After Vaginal Birth

The following exercises can be done as soon as desired:

  • Kegel exercises strengthen the muscles of the pelvic floor. These muscles are weakened by the birth process and should be exercised immediately after birth. However, it may be somewhat difficult to do these exercises soon after your delivery; do as many as you can and gradually the tone will return.
  • Squeeze the pelvic floor muscle (around the vagina) for three seconds, relax the muscle for three seconds and then squeeze again. Begin with 10 three-second squeezes, three times a day. Increase repetitions gradually.
  • Work up to 50-100 kegels each day.

Abdominal strengthening

Do each exercise one to two times each day with three to five repetitions.

Pelvic Tilt

  • Lie on your back with your knees bent.
  • Tighten your stomach and buttock muscles.
  • Allow your pelvis to tilt upward.
  • Flatten the small of your back against the floor as you inhale.
  • Hold for a count of five.
  • Relax and exhale.
  • Repeat three to five times.
  • CAUTION: DO NOT arch your back, bulge your abdomen or push with your feet to obtain this motion.

Abdominal breathing:

Deep abdominal breathing will help you regain the strength in your abdominal muscles and assist in relaxing.

  • Lie down on a comfortable surface with your knees bent.
  • Relax your body as much as possible allowing your weight to sink onto the surface.
  • Gently put your hands on your abdomen, close your eyes and begin to notice your breathing.
  • Inhale, abdomen and hands rise upward; stretch your abdominal muscles outward. Hold for a count of five.
  • Exhale, abdomen and hands fall downward; pull in your abdominal muscles. Hold for a count of five.
  • Repeat three to five times.

Ankle Circles

(To enhance circulation)

  • Make 10 circles with your ankles clockwise and counter-clockwise.
  • Do the ankle circles in different positions such as sitting, lying down, etc.
  • Repeat circular pattern three to five times.

Do the preceding exercises during the course of one week and then add each of the following exercises.

Leg sliding

  • Lie on your back with your knees bent.
  • Do the pelvic tilt.
  • Keep your back flat while sliding one heel up and down the bed.
  • Work only within the range where you can keep your back flat.
  • Repeat three to five times with each leg.

Arm and upper back stretch

  • Raise your arms over your head keeping your elbows straight with your palm facing one another and hold for five to 10 seconds.
  • Lower your arms out to your side, palms facing downward, while keeping your upper back straight.
  • Bring the backs of your hands together as far as possible behind your back and hold for five to ten seconds.
  • Repeat three to five times.

After the first week, continue doing the previous exercises, and begin to add more abdominal exercises as your strength allows.

Before doing more advanced abdominal exercises, it is important to check for extensive separation of the abdominal muscles. The abdominal muscle is divided by a seam; the muscle is really two halves that can often separate due to the size of the baby and the birth process.

How to check for abdominal muscle separation:

  • Lie on your back and bend your knees, feet flat on the floor.
  • Slowly put your chin to your chest and raise your head and shoulders until your neck is six to eight inches off the floor. Hold one arm out in front of you.
  • With the other hand, check for a gap or a bulge in the middle of your abdomen. There may just be a soft region between the muscles.
  • If there is a gap wider than the width of two fingers, avoid further separation by:
    • Doing abdominal strengthening while crossing your hands over the abdominal area to support and bring together the muscles.
    • Always exhaling as you lift your head; this decreases pressure in the abdominal cavity and allows your abdominal muscles to work more efficiently.
    • Consciously tightening your abdominal muscles when lifting to avoid abdominal bulging or any straining.

Straight curl-up

  • Lie on your back with your knees bent. Breathe in slowly through your nose.
  • Tuck in your chin and raise your head; point your hands toward your knees
  • Exhale and lift your shoulders off the floor for a count of five.
  • Inhale and slowly lower your body to a count of five.
  • Relax.
  • Repeat three to five times.

As your strength and energy increase, you can begin more progressive abdominal sit-ups by:

  • Folding your arms over your chest.
  • Placing your hands behind your head.

Diagonal sit-up (waistline exercise)

  • Lie on your back with your knees bent.
  • Exhale as you raise your head and right shoulder.
  • Point your right hand toward your left knee, keeping your heels on the floor and hold for a count of five.
  • Lower your head slowly for a count of five while breathing in through your nose.
  • Repeat using your other side, pointing your left hand toward your right knee.

Vigorous aerobic activity can usually be resumed after your postpartum check-up. Consult your health care provider before resuming.

Strategies for lifting, bending and moving after delivery

After giving birth you are more susceptible to back strain due to the pregnancy hormones that have softened your ligaments and joints. The following strategies will help minimize your risk of back injuries.

Lifting and moving

  • Any time you find it necessary to reach or lift low objects, spread your feet apart with one foot in front of the other and bend your knees. Bring the object close to you as you straighten your knees and lift. This allows you to use the muscles of your thighs for lifting rather than straining your back muscles.
  • When moving an object, try to push instead of pull. Use your legs, not your back and arms.

Bending

  • Avoid any position where you are bending at the waist with your knees straight, even if it is only a slight bend. Instead, alter your position so that you are sitting, squatting, kneeling or bending at the knees while leaning forward at the hips.
  • When getting in or out of bed or a car, turn your hips, pelvis and back in the same direction while maintaining a straight back. When getting out of bed, first roll to your side and then use your arms to push up from the bed.