I write this piece not to pressure any woman to engage in fitness in a way that isn’t authentic to her but to share my story and provide information about options I was previously unaware of. Parenthood is already overwhelming enough without the vast societal pressure mothers face! My hope is that women who choose to become biological parents are aware of actions they can take to maintain and perhaps even increase their physical strength during their childbearing season if they so choose.
A few years ago I was thrilled to hold my friend’s two month old baby…well, I was until my back started hurting! This beautiful babe was still pretty small and I immediately thought of a 2014 Washington Post article about how physically demanding motherhood could be. I knew I wanted to be a mother in the near future, however I was wondering how I could make it through the physical demands of motherhood.
I reached out to physical therapist Cristin McGetrick for support and learned that my hips were out of alignment and that my core could be strengthened to prevent this in the future. After some core strengthening and stabilizing work things got much better, and then I became pregnant. I didn’t want to lose the strength I had worked hard to gain. Yet I didn’t know what I could safely do in this season and what would help my post-partum recovery and long-term fitness.
I didn’t want to lose the strength I had worked hard to gain. Yet I didn’t know what I could safely do in this season and what would help my post-partum recovery and long-term fitness.
I reached back out to Cristin and we worked together throughout my pregnancy. At first the exercises were similar to what we had worked on before, and over time they adapted as my body did. I paired them with whatever cardio I could muster. By my eighth month all I could do fitness-wise was swim, as I was dealing with floppy ligaments, bloating, and sciatica. The water felt wonderful, and I was gloriously swimming laps the day before my son was born.
My son was in our arms less than three hours after my water broke, which in fact happened while I was doing a fitting for The Courtney dress. I had an emergency C-section and when the hospital staff came to change my dressing my back reflexively arched into the perfect bridge to allow them to get right under me. I felt a surge of pride at the work I’d done, however I knew there was much work ahead.
My son was four and a half pounds when he came home, yet because of my incision I could barely hold him to breastfeed. I needed pillows to cover and support my belly and it was months before I felt I could lean over to properly give him a bath. My husband took four months of leave and I truly don’t know how women without around the clock support do it, as I physically could not take care of my child’s needs for over a month.
Even babies need to do hard work to strengthen their core (aka tummy time)!
I was mentally and emotionally ready to exercise long before I could physically. Thankfully my healing went well. As soon as I was cleared by my doctor for exercise I took Cristin’s advice to visit Rene Lawson, a women’s health physical therapist. I had to get a script from my doctor which mentioned my “postpartum abnormality of organs and soft tissues of the pelvis”. This struck me as very strange since my recovery was going well and there was nothing “abnormal”. Oh to be a woman in this country at this time! The visit was unlike any other PT appointment I’ve had and something that I wish was the standard course of care for women in this country. I was given a few exercises (think kegels and the like) and cleared to start exercising and working with Cristin again. At this point I was exhausted by the toll of the past few months and I remember Rene’s wise words, “Children are for life.” This was a season to live through and the result would be the most beautiful little boy being part of my world.
The next week I slowly started swimming again and it felt awesome! A few weeks later I started working again with Cristin. It took me nearly six months to rebuild. I certainly got frustrated that it was such an uphill battle and struggled with jealousy of friends I saw increasing their fitness goals while I had to work so hard to get back to where I was. However I now fairly easily carry my twenty pound bundle of joy around the house, run, bike, swim, lift, and more. I feel physically able to do whatever is needed to care for my son and myself and can tell my strength is increasing. I honestly feel the best physically that I ever have!
Celebrating with Cristin on my last day of post-partum physical therapy
My husband recently saw an advertisement with the words “strong as a mother” and pointed it out to me, as we both love that sentiment. It really does take tremendous strength of every type to become a mother!
I’m shocked by how little I knew about what I could do during this season to work on my strength and recovery...
My journey has made me more passionate than ever about women’s health and giving women information and options. I’m shocked by how little I knew about what I could do during this season to work on my strength and recovery and how far we are behind countries like France. To combat this lack of information I’m sharing my story. And I’m doing something that may be even more valuable-an interview with my amazing physical therapist and friend, Cristin McGetrick! I encourage you to share it with all of the women you know who may benefit from this knowledge.
