Postnatal Exercises

This leaflet tells you about exercises you can do to help get back to normal after the birth of your baby.

The following exercises can be done from the day your baby is born.

Exercises to improve your circulation

During pregnancy, the blood circulation in your legs often slows down, causing swelling of your feet and ankles. This can worsen after the birth of your baby as your circulation returns to pre pregnancy state.

Try to support your legs on a stool or pillow when you are sitting down and avoid sitting with your legs crossed.

You should:

• Breathe deeply in through your nose and out through your mouth. Repeat 3 times.

• Bend your ankle to stretch your feet up and down.

• Move your feet around in circles.

• Sit on the bed and push the backs of your knees into the bed; the muscles on the front of your thighs should tighten.

Repeat 10 times, each leg.

Try to do all 4 exercises every hour for a few days, or until any swelling of your legs has gone.

These exercises are very important if you have had a Caesarean section to help prevent a deep vein thrombosis (DVT) blood clot in your leg or PE (a blood clot in your lungs).

Pelvic floor exercises

The pelvic floor is a made up of layers of muscles, stretching like a hammock from your pubic bone to the bottom of your tailbone (see diagram below). It provides the floor to your pelvis.

These muscles help to hold your bladder, bowel and the uterus (womb) in position.  They prevent leakage from your bladder and bowel, only relaxing when your bladder or bowel is emptying.

These muscles help to hold your bladder and bowel in position, also the uterus (womb) in women. They stretch to allow your baby to be born.  They prevent leakage from your bladder and bowel, only relaxing when your bladder or bowel is emptying.

Why should I do pelvic floor exercises?

All women need to do pelvic floor exercises throughout their lives.  Pelvic floor muscles may become weak:

• During and after childbirth.

• Through lack of exercise.

• By straining to open your bowels.

• By being overweight.

• From having a chronic cough.

During pregnancy, pressure on your pelvic floor increases with the weight of your baby. This may cause your pelvic floor to weaken and you may leak urine when you exert yourself, especially after the baby is born.

Doing your pelvic floor exercises before and after delivery can help to keep these muscles strong and flexible.

How to do pelvic floor exercises?

You should:

• Sit comfortably with your knees slightly apart.

• Imagine you are trying to stop yourself passing wind from your bowel by squeezing and lifting the muscles around your anus (back passage). You should be able to feel the muscle move and the skin around your anus tightening and being pulled up.

• Next imagine you are sitting on the toilet trying to stop passing urine, you are “zipping up” inside. You should be using the same muscles you used before.

• Join both of these exercises together to strengthen your pelvic floor. This is called pulling up your pelvic floor.

There are 2 ways of doing these exercises. You will need to do both.

Slow exercises

You should:

• Slowly tighten and pull up your pelvic floor muscles and hold for 5 -10 seconds, then relax for 5 seconds. Repeat this exercise 8 times.

You may not be able to hold for 5 – 10 seconds at first, but try your best and keep practising.

After a 2 minute rest, start your fast exercises.

Fast exercises

• Quickly tighten and pull up your pelvic floor muscles then let them relax straight away. Repeat this exercise 8 times.

• Do these exercises at least 3 sets every day.

When you have learnt how to do pelvic floor exercises you can do them while sitting, for example, watching TV, standing, such as, washing up, waiting for a bus or lying down.

You should continue to do these exercises every day for the rest of your life. It is important you continue to enjoy life and not allow your bladder to control your life.

Try to do these exercises every hour. Don’t try to stop the flow of urine while emptying your bladder as this can cause bladder infections.

It is fine to do the following exercises even if you have had a Caesarean section but you may need to do less or more slowly.  Only do what feels comfortable.

It can take several months for the pelvic floor muscles to return to their previous strength.

Abdominal (tummy) exercises

The most important muscles to strengthen are the deep muscles, which run across your lower abdomen. These muscles are vital in supporting the pelvis and spine and so preventing backache. The best way to tighten and strengthen these muscles is while doing your pelvic floor exercises.

To exercise these muscles:

• Place your hand on your lower abdomen and take a deep breath in through your nose.

• As you breathe out pull your tummy in towards your spine, then relax.

