Working in the postnatal wellbeing field, one of the most common questions I get from new mums is this:
What type of postnatal exercise is safe for me, and what exercises should I avoid?
It’s a difficult question to answer in a blog post – because the answer will be different for each woman. What is and isn’t considered to be safe will depend on several factors, such as the woman’s level of fitness before and during pregnancy, the type of birth she had (vaginal or Caesarean), whether she had a traumatic birth, or perhaps an episiotomy or perineal tear, how well her pelvic floor is restoring to full function, whether she has an abdominal separation (diastasis recti) and how severe it is, how much rest she’s currently getting at the time, whether she had significant blood loss during labour which might have affected her iron levels….
The list goes on and on, because the factors are very diverse, which is why in my clinic I always undertake a detailed initial assessment for each new Mum who comes to see me for rehabilitation.
But I know this isn’t possible for everyone, so I’ve put together a list of the five most important moves for new mothers to avoid.
When looking at this list it’s important to remember that these restrictions aren’t FOREVER! I know some women might see the list and become frustrated or demotivated, but please remember that by sticking to the guidelines now, you’re likely to recover from your pregnancy and delivery much quicker, which will enable you to get back to the fun stuff a lot sooner – and with less ongoing problems (such as embarrassing leakage issues in Body Attack!)
So the following moves are best avoided for the first several weeks (or months) until such time that you are fully healed from pelvic floor issues, diastasis recti, back pain, and C-section surgery. Remember that every woman heals at a different rate, so to be really sure you should seek advice and support from a women’s health OT, women’s health physio, or a fitness trainer with excellent training in postnatal wellbeing.
The top five types of exercises for new mothers to AVOID
Exercises that put lots of strain on the belly – such as crunches, sit ups, or double leg lifts. These all increase the “intra-abdominal pressure” in the torso, and can worsen an abdominal separation or increase pelvic floor dysfunction.
Sit ups aren’t the only way to work those abs!
High impact activities
Running, jumping, bouncing on a trampoline, jumping jacks, burpees, box jumps, skipping, Body Attack classes. These also put increased pressure on the pelvic floor musculature, which can lead to or worsen incontinence.
Box jumps can be too high impact for many postnatal women.
Heavy overhead work
Such as lifting heavy weights over your head – again can result in increased intra-abdominal pressure, plus, if you don’t have good core control – which is common post pregnancy due to weakened abdominals, there is a danger of lower back injury.
Weight training is great for postnatal women, but it should be modified for each individual’s needs.
Moves where your legs stretch apart from each other at speed
Splits, sumo squats, skiing type movements, mountain climbers, jumping jacks, kickboxing – place additional strain on your pelvic floor muscles and ligaments
Save the star jumps and interpretive dance for a few months down the track.
Moves where your belly is hanging down – such as planks. Now this is a bit of a controversial one, as lots of new mums and trainers like to use planks, because they know they shouldn’t be doing sit ups (see point 1!). But it’s best to use caution with planks early on, and to make sure that if you’re going to do them, that you’re able to properly engage your abdominal muscles, to prevent poor form and potential back pain.
Planks are great – but make sure your core is ready for them.
Right, so what CAN I do??
Well firstly, remember, these guidelines are only to be in place until you’re HEALED! So please don’t fret, or get impatient! It’s best to grade your workouts down a notch for a few months to make sure you heal fully, and start gradually building back up. Please don’t jump back in full-bore, and risk exacerbating a condition that hadn’t quite healed, or creating a brand new problem.
Things that are great in the early months (after six week check up) include:
Walking : Seriously this is the best – on your own, with a friend, or grab the pram and take bubs around the block – use good form and walk mindfully – don’t just stroll, really think about your stride, your posture and your breathing. Keep upright, shoulders back and down, core “on” while walking – especially when pushing a pram!
Pilates: My absolute favourite – you can choose from mat or equipment classes –Just make sure you let your instructor know you are postnatal. Everything in Pilates can be modified or replaced, so if your instructor doesn’t alter any exercises for you, think about how much knowledge they have – don’t be afraid to ASK them about what post-natal training they’ve done! Mums and Bubs classes are great as they are tailored for post-natal women.
