To Regain Shape After Pregnancy, Start With Baby Steps
First there is the excess blubber that was supposed to melt away like magic. Then there’s the new-parent fatigue that can make a walk around the block seem like a marathon.
Even so, regaining fitness after childbirth has become a healthy obsession among many new mothers. About eight of every 10 new mothers now bring up the topic, says Dr. Reinhold Ullrich, a Torrance obstetrician-gynecologist. Quite a change, he says, from a quarter-century ago, when he first offered his patients exercise instruction during and after pregnancy--and had trouble gathering enough students for a class.
These days, women want to know: How soon can they resume their usual routine? Can they regain pre-pregnancy fitness levels? The fitter a woman stays throughout pregnancy, Ullrich and other experts say, the easier it will be. But even the most faithful exerciser is bound to lose some fitness during her last trimester, when extra weight makes workouts more difficult.
The Good News
Not to worry, says Susan Johnson, director of continuing education for the Cooper Institute for Aerobics Research in Dallas. She reassures new mothers: “You can regain your prior level of fitness.”
Susan Caparosa, a San Diego State University exercise physiologist and researcher, agrees but adds a caveat: New moms need patience.
“It may take nine months to a year to get back into shape,” says Caparosa, who knows firsthand. She has a 10-month-old daughter and has been slowly but surely regaining fitness, taking her baby along for walks and squeezing in 15-minute toning sessions during naps.
Postpartum Bodies
During and after pregnancy, the body undergoes several changes that affect the ability to exercise. Hormonal changes cause laxity of connective tissue and joints, making joints more susceptible to injury. “The anatomical effects of these hormonal changes persist up to 12 weeks,” says Johnson.
During pregnancy, blood volume increases by 30% or more, resulting in an increased heart rate, according to exercise guidelines for pregnancy and postpartum issued by the American College of Obstetricians and Gynecologists. This change persists for about four weeks after delivery.
Most women also have vaginal bleeding for four to eight weeks after birth, according to Dr. Raul Artal, USC professor of obstetrics and gynecology and author of “Pregnancy & Exercise.” Some women also get hemorrhoids, hot flashes, heavy sweating and discomfort from the episiotomy.
Getting Back in the Swing
Given the litany of symptoms--which don’t exactly inspire anyone to sprint joyfully around the block or pop an exercise video into the VCR--it’s understandable that exercise experts most often utter three words when asked about postpartum exercise: Easy does it .
“Look at labor and delivery like running a marathon,” suggests Artal. “Would you go out and exercise the day after?”
Adds Johnson: “Consider postpartum exercise like rehabilitation.” When it comes to snapping back, though, she acknowledges: “Youth helps. Older moms have to take it slower.”
Agrees Ullrich: “I ask (new moms) to take it easy the first week or two, although walking is OK. There is a lot of healing going on.”
Once the healing is fairly complete, though, Ullrich encourages his patients to get back into a regular exercise program, which can usually be accomplished six weeks after delivery.
Some physicians recommend that patients keep participating in their prenatal exercise classes for a few weeks before rejoining regular classes. (There’s been no boom in postpartum classes, exercise experts say, because most women are eager to get back to their usual workout.)
Red Flags
Stop exercising and contact your physician if any of the following occur: bleeding, dizziness, pubic pain, back pain, shortness of breath or palpitations.
Problem Spots
Besides working to regain cardiovascular fitness, new moms should pay special attention, not surprisingly, to abdominal muscles and to the pelvic area. Two vital exercises for new mothers, Caparosa says, are pelvic tilts and pelvic strengtheners, better known as Kegel’s exercises.
The proper way to do a pelvic tilt, according to ACOG guidelines, is to stand with feet apart shoulder-width and knees slightly bent. (It can also be done while lying down or sitting.) Next, contract buttock and abdominal muscles so the pelvis is thrust forward gently. Then rotate the pubic bone upward, holding the position for 10 seconds and then releasing.
The Kegel exercise can be done immediately after childbirth, Artal notes. At first, he recommends performing the exercise while lying down with knees up and slightly apart. Then squeeze the muscles around the urethra as if holding back urination; hold a few seconds and relax.
Cutting Some Slack
Sleep deprivation is common during the first four months after childbirth, Caparosa points out, advising new mothers that sleep is more important than intense exercise during that period.
Coping With Snags
Fitting in regular workouts can seem impossible given the demands of new parenthood. Breast-feeding moms have an added dilemma: to feed and then work out or vice-versa? Breast-feeding before exercise seems the preferred order, according to an Indiana University study published last year in the journal Pediatrics. Infants better accepted breast milk given before exercise, the researchers found, probably because post-exercise milk contains more lactic acid and is less tasty.
Then there’s the no-babysitter problem: When you’ve penciled in exercise, your sitter cancels. Susan Johnson has two suggestions. Find a health club with reliable on-site child care. “Or, put your baby in a stroller and just go. Call it sweat bonding.”
Taking the Guidelines to Heart
New mothers should pay close attention to heart rate during exercise. The American College of Obstetricians and Gynecologists recommends women not exceed the following heart rate during postpartum exercise: Age: Beats per minute 20: 150 25: 146 30: 142 35: 138 40: 135 45: 131
These guidelines are conservative, according to ACOG. Under proper medical supervision, more strenuous activity and higher heart rates may be appropriate.
