Being a new mom is often stressful. Encouragingly, research shows that new and expecting moms who stay active are less likely to experience anxiety. Meeting the recommended physical activity guidelines of 150 minutes of moderate exercise per week is a great way for moms to protect and promote their mental health.
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Finding the time to fit in a home workout or exercise class can be challenging for moms. But small bouts of physical activity throughout the day, or “exercise snacks,” can be just as effective to achieve the health benefits of physical activity. Research shows that when moms reframe physical activity as “moving your body” instead of a structured activity, they find it easier to be active!
“You have to get beyond the mindset of having to do it all yourself.” That’s the advice that Mandy Bujold, 2-time Olympian and mom to 3-year-old Kate, has for new moms who want to be active. “There are people out there – family members, neighbours, friends – who would love to help, even for an hour or so, you can get out for a walk. You just need to ask them.” Learn more about what you can do to support the active moms in your life with SIRC’s Mom’s Got Game web portal, or check out the SIRC blog.
After childbirth, mothers have numerous concerns about their postpartum body and its capacity for returning to physical activity. One of the worries is whether physical activity may negatively affect the pelvic floor after pregnancy and delivery.
The pelvic floor is a crucial group of muscles that helps maintain bladder and bowel control, support internal organs, and coordinates with the deep core, diaphragm and deep back muscles. These muscles can require rehabilitation after having done a lot of the heavy lifting during pregnancy and possibly having been injured during childbirth.
In this blog, we’ll discuss how pregnancy and childbirth can affect the pelvic floor. We’ll also share ways to ensure your pelvic floor is strong enough to return to physical activity. As an exercise physiologist who engages in research with postpartum mothers and a physiotherapist with advanced training in pelvic floor rehabilitation, we recognize it’s essential for women to have the necessary physical recovery, knowledge and confidence to return to physical activity. Below we provide answers to frequently asked questions about the pelvic floor after pregnancy and childbirth.
What is the pelvic floor?
The pelvic floor is a group of muscles that helps maintain bladder and bowel control, support internal organs, and coordinates with the deep core, diaphragm and deep back muscles. To locate your pelvic floor muscles, visualize the muscles that span from the back at your tailbone to the front at your pubic bone, and from side to side on your sit bones. This is the floor of your pelvis, like a sling or hammock of muscles, ligaments and fascia.
Why see a pelvic floor physiotherapist?
Pelvic floor physiotherapists should be part of the postnatal support team, in addition to maternity physicians, lactation consultants, obstetricians, midwives and mental health supports. A recently provided framework for returning to sport postpartum suggests that to optimally prepare mothers for a return to running there should be advance planning for rehabilitation needs (Christopher et al., 2022). This would include an assessment by a physiotherapist to identify musculoskeletal and pelvic health needs after childbirth, before resuming exercise (Donnelly et al., 2019).
In our research, new mothers we spoke to who saw a pelvic physiotherapist said that they wanted to avoid any long-term damage. They also wanted to make sure physical activity was appropriate for their recovery. Describing her postpartum experience with a pelvic floor physiotherapist, a mother told us:
“I decided to see a pelvic floor physiotherapist during early pregnancy and again in later term pregnancy. This allowed me to learn ahead of time what my 6‑week postpartum recovery plan would look like and gave me some direction for rebuilding my core so that I could return to vigorous activity when I was ready.”
How to go about getting your pelvic floor assessed
The gold standard is an individualized assessment by a pelvic floor physiotherapist. This would include an internal vaginal or a rectal exam, or both. If these exams aren’t available to you, you can self-assess these muscles. To do so, insert your finger vaginally and feel for both a squeeze and lift of the muscles when you contract them. You should also feel for a release or letting go when you relax the pelvic floor.
How to return to physical activity safely without damaging your pelvic floor
In the early stages of postpartum, focus on rest and restoration. You must take time to work on the foundations: doing breathing exercises, prioritizing sleep, eating nutrient-rich foods, walking, and beginning to activate the deep core, pelvic floor and glutes. Your return to exercise should be progressive.
It’s important to listen to your body. And if you’re experiencing any bladder or bowel leakage, pelvic pressure, heaviness or pain with the exercise, then modify your exercise by practising non-weightbearing exercise such as cycling. In general, we want to encourage you to exercise for its physical and mental benefits. However, training past your body’s limits (for example, through pain or leakage) could further contribute to future problems or dysfunction.
How to strengthen your pelvic floor
There are many factors to consider as you recover after childbirth, including your posture, breathing, pressure management, and strength and coordination of your pelvic and core muscles. Some people benefit from pelvic floor strengthening, which may include performing Kegel exercises regularly. Such exercises help strengthen your muscles weakened by pregnancy and childbirth.
