Your postpartum recovery is more than just prepping a perineal care basket full of diapers, padsicles, peri bottles and ice packs. Yes, this is going to help with both healing and your comfort in those early weeks however it’s also important to consider your long term pelvic health beyond the first 6 weeks – think more along the lines of your first year postpartum.

You can set yourself up for a stronger postpartum recovery during pregnancy and here is how:

Build and Maintain Strength

Yes, you can absolutely get stronger during pregnancy. The stronger you go into pregnancy and birth, the faster you will heal. A simple google search will tell you to “use lighter weights than you did before you became pregnant and engage in higher repetitions—aim for 9-12—to reduce the risk of injury”. Although this advice is well intended (by Peloton), this is very general advice and does not take in to consideration individual circumstances. There is not a specific rep count everyone should follow, and you also do not necessarily need to reduce load/intensity until you are further along in your pregnancy – again, super individual but this advice, in my opinion is incredibly outdated.

In the pre/post natal space there is a lot of fear-based recommendations – like above – that suggest avoiding heavy weight training due to unknown risks. The good news is, more research is being done on the active and pregnant population and is supporting that heavy lifting improves pregnancy, delivery and postpartum outcomes. AND does not necessarily increase pelvic floor dysfunction.

You can still include progressive overload techniques within your training and build muscle however you will likely reach a point where you naturally start to taper your workouts to match your energy levels during the later part of your 3rd trimester. For some, that may even happen in the 2nd. I personally pushed pretty heavy until 35/36 weeks, built and maintained more muscle mass in my 2nd pregnancy and saw huge benefits to my recovery.

Remember, ’heavy’ is individual to each person. So instead of following blanket statements or weight resistriction, think about:

• How the weight is influencing your form
• Your ability to manage pressure/tension
• Is it causing you any to strain, breath hold and bear down or do you have any core or pelvic floor symptoms during/post workout?  If yes, then the weight might be too heavy (or exercise too challenging).
• Quality, consistency and adapting your workouts to your changing body vs following blanket statements/recommendations 

Overall, you do not need to change to 9-12 repetition only workouts, lighter weights than pre-pregnancy or weight restrictions in general. Of course, this is as long as you have no under lying medical conditions and are cleared to exercise by your doctor.

You can take the guesswork out of your prenatal exercise by following my 36 week Strong in Pregnancy program. 

Learn how to breathe and engage your deep core

Proper breathing mechanics are everything for a strong, pain free body.

Postural changes during pregnancy can result in a lack of rib cage mobility.  As your baby grows, it pushes up on the diaphragm and forward on to the abdominals to allow for more space. This can cause the rib cage to be in a constant state on inhalation (expansion) and affect how well the diaphragm can contract and relax. The intercostals (muscles in between your ribs) also become tight and weak from a lack of mobility. A center of gravity shift moves the pelvis into a more anterior tilt. This moves the rib cage slightly backwards and can limit that range of motion further.

Because of this, during postpartum it’s common to see a lot more abdominal motion with the breath vs the ribs or diaphragm when you’re regaining core strength and stability.

An optimal breath looks like this: 

On inhalation, the lungs fill
The diaphragm descends
The rib cage expands to the front, sides and back
The pelvic floor descends

As you exhale, the lungs empty
The diaphragm rises
The rib cage moves down and in
The pelvic floor rises

We want the ribcage to move in a 360, umbrella like fashion. These proper breathing mechanics carry over into everyday life and core function like bending, lifting, carrying your kids – which you will still be doing while healing your body.

Although there will be an element of disconnect once you are postpartum, practicing this throughout the during of pregnancy will help when it comes to that rebuilding that mind-muscle connection as well as keeping your foundation strong. 

Listen to your body

We often here the recommendation to “listen to your body” during pregnancy and postpartum. However this often isn’t helpful advice when a lot of people don’t actually know what they should be ‘listening’ for.

It takes some re-learning to tune in to these signs when we have often been taught to push through discomfort in regards to exercise and muscle building. That ‘athlete brain’ can take over during this period, especially if you are used to training at a higher level/intensity.

Here are some signs and symptoms to look out for:

• Are you struggling to get through all the reps without breath holding or straining and bear down?
• Do you feel discomfort along your abdominal wall? Or does the exercise hurt to perform.
• Are you leaking with impact or stress? 
• Are you feeling pressure or a heavy sensation in your pelvic floor?
• Are you noticing any pelvic or SI joint pain. Hip pain, low back pain, tailbone pain when performing certain movements or immediately after?

Although awareness alone may not reduce dysfunction entirely, as childbirth is also a factor in this, recognizing these signs and symptoms of strain on your core and pelvic floor during pregnancy and proactively responding to them, will give you a better baseline in your postpartum recovery and help you assess your readiness for certain movements and exercises along the way. 

Proactively learn the basics of pelvic health

You do not need to understand in depth anatomy of the pelvic floor. However, learning about basic function, how pregnancy and childbirth can affect it and the realistic timeline those muscles need to recover, can drastically improve your postpartum expectations and experience.

I have worked with so many women who do not address their pelvic floor health until they are experiencing symptoms during or post pregnancy.

During childbirth, the pelvic floor muscles can stretch anywhere from 2-3 times their resting length. Even during an uncomplicated vaginal birth these muscles have endured a lot of trauma and injury. Alongside this, they have carried extra load for 9/10 months. 

Approaching your postpartum recovery like you would any other injury – with intention and gradual intensity vs jumping right back in – will set you up for long term success. We’re given this benchmark of 6 weeks clearance when it comes returning to exercise which is somewhat misleading. This very general advice is only taking into consideration your uterus shrinking to its pre pregnancy size, perineal tears healing and if you had a cesarean, your incision healing. There is no instruction or direction on actually how to return to exercise and because of this ‘all clear’ or “you can return to what you were doing pre pregnancy’, it instead sets so many women up to fail with this expectation that we should be able to return to any pre pregnancy activity without dysfunction. 

I also see so many women who do not notice dysfunction until they actually try to load their pelvic floor.

The best approach to understand your individual pelvic health and what to expect during the postpartum period is to visit a Pelvic Floor Physical Therapist. You can find a local one here. Although it is likely an out of pocket expense, it is 1000% worth it. Just one visit will provide you with so much insight. 

To compliment your physical therapy, I encourage following a postpartum return to exercise plan that addresses full body function. I have had years of hands on experience with both pregnant and postpartum women and from that created two online programs.

I currently offer Return to Movement – a 10 week early postpartum program

And Return to Strength – a 12 week progressive return to fitness program for all levels