Returning to Exercise and Sex at 6 weeks
So many women put A LOT of stock in their 6-week follow-up with their birth provider. Follow-up appointments with our OB/GYN basically entail a basic check of your pelvic organs and making sure any pelvic muscular tears/C-section incisions appear to on the right track with healing. There should also likely be a discussion of desired birth control method. The latest recommendations by the American College of Obstetricians and Gynecologists recommends that postpartum care is an ongoing process and by no means a single encounter.
Many new moms use this ONE visit (if they even attend it) to get their “free and clear” to exercise as well as return to penetrative sex. A message we hear again and again many are sorely disappointed when there is little discussion/follow-up on the profound physical recovery from birth. There may be no check of the abdominal wall, no in-depth check of severity of pelvic organ prolapse, and certainly limited screening of any of the various bodily pains women experience postpartum. We recommend that getting the go-ahead for sex and exercise means you proceed with caution, not hop right into both at the same frequency/intensity that you did pre-baby. Our friend Abby has a unique story that many find to be helpful HERE
We know that women deserve better. Your medical provider got you and baby safely to this point, but will not likely be of much help with your physical recovery. Here at E&E, we wanted to give a better idea of screening for physical recovery postpartum looks like. This will support your physical health well-being during the "fourth trimester" and beyond and help to ensure your recovery goes forward without any major problems!
This screening is used to give you a green light, yellow or red in returning to exercise. If you find yourself in the red category, seeking out a physical therapist will help ensure your success. Yellow means proceed with mindfulness and seek help if things don’t get better. Congrats if you pass all of these with flying colors— your body is recovering well! We encourage all mamas to be constantly checking-in and make sure they are truly feeling good!
The following exercises/screens are intended for women who follow into two groups:
(1) Those mamas getting BACK on their fitness journey. Nothing feels horribly wrong per se, but its been awhile since you’ve really EXERCISED. “I haven’t exercised since having my baby four years ago!” We get it. We have never felt busier than when we became mamas. All of a sudden we had this little person with SO many needs and we still had all the other parts of our lives to juggle. Taking this opportunity to start fresh!
(2 It is also for the moms that have stated that "My body has not felt right after having my children." Something is a little off, and we’re here to help you get to the bottom of it!
Here are the big issues that this guide can help with. If you are experiencing any of these things, the guide is a “no-brainer” purchase.
Incontinence: leakage of urine when you cough, laugh, sneeze, exercise
Low Back Pain: with lifting or standing
Hip pain
Pelvic girdle pain (persisting pain at pubic symphysis (SPD) or sacroiliac (SI) pain
Diastasis Recti (abdominal separation) and/or umbilical hernia)
Pressure in pelvic region with lifting, prolonged standing, and/or bowel movements
Note a bulge in the pelvic area after wiping or squatting down, difficulty with intercourse, difficulty with tampon wearing/insertion
Mild prolapse noted during a physician appointment
Unable to return to recreation sports at same level as prior
Experiencing irritation from the scar tissue from a C-section, episiotomy, or vaginal tearing. We provide you with instructions for selfceare.
Testing/Rehabilitating your Muscles
Upper Body
Hip Strength
Core
Low back
Lumbar Segmental Instability Test - Lie face down. Have someone apply pressure to your lumbar spine (low back). Repeat this with your legs lifted off of the floor. If pain is felt only in the first position (with your legs on the floor), this means the test is positive.
Lower Leg
We always suggest that if your injury or problem is specific we recommend that you consult with a Women’s Health Physical Therapist. You are able to use the PT Locator: pelvicrehab.com
These are a couple great reasons to consult with a Women’s health therapist that the Guides may not be able to completely resolve:
Painful sex, strongly uncomfortable or feeling different than it did prior to baby even after 6-8 weeks of healing.
A tight pelvic floor that you are unable to relax this often is associated with intercourse, tampon insertion, pelvic pain while sitting or sitting on a bike seat
Stubborn scar tissue from a C-section, episiotomy, vaginal tearing that you experience discomfort with or are worried about the healing. You are experiencing sensitivity around those tissues. That you can not get to go away on your own.
As always hoping to load you with knowledge so you are able to get back to feeling yourself!
Krystle Howald, PT, DPT