post-natal exercises following a pregnancy loss · there are two different kinds of exercises. you...

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Post-natal exercises following a pregnancy loss

Information for patientsWomen's Health Physiotherapy

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This leaflet offers advice on safe and effective exercises for the first 6 weeks following your pregnancy loss. The exercises will help you to:

• Regain the strength of your core stability muscles• Regain your fitness• Improve your posture• Flatten your tummy• Reduce any pelvic discomfort and swelling• Prevent backache• Prevent bladder and bowel leakage

Where are my core stability muscles?

Your 4 core stability muscles are shown in the diagram (in bold). These muscles support and stabilise the pelvis.

Coccyx

Pelvic floormuscles

Deep abdominal(tummy) muscles

Diaphragm (muscle)

Backbone(spine)

Deep backmuscles

Pubic bone

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What happens to my core stability muscles during pregnancy and birth?

These muscles are stretched during pregnancy and birth and this can affect the stability of your pelvis.

When should I start these exercises?

You should start the exercises as soon as possible.

What do I need to do?

1. Strengthen your pelvic floor muscles:

Your pelvic floor muscles help prevent leakage from the bladder and bowels. They also help to stabilise the pelvis.

Breathe out and imagine you are trying to stop yourself from passing urine or wind. The muscles you are tightening are the pelvic floor muscles.

Bladder

Pubic Bone

Urethra

Entrance to vagina

Pelvic floormuscles

Spine

Rectum

Coccyx

Uterus (womb)

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There are two different kinds of exercises. You should always practice both kinds of exercises. Try to do these exercises 3-4 times a day.

Gentle long holds:

• Lie or sit in a comfortable position.• Relax and breathe in. As you breathe out, gently pull in the pelvic

floor muscles.• Hold the muscle for a few seconds and then release the muscle

fully.• Repeat this 5 times.• You may not feel much happening at first but keep trying.• Build up to a 10 second gentle hold and repeat 10 times. Rest for

5 seconds between each squeeze.

Quick, short squeeze:

• Pull up the pelvic floor muscle as quickly and strongly as you can and then let go immediately.

• Rest for 2 seconds and then do it again.• Repeat this 10 times.

Later on you should be able to practice both these exercises when you are in a standing position. Remember that it is important to do pelvic floor exercises for the rest of your life.

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2. Strengthen your abdominal muscles (tummy muscles)

Start doing this exercise in the most comfortable position for you - lying on your back or side with your knees bent or sitting with your back well supported.

• Place one hand on the lowest part of your tummy.• Let your tummy relax completely as you breathe in through your

nose.• Breathe out and pull the lower tummy in gently.• Feel the muscle under your hand tighten or move in towards your

back a little.• Hold this tightening while you breathe normally for 10 seconds.

Relax the tummy and feel it let go. Rest for a few seconds.• Repeat this tightening and holding 10 times.• Try to exercise the tummy muscles like this at least 3 times a day.

As the muscles regain their strength you should be able to feel the tummy and pelvic floor muscles tighten together gently. All women should continue to exercise their pelvic muscles for life, to maintain bladder and bowel control.

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Is there anything I should do to look after my bladder and bowels?

• Make sure you are emptying your bladder regularly, every 3 - 4 hours.

• Do not get into the habit of going to the toilet 'just in case'.• Do not stop and start the flow of urine.• If you are finding it difficult to control or pass urine, talk to your

midwife or ask to see the physiotherapist.• If you have had stitches in you pelvic floor muscles, then apply

gentle pressure over the stitches when you open your bowels.• Breathe out slowly when you open your bowels.• Do not strain to empty either your bladder or your bowels.• Always wipe from front to back. Keep the area clean and dry.• Aim to drink at least 1.5 litres of fluid a day.• Eat plenty of fruit and vegetables to avoid constipation.

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What other exercises can I do to help my core stability muscles?

Try the following exercise.

Pelvic tilt

• Lie on your back with the knees bent and feet flat on the floor or bed.

• Breathe out and flatten your back towards the floor or bed.• You should feel the pelvis tilt back and the lower tummy muscle

tighten.• Hold this position for a few seconds while you breathe normally

and then gently release.

Repeat 10 times.

If you notice any bulging of your tummy muscles while you are doing any of these exercises, get advice from the women's health physiotherapist before continuing with the exercises.

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Why do I have to look after my back now?

Your joints are more flexible than they were before you were pregnant and can stay like this for up to 6 months or more. You can easily strain your back during this time, so try not to lift any heavy items.

How can I look after my back?

It is very important to have good posture.

A good posture will automatically work your core stability muscles and this will protect your back.

• Stand tall with your body weight equal on both feet.• Imagine a piece of string gently pulling you up from the top of

your head.• Feel the lower tummy muscles tighten a little.• Relax the shoulders and breathe normally.• Remember to keep this good posture when you are sitting.

Practice this correct posture as often as you can, for example standing in a queue or walking.

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How should I lift heavy items?

• Bend the knees.• Keep your back straight.• Tighten your core stability muscles and breathe out as you lift

slowly.• Hold the heavy item close to you.• Stand up tall.

How should I get out of the bed?

• Bend your knees.• Roll over and put your legs over the side of the bed.• Push up with your hands into a sitting position.

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How can I regain my general fitness?

• Taking a daily walk is a good all-round exercise.• Increase the walking distance gradually, especially in the first 6

weeks.• Progress at a pace that suits you.• Get plenty of rest and relaxation.• Listen to your body and stop if you have any back pain or bladder

problems.• You may go swimming after your 6 week postnatal check up.• We recommend that you wait at least 3 months before doing

more vigorous activities.• It may take up to 6 months or more to recover completely.

Who should I contact for more advice?

Contact the women's health physiotherapists on:

• 0114 271 3090

You can also find more information on the Chartered Society of Physiotherapy website:

• http://pogp.csp.org.uk/

For support with bereavement you can also contact Bereavement Services on:

• 0114 226 8425

PD7127-PIL2764 v4 Issue Date: December 2019. Review Date: December 2022

Alternative formats can be available on request.Please email: [email protected]© Sheffield Teaching Hospitals NHS Foundation Trust 2019Re-use of all or any part of this document is governed by copyright and the “Re-use of Public Sector Information Regulations 2005” SI 2005 No.1515. Information on re-use can be obtained from the Information Governance Department, Sheffield Teaching Hospitals. Email [email protected]

post-natal exercises following a pregnancy loss · there are two different kinds of exercises. you...

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