The Sports Injury Clinic Newsletter

EXERCISE AND WELLBEING AFTER PREGNANCY.

WHY EXERCISE

Exercise has numerous health benefits, all of which apply equally to the post partum woman as at any other stage of life. These benefits include assistance with weight loss, increased aerobic fitness, maintenance of bone density, improved cholesterol levels, social interaction and psychological well being. Additional to these health benefits, exercise after giving birth can hasten recovery, assist with muscle strength and toning.

HOW SOON TO EXERCISE AFTER GIVING BIRTH

Gentle exercise (such as walking) can be started as soon as comfortable after giving birth. Some women will feel able to start exercising early and may do so as long as they start gradually. Six weeks after giving birth, most of the changes that occur during pregnancy will have returned to normal. After a Caesarean birth women should refrain from aerobic exercise for at least six weeks to allow adequate healing. As a guide women should wait until at least one week after they no longer feel any discomfort and have been to their doctor for a check up.

TYPES OF EXERCISE

Most forms of recreational aerobic exercise can be resumed after giving birth. In practice, walking is the simplest to start, as the baby is readily transportable in the pram, and indeed is often most settled when moving in the pram. Cycling, swimming, weight training and other forms of exercise require more planning with a new baby as the baby can not always accompany the mother in these pursuits. Exercise classes for women who have given birth are run in many centres, which focus on improving aerobic fitness, pelvic floor strength and weight loss. These often incorporate the new baby, or provide on site child-care. Before commencing any form of exercise always remember to properly warm up. A good warm up should begin with a low intensity activity that incorporates all major muscle groups. For example when walking begin slowly and build up the intensity during the walk. All exercise should also be combined with stretching. Refer to the Smartplay “Warm Up” brochure for further information. Again commence with the major muscle groups consistent with the level of stretching you did prior to being pregnant and gradually build the intensity of the stretch. Note that at all times the stretch should feel comfortable.

CLOTHING

It is very important to ensure that adequate breast support in the form of a sports bra is worn for moderate to high impact exercise after giving birth. In general, impact exercise is best performed soon after breast feeding, when the breasts are relatively empty. It is important to wear clothing in layers to allow for removal when required, thus minimising overheating and dehydration. Good footwear is important for all weight bearing exercise, such as walking, especially in this period because the changes that have occurred during pregnancy may still be normalising.

PELVIC FLOOR

The pelvic floor may be adversely affected by pregnancy and childbirth. Most women are taught pelvic floor exercises during pregnancy and these are important to learn correctly and can be resumed immediately after giving birth. If there are any pelvic floor symptoms eg:- urinary leakage, dribbling or urgency or if you experience a heavy, dragging feeling then it is important to seek the attention of a physiotherapist specialising in women‘s health.

BREAST FEEDING

Several studies have shown that neither vigorous nor regular exercise has adverse effects on a mother‘s ability to successfully breast feed. The growth of breast fed infants is not affected by maternal weight loss of up to 0.5kg per week after giving birth. It is especially important if breast feeding to maintain good fluid intake in association with exercise.

POST NATAL DEPRESSION AND EXERCISE

There is evidence to indicate that exercise in the period after giving birth is associated with reduced anxiety and depression as well as increased vitality.

MEETING DIETARY NEEDS

ENERGY: Most women will notice an increase in their energy expenditure after giving birth, just caring for their baby. However, if breastfeeding, this will be significantly higher. In fact an extra 2500 kilojoules (600 calories) is required, which may explain an increased appetite. Adding exercise increases this requirement further. Ensure that energy needs are met by eating well at regular meals and including snacks throughout the day.

SPECIFIC NUTRIENTS: Nutrient needs are also increased for breastfeeding mothers. Specifically there is an increased need for protein, calcium, zinc, magnesium, folate and most vitamins. It is therefore recommended that nutrient dense foods be eaten including fresh fruit and vegetables, whole grain breads and cereals, lean meat and dairy products. Calcium is particularly important for bone health, so ensure at least 4 serves of dairy products daily.

HYDRATION: While drinking plenty of fluid is important for everyone, it is particularly so for breastfeeding mothers, who may notice an increased thirst. Once again, exercise further increases the need for fluid, to replace sweat losses. The amount required depends on the individual and the type and intensity of exercise, as well as the temperature and humidity.

STOP

Physical activity should be an enjoyable experience despite there sometimes being slight discomfort associated with it initially. You shouldn‘t continue with physical activity if the discomfort is greater than you expect with the level undertaken, and you should consult your doctor or medical practitioner if you have any concerns regarding the type or intensity of the activity before resuming.