When the guard at Kaiser Hospital in Hollywood helped me into a wheelchair for my middle-of-the-night hospital check-in, he took one look at my ecstatic smile and said, “You’re the happiest laboring woman I’ve seen in a long while!”
This was my first baby and the fun, and my labor, were only beginning. At checkout time a couple of days later, however, I wasn’t in the mood to smile, healthy baby notwithstanding. You see, I had tried to fit into the relatively loose outfit that all of the childbirth books advised bringing for these occasions. Impossible. So I slunk out of the hospital in my maternity clothes.
“The feeling women have is that as soon as you have the baby you’re going to be back in your jeans,” says Judy Greenfeld, who teaches pregnancy and recovery exercise classes. “There’s just this fantasy. But their bodies are stretched out. By six weeks, there’s almost a panicky kind of feeling of ‘God, what do I do?’ A lot of us just want to hide.”
Greenfeld, who has degrees in dance and exercise physiology, uses low-impact aerobics in her private exercise sessions. Whether they’ve been exercising during the pregnancy or not, three to six weeks after women give birth is a typical time to begin the long, hard work of getting back in shape. According to Greenfield, it takes at least six months of “religiously taking care of yourself, eating right and exercising,” to get back to the shape you were in before pregnancy.
And even then, though a woman can be fit and trim, her body will not be exactly the same. For example, breasts might be smaller, hips may be larger, abdominal skin will be stretched, the pelvic floor will be looser, and some women may have bladder and rectal problems.
“There’s a certain amount of change in the body that is unavoidable, inevitable, and there really isn’t anything a woman can do to affect that,” says Barry Herman, an OB/GYN and director of the Southern California Women’s Center.
“How drastic that change is depends on a lot of things. Probably part of it is the size of the baby and the size of the mother going into the pregnancy. The biggest determinant of stretch marks, for example, is the elasticity of your skin, and that’s not something you have anything to do with,” says Herman, co-author of “The Twelve-Month Pregnancy.”
The only real thing you can do to affect abdominal laxity is to not gain more weight than you need to, so your abdominal wall won’t stretch more than it has to. Afterward, you can strengthen the abdominal wall through sit-ups and so on, while you work on eliminating the fat through exercise and diet.
Every postpartum woman is told by her gynecologist to perform Kegels, vaginal tightening exercises, regularly for the rest of her life. Since the pelvic floor is made up primarily of muscles and ligaments, only the muscles can be affected by exercise. Kegel exercises can never quite return a woman’s pelvic floor to where it was before. They will improve muscle tone and improve sexual function, but they won’t improve the ligaments that have stretched.
Nevertheless, shaping up and feeling good are within the reach of every woman. Examples such as Mary Decker Slaney, who holds both U.S. and world records for running, can inspire even the most exhausted new mom. Slaney, anxious to return to competition, began to exercise six days after giving birth.
“I recommend that people be guided by their own bodies,” says Mona Shangold, M.D., director of the Sports Gynecology Center at Georgetown University School of Medicine and co-author of “The Complete Sports Medicine Book for Women.” “Pain is usually an indicator that healing is incomplete. If a woman can exercise without pain or discomfort, she can do so safely right after delivery.”
For many women, however, reality is a “Catch-22” situation: The more extra weight they have postpartum, the harder it is to move around, and thus the harder it is to lose the weight. Joanne Kuhn, a licensed athletic trainer, gained 35 pounds during her pregnancy, and lost 20 during the Caesarean birth. Kuhn began by doing pelvic tilts and leg lifts on her stomach and back. Then she started walking with her baby in a stroller.
“The best thing for me was the stationary bike,” says Kuhn. “Because I didn’t have to drag all my weight with me. I rode it every other day for 20 minutes, then I started dropping weight. Before the baby I used to ride it for 45 minutes. Then I started walking, even trotting a little with the stroller every day.”
It wasn’t until Kuhn’s baby was 4 months old that she finally felt good, though she still wanted to lose more weight.
Some instructors and exercise books suggest beginning gentle abdominal exercise within 24 hours after giving birth. Many doctors advise waiting about six weeks after a C-section before beginning to build up to strenuous exercise (Shangold says to wait three weeks before maximal weight training, but that it’s OK to do sub-maximal training before that). The American College of Obstetricians and Gynecologists conservatively recommends waiting several weeks even after an uncomplicated delivery.
“Getting in shape is not an emergency,” points out Herman, “and you shouldn’t feel that you have to do it on high power. It certainly doesn’t do any more good to do it that way, and it may even cause harm. Start easy and build up over a period of months.”
According to Dr. Herman, with a vaginal birth, you’re limited by three things: how you feel, the perineal incision and the hormonal affects on joints and ligaments, which tend to be more lax. You might be able to start as soon as two to three weeks after giving birth, but you should start easy.
Low-impact aerobics is one of the best ways to regain fitness postpartum.
“The medical information is pretty clear that low-impact aerobics is infinitely better than high-impact aerobics,” says Herman. “High-impact aerobics doesn’t offer anything more from a positive point of view, but it does offer significant problems from a negative point of view.”
Herman admits that he finds the low-impact version of aerobics less fun than the traditional high-impact kind, but others find it quite enjoyable. Instructor Greenfield, for example, swears by them. She recommends dance-like movements, never on your toes, stepping side to side, and steps such as the cha-cha or twist. She emphasizes smooth, steady, non-bouncing movements with lots of arm movements to get you sweating.
Swimming, biking and walking are other exercise options for the new mom dedicated to someday resembling her old self. Above all, suggests Trudy Keller, a childbirth educator in Anchorage, Alaska, and president of the International Childbirth Education Association, “Find something you like to do, because if it’s something you enjoy you’re so much more apt to continue with it.”
Susan K. Perry, Ph.D., is a social psychologist, author and freelance writer. For more information, visit www.bunnyape.com.
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