Yoga – another great low impact option. Again, let your instructor know you are postnatal, be gentle with your body and don’t push too far into any pose. Remember you may still have some amounts of relaxin running through your body, which keeps your ligaments more prone to over-stretching. Also, avoid hot or bikram yoga if you’re still breastfeeding.
Weights – weights are a fantastic way to build strength and fitness back up after baby, they’re also a great way to address potential muscle imbalances that arise in new Mums. It’s best to avoid group classes until you’re healed and I recommend booking some one to one sessions with a trainer to check your form and set up a program if you’re not familiar with weight training.
Finally, a word on instructors and group fitness classes:
As I mentioned earlier in the article, don’t assume your instructor or trainer has any knowledge about working with postnatal clients. There are so many amazing trainers out there. But unfortunately many of them don’t have specialised training in working with pregnant and postnatal clients. There’s a lot happening in the postnatal body, and recovery can often take a lot longer than we think it will. There’s also a lot going on ‘inside’ our body that we can’t see, which we should be mindful of when it comes time to get back to exercise. So always ask your trainer what postnatal training and qualifications they have, and ask them to talk about how they will adapt a program for you. If you’re not happy with their response – find another trainer! You only get one body, so make sure you find someone who’s going to help you look after it!
Also, let’s just chat about group fitness classes. Quite often group classes will have up to 30 – or even more – people in the class. So it’s difficult for a trainer (even one who knows you are postnatal) to watch you carefully and remind you of all the modifications. So there’s a lot of responsibility on the postnatal woman (ie. You!) to make sure you know your restrictions when it comes to these classes, which often feature lots of the movements I mentioned above. Also, be particularly cautious of energy in group classes. When something is super fun and inspiring, it can be quite easy to get “dragged along with the crowd” and attempt moves that are outside of your comfort zone, or to feel like you’re not doing enough and want to measure up to everyone else.
My final piece of advice…
Just be patient, take these first few months to really get to know and respect your body, and do the right thing by it. Trust me – your body will thank you for it down the track – and hopefully never let your pelvic floor fail during Body Attack!
Until next time, keep well.
Cheers, Sarah xx
ps. If you’d like to know more about how best to regain strength and function while recovering from pregnancy and childbirth, check out my Body Mind Baby online postnatal wellbeing program, our next program begins on May 2. Register before April 22 to take advantage of our early bird pricing – just $117 down from $147.
One of the best parts of my job is that I get to spend a lot of time talking to women.
Talking one to one to clients, chatting to Facebook followers, communicating over email to women I’ll probably never meet, and also making presentations to small groups on a regular basis. I’m a talker, I love to talk. I get it from my Mum. Who got it from her Mum, but that’s beside the point.
The point is I love talking, especially to other mothers, because it’s how I can best support the clients I work with, how I can get the message I want to share out into the world, but most importantly, it’s how I learn so much about this wonderful client group I work with.
Yesterday I was excited to be the guest speaker at a meeting of the Australian Breastfeeding Association here in Adelaide, where I was asked to talk on the topic of ‘self care for Mums’.
Now it’s true that phrases such as ‘self care’, ‘put yourself first’ and ‘find time for me time’ can often feel like massively cliched buzzwords in today’s motherhood environment. They’re a dime a dozen and I bet they’re sprawled all over the sponsored ads clogging up your news feed on a daily basis. It seems everywhere we turn Mums are being told to take better care of themselves, meditate more and eat more kale. Hey, I’m one of those people saying those things!
And while most people would agree that taking care of your own wellbeing is an exceptionally important task, both for your own sake, and that of your family, there is also another consideration to this ‘make me-time a priority’ message, as one of the women in my presentation yesterday pointed out.
Her comment was that this drive for mothers to prioritise self care can often feel like another big unachievable task on that never-ending ‘to-do’ list. Something that women already know they should be doing, and desperately want to do, but for whatever reason it just doesn’t happen.