To get started with Kegel exercises, identify your pelvic floor muscles and practise your technique. Imagine that you’re sitting on a marble then tighten your pelvic muscles as if you’re lifting the marble. Do this for 3 seconds and then relax for 3 seconds.
As you engage your pelvic floor muscles, be mindful of keeping your breath calm and your thighs and buttocks muscles relaxed. It may help to exhale as you contract your pelvic floor muscles. Since nobody can see when you’re doing these exercises, you can do them anytime and anywhere. It’s even possible to them at red lights or when brushing your teeth.
You may require further guidance to learn how to do these exercises correctly. It’s also important to recognize that pelvic floor activation isn’t appropriate for everyone. Some people have tight or tense pelvic floor muscles, in which case pelvic floor exercises may worsen symptoms.
Signs that you should modify, reduce or stop physical activity and seek professional support from a physiotherapist
- Urinary or fecal incontinence
- Urinary or fecal urgency that’s immediate and hard to put off
- Heaviness, pressure, bulge or drag in the pelvic area
- Pain with intercourse
- Constipation resulting in problems with defecation
- Separated abdominal muscles
- Decreased abdominal strength and function
- Pain in pelvis and lower back
We urge mothers to take the time to properly assess their pelvic floor after childbirth. This is important because of the pelvic floor’s vital role in supporting their organs and core as well as how much pregnancy and childbirth can have on pelvic floor muscles. Assessments can help mothers ensure their body is ready to return to physical activity. In the words of a mother in our research, “I had a great experience seeing 2 different physiotherapists and learning about their knowledge base and the anatomy of the pelvic floor.”
Recommended resources
Mothers moving forward: A postpartum guide to being physically active (comprehensive guidebook)
Moving women forward: A guide to becoming physically active after childbirth
From one mom to another: Tips for being active after welcoming a new baby
“My daughter once told me, ‘Mum, you do everything for us. You should do something for yourself,” recalls 4-time Paralympian Ina Forrest, reflecting back on the early days of her wheelchair curling career. Over the years, Forrest has come to appreciate how her involvement in sport has modeled important values for her children, including how to set goals and support each other to achieve them. This #MomsGotGame.
“Being younger in an all-women’s league has shown me that you can play hockey and be a mom. It wasn’t ever in my mind that I couldn’t do both. Seeing others do it helped relieve some of the pressures of motherhood.” Learn more about women’s’ experiences returning to sport after childbirth and tips for creating inclusive sport spaces for new moms in the SIRC blog.
Olympic bronze medalist and former world champion mountain biker Catharine Pendrel gave birth to her first child, Dara, 6 months before she represented Canada in Tokyo for her fourth Olympic Games. In the lead up to the Games, Pendrel discovered that she’s actually a better parent when she makes time for physical activity. “It felt good to have time to myself and to be really focused on my training. And I could do it guilt-free,” she says. This #MomsGotGame.
Kids don’t have to be the only ones getting active during their organized sport activities. Training sessions provide an ideal time for moms to get active too! Creating opportunities for parents to engage in individual or group exercise during their children’s sport practices is one way sport programs can enhance sport moms’ physical and mental wellbeing.
This article was originally published by The Conversation on March 20, 2022
The birth of a child is a momentous occasion in a woman’s life. It may also be one of the most challenging transitions that women face, requiring adaptation to identity and role while undergoing a unique physiological transformation.
Physical activity after recovery from birth can be helpful. Women who engage in postpartum exercise tend to have better mental and physical health outcomes. Benefits of exercise for new moms include weight loss, improved aerobic fitness, improved mood and increased social connectedness. However, physical activity rates tend to drastically decline after pregnancy.
Despite the potential positive impact that physical activity may have during the postnatal transition, little academic attention has been given to helping women return to exercise after the birth of a child. As an interdisciplinary research team in sport and physical activity, we have been working to address this gap by exploring women’s postnatal physical activity experiences.
Women’s questions about postpartum exercise
We asked women what questions they had about physical activity engagement within their first three months postpartum. What they shared about their physical activity engagement parallels what has been identified in research: mothers’ physical activity is reduced with the birth of a child, and primary barriers to engagement include a lack of opportunity.
Women’s questions were fuelled by feelings of uncertainty and confusion about their return to physical activity, asking: How much physical activity should I do? What intensity of exercise is safe for me? What type of physical activity should I engage in? How do I engage in physical activity with my newborn? How will I know if I’ve pushed my body too hard?
The American College of Obstetrics and Gynecology states that women should slowly return to physical activity after giving birth and work their way up to the general physical activity guidelines of 150 minutes of moderate to vigorous aerobic physical activity per week. If women have had a surgical birth or tearing during a vaginal birth which required stitches, it may take longer to become active.
Most women were curious about strategies and recommendations for physical activity after the birth of a child, including finding the time, energy and motivation to exercise.
