postpartum pressure when standing?

Six ways you’re sabotaging your postpartum recovery

Having a baby is a big emotional and physical transition. Go easy on yourself, and please don't try to "do it all."

By Kate Daley February 1, 2019

Photo: iStock Photo

The happy pictures of glowing new moms and hours-old babies you see on social media make childbirth seem easy, like it’s totally NBD. But giving birth is a life-altering event, and many women have unrealistic expectations about how fast they can (and should) get back to “normal.” When you have a hungry or fussy newborn and birth injuries to contend with at the same time, you have to adjust your recovery timeline and go easy on yourself.

“Respect the fact that you are going through a massive life change and a massive recovery,” says Batya Grundland, a family doctor who focuses on obstetrics and perinatal care at Women’s College Hospital in Toronto. If you want to get back on your feet and feeling better, faster, here are some things to watch out for.
1. Trying to do it all

From booking a newborn photoshoot to hosting family who want to meet the baby (and cleaning the whole house before all the visitors arrive), it’s common to overdo it in those first few weeks. But even if you had a relatively easy delivery and didn’t get many stitches, you’ve just gone through a major physical trauma—experts say that for those first few weeks, rest is key. For at least the first 24 to 72 hours post-birth, spend as much time as possible in bed, skin-to-skin with the baby, especially if you’re trying to get the hang of breastfeeding, says Jennifer Brewer, a registered midwife in Toronto. Many midwives recommend a full week of bed rest, but Brewer understands that a week isn’t always possible for most women (especially if you have other children). Try for at least a few days, if you can. Staying horizontal, not walking around too much, and keeping pressure off your pelvic floor will help with healing and minimize postpartum bleeding.

Impose limits on yourself and others. If a messy house drives you insane, ask someone else (like your partner or mother-in-law) to help with household tasks. Or set a timer and clean for 10 minutes, but no more. When family and friends come to visit, give them a specific window for when they can come and ask them to bring their own food and refreshments, or any supplies you might need. (Hint for your visitors: nipple cream, a pack of pads, baby wipes, fancy coffee delivery or snacks for a ravenously hungry nursing mom may be way more useful to you and your partner than overloading on cute baby outfits and blankets.)

“Don’t invite people who are going to come in and just expect you to get up and make them something,” says Brewer.

Visitors often want to pass the baby around, too. While it’s nice to have your hands free for a bit, the fights over who gets to hold the baby make it especially hard for you to learn your new baby’s hunger cues. It can take three to five days (or more) for your milk to come in, which means some of your first well-wishers might arrive while you’re still trying to get into a good feeding rhythm. If you’re worried about your baby’s weight (the rule of thumb is that they should regain their birthweight by week two), minimize the amount of time the baby spends cuddling in others’ laps. (Sorry, Grandma!)

Also, make sure to ask everyone to wash their hands. Newborns are especially vulnerable to germs, as their immune systems are still forming.
2. Ignoring physical and mental red flags

Keep an eye on how you feel overall, and identify red flags early. If your post-birth pain is no longer being controlled by medication, if you begin seeing discharge from your stitches, or you experience heavy bleeding that’s persisting or getting worse, call your doctor as soon as possible, recommends Grundland.

Beyond the physical symptoms, it’s also important to monitor your mood. If you’re unable to feel a sense of connection with your baby, or if you can’t sleep at night—not because of your newborn, but because your worries are keeping you awake—you need to seek help early. This is especially essential if you’re having suicidal thoughts or thinking about harming your baby, says Grundland. Brewer agrees: The number one concern she sees in new mothers is mood issues that aren’t being addressed.
3. Forgetting to prioritize self-care

Maybe you read the term “self-care” and rolled your eyes. Who has the time for self-care at this stage of motherhood? But try to take at least half an hour of time to yourself every day, even if it’s just to have a shower or to go to the bathroom alone, says Brewer. Ask your partner or a family member to come and take the baby for that solid chunk of time, so you’re not standing in the shower, unable to relax, wondering if that sound you’re hearing is your baby crying in the other room.

Alt text 17 mind-blowing ways your body changes after giving birth
If you’ve had a vaginal birth, use this time to take an epsom salt bath in lukewarm water for 15 to 20 minutes, which will help promote healing. (Separate sitz baths that attach to the toilet work as well, but they’re not nearly as relaxing, and can put pressure on an already sore area.) Applying frozen pads soaked in witch hazel will help soothe a sore perineum or ay hemorrhoids. Or, if you’re feeling up for it, go outside for some fresh air or a coffee shop visit, or just find a quiet place to read a magazine solo. “Around the six week mark, if people really aren’t yet doing these mental health things—like handing off the baby for a half-hour—I start to see issues,” says Brewer.

It’s not selfish—it’s self-care that might save your sanity, and hasten your physical recovery as well.
4. Eating (and drinking) poorly

While you might be tempted to grab whatever carbs you can eat with one hand, try your hardest to keep healthy foods stocked. (Almonds, apples and protein bars are easy, one-handed snacks to add to your shopping list.) The first six weeks are about survival—it’s not about losing the baby weight. Eating well will help you manage your energy levels and mitigate any constipation.

