Postnatal Physiotherapy


Exercise following delivery
Walking: Start with no more than 10 minutes on day one, gradually increasing by a minute or two daily. Walk as briskly as possible. Use this time for yourself or take your baby with you.

Swimming: Wait for 6 weeks or until all vaginal bleeding ceases.

High Impact: If hoping to return to more vigorous, high impact exercise, e.g. gym, jogging, aerobics etc wait for at least 6 weeks. It is also important prior to your return that you have adequately strengthened your abdominal muscles as well as the muscles supporting your bladder and lower back.

Contact Sports: Wait for at least 3 months.

In addition:
Follow-up Session in hospital (6 weeks+ after delivery): 10.30am – 12.30pm on 3rd Tuesday of the month. Tel: Carmel/Deirdre 091 544210 to confirm.

Aquafit, Yoga & Pilates – from six weeks on.

Further information:
Physiotherapy, UCHG. Tel: 091 544525 / 544489


It is very important to take care of your back after you have had a baby. Caring for your baby will involve lifting, feeding,  nappy changes – all activities that add strain on your back. After your baby is born your back is particularly vulnerable because –

1. Your stomach muscles, which normally help support your back are weak.
2. Your joints can be more unstable and at risk of damage due to the increased levels of hormones in your body.
3. Although the hormone levels settle quickly it is important to note that the effects of the above changes may take up to 3 months to return to normal.


Try to limit your lifting to your newborn baby if possible for 6-8 weeks.
• Avoid flexing your lower back.
• Use your legs by bending your knees.
• Get close to whatever you are picking up.

Remember when you are lifting, tighten your pelvic floor and deep tummy muscles.


1. Sit upright so that your lower back is well supported.
2. It may be necessary to place a small rolled up towel in the small of your back.
3. Place a pillow under the elbow of the arm cradling baby.
4. Lying on your side is a particularly comfortable way to breastfeed.


Floor Standing / Kneeling
1. Change your baby on a surface that is the right height for you (approximately waist level).
2. Whether you sit, stand or kneel keep the lower back straight.

Have everything you need close at hand. This will prevent any excess strain to your back caused by twisting and turning.


What is the pelvic floor?
The ‘pelvic floor’ is a group of muscles occupying the floor of the pelvic basin.
It acts like a trampoline or sling providing support for the pelvic organs, including the bladder, womb and bowel. These muscles are prone to stretching and weakening as a result of childbirth, chronic coughing, repeated lifting, constipation and in some cases the menopause.

Benefits of strengthening the pelvic floor:
• Keeps you dry.
• Helps prevent/stop leaking of urine with coughing, sneezing, exercise, dancing, laughing etc.
• Reduces the feeling of ‘something coming down’.
• Reduces urinary leaking associated with needing to rush to the toilet.
• Increases control of wind.
• May prevent the need for surgery.
• More enjoyable sex-life!

Identifying the pelvic floor muscle:
• Tighten and lift around the back passage (as if you were trying to stop passing wind). At the same time, include tightening of the front passages.
• One way of identifying the correct muscles is by touch and to try this try the following:
1. Place finger tips just behind the vagina.
2. Squeeze the pelvic floor muscle as above.
3. You should feel it tighten and lift up and away from your fingers.

Points to note:
• Make sure you are not holding your breath.
• Be careful that your legs or buttocks are not tightening.
• Remember no one should be able to see you doing the exercise.
• It is not recommended to exercise by ‘stopping and starting’ while passing urine.
• As the muscle becomes stronger, tighten it as you cough, sneeze, laugh etc.
This will help to keep you dry.
• Remember you can practise your exercises while doing other daily activities.

Your pelvic floor exercises are exercises for Life!


This position will reduce strain on the pelvic floor.
1. Put your feet on a stool with your forearms resting on your thighs.
2. Straighten your lower back by growing tall, lengthening your spine.
3. Let your knees fall out and lean forward from your hips (keeping your chest up).
4. Breathe deeply – allowing your tummy and the base of ribs to relax forwards.