Interview with Cristin McGetrick, PT, DPT, CSCS
Could you explain what diastis recti is and why so many women struggle with it post-partum?
Our rectus abdominis (think six-pack abs) is formed by two columns of muscles. Splitting the columns in half is an area called the linea alba, which is made up of non-elastic tissue called fascia. As the belly grows with the baby the linea alba can stretch the rectus abdominis apart. This stretching can lead to increased abdominal weakness during and after pregnancy. Age, previous births, and multiples can lead to an increased likelihood this can occur, but it can affect anyone.
Picture from Move Forward.
It is impossible to completely prevent diastis recti, however physical therapy can help with increasing the stability of the rectus abdominis and pelvic floor during pregnancy. It can also increase the likelihood of “bouncing back” after child birth.
Your muscles are like rubber bands; the tighter they are start before being stretched out the easier it is for them to go back to how it was beforehand. This concept carries over to pregnancy. The stronger and tighter your muscles are before you get pregnant, the easier it is for them to recover once the child is delivered. If nothing is done to help correct this it can lead to back pain, a feeling of overall weakness in the abdominal region, flabbiness (the muscles feeling less tight), pelvic floor issues, and poor posture.
What are the pelvic floor muscles and why do some women have pelvic floor challenges post-partum?
Image from The Pregnancy Centre.
Your pelvic floor is the layer of muscles that go from your pubic bone to the tip of your sacrum. These muscles are important because they support the sphincters for the bladder, uterus and rectum. They also assist with the birth of a child and stretch during this time. With age these muscles naturally become weaker, but during pregnancy the added pressure, increased hormones, and weight of the baby can also lead to weakening. The biggest culprit of pelvic floor weakening is childbirth itself, as stretching and possible tearing can cause these muscles to become significantly affected. Pain in this area and bladder incontinence (peeing a little when you sneeze, cough, lift, laugh etc.) can occur if these muscles are not properly strengthened.
Luckily, physical therapy has a specialty called women’s health to offer support here. Women’s health physical therapists are clinicians who are very well-trained in the evaluation and treatment of this specific group of muscles. Check out the women’s health PT locator website to find a specialist near you.
What are some things you can do prior to as well as during pregnancy to lessen the chance of these and other post-partum physical challenges?
There are so many different things that someone can do before and during their pregnancy, but just getting out and being active is a huge step in the right direction for an easier recovery post-partum. Before becoming pregnant stay active doing whatever you love to do. Running, weight training, hiking, yoga, biking…you name it! Try to incorporate some generalized strengthening especially with the hips, core, and pelvic floor.
Just because you are pregnant does not mean you have to stop exercising, unless given orders from your doctor. Throughout the pregnancy you can maintain the same level of exercise and activity as beforehand. One thing I would not recommend and advise against is picking up a new exercise or activity while pregnant. A physical therapist can get you on the right path for your current level of exercise and assist with the modifications needed while your belly grows.
Now for post-partum recovery. What can women who have already had a baby do to be able to resume their pre-baby level of fitness? Are there any differences for women who have had a vaginal birth versus a C-section?
After you have had your baby, and once cleared by the doctor, you are free to resume exercises gradually. Right after birth, as long as recovery is going well, Kegels and walking are usually ok. Sometimes C-sections may require a little more recovery time than a vaginal birth, but it all depends what your doctor advises.
Once cleared to resume exercise make sure you have good pelvic floor control. No one wants to have bladder leakage while trying to run or lift weights! Seeking assistance from a women’s health physical therapist can be a huge help in decreasing the likelihood for incontinence. They can give you the appropriate exercises to get back to strength training without any bladder problems. You can then gradually increase your core and general strength training as well as resume cardio activity.
It is possible to get your pre-baby body back, but for most people it takes work and time. We all know that one person who had a smooth pregnancy and their pre-pregnancy body came back easily and quickly, but unfortunately that is not the case for the majority of women. We all recover differently and some people “bounce back” quicker than others. The biggest thing is to not compare yourself to anyone else. Take the time you need. Physical therapists are always out there to guide you in the right direction at any point before, during, or after your pregnancy.