes
Some of the most common physical changes that occur after having a baby make it especially difficult to start exercising. They are:
Lochia, or bloody vaginal discharge after birth, will start to disappear after several weeks. It is very common for the bleeding to stop and start intermittently during this time. Vaginal bleeding after a cesarean birth will usually be less than after a vaginal birth.
After giving birth, your uterus is still undergoing a series of changes in order to get back to its original size. The uterus shrinks from approximately the size of a basketball during pregnancy, to the size of a grapefruit after delivery, to the size of a pear six weeks postpartum. You will have a sensation similar to contractions, although not as painful. Breast-feeding may make these contractions worse, as the baby’s sucking releases a hormone called oxytocin that contracts the uterus. These contractions should disappear after a couple of weeks. Lying on your stomach may help with the pain (unless you’ve had a C-section), as may keeping your bladder empty.
When your milk supply comes in, two to four days after delivery, your breasts may become painful and firm. Fullness is a result of an increase in blood flow, which prepares your breasts for increased milk production. If you are not breast-feeding, the pain and swelling may subside within a few days. Snug-fitting bras may help; try to avoid getting warm water directly on your breasts, as this may increase milk production. If you are breast-feeding, frequent nursing will help keep your breasts soft. It may take a few days to get on a schedule with your baby to prevent engorgement. Using a breast pump to release a little breast milk may help, as may applying ice several times a day.
Pain When Urinating
Since the bladder and urethra are next to the bruised birth canal, difficulty urinating is common for new moms. If you were under anesthesia during a C-section, you may also have problems urinating. Drinking water immediately after delivery will help. Be sure to soak your bottom in warm water to promote healing.
If you’ve had an episiotomy, good hygiene is essential during healing. Soaking in warm water three to four times a day will help soothe the soreness. Ice packs are recommended until the swelling is gone. A mild pain reliever or medication prescribed by your doctor will also help.
You may be sore and swollen in this area after birth. Keeping the perineum clean with soap and water will encourage healing.
Hemorrhoids can develop due to the weight and the pressure of the baby, from the force of pushing during labor, and from constipation. Taking a hot bath three to four times a day, applying cold packs containing witch hazel, and sleeping on your side to take pressure off the veins of the rectum may help.
All new mothers experience some fatigue postpartum, whether they exercised throughout pregnancy or not. This may last for weeks, as your body tries to recover from the marathon that is pregnancy. Exercise will help (see suggestions in Part 2); however, recognize that your body has gone through a lot of changes. Give yourself time—and a break!
Physical Changes Due to Hormones Levels
After birth, your hormones continue to shift. These are common symptoms as your hormones stabilize:
The American College of Obstetricians and Gynecologists reminds new moms that many of the physical changes that took place during pregnancy will persist four to six weeks after giving birth.
So, with all of these things going on at the same time, just how does a new mom begin to exercise? Gradually! During my career as a personal trainer, I’ve advised many women just how to get started during this crucial time. Getting rid of that “bundle of fat” may not be easy, nor may it be on your top-ten list. The first thing I say to my anxious clients is “Relax, don’t worry, and get started!” Now is the time to investigate an exercise program to get back into pre-pregnancy form—not only for the moms who stayed fit and active during pregnancy, not only for the moms who are exercise beginners, but also for the moms who have children already and have not been able to lose the weight from their last pregnancy.
Now that you’ve had your baby, exercise and good nutrition are the keys to returning to your pre-pregnancy shape. The longer you wait to exercise after you’ve had your baby, the longer it will take to drop the extra weight gained during pregnancy. For those who remained active for the whole nine months, great! It will be that much easier to shed the weight. However, also know that you may not be able to pick up where you left off. Start slowly, and ease into an exercise routine. If you’ve just started exercising, good for you. However, keep it manageable and start slowly. Ten minutes a day may be enough in the beginning. Remember, as with any exercise program, consult your doctor before starting.
Good nutrition and eating habits are also imperative for shedding the excess pounds after having a baby. Breast-feeding and non-breast-feeding moms will have different nutritional needs; however, the term “dieting” should be removed from the vocabulary of all moms. This book will give nutritional tips and suggestions for moms, whether breast-feeding or not.
Recovery after pregnancy can take a long time. All bodies are different; some women can take longer than others to return to their pre-pregnancy shape. I tell all of my clients to give themselves a year to regain their bodies. Exercise should not be put on the back burner, however, as it is a crucial component in getting on the road to recovery. A balanced, safe, goal-oriented exercise program can help women get back their strength as well as tone and tighten muscles that were stretched during pregnancy. Generally, if you were active during pregnancy, you can resume a light workout a few days after your delivery. If you had a cesarean section, you will need more time to heal. If you’re a newcomer to fitness, you’ll need to start exercising more slowly.
Weight Gain/Loss After Pregnancy
The average weight gain during pregnancy is twenty-five to thirty-five pounds. During birth, moms lose about twelve to fifteen pounds, leaving about thirteen to twenty pounds of excess weight to lose in the postnatal period. This is when it gets tough. The last extra pounds can be hard to get rid of. However, there’s good news: The consistent, safe exercise program described in this book can help you do that.
Research has indicated that women who begin to exercise right after (uncomplicated) delivery tend to lose more weight in the first six weeks than mothers who do not exercise then. Only about 35 percent of women exercise after giving birth. Studies indicate that if you worked out during pregnancy, you will tend to start exercising right after delivery.
