Advice From The Midwife

Pregnancy, birth and motherhood tend to raise a lot of questions and worries with soon-to-be and new-mums. We’ve sat down with midwife, Claire Wilson, to get the inside scoop and discover the answers to these common questions and concerns – ‘When will my body be ready to resume regular exercise after giving birth?’, ‘Will my stomach ever go back to the way it was before pregnancy?’ and even those embarrassing worries such as ‘Will I wet my pants if I jump around too much?’.

Claire Wilson
Registered Midwife
Bsc Hons
Lister Hospital

Meet Claire Wilson, a registered midwife currently working at Lister Hospital. Claire is kindly sharing her knowledge and advice about postnatal recovery, and has provided great answers to some of the most frequently asked questions.

Question: When can I get back into exercise after having a baby?

A lot of the women do keep fairly active and fit throughout their pregnancy, however, whether they are commencing or resuming exercise they should all have their 6 week postnatal check with their GP’s before getting back into intense fitness after giving birth, especially if they’ve had a c/section. Whilst waiting for the appointment women could start with something low impact, like walking. Some women may find they get short of breath when working out, which could relate to their initial fitness level or it may need some further investigation as postnatal women that are experiencing breathlessness may have a low haemoglobin (also known as ‘Hb’, is a protein found in the red blood cells that carries oxygen around your body and gives blood its red colour) level, especially if they had a heavy blood loss at delivery, in which case they should see their GP’s.

More on the topic:

The NHS recommends staying active during pregnancy, with light activity such as walking, yoga or dancing, as this will help new mums ease back into fitness after giving birth. The NHS also adds that women should be aware that pregnancy does change your body, not all changes will be permanent, but that it is a gradual process of slowly working your way back to your former body.

Question: Will pregnancy and birth affect a woman’s flexibility, making her less flexible?

Flexibility shouldn’t be an issue for women both during and after pregnancy. Throughout pregnancy, women’s muscles and ligaments will relax and soften due to the hormone progesterone and after pregnancy, it is important for women to wait for the 6 week check when most physiological changes that occur throughout pregnancy have returned to normal.

Question: Should women expect to experience back pain both during and after pregnancy?

In healthy women this shouldn’t be an issue. During pregnancy, it is usually the heavy uterus and changes caused by the progesterone, mentioned above, that can cause women to suffer from back pain, but this should no longer be an issue for postnatal women.

Let’s delve a little deeper:

The NHS advises that women experiencing postnatal back pain should consult their GP or health visitor as it can often be helped and treated through exercise and learning to better look after your back.

Question: Can you explain the idea of ‘abdominal splitting’?

Your abdominals should never split but rather your rectus sheath can separate during pregnancy. Your midwife will check the separation after the delivery and if significant a physiotherapist referral will be made. Less significant separations can be rectified with simple exercises.

Here’s a little bit more information on the topic…

The rectus sheath becomes separated during pregnancy, stretching and weakening to make room for your growing womb (uterus). It is very common, but the misconception of the muscles tearing or rupturing is incorrect, the muscles rather separate and stretch, leaving a larger gap which looks like this:
The NHS estimates that the separation between your stomach muscles will usually go back to normal by the time your baby is eight weeks old, but if the gap is still obvious a physiotherapist can provide you will some specific exercises to help minimise the issue.

Question: Can all women expect to suffer from incontinence after giving birth?

It may come as a surprise to most women that incontinence is not normal but rather something that some women may experience if they have had a difficult delivery in which case they may need to be referred to an expert for more advice. The most effective way to avoid incontinence is through exercise, these exercises are known as pelvic floor exercises. Before discharging any new mum, the midwife should go through these exercises with you.

How to perform your pelvic floor exercises:

The NHS explains that women can perform their pelvic floor exercises either lying down, sitting or standing and with practice, it can be done anywhere and at anytime – even while watching TV.
1) Squeeze and draw in your back passage as if you’re holding in wind.
2) Squeeze around your vagina and bladder tube (urethra) as if you’re stopping the flow of urine, or squeezing during intercourse.
3) Now relax. This is a short squeeze. Rest for a second, then repeat these squeezes until you feel the muscles get tired.
4) After a short rest, squeeze again as above. This time hold the squeeze for as long as you can (but not for more than 10 seconds) then relax.
5) It’s important to keep breathing normally while you do these exercises. Make sure you don’t pull in your stomach or squeeze your buttocks when you squeeze.
Aim to build up to 10 repeats of each exercise, four to six times a day.

Question: Will exercise have any negative impacts on breast milk?

Exercising will not affect breast milk negatively. It may increase the supply as endorphins (which we all know are released when exercising) which can encourage the ‘let down’ of breast milk.
Therefore the only thing women may need to be wary of is the possibility of leaking while exercising, especially if exercising in the home with your baby close by. Simply by using regular maternity breast pads, or opting to feed or express prior to exercise, may help alleviate the leaking. Similar to exercising during pregnancy, a well-fitted bra with extra support will help to avoid sagging and provide comfort for postnatal mums.

What else do we know:

Exercise contributes to our overall health and is beneficial for breastfeeding mums, even “vigorous exercise does not significantly affect the amount or composition of milk your body produces”. The NHS advises new-mums to ensure they are eating a healthy balanced diet during breastfeeding.