Advice Following a Vaginal Delivery
It is important to look after yourself following the birth of your baby. Every woman’s journey through pregnancy and delivery is different which means recovery can vary depending on your own individual circumstances.
What can you do?
• Follow the advice in the Fit for the Future leaflet.
• Read about caring for the perineum in the early days following delivery. The perineum is the area between the vagina and the anus.
• Start your pelvic floor exercises (as noted below). As long as you have had your catheter removed (if you had one) and you are passing urine again as normal then it is safe and advisable to start these exercises.
• For returning to exercise please see further information below.
Advice Following a Caesarean Delivery
Caesarean Section involves surgery to the abdominal wall. Your return to day-to-day activities will be more gradual to allow your body time to heal and recover.
What can you do?
• In the first few days watch this short video Physiotherapy advice for after your Caesarean Section. This video is also available with subtitles in Polish, Russian, Mandarin, Urdu, Arabic and Deaf Sign.
• Follow the advice in Fit for the Future leaflet.
• Start your pelvic floor exercises (as noted below). As long as you have had your catheter removed (if you had one) and you are passing urine again as normal then it is safe and advisable to start these exercises.
These tips are great for helping in the immediate recovery phase. For returning to exercise please see further information below.
The Importance of Pelvic Floor Muscles
Pelvic floor muscles lie across the base of your pelvis and help keep the pelvic organs, including the bladder, bowel, and uterus (womb), in the correct position. These muscles work to help keep the bladder and bowel openings closed to prevent unwanted leakage (sometimes called incontinence) and they relax to allow easy bladder and bowel emptying.
Just like any other muscle they need regular exercise to remain strong and effective.
After pregnancy, this group of muscles can be weak due to the extra weight of baby as well as hormonal changes. These muscles may have been injured during labour particularly if you had an assisted delivery (eg forceps) or a significant tear or a large baby.
What can you do to help?
• Check out this leaflet about how to do Pelvic Floor Exercises and/or the video below for further advice.
• The Your pelvic floor video was produced by NHS Highland in conjunction with Association for Continence Advice.
Abdominal Muscle Separation or Diastasis Following Pregnancy
During pregnancy all the abdominal wall muscles stretch and lengthen to accommodate your growing baby. Diastasis refers to the thinning and widening of the linea alba. This is the connective tissue down the midline of the abdomen between the two sides of the “six pack” muscle or rectus abdominis muscle. This can appear as a gap or doming/bulging of the tummy. The doming may be more obvious when you do things which put more strain on your abdominal muscles such as sitting up from lying, lifting something heavy, coughing or straining on the toilet. It is completely normal for there to be widening of this gap and all women will have some degree of separation towards the end of pregnancy. This separation most often resolves naturally in the weeks following birth however, for reasons not fully understood about 1/3 of women will have a degree of separation which is ongoing. If you notice abdominal separation following pregnancy, there are things you can do to help.
What can you do?
In the early post-partum period – first 6 weeks
- As far as possible reduce activities and exercises which cause doming in the middle of your abdomen; reduce heavy lifting and avoid sit- ups in this early stage.
- To get out of bed, roll onto your side to avoid putting extra stress on your abdomen.
- Avoid constipation and/or straining on the toilet. Be sure to drink plenty of water and increase fibre intake.
- Practise relaxed breathing exercises to reduce abdominal tension. Often the imagery of breathing “in through your head and out through your feet” is helpful.
You can also read information on diastasis here.
Your midwife may refer you to physiotherapy. Individualised rehabilitation offers the most effective management for most women and there is no one size fits approach to rehabilitation. It will be dependent on your specific goals. You can also discuss referral to Physiotherapy with your midwife, health visitor, GP or you may self-refer via the form below.
Physiotherapy Self Referral form
Returning to Exercise
Physical recovery takes time following pregnancy and delivery. There is a lot you can do to improve your movement, strength, and conditioning, particularly if you are considering to return to higher impact exercise such as running.
What can you do?
• Check out this advice from the UK Chief Medical Officers on recommended levels of activity during the first year following giving birth Physical Activity Following Childbirth
• Read more on the This Mum Moves website about ideas to improve your physical activity levels.
• There are free online workouts here to help support your journey. You will find suitable workouts for the complete beginner as well as more challenging workouts for people who exercised before and during pregnancy.
• This Exercise Chart offers suggested exercise progression for women looking to return to running.
If you are experiencing ongoing pelvic girdle pain or lower back pain, urinary leakage, a sensation of heaviness in the vagina or any other symptoms that are concerning you as you return to exercise, speak to either your midwife, GP, or physiotherapist as you may benefit from further assessment and rehabilitation.