Postpartum Recovery Get your body back

WELCOME

Welcome! I'm so excited that you chose to let me help you get your body back after pregnancy! Pregnancy is truly an amazing journey from start to finish but it doesn’t end there; now your body is working overtime to regain strength, heal, produce milk and function all through sleep deprivation. This postpartum manual is written to guide through fitness and recovery 72 hours after the delivery of your beautiful baby!

First, let me introduce myself. I, Tabitha Gomes, am a certified personal trainer with a passion for helping women. I've always been fascinated by women's bodies during pregnancy and read as much as I could find pertaining to pregnancy and fitness. Unfortunately this is still an area with not enough information available to help women. Like a fitness nut would, I took what I found and applied it to my pregnancy and my recovery, and along the way I did the best that I could to record my experiences. I must say it was a neat experience and recovery was humbling. For the rest of my life I don't ever think I'll forget what it feels like to be so broken after delivery. Recovery was a long process but I made it out and back to my pre pregnancy state, and fitness level all while nursing. I was determined to get my body back because I planned on another pregnancy a year later. I am excited to share with you the research I've found and the exercises that helped me regain my strength broken down into a simple 3 Phase, 12-week plan.

This plan is meant to begin 72-hours after delivery, exciting right! Many may ask;

"why 72 hours and not 6-weeks?" The definition of exercise does not solely include strenuous activity in fact according to dictionary.com exercise is "bodily or mental exertion, especially for the sake of training or improvement of health"1

Also, according to a study conducted in 2015 72 hour pilates …15 minutes of exercise >>I STILL HAVE MORE TO ADD<<

What happens after 6-weeks?

After the 6 week marker and once you have further consulted your physician on your recovery; you may be able to engage in more strenuous activity. Everyone's recovery timetable, muscle memory, and strength is different so this plan will be focusing on rebuilding and strengthening for the worst case scenario. Don't worry though, if you are recovering quickly there will be recommendations for you as well

What about my breast milk supply?

Your milk supply will be OK since this workout plan will not require you to participate I strenuous activity. Refer to the eating for nursing page for continued guidance on water and food consumption to maintain or increase your breast milk supply

1. <http://www.dictionary.com/browse/exercise>

RELAXIN HORMONE

The Relaxin hormone is the culprit for all things good and bad. This hormone is produced during pregnancy to make your ligaments stretchy and elastic in preparation for childbirth however this hormone does not discriminate 1. Relaxin can stay in your body for up to 6 months postpartum, as a result, your joints may be weaker than usual. High impact exercise can increase the risk of injury for your ankles, knees, hips, pelvis and spine.

For your safety, it's best to avoid high-impact exercises for three to six months after delivery 2. Everyone is different so it's best to listen to your body and try not to over exert yourself.

1. https://www.nct.org.uk/parenting/your-body-after-birth

2. http://www.fitpregnancy.com/exercise/postnatal-workouts/8-steps-easing-back-fitness-routine-after-birth

TRANSVERSE ABDOMINALS

Your transverse abdominis muscle is the deepest of four abdominal muscle layers. It is a thin sheet of muscle fibers that run horizontally on the inside of your torso. These deep muscles extend from the top of your rib cage (the six inner part of your ribs) where they begin to fan out, and wrap around to your lower back, and attach to the top of your hip bones towards your pelvis.

The contraction of the transverse abdominis is like a corset, it narrows and flattens the abdomen and it's primary function is to stabilize the lower back and pelvis. 1

There are several breathing techniques in Pilates lateral breathing is one emphasized overall. Learning the lateral breathing technique will establish good form and enhance the ability to strengthen your inner corset (Transverse Abdominals), shrink your waist, and improve posture. Keeping the abdominal muscles pulled inward and upward and breathing or exercising will feel like an advanced exercise in itself but it will get easier over time.

Zipping up Your Internal Corset:

In this technique you will redirect your breath from your belly or chest into the back of the body and the sides of the rib cage. This is also known as zipping up your corset.

Put your hands on the sides of the body around the rib cage and take a deep breath. You should feel air fill your lungs, your ribs will push your hands outward as you inhale into the sides and back of the body. As you exhale your ribs will contract and your hands will draw back towards each other as your ribs get closer together. Repeat this several times until can feel yourself breathing with your diaphragm and your ribs expanding and contracting. When your ready on the exhale tighten your transverse abdominals pulling your ribs as close together as possible. 2

Next put your hands on the sides of the body around your waist, continue lateral breathing, and focus on your pelvic area and your abdomen below the belly button. When your ready, on the exhale tighten your transverse abdominals by pulling your muscles up and inward. Your belly button will move toward your spine and lengthen your torso, as if you were zipping up a corset.

Finally put your hand on your pelvis or lower abs and continue lateral breathing. When your ready, on the exhale tighten your pelvic floor with a kegal and bring the muscles up and in.

Continue lateral breathing while engaging your entire torso, when the abs are pulled up and in properly, they protect the spine and act like a supportive corset for the whole trunk.

Be sure to zip up your corset before you begin all your abdominal exercises.