What she was questioning was this: why is it just the responsibility of the mother to look after her own wellbeing? Where’s her support squad? Shouldn’t we expect our husbands, partners, parents, friends, aunties, grandmothers, or whoever else we have in our lives, to also step up to the plate. To be there to help us look after ourselves, just as we support everyone around us to look after themselves.
It’s a valid point.
Certainly we shouldn’t expect other people to look after us and cater to all of our needs. It’s not the 1950s after all.
But surely we deserve a little bit of consideration? Especially in those early months (or even years) of motherhood. It’s okay to want our village to step up. But here’s the thing. What we might actually need to do first is invite that village in. To reach out and seek support, to let our tribe know that we’re really focused on supporting our own wellbeing and that we’d love any help they could offer up. They’re not mind readers after all.
I know asking for support is not always on our list of top five favourite things to do. It can leave us feeling open, vulnerable and perhaps even weak. But it can also open us up to truly receiving love and compassion from those around us, and to feel sincere gratitude for those people in our own little village when they step up.
Which brings us back to the question of “are we wholly responsible for our own wellbeing”? Well I guess the answer is yes – because our own wellbeing is too important for us not take the reins. It is ultimately up to us, but that doesn’t mean we can’t sub-contract the task out to those we know and trust as well. We just need to have faith that those we ask will respond. But it starts with asking. And that’s on us.
What about you? Do you have people around you who support your wellbeing? How do they do it? How would you like them to help?
Let me know in the comments, pop a note below this post on facebook, or even email me at email@example.com
Until next time.
How does the song go again?
“It’s the most wonderful time of the year….”
It’s a common refrain around December, but the sad truth is that for many people Christmas isn’t actually wonderful. For some it’s hardly bearable.
At this time of year, when family, friends and colleagues congregate and celebrate, many people may be keenly feeling the loss – recent or otherwise, of someone dear to them. Perhaps through death, or divorce, or a long distance move. Countless others may be facing yet another year feeling so very alone, whether it be social isolation or a battle with the black hole of depression.
While many of us may be looking back on the past year in self-reflection, and expressing our gratitude for all we’ve achieved and all we have, there are just as many others who are desperately counting down the days until they can say goodbye to 2015, because for whatever reason it was a harsh year for them. Perhaps a business venture failed. Maybe they lost their home. They might have struggled with their health. Or have been deeply betrayed by someone they trusted.
While many of us may be joyously wrapping presents and baking hams on Christmas Eve, there are also those who will look upon the tiny collection of gifts they could barely afford for their children, or the Christmas dinner they bought on credit for their family, through lashings of hot, angry, disappointed and despondent tears. Heartbroken they weren’t able to live up to society’s (or their own) expectations of creating the picture perfect Christmas.
Yes, there are many reasons why a large portion of people look upon Christmas with heartache and dread, rather than joy and laughter.
Christmas isn’t always joyful.
If this is you. Please know that I feel for you. I truly do.
I know I’m one of the fortunate ones. I’m so privileged to be able to have a roof over my head, a well-stocked fridge and smiling, happy, healthy daughters breathlessly counting down the sleeps until the big day. Although it has been a difficult year for me on a few levels, at this time of year, when I’ve had the chance to slow down, reflect and recalibrate, I’ve been able to truly feel the festive spirit and I know I’m okay.
But if you’re still struggling, if the thought of Christmas breaks your heart or turns your stomach, if you can’t wait to put a pin in 2015 and all it represents, then please take a look at these suggestions for ways to make it through these next few days.
How to cope when Christmas is hard.
1) Recognise how you’re feeling.
Admit out loud to yourself that Christmas is going to be hard, or that you’re actually dreading it – be honest with how you’re feeling and why. Write it all down in a journal. Confide in a trusted friend. Pray to your God, or talk to a mentor, religious leader, or even call a crisis support hotline such as Lifeline if you can’t find – or don’t want to talk to – someone you know about this. But don’t try to fake it – don’t try to force yourself to feel merry if you don’t. Allow yourself to be sad, if you’re sad. Be angry, if you’re angry. Feel grief if you’re grieving. Be honest. With yourself and others. People will understand. They may not know exactly how to respond or support you. But they will understand.