Repeat 5 – 10 times, 3 times a day.

Once you are able to do this comfortably, repeat this exercise but this time keep your tummy muscles pulled in for up to 10 seconds while you breathe in and out.

Repeat 5 -10 times, 3 times a day.

Sitting, standing or lying on your back with your knees bent, feet flat:

• Pull your tummy in, tilt your bottom upwards slightly and press the small of your back against the floor or bed. Hold for a count of 3.

• Relax.

Repeat 5 times, 3 times a day.

This exercise is particularly helpful if you are suffering from backache.

The following day:

• As you press the small of your back against the floor or bed, raise your head off the pillow.

• Hold for a count of 3.

• Relax.

Repeat 5 times; add one more each day up to about 20 if you feel able to.

Please note

Many women who have recently given birth find that they have a gap in the centre of their tummy between their muscles. These muscles can separate like this as your baby grows and it will feel like they no longer meet in the middle.

The best way to get the muscles to ‘knit’ back together is to carry out the gentle exercises above. If you try to do more strenuous exercises, you may make it worse. If your muscles have not separated (ask your midwife to check), or when they have ‘knitted’ back together, you may carry out the following exercises.

All of these exercises should be done 5 times, 3 times a day. Add one repetition daily up to about 20 if you feel able to.

Please remember it is OK to do the following exercises even if you have had a Caesarean section but you may need to do less or more slowly. Only do what feels comfortable.

Knee rolling exercise

• Lie on your back with your knees bent, feet flat and arms out to the sides.

• Press the small of your back against the floor or bed. Keeping your knees together roll them as far to the left as feels comfortable, then back to the middle.

• Relax.

• Repeat to the opposite side.

Repeat 10 times on each side, 3 times a day.

Hip up exercise

• Lie on your back with one knee bent and one straight.

• Push the heel of the straight leg down away from your waist so that the leg becomes longer. Then shorten the same leg by drawing the hip up towards your body, keeping the knee straight.

• Relax.

Repeat 10 times on each side, 3 times a day.

Curl ups exercise

• Lie on your back with your knees bent, feet flat, hands on thighs.

• Press the small of your back against the floor or bed.

• Lift your head and stretch your hands towards your knees.

• Lower down slowly.

Returning to sport

Build up gradually. Do not expect to return to the same level of fitness straight away. If you were used to energetic exercise, you should be able to start gently after 2 – 3 months, if not wait until you are ready.

If attending any exercise classes, make sure the instructor is qualified and is aware that you have recently given birth.

General advice

For 3 – 6 months after the birth of your baby, your body is under the influence of relaxin, a pregnancy hormone, which softened your joints during pregnancy. Relaxin affects every joint, for example, knees, ankles and feet, and may cause strains and sprains.

Remember:

• Do not exercise when you are really tired.

• Have a rest every day.

• When getting out of bed, bend both knees, press them together and roll over to your side, then push yourself up with your arms.

• Good posture is important, you should walk and stand ‘tall.’

• Never lie on your back and lift both legs in the air or do ‘sit-ups’ with your legs straight. These can be very dangerous, you must not do this.

When lifting you should:

• Keep your back straight and bend your knees.

• Hold your baby or objects close to your body as you stand up.

You will put extra strain on your back if you do not bend your knees and hold your baby away from you.

You should not lift heavy or large objects for 6 weeks after having your baby.

Do

Do not

Nappy changing positions

The surface you use to change your baby should be at waist height, if possible, to avoid bending. However, if you do change your baby on a changing mat on the floor, remember to keep your back straight to avoid putting strain on your back.

Do

Do not

Do

Do not

Feeding positions

Always sit right into the back of the chair or in bed when feeding your baby. You can use pillows if you are in bed or a small pillow or folded towel behind your waist to support you if you are sitting in a chair.

Use pillows on your lap to help to position your baby to the level of your breasts, making sure you keep your back straight. Try not to bend forward.

Do

Do not

Do

Do not

Useful hints and tips after having your baby

Coughing

If you have had a Caesarean section, you may find you need to cough but have difficulty doing so. It is important that any phlegm is cleared from your chest. You will not harm your wound by coughing. It may help to use a pillow to support your wound while you cough.