Based on these frequently asked questions, we provide recommendations for supporting women in engaging in postpartum physical activity for two relevant groups:
- physicians and health-care workers;
- community leisure service providers (such as recreation programmers and fitness instructors).
Since both groups are actively invested in improving community health and well-being, we hope to outline how they can work together to provide accessible, equitable and meaningful physical activity opportunities for postnatal women.
Physicians and health-care workers
In Canada, the most common health-care experience for new mothers is a six-week followup with their physician or midwife. At this point mothers are told they can return to physical activity if their body has healed appropriately. Unfortunately, most women feel this support is inadequate, stating a need for more information from health-care professionals about guidelines for returning to physical activity.
So, how can physicians and health-care workers better assist these women? Women outlined how best to help them return to physical activity. Since all women do not experience childbirth and recovery the same way, opportunities for equitable and individualized care for postpartum women are essential. This means offering not only extended care beyond the six-week mark, but tailoring care for each woman’s recovery process and physical activity engagement.
Specifically, there is a need for physical activity education by midwives, physical activity counsellors or physicians. Women also recommended that access to a pelvic physiotherapist be a standard part of postnatal care.
It’s important to assess the pelvic floor after childbirth. It is a crucial group of muscles that helps maintain bladder and bowel control, supports internal organs and co-ordinates with the deep core, diaphragm and deep back muscles. These muscles do a lot of the heavy lifting during pregnancy and can be strained during childbirth, requiring rehabilitation.
Additional resources would be valuable to give women tools to develop confidence to return to physical activity. These include safe exercise choices and progressions during the postpartum period; nutrition, hydration and sleep guidelines; exercises that can be done with an infant; and information about child-friendly exercise spaces.
Such information could be packaged in multiple formats — such as pamphlet, website and phone app — and offered as part of the standard package when women are discharged from the hospital following delivery, or at a six-week physician follow-up.
Community leisure service providers
Women in our studies also desired more informational support to join local fitness and community centres. Such involvement meant the chance to meet other mothers and learn more about safe physical activity engagement postpartum. Yet, accessing these programs was often fraught with barriers.
In a study to be published in Health and Fitness Journal of Canada, we found postnatal women wished for individualized and affordable community programming, given the high costs of caring for a newborn. In interviews with mothers after a group exercise program, we found this form of programming to increase community connection, motivation and accountability.
Mothers also said that flexible childcare and attendance options — such as a combination of daycare facilities, classes that accommodate infants and online fitness classes — would support engagement.
Lastly, women spoke about how mothering social groups, resource-sharing between programmers and health-care providers, and maternity consultants for staff can help increase postnatal programming quality, and in turn, participation.
As a society, we can do better to support postpartum women’s physical activity engagement. When women are physically active, they feel physically and mentally well, enabling them to better handle the challenges of motherhood and be positive health role models for their children.
If you are interested in participating in a research study to better understand the experiences of mothers postpartum, please visit this page.
This article is republished from The Conversation under a Creative Commons license. Read the original article.
Disclosure statement
The authors do not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.
Becoming a mother is an exciting milestone in a woman’s life. Once you welcome home a baby, nothing is ever the same again. While the transition to motherhood comes with many ups and downs, engaging in physical activity is a great way for new moms to protect their physical and mental health. For more information, see Moving women forward, a blog post about becoming active after childbirth.
As a research team, we’ve been exploring postpartum women’s perspectives of physical activity engagement. To fully understand the challenges that new mothers face, we went to the experts: mothers. We asked moms, who were 6 to 12 months postpartum, for advice they would give to other new moms about being physically active.
In this blog, we outline key considerations for new moms based on the advice of the postpartum women in our research. We also offer tips for returning to movement with the aim of optimizing physical and mental health during the postpartum period.
1. Reframe physical activity as something that benefits your mind and body
Small amounts of physical activity, even 10 to 15 minutes worth, can benefit both your physical and mental health (Teychenne et al., 2020). Many women discussed how challenging it is to start being physically active. Yet once they started, physical activity was invaluable to their mental health. They recommended mothers reframe physical activity as something they do for both their minds and bodies. Researchers have found that being active outdoors, and preferably in nature, can be even more beneficial (Gladwell et al., 2013).
Exercise can also be empowering for mothers. Motherhood comes with many personal and societal expectations that can feel overwhelming (Bean & Wimbs, 2021), and the responsibility of caring for a newborn and other children can be consuming. Making time for oneself through physical activity can calm negative thoughts and provide a break from caregiving responsibilities, giving space for moms to feel accomplished, powerful and connected to their bodies (Lloyd et al., 2016).
Movement tip for new moms:
- Reframe physical activity as something that you do for your mind and body. Research shows, when moms feel healthy and happy, they also feel like better parents (Hamilton et al., 2010).
