Exercise in the postpartum period can alleviate fatigue, provide energy and shift a mood.
Mothers
Mothers are tough. New mothers are super tough! Whether it's the first, second third, ninth child … it’s an endurance sport for sure. Giving birth is no small feat and the days, weeks, months and years that follow requires nerves of steel balanced, often precariously, with the softest heart and malleable resolve.
The new mothers and mothers-to-be I see regularly are heroic in their daily effort of becoming and being mothers. The nearly new mothers have their own challenges, and those who have been mothers for a decade or more are battle-worn warriors. But the postpartum period is a special time. Some cultures practice the tradition of postpartum confinement usually from 30 to 40 days after the birth where mothers don’t leave the home, shower or see anyone outside immediate family members and are looked after by other women in their lives or community. This practice is becoming popular in many families, for some new mums though feeling isolated and shut away can seem stifling and oppressive. Being flexible and having support is key during this time. Each birthing experience and the family unit is unique. The one commonality is that it is a demanding and exhausting time.
Fatigue is the most expressed feeling by women up to 1 year postpartum. It’s exhausting. So to be telling mothers 6 weeks after delivery to get up and get exercising seems unrealistic, trite, and just cruel. However, all the science suggests, and all the real-life evidence I see, confirms that getting physically active even for 10-20 minutes here and there throughout the day, or a couple of times a week can make all the difference to managing levels of fatigue, energy and stress as well as helping with regular sleep and eating patterns. One thing for certain is it does make new mums feel better… I know it’s a crazy concept. Exercise in the postpartum period can also reduce incidences of feeling overwhelmed and can even promote better sleep, albeit in brief bursts … Crazy, right?
THE SCIENCE
Around 20 years ago, The Stockholm Pregnancy and Weight Development Study, a combined retrospective and prospective study of body‐weight changes during pregnancy and one year postpartum in 1432 Swedish Women. They found postpartum weight retention was influenced by lifestyle factors occurring both during and after (rather than before) pregnancy and women returning to pre-pregnancy weight was more common in women with regular postpartum leisure-time physical activity habits and regular breakfast and lunch habits’.
According to ongoing research,
‘When compared with no exercise, exercise reduced symptoms of postnatal depression and when exercise is tailored to an individual or group and social support is experienced by participants there is an added positive impact’ (Daley et al. 2009 & 2015).
A 2004 study comparing postpartum mothers participating in a pram-walking group reported improved mood and fitness levels. Those in the social support group with no walking, reported mood shift only (Armstrong & Edwards 2004).
According to Larson & Myer (2012), many women report feeling dissatisfied with their bodily appearance from 6 months to 1 year postpartum. Those engaging in moderate levels of physical activity during this time were more likely to return to pre-pregnancy body weight with less incidence of depressive or anxious symptoms. Behavioural interventions such as exercise during pregnancy and in the first postpartum year can help mitigate longer-term health risks for women (Germeroth 2019).
Women 6-20 weeks postpartum reported ‘decreased state anxiety, depression and total mood disturbance and increased vigour’ after a single exercise session whereas those who had 60 minutes of rest only, reported improved mood and vigour only.
EXERCISE
Some women are capable of resuming physical activity within days of delivery while others may have ongoing issues. The best idea is to start slow and gentle, generally after the 6-week check-up, and only doing exercises that feel ok. There is no joy in heading out for a run if breasts are full and sore, squatting or deadlifting can be precarious if recovering from episiotomy or caesarean-section and lifting weight above the head or hanging from a pull-up bar can feel wrong in all sorts of ways. It’s going to be different for everyone but some kind of movement and resistance training can make new mums feel good about themselves and the world around them.
Recommended exercises include breathing exercises, glute bridges, abdominal exercises, spinal strength and rotational exercises. Some cardiorespiratory training is good too particularly if it can be performed outdoors in nature which is not always possible with a new baby. Moderate-intensity aerobic exercise is also beneficial for shifting mood and providing a feeling of wellbeing with even a single 60‐minute aerobic exercise session at 60% of effort in postpartum women.
For me, it was The Cher Exercise video in my kitchen that saved my sanity and built my strength back after my first child. If he slept more than 40 minutes I got to do the whole session and it was a good day!
REFERENCES
Clapp, J. F. (1998) Exercising through Your Pregnancy Human Kinetics Champaign, IL.
Germeroth LJ, et al. Trial design and methodology for a non-restricted sequential multiple assignment randomised trial to evaluate combinations of perinatal interventions to optimise women's health. 2019 Apr;79:111-121. doi: 10.1016/j.cct.2019.03.002. Epub 2019 Mar 6. PMID: 30851434; PMCID: PMC6436999.
Jayson, Cj. (2018). A Study to Analyze the Effectiveness of Postnatal Exercise in Improving Functional Status on Caesarean Women.
Larson- Myer Effect of Postpartum Exercise on Mothers and their Offspring: A Review of the Literature 2012 https://doi.org/10.1038/oby.2002.114
Physical Activity and Exercise During Pregnancy and the Postpartum Period, Obstetrics & Gynaecology: April 2020 - Volume 135 - Issue 4 - p e178-e188
doi: 10.1097/AOG.0000000000003772
Na Liu, et al. 2020 Effects of exercise on pregnancy and postpartum fatigue: A systematic review and meta-analysis, European Journal of Obstetrics & Gynaecology and Reproductive Biology, Volume 253, 2020, P 285-295,
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