Some women are concerned that exercise may impact their ability to breast-feed. No research supports that notion. Your body will tell you how active to be.
Not only do new moms have to deal with shedding excess weight gain, but the physical demands of motherhood take a toll on the body. New moms have to deal with lifting and carrying their baby and heavy diaper bags, strollers, and car seats, which can leave them vulnerable to pain and injury. This book will suggest techniques for strengthening those affected muscle groups, such as the lower-back and abdominal areas. The core muscle groups are areas of the body that should not be overlooked after delivery. Strengthening them helps restore the body to optimal functioning and helps prepare women for the many physical demands of motherhood.
Throughout the years, I have discovered a pattern to the concerns and questions new moms have about exercise. Most women are reluctant to start exercise programs right after having a baby. Here are the top-ten frequently asked questions of the postpartum mom:
1.QUESTION: How long will it take for me to get back to my pre-pregnancy figure?
ANSWER: First, accept the fact that you will have gained an extra few pounds after you’ve given birth. But then just take one look at your sleeping baby and you will be reminded that gaining and losing the weight is worth it. Generally, it takes up to six months to a year to lose the remaining weight. We all know of women who have bounced back after two weeks. They appear just as fit as they were before pregnancy. This is not the norm. Your goal should be to lose two to four pounds a month. You may lose less if you are breast-feeding.
2.QUESTION: I’ve heard that losing weight while nursing is not recommended. Is this true?
ANSWER: Losing more than four pounds a week is not encouraged while you’re breast-feeding. The body stores toxins in fat, and if you lose weight too quickly, there is a possibility that the toxins will enter your breast milk. Also, burning a large number of calories in a short period of time may affect your milk production. Gradual weight loss, combined with exercise, is the recommended course of action.
3.QUESTION: Is it safe to exercise with weights after having a baby?
ANSWER: Strength training (using weights or your own body weight) is an excellent way to tone muscle groups that were weakened during pregnancy and labor. Later in the book I will discuss the benefits of core strength training, or strengthening of the abdominal muscles and lower back.
4.QUESTION: When can I start exercising after I’ve had my baby?
ANSWER: Good news! Years ago, exercise during pregnancy was discouraged and not recommended until six months after birth. Times have changed. The American College of Obstetricians and Gynecologists recently reversed those recommendations and now say it’s okay to start exercising right away, as long as you feel up to it and get the approval of your doctor. Exercise actually promotes healing. If you’ve had a cesarean section, you will have to wait a bit longer to start your exercise program, as your incision will need to heal. If you were lucky enough to exercise right up to giving birth and had a normal vaginal delivery, you can probably start light exercise days afterward.
5.QUESTION: How do I know if I’m exercising too soon or too much?
ANSWER: Women experience a bloody vaginal discharge called lochia during the first few weeks after delivery. This is normal; however, if the flow becomes redder and heavier, this may be a sign that you’re trying to do too much, too soon. Stop exercising and notify your doctor.
It is important to listen to your body. If you’re finding yourself extremely fatigued, it may be too soon for exercise, or you may be working out too hard.
6.QUESTION: Is biking safe during my postpartum recovery?
ANSWER: That really depends on the type of delivery you had. If you had some tissue damage during delivery or an episiotomy (stitches to repair tearing of the vagina), you may need more time to heal. Biking is not recommended immediately following a C-section; you will have to let your incision heal before including it in your exercise plan. Doughnut seats are recommended to relieve pressure if you find yourself sensitive when riding a bike.
7.QUESTION: What is the best way to lose weight postpartum?
ANSWER: Practicing good eating habits and getting a balanced workout, one that includes cardiovascular exercise and strength training, with obtainable goals, are the best ways to lose weight safely and effectively. Walking, swimming, biking, and jogging (when your doctor says its okay) are great forms of aerobic exercise. Light resistance training will help build strength and restore tone.
Listen to your body; it will tell you when to lengthen your workouts. In the beginning, the luxurious forty-five-minute workout may be a distant memory.
8.QUESTION: Are genetics a factor when trying to get back into pre-pregnancy shape?
ANSWER: Yes! How easily you get your old body back depends on many things, including genetics, how much you exercised during pregnancy, and whether you had complications during pregnancy and delivery. Everyone has a certain body type, and you should work with what you have. Don’t compare yourself with pictures in a magazine or with your friends. It took nine months to have your baby; give yourself that much time to get back into shape.
9.QUESTION: Does it matter if I work out before I breast-feed?
ANSWER: Always try to exercise after nursing your baby so your breasts won’t feel uncomfortable and full. Try to avoid exercises that make your breasts sore and tender.
10.QUESTION: How do I get rid of stretch marks?
ANSWER: Stretch marks are a result of rapid weight gain and are common during pregnancy. This stretching of the skin results in red or purple lines across the lower stomach, thighs, or breasts during pregnancy. Stretch marks are permanent, but they become less noticeable once the weight is lost and the skin shrinks back to normal. Usually stretch marks are genetic, and some women have the misfortune of getting more than others. Even though stretch marks are inevitable for some, keeping the skin moist and eating well are some of the best ways to prevent them and help make them less noticeable.
From the Trade Paperback edition.