2) Know that you are not alone.
My gosh, you are so not alone. There are thousands of people out there who share your feelings on Christmas. In fact, Lifeline estimates it will take 27,000 phone calls this festive season. That’s 27,000 other people also struggling at Christmas. You may not see them, because so many people haven’t undertaken step number one – they’re hiding how they truly feel, for one reason or another. Society’s notion of Christmas as a happy time of celebration and joy is a strong cultural line – it takes a brave person to put their hand up and say “that’s not how I feel about Christmas”. Which is why step one is so important. Honest communication is an integral step when it comes to addressing our feelings and working our way out of them. By admitting how you feel, you might be surprised at how many others tell you they’re feeling the same. You’re not alone. You’re not he only one who feels this way. Even if it feels like you are. Please trust that others are feeling the same way as you too.
3) Accept it – and let it go.
This one can be the hardest. Sometimes we rail so hard against any feelings of unpleasantness, we believe we need to feel happy or good all the time. Aren’t we supposed to be joyful – shouldn’t we do everything we can to fight against any negative emotions? Especially at Christmas time – our old companion, guilt, can get hold of us. “Look at everything you have, you have no right to feel this way, you should be ashamed of yourself for being so miserable at Christmas.” And how do we respond? By beating ourselves up – fighting against ourselves and our thoughts and emotions. Berating ourselves whenever despair or anger crosses our minds.
The trouble with this is that the more you wrestle with pain and anger and fear and hate, the more they will pull you under. Just like quicksand.
For this reason, acceptance is a powerful tool. When I talk about “acceptance”, I’m not referring to “resignment” or giving up – it is not about taking a blanket “whatever” attitude to everything, and accepting every little thing that goes wrong, as your lot in life. By accepting how you feel about Christmas today, it doesn’t mean you are giving up on ever feeling joyful or festive ever again.
What it IS about, is about making room in your mind for the unpleasant feelings and sensations that come with negative events you can’t control. It’s about accepting that you’re going to have these feelings, and letting your body experience them, without struggling against them or constantly questioning them, so that you can experience them and let them go.
The next step on from acceptance is about figuring out what you’re really comfortable with leaving the way it is and what it is that you’d like to change from your current state. Then moving forward and taking action on those changes. But perhaps, Christmas isn’t the easiest time to undertake this second step. At this point, it’s okay to just accept, let go, and commit to moving on a little bit later once the holidays are behind you.
As always, dealing with major issues in our lives is never as easy as a three step guide you find on the internet. Ultimately, it’s up to you to be aware of how you’re feeling and whether you can move through this on your own, or perhaps whether you need a bit more support. From family, friends, or a professional, such as a counsellor or mental health clinician.
This holiday season certainly has the ability to stir up many wounds and emotions, some often thought to be long forgotten. So please be gentle with yourself these holidays. You’re only human after all.
Until next time,
Please always remember that Lifeline is always available to people in need of someone to talk to when you feel like you need support. Call their hotline on 13 11 14 to speak to a trained counsellor 24 hours a day.
For those of you in a more festive place this season, perhaps you might be willing to support Lifeline by donating to their Christmas Appeal. Your donation might mean that a few extra calls get taken this year.
(Please note, this isn’t a sponsored post for Lifeline, but having volunteered for them previously I’m a huge fan of their work.)
I know you’ve seen them. They’re everywhere. At the newsagent, in bookstores, even in the magazine aisle of the supermarket. Adult colouring in books, also known as mindfulness colouring books – there’s simply no escaping them! All of a sudden, colouring is THE hot new thing in wellbeing. It’s supposed to help improve focus and concentration, while promoting relaxation. Many are also touting colouring as a wonderful form of therapy. But is this going a bit far? Now I love a good colouring session as much as the next girl, and I’m super happy I have two artsy kidlets, for whom I can buy hundreds of Smiggle pens which I immediately claim as my own!
