After childbirth, your body needs about six weeks to return to its normal anatomy and physiology. Most precautions at this time are to protect the uterus; it is still enlarged and healing, and the cervix is still open. To prevent bacteria from entering the uterus, you should not use tampons for bleeding in the first month after childbirth. If you had a cesarean section, you might need longer before beginning activity to allow the incisions to fully heal. Check with your doctor for more specific guidelines.
Impact activities are not recommended during the time immediately after delivery, as this can cause increased uterine bleeding and stretching of the ligaments that hold up your uterus. Swimming should also be avoided until vaginal bleeding or episiotomy tears have healed. A healing episiotomy also limits cycling, although riding a recumbent bike with padded shorts is possible as long as it is not irritating the area.
You should gradually return to exercise. If you find that you bleed heavily after a workout, rest for a few days then try again at less intensity. Also be aware that your ligaments throughout your body are still loose, and you can be prone to ankle or ligament sprains. Because breasts remain enlarged throughout breastfeeding, continue to wear your extra-supportive athletic bra; this also prevents nipple irritation. You might need to put gauze over your nipples if they are sore, and wear nursing pads to prevent leakage. If you are breastfeeding, you still need to follow pregnancy guidelines for nutrition, including extra calories and fluids.
Having trouble controlling urine, or incontinence, is a common problem after childbirth due to the stretching of all structures. This improves over time and with Kegel exercises. If you are still having difficulty with incontinence after two months, speak to your doctor about it. If you have associated burning, funny odor, or are urinating often, you might have a urinary tract infection.
These are exercises to strengthen the muscles at the base of your pelvis and help support your urinary muscles. Kegels are done by squeezing the vaginal muscles as if you are stopping your flow of urine. Hold each contraction for 5 to 10 seconds. They should be done 10 to 20 times 3 to 5 times a day. They can be done anywhere, and no one can see you doing them.
Fatigue is very common after childbirth for many reasons. You are probably not sleeping through the night with the challenges of baby care, and your body is healing. You might also be slightly anemic after delivery, which contributes to tiredness. Listen to your body and let it rest and heal as best you can. This will make you a better mother and preserve your health and physical fitness in the long run. If you are too fatigued for daily activities, speak with your doctor.
From The Active Woman's Health and Fitness Handbook by Nadya Swedan. Copyright © 2003 by Nadya Swedan. Used by arrangement with Perigee, a member of Penguin Group (USA) Inc.
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