Postpartum Care: Tips for After Delivery Health Article

Congratulations! Whether you delivered vaginally or by cesarean section, take adequate time to regain your strength. Full recovery may take up to six weeks. If you experienced significant complications, it may take longer. Talk to your doctor about when to start exercising again.

Your body is now undergoing the following changes:

• The uterus does not return to its pre-pregnancy size until approximately six weeks after delivery.
• Vaginal bleeding, or lochia, while heaviest the first few days after the delivery, may occur intermittently for three to eight weeks.
• The abdominal wall has been significantly stretched during pregnancy and will likely lack tone for several weeks. A condition known as diastasis recti, where the abdominal muscles separate in the midline of the abdomen, can also occur from this stretching.
• Episiotomy, which widens the vagina during delivery, is a laceration that usually heals within a couple of weeks. Other vaginal tears as well as larger episiotomies may take longer to heal.
• Infections such as chorioamnionitis (an infection of the embryonic membranes) or postpartum endometritis (an infection of the inner membrane of the uterus) may delay recovery.

At the same time, your center of gravity and balance are restored, your posture is again upright, and your ligaments and tendons will assume their former tone, all decreasing your risk of injury.

Be patient in resuming your exercise program, but be persistent. Your fitness was not achieved in a day, and you will not regain it in a day. Proceed at a pace that does not cause injury. If some activity is uncomfortable or painful, reduce the amount and intensity for a few days before increasing the activity level of your program. Within a few more weeks, you will be back to your fit self.

Current recommendations are that individuals do moderate to vigorous activity for at least 30 minutes on most days, preferably every day. For weight loss, even more activity is recommended. Walking is a great way to start exercising again. A brisk walk several times a week will prepare you for more vigorous exercise. Take your baby along in a stroller and enjoy your exercise together-it'll be good for both of you!

Examples from USDA guidelines of moderate and vigorous physical activities include:

Moderate:

• walking briskly (about 3.5 miles per hour);
• hiking;
• gardening/yard work;
• dancing;
• golf (walking and carrying clubs);
• bicycling (less than 10 miles per hour); and
• weight training (general light workout)

Vigorous:

• running/jogging (5 miles per hour);
• bicycling (more than 10 miles per hour);
• swimming (freestyle laps);
• aerobics;
• walking very fast (4.5 miles per hour);
• heavy yard work, such as chopping wood;
• weight lifting (vigorous effort); and
• basketball (competitive).

Sticking With It-What Works

According to the U.S. Surgeon General, you are more likely to keep doing physical activities if you:

• think you will benefit;
• include activities you enjoy;
• feel you can do the activities correctly and safely;
• have access to the activities on a regular basis;
• can fit the activities into your daily schedule;
• feel that the activities don't impose financial or social costs; and
• experience few negative consequences (such as injury, lost time, and negative peer pressure).

In other words, you are more likely to stick with your exercises if you set yourself up to succeed from the start. Choose realistic goals, learn to do the exercises correctly and safely, and chart your progress.

How Hard Should I Exercise?

Everyone is different, and it's important to listen to your body. You should be able to sense when you are challenging yourself, when you're not doing enough, and when you are nearing your limit.

Use the Borg scale to estimate how hard you should work. The numbers on the left of the scale describe how hard you feel you are working.

For endurance activities, you should gradually work your way up to level 13-with the feeling that you are working at a somewhat difficult level. Gage this according to your own comfort level. Some people might feel this way when they are walking on flat ground; others might feel this way when they are jogging up a hill.

Strength exercises are higher on the Borg scale. In order to build muscle, gradually work your way up to level 15 to 17 (hard to very hard exercise). You can tell how much of an effort you are making by comparing it to your maximum effort. How hard does your current effort feel compared to when you are lifting the heaviest weight you can lift? Once you start exerting more than a moderate amount of effort in your muscle-building exercises, your strength is likely to increase quickly.

As your body adapts to different levels of exercise and you become more fit, gradually make your activities more challenging. If you feel that your level of effort doesn't match the numbers you see on the Borg scale, check with an exercise professional. These experts can help you match your level of effort with the right number on the scale.

Go to Bodily Changes During Pregnancy, Who Shouldn't Exercise in Pregnancy,Create a Program in Pregnancy, and Endurance Exercises in Pregnancy.