But while colouring might be fun, is it actually good for our health? Is it really therapy?
Smiggle, I love you. (No, this is not an ad for Smiggle!)
I went to an expert for the answers. My wonderful friend Belinda Ryan is an art therapist and owner of Ignite Art Therapies. I asked her to tell us her thoughts on mindfulness colouring. Here’s what she had to say:
Yes! Lets talk about colouring.
There is definitely an ever increasing trend toward colouring books. Not just for kids but for all of us with a number of Amazon’s best sellers being Adult Colouring books.
So why has this taken off so much? There are a few reasons. Firstly, it is quite nostalgic to pick up a set of colouring pencils, it takes us to a place where we once were – the innocence, the freedom to do what we want and to be totally in the moment. I think we all have that little child inside us that wants to be creative, and this trend gives us permission to do so. It’s also about moments to play – we live in such a rule stricken world and it’s a great thing that we can play with a pencil and a page, one section at a time.
But the main benefit of mindful colouring is that of focus.
There is something about colouring that takes you to a peaceful place. It’s the repetitive action and zoning into a focused state that is of benefit. While you are colouring you are absorbed in that one activity and the rest of the world is on hold. When we colour our mind slows down and those things that stress us out disappear for a moment. It’s relaxing, meditative and allows us to centre our energy – something that is very hard to capture in this fast paced world in which we live.
Without trying to burst the ‘colouring is amazing’ bubble, there have been many claims that this is art therapy and while it is very therapeutic in nature, and a brilliant mindfulness activity, it is just that. It doesn’t tackle the things that are causing the stress, anxiety, fear, hormone enraged anger or withdrawal, but rather it gives us some respite from it. Art therapy differs as it allows those issues to be present so that they can be explored, understood, transformed and let go of ,through facilitated creative exploration.
That being said, colouring definitely is of benefit and it is something I give my clients to do as a zone out activity. There are numerous activities that calm us down, let the world disappear for a while and as long as we don’t fully escape the things we need to deal with (that’s what art therapy is for), then colouring is a good thing.
Belinda Ryan, Art Therapist and Director of Ignite Art Therapies.
So there you have it – advice on colouring from an expert. Yes, it is wonderful, and yes it can be part of a therapy program, but on it’s own it is not therapy. So if you feel like you need some support to work through any issues and you fancy the idea of doing it through art, make sure you check out a qualified art therapist, such as Belinda.
I’ve been talking a lot about Mums and Postnatal Depression (PND) lately. But interestingly, one of the things that regularly crops up when I speak to Mums about this topic is their concern or experiences regarding their husband or partner having depression.
It’s something that’s not widely spoken of or understood, but Postnatal Depression in Dads is a very real issue.
Which is why I’ve written this guest post over at Mum Central, talking about this very topic.
Head over to take a look and please share through your social media channels, so we can start to get this subject out into the public awareness.
Finally, if you’re concerned that you or someone you love needs support with depression, please speak to a trusted health professional, and check out any of the following support services listed below.
How is Dad Going?
Black Dog Institute
For immediate emergency support, please call Lifeline on 13 11 14.
Until next time,
I’m taking a huge guess here – but I’m going out on a limb to say that most new mothers have asked themselves this question at some point in the first few years of becoming a mother.
Welcoming a new baby into the world is an experience like no other. Being a new parent brings a whole gamut of emotions, responsibilities and questions. Many of which we’re completely unprepared for.
But what happens when those emotions, responsibilities and questions become too much? When “unprepared” becomes “unable to cope”?
When does new parent overwhelm become postnatal depression?
Is it just the baby blues? Or is it postnatal depression?
Current statistics tell us that postnatal depression (PND) now affects one in 7 new mothers and one in 20 new fathers. But despite the increased incidence of PND in our society, there still seems to be misunderstanding about what PND actually is and how it is treated.
