You birthed a baby! Congratulations! You’ve made it to six weeks postpartum, and you realize that newborns are wonderful and amazing, and you’ve never loved anything more in your entire life. And you’ve also realized that you can probably survive ANYTHING if you can survive six weeks with a newborn, lol. You may be sleeping regularly, and you may be wishing you were sleeping regularly and wondering if that adorable new little human in your life is EVER gonna stay asleep when you need them to. Either way, you are up to your eyeballs in hormones, dirty diapers, and the fear of getting pregnant again right now, along with love, snuggles, and new smiles, and someone calls you Mom.
And it’s time to go back to your doc to get that magical six week check-up.
At this point, you may feel normal again “down there” or you may feel differently.
At this point, you might be considering taking on some workouts, or you may just be trying to keep your head above water with a brand new baby. You may feel ready to rip a barbell off the floor right after you check out of the doctor’s office after getting clearance to “ease back in.”
So what does getting clearance from your doc at six weeks postpartum REALLY mean for your fitness?
There’s a lot to discuss here. So, let’s get to it.
As a post natal fitness specialist, and personal trainer, I have LOTS to say on this topic. Also, having lived through this twice as a mother who has birthed beautiful humans, I have personal experience as well.
Hopefully your doctor has assessed you for a diastasis, or the separation of the abdominals while growing your babe. This separation is completely normal, but….you need to know about it, and how to rehab yourself and your core to protect your abdominals from separating further with not-so-awesome exercise choices postpartum, and also from herniating your intestines through that abdominal wall (so sexy, isn’t it). Your doctor likely will have you lie on your back and and raise your head and feel with his/her fingers for gaps in your abdominal wall from your sternum down towards your pubic bone, and tell you something like “you have a three finger gap at this location” or give you a measurement in centimeters. Guess what? Whether or not you birthed vaginally or via C-section, all this stuff matters for you.
What your doctor may not tell you about a diastasis: Your doctor may not advise you how to begin healing your diastasis OR your doctor may not give you proper exercises to begin healing your diastasis. Your doctor may not tell you that it’s important to check your diastasis regularly and assess whether or not you feel tension in your abdominals even if you have a diastasis that seems to be improving. Your doctor may not tell you that it’s important to avoid exercises or activities that put additional pressure or force on your diastasis to aggravate it (planks and push-ups come to mind).
Hopefully your doctor has assessed your vaginal health and healing (especially if you had any tearing during labor). This may be a quick exam, but it doesn’t hurt to ask for the health of your pelvic organs and their position here as well. Be detailed with your doctor, and ask him/her to check for any pelvic organ prolapse concerns as well. Let them know if you are struggling to go #1 and/or #2 at this point. Also, be sure to see how you are healing if you experienced tearing or anything of that nature.
What your doctor may not tell you about pelvic health: If you experienced any tearing other than surface tears on the skin, it’s pretty important that you see a professional who specializes in pelvic floor health, because your pelvic floor has trauma and injury and likely needs help returning to top notch functioning to prevent future pelvic floor issues down the road. There is likely tearing or injury to your perineum, rectum, and other “down there” geography, and those areas need time and attention to begin healing properly. Your doctor may also not tell you or even check about the status of your pelvic organs and their health/positioning. It’s important to ask about this yourself, and ask to be checked. In the event this area is a concern, it’s important to visit a professional who specializes in pelvic floor health to begin healing and/or improving the conditions for pelvic organ prolapse as well.
Your doctor may ask about your mental health. Be detailed with your doctor about your mental health. Um, you just went through A LOT, and the health of your baby is top priority on your brain right now. Guess what? That’s AWESOME. Here’s the thing, YOU, YOUR body, and YOUR HORMONES are going through the ringer right now, and YOUR mental health is important too.
What your doctor may not tell you about postpartum mental health: Build yourself a team of support. This team will likely be comprised of other moms that are friends and that you can talk candidly with, even if it’s just to drop a few lines via text of “I’m hanging in there, but shit this day is kicking my ass.” This team will likely include your partner, but guess what? They go back to work at some point, and then you are flying solo with baby and your emotional rollercoaster. Also, they sometimes have difficulty understanding the physical and emotional rollercoaster stuff, so while I believe your partner should be on your team, I also feel strongly about having an arsenal of other people in your corner as well. Breastfeeding? Get some moms who have breastfed successfully in your corner and who aren’t gonna BS you about how easy it is. Getting your postpartum tribe together is HUGE for your mental health. But also recognize that if you need more help than what your tribe can give you, it’s awesome to speak with your doctor about that too!
Your doctor may give you the “all clear” to begin easing back into fitness. Be detailed with your doctor about what you did before pregnancy and what you did during pregnancy, and what you are hoping to get back to postpartum. Make sure you doctor KNOWS what you mean when you say “deadlifts” and “barbell squats” and things like that. When your doctor gives you the “all clear” it absolutely does not mean “do your normal stuff.” It truthfully means “begin exploring structured movement again at an appropriate pace for YOU.”
What your doctor may not tell you about easing back into fitness: Returning to fitness as you knew it pre-pregnancy isn’t a smart idea. To come back safely, we need to consider how your body and moved, changed shape, and gained or lost function in some areas. This is true for vaginal birth AND C-section birth. During this period, it’s smart to work with someone who specializes in postnatal fitness for a variety of reasons. This professional will help you design a workout program that prioritizes your core and pelvic floor health of your postpartum body along with treating YOU as a whole person. Guess what? Hormones, lack of sleep, breastfeeding, and getting the hang of life with a newborn are HUGE things, and they ALL impact your fitness (whether or not you want them to). This professional needs to be knowledgeable in exercise selection and how they impact core and pelvic floor health, and how they help make YOU better for motherhood and for life. This professional also will refer you to someone who specializes in pelvic health if the need arises.
Here’s the thing. Your doctor helped YOU during pregnancy and helped you deliver that beautiful new baby. Your doctor had the overall health of YOU and your babe to care for. Your doctor can’t be your personal trainer, your pelvic floor professional, AND your support team at home. We have to advocate for ourselves, here, mamas. We have to be diligent, ask questions, talk about concerns, so we know WE are getting the care WE need right along with our new babies.
Dear Mama, I know you. I KNOW how you want to just jump right back in where you left off. But Mama, I got you, I AM YOU. It’s time to let your body rehab and heal, and come at it with your WHOLE self in mind. Remember, just because we are strong enough to do something, doesn’t mean we SHOULD do that something. Postpartum lasts the rest of your life, and it’s time we give it the attention it deserves.