Make sure you tell your midwife if you feel ‘chesty’. You may find the position below makes coughing less painful.

Contact

If you need further advice, or have any worries, please contact:

University Hospital of North Tees

Community Midwives

Monday – Friday, 8.30am – 9.30am
Non-urgent messages can be left on an answering machine and will be picked up throughout day.
If your call is urgent, you should contact the hospital where you are due to have your baby.
Telephone: 01642 383439
Telephone: 01642 383440

Antenatal Day Assessment Unit

Monday – Friday, 8.30am – 9.30pm
Saturday and Sunday, 9.00am – 5.00pm
Outside of these hours, calls are transferred to the Delivery Suite.
Telephone: 01642 624239

Delivery Suite
24 hours a day, 7 days a week.
Telephone: 01642 382718

Antenatal/ Postnatal Ward
24 hours a day, 7 days a week.
Telephone: 01642 382722

University Hospital of Hartlepool

Antenatal Day Unit
Monday – Friday, 9.00am – 5.00pm
Outside of these hours, calls are transferred to the Birthing Centre.
Telephone: 01429 522879

Community Midwives
Non-urgent messages can be left on an answering machine and will be picked up throughout day.

If your call is urgent, you should contact the hospital where you are due to have your baby.
Telephone: 01429 522279

Peterlee Community Hospital

Community Midwives

Monday – Friday, 9.00am – 10.00am

Non-urgent messages can be left on an answering machine and will be picked up throughout day.
If your call is urgent, you should contact the hospital where you are due to have your baby.

Telephone: 01429 522270

Other useful addresses and numbers

Footsteps
Ochill Terrace
Billingham
Telephone: 01642 528920

Ragworth Children’s Centre
St John’s Way
Stockton
Telephone: 01642 528061

Sunrise Children’s Centre
Yarm Road
Stockton
Telephone: 01642 527218

High Fliers Children’s Centre
Tedder Avenue
Thornaby
01642 527809

Further information available

NHS Choices
Calls to this number are free from landlines and mobile phones.
When it is less urgent than 999 call 111
Website: www.nhs.uk

National Childbirth Trust
Alexandra House
Oldham Terrace
Acton
London
Monday – Friday, 9.00am – 8.00pm
Telephone: 0300 330 0772
Website: www.nct.org.uk

Bladder and Bowel Foundation
SATRA Innovation Park
Rockingham Road
Kettering
Northants

Monday – Friday, 8.00am – 8.00pm

Telephone: 0845 345 0165
Website: www.bladderandbowelfoundation.org

Comments, concerns, compliments or complaints

Patient Experience Team (PET)

We are continually trying to improve the services we provide. We want to know what we’re doing well or if there’s anything which we can improve, that’s why the Patient Experience Team (PET) is here to help. Our Patient Experience Team is here to try to resolve your concerns as quickly as possible. The office is based on the ground floor at the University Hospital of North Tees if you wish to discuss concerns in person. If you would like to contact or request a copy of our PET leaflet, please contact:

Telephone: 01642 624719

Freephone: 0800 092 0084

Opening hours: Monday to Friday, 9:30am to 4:00pm

Email: [email protected]

Out of hours

Out of hours if you wish to speak to a senior member of Trust staff, please contact the hospital switchboard who will bleep the appropriate person.

Telephone: 01642 617617

Data protection and use of patient information

The Trust has developed Data Protection policies in accordance with Data Protection Legislation (UK General Data Protection Regulations and Data Protection Act 2018) and the Freedom of Information Act 2000. All of our staff respect these policies and confidentiality is adhered to at all times. If you require further information on how we process your information please see our Privacy Notices.

Telephone: 01642 383551

Email: [email protected]

Leaflet feedback

This leaflet has been produced in partnership with patients and carers. All patient leaflets are regularly reviewed, and any suggestions you have as to how it may be improved are extremely valuable. Please write to the Clinical Governance team, North Tees and Hartlepool NHS Foundation Trust, University Hospital of North Tees, TS19 8PE or:

Email: [email protected]

Leaflet Reference: PIL1002
Date for Review: 08/09/2024