Beyond the “Baby Blues”
In recent years there’s been an increased awareness of the “Baby Blues”, that short period of time after childbirth in which new Mums can feel exceptionally sad or teary for no apparent reason. This episode generally coincides with the new Mum’s breast milk “coming in” and is primarily hormonal in its cause.
However, postnatal depression shouldn’t be confused with the baby blues, because it is something else entirely.
When feelings of sadness, hopelessness, fear and worry extend beyond a period of a few weeks it can signal that the mum is in fact experiencing postnatal depression.
How do I know if it’s PND?
The difficult thing about diagnosing PND is that the early signs and symptoms are so similar to the general experience of many new mums who may be overwhelmed with their new role as a parent.
Feelings of worry, exhaustion, bouts of tearfulness or irritability, feeling inadequate as a mother, feeling unable to cope, blaming yourself when things go wrong, being overly critical of yourself, decreased sex drive, difficulty concentrating, difficulty sleeping, loss of appetite. The majority of mothers can relate to having felt these emotions as a new mother – but they are also classic symptoms of PND. So how do we know if a Mum is just “going through a rough patch”, as opposed to something more serious?
From a health professional’s perspective, we will do an in-depth interview to help each woman determine whether it’s a case of the “blues” or if it’s actually depression.
What we look out for is these types of issues:
- Difficulty being able to laugh and see the funny side of things
- Decreased ability to look forward to enjoyable activities
- Blaming yourself unnecessarily when things have gone wrong
- Feeling anxious or worried without good reason
- Feeling like things are frequently “getting on top of you”
- Difficulty sleeping or sleeping excessively
- Frequently feeling sad or miserable quite often
- Frequent bouts of crying
- Having thoughts of harming myself of others
In particular, we want to know how long these feelings have been experienced, generally if it’s more than a two week period, the likelihood that it’s actually depression is increased. (although with the last point about thoughts of harm, it’s important to address these, no matter how long they’ve been occurring.
With the early stages of depression there is no definitive test you can take which will answer “yes” or “no” to the question of “do I have postnatal depression?”. Which is why I always encourage anyone who might be worried they have PND to seek support from an experienced and understanding health care worker. They can help women work through these issues above.
I think I could have PND – what do I do now?
In my professional opinion, when it comes to seeking help for PND (even if you’re not sure its PND) , it’s a case of “better safe than sorry”. Seeking support and advice early is always recommended, as the types of interventions generally suggested for a woman with mild PND are the sort of things that would also support any mum who is simply overwhelmed. These might include:
- One to one, or couples counselling
- Relaxation and stress management strategies
- Mindfulness and meditation strategies
- Changes to diet and lifestyle – including sleep and exercise
- Increased practical support around the home
As with many other things in life, PND generally occurs along a continuum. It is rarely black and white. The experience of PND can range from a mild case with the mother experiencing just a few of the common symptoms for a period of a few months, through to extreme PND where a mother may feel exceptionally hopeless and have thoughts of self-harm or suicide. Both examples would be considered depression, they’re just at different levels of intensity.
Many women put off seeking help for PND due to a number of reasons, frequently downplaying or talking themself out of speaking up. “It’s really not that bad”, “I’ll feel better once I get some decent sleep”, “It’ll get better once my baby is older”. These kind of assumptions can delay women from seeking timely support.
We know that early detection and treatment is the best possible course of action for parents who experience PND. If we can recognise the signs early, parents can access the type of support services listed above, and make lifestyle changes straight away. In many cases this can help to prevent the depression from becoming worse. But when PND is left unaddressed for long periods of time, it can escalate rapidly, meaning more intensive treatment options could be required, including the addition of psychiatric care or antidepressant medication.
For anyone concerned that they, or someone they know, might be experiencing PND, the best course of action is to seek support from a health professional. Speaking to your maternal health nurse, midwife, obstetrician, or GP is generally the first step. But you can also feel confident seeking out a counsellor, mental health OT, or psychologist, which in many cases doesn’t require a referral.
For further resources about PND, please visit the following websites:
If you require immediate support, please contact Lifeline on 131 114