Soft tissues take about 6–12 weeks to heal, so even if you’re feeling amazing, these guidelines aim to support healing on the inside. Every day you’ll get a little bit stronger, which is why the guidelines progress over the weeks. Any concerns – bleeding or lasting heaviness – please ring your midwife/child health nurse or doctor’s office.
Immediately post-birth (hospital and home)
- Deep breathing: take 5 deep breaths every hour, followed by a cough or a huff.
- To clear your chest with a huff or a cough, take a deep breath, draw up your pelvic floor as if stopping a wee and do one big cough. A huff can also be effective and use less pressure – this is the same as a cough, but with your throat open as if fogging up a mirror.
Getting out of bed
Bend your knees up, roll to get onto your side and use your legs and arms to push yourself up into sitting position.
Lying down to rest
This is the most important (and often most difficult) part of healing during the first few weeks, balanced with gentle activity.
- Weeks 1–3: rest lying down for 20 minutes four times each day
- Weeks 3–6: rest lying down for 20 minutes from one to three times a day
Bladder
- Make sure you have normal sensation in the bladder. If you’re not sure, alert nursing staff.
- You should wee every 2–4 hours. You should feel the urge to empty and feel when you’ve emptied your bladder.
- Drink about 3 L non-caffeinated fluids, 1 for baby and 2 for you. Eat fresh fruit and vegetables.
Bowel
- If you are feeling constipated, take action quickly. Ask your chemist about whether you can use Movicol, Osmolax or similar.
- When using your bowels: sit well, sometimes leaning back can feel better.
- Wrap some toilet paper around your hand and support the front (over the vulva). This allows your body to feel supported and relaxed, and your bowels to empty more easily. Do this for as long as you need.
- Aim to have your knees up higher than your hips
- Bulge the low tummy forwards like a basketball
- Relaxed deep breaths
- Try a hissssss like a snake through your teeth.
- Avoid straining and drawing the tummy inwards strongly – this increases downward pressure on the pelvic floor and actually increases tightening of muscles and closing of the anus, opposite to the desired effect of releasing the anal sphincter.
Timeline
Weeks 1–3: walk 5–10 minutes at a time. Build this up so you’re doing a little more each day. Doing short walks multiple times is better than one long walk.
Weeks 3–6: continue to increase your walking time each day until you can do
30–45 minutes once or twice a day.
Cleaning and home duties
In the first six weeks of tissue recovery aim to avoid heavy, prolonged or strenuous activities. Light home duties done in a relaxed manner are perfectly OK. Pacing and balance are the key.
Here are some tips for modifying your home duties over the first 6 weeks post op:
- Taking washing out of the machine – take out a third of the washing, hang, then take another third, hang etc.
- Dishwasher – get into a lunge position to move things from the bottom of the dishwasher up to the counter.
- Vacuuming /mowing – best avoided, but if you have to do it do one room/area at a time and have a lying-down rest afterwards.
- Lift as you feel able – recent evidence shows it is better not to have a weight restriction but, instead, to listen to your body.
- If you’re doing anything on the floor or ground (cleaning up a spill, weeding etc.) consider going on all fours or using a small stool to sit on, rather than squatting or bending forwards for prolonged periods.
Deep abdominal exercises
- Weeks 2–3: Lie on your back, with your knees bent and feet supported on the ground. Or positioned your hands and knees
- Take a few slow breaths, on the exhale tighten the muscles of your lower abdomen, as though your belly button is moving towards your spine, hold 3-4 sec and try to breathing normally.
- Aim to do 6–10 reps three times a day.
After week 1, aim for 3 sessions per day until we see you at 6 weeks.
Things may feel different after the birth, but if you are concerned or in pain, contact your midwife / obstetrician. If it’s the exercises that hurt, just stop until you see your physio.
Aim to do these exercises in a lying or sitting position initially:
- Draw in and lift front as if stopping a wee, let go and rest for 3, 3x,
- Draw the vaginal walls together and up inside, let go and rest for 3, 3x
- Circle and draw in the back passage as if stopping wind, let go and rest for 3, 3x
- Elevator doors closing – this is a shallow movement, draw together, let go and rest for 3, 3x
If any of these hurt or make you feel worse, just stop until you see your physio.
Always draw up at the front before standing up from a chair, coughing, sneezing, lifting or laughing, even early on. If you can’t hold it, it’s OK, research shows trying to draw up helps tension the tissues and protects you anyway.
Pelvic tilts
- Lie on your back, with your knees bent and feet supported on the ground
- Tilt your pelvis back and tighten your lower tummy muscles so your back flattens
- Repeat this as many times as you find comfortable.
Remember:
- Accept offers of help.
- Rest when you can.
- Enjoy your baby
- Reach out if you are struggling, 1800 882 436