1. http://www.physio-pedia.com/Abdominal_Muscle_Anatomy

2. https://www.verywell.com/learn-lateral-breathing-2704659

DIASTASIS RECTI

Sections -COMING SOON

PELVIC FLOOR

You've probably heard a lot about your pelvic floor muscles and the importance of kegels but you might not fully understand why its so important. Your pelvic floor made up of muscles and ligaments at base of your pelvis and connect from your tailbone to your pubic bone and on the sides of your pelvis.

The pelvic floor supports:

• Your bladder, intestines and uterus.

• Maintains bladder and bowel control including when you sneeze, cough or lift heavy objects.

• Plays a vital role, along with other muscles, in supporting your spine.

• Helps you enjoy sex more.1

Although your pelvic floor can stretch and bounce back; during pregnancy it bears weight for a long period of time, and with the help of relaxin the muscles and ligaments can become weak and overstretched. With a vaginal delivery your pelvic floor stretched even more including the nerves that connect to it.

Other contributing factors to an over stretched pelvic floor include:

• Your genetics

• The number of deliveries you've already had

• Pushing for a long period of time

• Having forceps or a vacuum extraction used during delivery

• Having a large baby

• Having a severe tear2

All this can make your pelvis floor extremely weak and your perineum (the area between your anus and vagina) numb and or sore. Additionally, with a weak pelvic floor you could be suffering from stress inconsistence which affects 1/3 of all new moms3. You may accidentally leak pee when you cough, sneeze, laugh, or exercise. These weak muscles will also have less sensitivity and can contribute to less satisfying sex.

Peeing your pants and less satisfying sex is probably all that had to said for you to want to fix the problem but now that you understand its importance, lets fix it!

Begin doing pelvic floor exercise (kegels) as soon you have the ability to do them after delivery. You may not be able to feel yourself doing them for the first few days because the pelvic floor nerves have been over stretched but try anyways. Kegels helps stimulate blood circulation, can reduce swelling, and will help you heal faster4.

Start out by finding your pelvic floor muscles:

1. Stop urination in midstream, hold for 3 seconds then release

2. Squeeze your muscles pulling up and in as if you're trying to hold your pee

3. Using 1 or 2 fingers inserted in your vagina, squeeze muscles surrounding it.

In the beginning you may feel your lower ab muscles tighten as well, its ok. If you find yourself tightening your upper abs (above your belly button), your butt, thighs, or holding your breath, you’re trying too hard. Once you've identified your pelvic floor muscles you can do the exercises in any position doing almost anything, but at first you might find it easiest to do them lying down. Do not continue practicing kegels by stopping urination, doing this too often can weaken the muscles over time, lead to incomplete emptying of you bladder and increase your chance of a urinary infection.5

Kegels:

Breathe in, and as you breathe out, squeeze your pelvic floor muscles. Hold the contraction for five seconds, and then relax for five seconds.

Repeat the exercise 5 times in a row, rest and repeat the set.

The goal is to work up to 10 second contractions with a 10 second rest in between aiming for more contractions per set. The recommendation is 3 sets of 20 kegels everyday6.

It may take you between 6 to 12 weeks to build up to the recommendation depending on how strong your muscles were or how damaged they got. Don’t be discouraged you will get there.

1. https://www.nct.org.uk/parenting/your-body-after-birth

2. http://www.whattoexpect.com/first-year/vagina-after-birth/

3. http://www.babycentre.co.uk/a1014312/your-pelvic-floor-after-birth

4. http://www.whattoexpect.com/first-year/perineal-tears/

5. http://www.mayoclinic.org/healthy-lifestyle/womens-health/in-depth/kegel-exercises/art-20045283?pg=2

6. http://www.whattoexpect.com/womens-health/kegels

EATING FOR EXERCISE & NURSING

COMING SOON

PHASE 1

Welcome home! I know you're exhausted, having a baby is hard work and the hospital probably didn't let you rest well. Unfortunately sleep is not something you'll get much of in the next year but we'll get through this workout in small phases together. The goal is not to strain or exhaust your body but to begin to strengthen it back to the way it was. These exercises will help minimize postpartum maternal fatigue, heal diastasis recti, and relieve stress (or bladder) inconsistency through actively training your pelvic floor and transverse abdominal.

Before beginning: If any of this make you nervous in any way, if you feel that you cannot perform these exercises due to other health issues, or would like a second opinion; PLEASE consult your physician. I, Tabitha Gomes, am a certified personal trainer and not a medical professional and this is a fitness and recovery guide not a medical prescription.

Beginning 72 hours after delivery.

*5 days of walking per week for a total of 150 minutes per week as recommended by the American College Of Obstetricians and Gynecologists. Walking doesn't need to be accomplished in all one session, it can be broken down into multiple 10 minute intervals, as necessary.

*Pelvic floor and abdominal exercises are to be competed daily.

*Maintain a fitness journal. For your own success it is important to document your exercise sessions; the time it was accomplished, how many repetitions were completed for each exercise, how long you walked, and how you feel before, during, and after exercise.

WEEK 3-4 COMING SOON

PHASE II & PHASE III weeks 5-12 COMING SOON

Credits:

Created with images by PublicDomainPictures - "adult baby background"

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