Postpartum Exercises The most important exercises to do during the first few weeks after birth are to rest

and get to know your baby. Realize that it may take your body many weeks to recover from the changes of pregnancy. Try not to be a superwoman or rush immediately to regain your shape. Guidelines Progress at your own rate. Gentle exercises are important to help heal muscles. Relax and breathe deeply throughout and between the exercises. Exhale on the effort. Do NOT hold your breath. Support your head and shoulders with a pillow for comfort. Start by doing each exercise twice. If you notice an increase in bleeding or a re-occurrence of bright red bleeding, stop your exercise and call your health care provider. The following exercises can be done as soon as you feel ready. Check with your health care provider for recommendations about when you can begin a more extensive exercise routine. Walking Follow the instructions of the nursing staff to get out of bed and start walking as soon as possible. Leg Bracing Cross your ankles and straighten your legs. Tighten your thighs and squeeze your buttocks together. Hold for a count of 5. Repeat 3 to 5 times. Kegels (pelvic floor exercises) Abdominal strengthening Abdominal muscle separation Arm and upper back stretch Sit-backs Diagonal sit-up (waistline exercise) Aerobic activity Protect your back Strategies for lifting, bending and moving after delivery Kegels (pelvic floor exercises) Kegel exercises strengthen the muscles of the pelvic floor. These muscles are weakened by the birth process and should be exercised right after birth. However, it may be hard to do these exercises soon after your delivery. Do as many as you can, and the tone will slowly return. Gently tighten and then relax the muscles of your perineum (pelvic floor muscles). May be done lying down, sitting or standing. Start with 2 - 3 seconds per tightening (contractions), moving up to 5 and then to 10 seconds. End by holding your contraction for 20 seconds. Begin with 2 - 3 contractions per session and build up to holding 5 contractions several times per day. Dont be discouraged if these are hard to do at first. They will become easier with practice. Abdominal strengthening Do each exercise one to two times each day with 3 to 5 repetitions.

1. Pelvic tilt will help tone and strengthen your abdominal muscles and relieve backache. Lie on your back, with your knees bent. Tighten your stomach and buttock muscles to tilt your pelvis. Flatten the small of your back against the floor and hold for a count of 2 to 3 seconds. Increase gradually to a count of 10. Relax and exhale. Repeat 3 to 5 times. CAUTION: DO NOT arch your back, stick out your abdomen or push with your feet to do this motion. Remember to always contract your pelvic floor before doing abdominal muscle exercises. 2. Abdominal breathing Deep abdominal breathing will help you regain the strength in your abdominal muscles and help you relax. Lie down on a comfortable surface with your knees bent. Relax your body as much as possible, allowing your weight to sink into the surface on which you are lying. Gently put your hands on your abdomen, close your eyes and being to notice your breathing. Inhale. Abdomen and hands rise upwards; stretch your abdominal muscles outward. Hold for a count of 5. Exhale, abdomen and hands fall down-ward; pull in your abdominal muscles. Hold for a count of 5. Repeat 3 to 5 times. 3. Ankle circles (to enhance circulation) Make 10 circles with your ankles clockwise, then repeat counter-clockwise. Do the ankle circles in different positions such as sitting, lying down, etc. Repeat circular pattern 3 to 5 times. 4. Leg sliding/stretches Lie on your back with one knee bent. Keep your back flat while sliding the heel of the straight leg up and down the surface on which you are lying. Work only within the range where you can keep your back flat. Repeat 3 to 5 times with each leg. Abdominal muscle separation Before doing more advanced abdominal exercises, it is important to check for separation of the abdominal muscles. The abdominal muscle is divided by a seam running up and down. The muscle is really two halves that can often separate due to the size of the baby and the birth process. How to check for abdominal muscle separation Lie on your back and bend your knees, feet flat on the floor. Slowly put your chin to your chest and raise your head and shoulders until your neck is 6 to 8 inches off the floor. Hold one arm out in front of you. With the other hand, check for a gap or a bulge in the middle of your abdomen. There may be a soft region between the muscle. If there is a gap wider than the width of two fingers, avoid gurther separation by doing abdominal stregthening while crossing your hands over the abdominal area to support and bring together the muscles. Always exhale as you lift your head. This decreases pressure in the abdominal cavity and allows your abdominal muscles to work better.

Tighten your abdominal muscles when lifting to avoid abdominal bulging or any straining.

Arm and upper back stretch Raise your arms over your head keeping your elbows straight with your palms facing one another and hold for 5 to 10 seconds. Lower your arms out to your side, palms facing downward. Keep your upper boack straight. Bring the backs of your hands together as far as possible behind your back and hold for 5 to 10 seconds. Repeat 3 to 5 times. Continue doing the previous exercises, and begin to add more abdominal exercises as your strength improves. Sit-backs Begin these about 1 - 2 weeks after birth. Sit with your knees bent, feet flat on the floor and arms stretched out in front of you. Lean back as far as you can without feeling weak or unsteady. Gradually increase the distance you lean back as you build up strength. Soon you will be able to lean all the way to the floor, and then you can vary this exercise with folding your arms over your chest. Diagonal sit-up (waistline exercise) Lie on your back with your knees bent. Exhale as you raise your head and right shoulder. Point your right hand toward your left knee, keeping your heels on the floor and hold for a count of 5. Lower your head slowly for a count of 5 while breathing in through your nose. Repeat using your other side, pointing your left hand toward your right knee. Aerobic activity Gentle aerobic activity, such as walking, can begin as soon as you can handle it. Vigorous aerobic activity can usually be resumed after your postpartum check-up. Consult your health care provider before resuming. Protect your back Consider the following suggestions: Try not to carry your baby by supporting him/her on your hip. This causes your spine to twist. Slings with padded shoulder supports are recommended. Diaper or dress your baby sitting on the bed next to him/her or at the changing table rather than leaning over. When feeding your baby: Support your baby and your arm on a pillow. Consider using a specially designed nursing pillow to position yourself comfortably while breastfeeding. Avoid sitting with rounded shoulders and leaning over the baby. When standing, keep at least one knee higher than your hips to reduce the sway in your back. Try putting one foot up on a step stool. Kneel next to the bathtub when bathing a toddler. When talking to a child, bend at the knees and get down instead of bending over.

Strategies for lifting, bending and moving after delivery You are more prone to back strain after giving birth, because the pregnancy hormones have softened your ligaments and joints. The following strategies will help minimize your risk of back injuries. Lifting and moving Any time you need to reach or lift low objects, spread your feet apart with one foot in front of the other and bend your knees. Bring the object close to you as you straighten your knees and lift. This allows you to use the thigh muscles for lifting instead of straining your back muscles. When moving an object, try to push instead of pull. Use your legs, not your back and arms. Bending Avoid any position where you bend at the waist with your knees straight, even if it is only a slight bend. Instead, alter your position so that you are sitting, squatting, kneeling or bending at the knees while leaning forward at the hips. When getting in or out of a bed or a car, turn your hips and back in the same direction while keeping your back straight. When getting out of bed, first roll to your side, and then use your arms to push up from the bed.