At Belly Bandit, we recommend wearing a Belly Wrap to help support your core post-delivery. But what else can you do to help restore your core in the postpartum period? We turned to our friends at Juna to help with some post-delivery tips!
Want to give Juna a try? Use discount code BANDIT at checkout to get $19.99 off any subscription through the website.
After having a baby (regardless of the mode of delivery), your body goes through tremendous changes. Your abdominal muscles were gradually stretched for 40 long weeks, which can leave them weak and compromised after delivery.
If you had a C-section, those same muscles were also cut during the surgery and are compromised even further. If you had a vaginal delivery, your pelvic floor muscles were stretched 3.5 times their normal length and will need time to heal and return to normal (especially if any tearing was involved).
This means that two out of four very important core muscles will not be able to work optimally immediately after delivery: your pelvic floor and your abdominal wall.
These muscle groups can take up to 12 weeks to heal, depending on the circumstances, and may require up to 12 months to return to normal. In some cases, these muscles do not return to "normal" on their own and require a little more hands-on rehabilitation for recovery. Whether you’ve just given birth (congratulations!) or are preparing for postpartum life, here are four tips for restoring your core after birth.
Recognize the Symptoms
A compromised abdominal wall or pelvic floor can lead to symptoms that are extremely common but not necessarily "normal.” The good news is they can be fixed! These symptoms can include:
* Mom "pooch" or abdominal bulging
* Lower back pain
* Pelvic pain
* Stress urinary incontinence
* Pelvic organ prolapse
* Balance issues
* Feeling like you can't regain strength in your core, no matter how much you work out
All of the above symptoms are most likely a result of a weak core and can be treated with the appropriate care.
Assess If You Have Diastasis Recti Abdominis
One type of abdominal wall weakness that concerns new moms is diastasis rectus abdominis (DRA). This is the separation of the rectus abdominis (aka your abs) that results in the stretching of the midline fascia, called the linea alba. It appears clinically as a separation or "gap" in the abdominal wall. DRA is often accompanied by the coning or doming of your core during exertion, i.e. your belly button rises to a peak when you do a crunch.
It can also cause a mom "pooch" that doesn’t resolve on its own, or the feeling that you are unable to regain strength in your core no matter how much you exercise. Approximately 35% of women have a diastasis rectus abdominis at six months postpartum—but the good news is that it's entirely fixable.
How to Assess DRA
- Start by lying flat on your back with your knees bent
You will be measuring the separation of the rectus abdominis muscle in 3 locations:
- Halfway between the sternum & belly button
- At the belly button
- Halfway between your belly button & pubic bone
- Start with two fingers side-by-side and place them in each of the three locations above (one at a time).
- Press about 1 - 2 inches deep into your abdomen directly in the midline of your belly, and lift your head off the floor.
- You should feel the edges of the rectus abdominis muscle close around your fingers as you lift your head.
- If you do not feel the edges, you may need to add or take away one finger.
- When you feel the borders of this muscle close around your fingers, your measurement is how many fingers can fit in the space between.
- This can range from zero to 4+ fingers.
Troubleshooting the Assessment
- You may need to lift your head and shoulders off of the floor if your rectus abdominis muscle is having trouble activating.
- You may need to press deeper into your abdomen or add/remove a finger if you do not feel the edges of the muscle.
- You may need a friend or partner to measure for you if you cannot reach all three locations.
- If you do not feel a separation, it is very likely that you do not have DRA!
Start a Postpartum Exercise Program
While many new moms are eager to work out and feel like their old selves again, jumping right back into your pre-baby regimen can lead to injury and potentially damage your core.
The American College of Obstetricians and Gynecologists recommends that return to exercise be individualized and determined by your mode of delivery as soon as it is medically safe.
If you had an uncomplicated vaginal delivery:
- You may return to exercise when you feel ready. Keep in mind that tissue healing typically takes between 2-4 weeks, although it can take up to 12 months to be fully healed. If you had any perineal tearing, we advise that you start pelvic floor exercises when you can perform an isolated pelvic floor muscle contraction (also known as a kegel) pain-free.
If your vaginal delivery was more complicated and you're not sure if you feel ready to return to exercise:
- We recommend you wait until you have had a thorough examination with your provider. This is to ensure you are fully healed and it is safe for you to return to exercise.
If you had a cesarean delivery, it is advised that you return to exercise after a thorough exam when you have been cleared by your provider.
- It is important not to push your body during the first 6-8 weeks postpartum, when your incision and the many tissue layers underneath are healing.
Once you’re cleared to start exercising, a great place to start is with a specialized postpartum program like the Juna app’s Core Restore, available on both iOS and Android.
The Juna Core Restore program focuses on rebuilding the abdominal wall and pelvic floor muscles, while also incorporating the back muscles and breathing. The core-centered exercise program is designed for those who don’t feel “held together” in the center, unbalanced, and/or have difficulty performing everyday tasks like lifting, bending and carrying baby.
Here's a snippet of what to expect from the Juna app:
See a Pelvic Floor Therapist
Not enough women know about pelvic floor therapists: physical therapists that specialize in rehabilitating the muscles of your pelvic floor.
If you’re experiencing constant painful sex, incontinence, or pelvic prolapse, a pelvic floor therapist is trained to work with you and fix those issues.
Think of it this way: Olympic athletes work with physical therapists after exerting all their strength on the track, field or court. Giving birth takes Olympic-level endurance and puts a huge amount of strain on your pelvic floor, making pelvic PT essential for recovery.
Pelvic floor therapy is covered by some insurance plans. Talk to your provider about your options.