2. Take it slow when jumping back in
Returning to physical activity postpartum should be a gradual process. Many of the mothers we spoke with shared that they hadn’t returned to their pre-childbirth levels of physical activity. Despite receiving clearance at the standard 6‑week, post-partum check-up, they didn’t feel ready to resume regular physical activity.
The women we spoke to also said they managed expectations of how much physical activity they could do by listening to their bodies. While they were excited to move again, physically overextending themselves led to pain and delays in recovery. Checking in with their healthcare team was also an important part of their return to movement journey.
Movement tips for new moms:
- Try low-impact, low-intensity activities, like walking, swimming or stretching when getting back into physical activity.
- Listen to your body. Adjust the volume or intensity of your activity based on how you feel. If something feels “off,” consult your physician or physiotherapist.
3. Be creative: Don’t wait for the “stars to align”
For many mothers, making the time for physical activity after childbirth requires flexibility and creativity. Before having children, the women in our research were accustomed to exercising in structured ways. These mothers had expectations of returning to their pre-baby routines, leading to stress and demotivation when those routines were hard to manage.
When the moms in our research reframed physical activity from structured exercise to “moving your body,” they found it easier to be active. Instead of waiting for the “stars to align,” they integrated movement into their daily routines by napping their infant in the stroller so they could get a walk or run in or through engaging in housework, errands and childcare. Likewise, allowing for flexibility around when, where and how they engaged in movement helped to follow their infant’s unpredictable schedule. Doing so lessened feelings of guilt or stress during times when the moms missed scheduled exercise or when it looked different than originally planned (Dixon, 2009; Lloyd et al., 2016).
Movement tips for new moms:
- Fit in small bouts of physical activity throughout the day as “exercise snacks,” especially if it’s difficult to find a large block of time for exercise (Islam et al., 2022).
- Incorporate your child or children into your physical activity routine. For example, you could exercise at home while your baby is doing tummy time or at the playground while they’re having their own fun!
- Remember, physical activity isn’t a one-size-fits-all prescription! Try a variety of activities, from exercising at the gym to gardening at home to joining a sports team. Go with activities that you find satisfying, meaningful and enjoyable, while also fitting with your lifestyle.
4. Grant yourself grace: Practise self-compassion
The women in our research described motherhood as a rollercoaster, with many “ups and downs.” It’s important to allow space for patience and grace while returning to movement because postpartum bodies are healing and adjusting to a new routine.
After giving birth, a safe return to physical activity happens slowly and with caution, which requires some patience (Evenson et al., 2014). Mothers often report feeling frustrated, stressed or confused about returning to exercising (Currie, 2004). Part of this process includes replacing the “bouncing back to pre-baby body” mindset with focusing on physical movements that your body is currently capable of.
But remember, you’re not alone on this journey! In addition to consulting with medical professionals about returning to movement, connect with other mothers to hear and share stories. These connections can be critical in combating the guilt and self-doubt that often (and unfortunately) go hand-in-hand with motherhood.
Movement tips for new moms:
- Be patient. Focus on what your body can do today, rather than what it used to do before (or during) your pregnancy. Just like for your child or children, you need to take baby steps. In your case, they’re for your return to movement postpartum.
- Remember that you’re not alone on this journey. Talk to your healthcare providers, family and friends, and other mothers for support and shared learning.
5. Leverage support from your loved ones
The people closest to new mothers, including spouses and family members, see and may also experience the various changes that happen when a new baby arrives. Most moms agree that this support system is critical.
Family and friends are important sources of emotional support. For example, women often need to reconsider what it means to be physically active during and after their pregnancies. This can be as much of a mental shift as a physical one. During this period, loved ones can offer encouragement and compassion as you navigate the transition. They can also help you to be accountable to your physical activity goals (Bean & Wimbs, 2021). Take a read of another blog post to see how team sport can also be a great source of support for postpartum women.
But emotional support only goes so far. Other types of support are needed to minimize the barriers that new moms face to being physically active. Other types may include childcare and household support, such as running errands, doing chores and preparing meals. When family and friends take on childcare and household responsibilities, then the mental (and physical) load for mom is reduced, which allows mom the time and energy to meaningfully engage in movement (McKeown, 2021).
Movement tips for new moms:
- Build your support system before baby arrives. Identify family and friends who can provide you with the types of support you’ll need, from encouragement and accountability to meal prep and childcare.
- Don’t be shy to ask for what you need. Asking for help shows others that we trust and rely on them. It isn’t a sign of weakness to ask for help. What you need in that moment might be a nap, so that you can meaningfully engage in physical activity later. And that’s okay.
From one mom to another…
The return to movement doesn’t need to be a daunting task. When you focus on your well-being, listen to your body, get creative, practice self-compassion and lean on your support system. You might find that moving your body is easier than you think. This way, moms can be happy and healthy, helping their babies be happy and healthy, too.