Avoid slumping your lower back or drawing your waist backwards and bearing down, as these actions close the back passage. A relaxed sphincter promotes efficient bowel emptying. So therefore when the bowel signals it is time to empty, please do not defer as this can lead to constipation. Establish a daily time for bowel emptying and avoid rushing because of a busy schedule. Remember stress increases tension and makes emptying your bowel more difficult. Therefore try to relax when emptying your bowel and avoid straining.

If you have a slower emptying bowel, look at:
1. Increasing your fibre levels.
2. Increasing your water intake (1.5 – 2L fluid).
3. Starting regular exercise.
4. Adopting the new toilet position with waist relaxation.


This leaflet will help you recover physically immediately after your caesarean-section. You will usually be in hospital for five days afterwards, and will be encouraged to get up and about as soon as possible.


While you are less active, it is important to use our lungs well, especially if you have had an anaesthetic:
1. When sitting up in bed, take a deep, slow breath in through your nose, hold for the count of 3, then sigh the air out.
2. Repeat this 5 times.
3. Do this exercise regularly until you are up and about
4. If you feel the need to cough, try to support your wound with a small pillow or both hands. Bending your knees when lying in bed will help to ease strain on your wound when coughing.


1. When sitting up in bed, make sure you are well supported with pillows.
2. Placing a small pillow or roll in the ‘small’ of your back may increase your comfort.
3. Whether breast or bottle feeding a pillow underneath your elbow will help support you and your baby… and will help protect your stitches.

1. When lying on your back, it may be more comfortable will a pillow under your thighs.
2. When lying on your side, comfort may be increased by using pillows as shown. This may also be a comfortable position for breastfeeding.

Getting out of bed


1. Try to attend a Postnatal Class prior to your discharge.
2. Your Physiotherapist will give you further advice on posture, back care and appropriate exercises.
3. These are held Monday, Wednesday or Friday mornings at 11am on
St. Angela’s Ward.

Going home in the car?
Place a pillow between yourself and the seatbelt.


• Check with your insurance company that you are covered .

• Avoid lifting a weight heavier than that of your newborn for 2 months.
• Always bend your knees and keep your back straight.


Your abdominal muscles are the largest group of muscles in your body and they consist of several layers. As your bump grows during your pregnancy your abdominal muscles stretch and lengthen. Towards the end of your pregnancy your outermost layer of abdominal muscle will separate centrally leaving a gap (diastasis).

To check your gap
1. Lie on floor with knees bent up.
2. With the fingers of one hand (palm facing towards you) press down into your abdomen approximately 2cm above your belly button.
3. Lift your heads and shoulders off the bed.
4. You should feel a space which narrows as you lift your head and shoulders.
5. Your gap may be 4 fingers, 3 fingers, 2 fingers or 1 finger wide.


These gentle exercises will help to strengthen your abdominal muscles while providing support
and stability for your back.

They will also:
• Shorten your elongated muscles and encourage them to lie side by side again.
• Improve posture.
• Help support lumbar spine.
• If toned up future pregnancies will not put as much strain on tummy/lower back.

Early abdominal exercises (gap 4 fingers or less)
It is important to note whether you had a vaginal delivery or a caesarean section, you can start these exercises from today.

Deep abdominal exercise – exercises deepest muscle in the stomach and draws in your waistline.
1. Lie on your side comfortably.
2. Let your tummy relax.
3. Breath in.
4. As you breath out, gently draw in your lower abdomen towards you.
5. Hold for a few seconds, breath normally, relax.
6. Avoid bracing the abdomen strongly.

Pelvic tilt – this exercise continues to restore your muscles to their normal length
1. Lie on your back with both knees bent.
2. Draw in your deep tummy muscles and pelvic floor muscle.
3. Tilt the pelvis so your back flattens into the bed/floor.
4. Hold for 5 seconds, breathing normally, relax gently.

To progress (Gap 2 fingers or less)
1. Lie on your back with your knees bent up.
2. Prepare with deep tummy contraction and pelvic floor squeeze.
3. Pelvic tilt.
4. Then lift your head, running your fingers along your legs towards your knees.
5. Breath normally.
6. Relax back gently.

It is never too late to start exercising muscle. They are never beyond repair; they just need to be worked on.

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