“All women are a little bit constipated postpartum,” says Grundland. When you’re in labour (and if you’ve had surgery, such as a C-section) your digestion slows down, and constipation can cause painful bowel movements, or cause or worsen hemorrhoids. Eat lots of fibrous veggies, consider taking some flax supplements, and drink lots of water. (If dietary interventions don’t work, Grundland says it may be worth speaking with your healthcare provider about stool softeners.) If you’re breastfeeding, try to eat full-fat foods such as fish, yogurt and avocados to satiate your hunger.

When you’re bone-tired, your first instinct might be to reach for a cup of joe, but Brewer doesn’t recommend having more than one cup a day. Coffee dehydrates you, and small amounts of it end up in your breast milk, which can ultimately cause even more sleep deprivation. Instead, hydrate throughout the day with lots of water, or you can try lactation teas or coconut water for additional electrolytes.
5. Doing too much exercise too soon (and the wrong types)

Until your six-week postpartum check up, you shouldn’t be doing any serious exercise, says Amy Gildner, an orthopaedic physiotherapist and certified pelvic floor physiotherapist at West End Mamas in Toronto. “It’s definitely a time to rest and repair,” she says.

Once your healthcare provider gives you the green light, don’t go out and join a hardcore baby bootcamp right away. When you’ve got a six-week-old, you likely won’t be ready or able to do squats and planks like the mom of a six-month-old. One of the biggest mistakes women make is returning to exercise that is too challenging, says Gildner. Even if you were in great shape before (or even during) your pregnancy, you need to recognize that it won’t feel the same afterward. Approach your exercise goals like you’re coming back from an injury—which you are—and ease into it slowly, she recommends. And remember that the often-repeated “no pain, no gain” workout philosophy does not apply to postpartum healing.

So, skip sit ups and crunches—those aren’t great for anyone, especially postpartum, says Gildner. Avoid heavy lifting or straining during those first few months. Activities like spinning can be great for postpartum women who are having trouble walking, but be wary of leaning over and putting too much strain on a C-section scar.

“I don’t think it’s good to stay stagnant either,” says Gildner. She recommends that women begin getting active in a way that isn’t painful, as soon as they are able. Start off with walking, then add in some hills and gauge how you’re feeling before taking it to the next level. If you’re feeling the need to stretch and move, look into more gentle methods, like guided parent-and-baby yoga classes or moderate Pilates classes specifically designed for postpartum women.
6. Skipping pelvic physiotherapy

At the six-week mark, most women, whether they had a vaginal birth or a C-section, will benefit from being assessed by a pelvic floor physiotherapist. (This is separate from your six-week checkup with your primary care provider, and may cost you out of pocket, unless you have extended health benefits.) While a pelvic floor physio is an added cost, “it’s so worth it,” says Brewer. The physio will assess your core and back muscles, check on the healing of any scar tissue, and they’ll examine your pelvic floor, the sling of muscles holding up your pelvic organs. Be forewarned—this involves an internal vaginal exam. Pelvic physiotherapists can also help with healing diastasis recti, which is the thinning of the linea alba tendon in between your abs (making it seem like they are separating), caused by intra-abdominal pressure.

“One hundred percent of pregnant women have diastasis,” says Gildner. “It’s completely normal.” But getting the extent of your diastasis assessed, and managing it with personalized at-home exercises the physio recommends for you, is important for proper healing. Most physios will recommend deep core work such as Pilates moves or oblique exercises, as well as pelvic floor exercise cues, similar to doing Kegels.

It can be a tricky skill to master, especially after childbirth. To isolate your pelvic floor muscles, pretend you are scooping up a marble with your vagina and then pulling the marble up to your bellybutton. Don’t tense up your whole body, though. “I find some women brace even their neck muscles when I get them to do a Kegel. It’s a more subtle movement, focusing only on the vaginal muscles,” says Gildner. To help get the mind-muscle connection back, aim to do 10 to 15 Kegels per day, but don’t go overboard, either. Doing too many per day while you’re healing will do more harm than good.

C-section moms should also get assessed, says Gildner. “The biggest myth of C-sections is that your pelvic floor is fine because you didn’t deliver vaginally. Nothing could be further from the truth.” You are still pregnant for nine months, your core is often weak, and scar tissue can create a lot of issues with your abdominal muscles in your core. C-sections often cause women to experience back pain, stemming from a weak core. “We often don’t see [C-section] clients until a few months afterward, when the issues are chronic and harder to fix,” she says.

The fourth trimester asks a lot of your body: constantly reaching down to get your newborn from the bassinet, nursing in awkward positions, or babywearing, which can put a lot of strain on both your back and abdominals. The lack of sleep can make it even harder to recover.

Remember to take it easy. You don’t have to be Superwoman, but you do need to try and look after yourself (both physically and mentally) as much as you’re looking after your newborn. Remember to feed your body well—not just your baby’s—and snuggle up with your little one as much as possible. All this quiet, restful time will pay off in the long run, making you a happier parent who’s able to fully enjoy her baby.

Read more:
How postpartum doulas can help parents through the first few weeks with a new baby
Six things every mom should know about postpartum recovery