Baby

Do at least fifty times a day.

1. Lie on your back with knees bent. Close your hands over the abdominal area so you will be able to pull the muscles toward the center of the abdomen as you slowly raise your head.
2. Take a deep breath. As you slowly exhale, lift your head [and later your shoulders, to a forty-five degree angle], at the same time pulling the muscles together with your hands. Return your head [and shoulders] to the bed or floor.

Much literature has been written on the benefits of aerobic exercise. The benefits we are most concerned with here are those specifically dealing with a new mother. Those benefits are increasing stamina and endurance-the ability to do more but feel les tired-and decreasing body fat.

Decreasing Body Fat

After delivery and with exercise, your body will slowly begin losing some of stored fat it laid down during pregnancy. How much you accumulated during the nine months depended on your percentage of body fat going into the pregnancy and the kinds and amounts of foods you ate during pregnancy. The leaner your body was, the less likely it is that you laid down large fat stores. Hereditary factors also come into play.

After delivery, the fat stores will gradually decrease over a period of four to six months. There are no miraculous changes that occur within the first six weeks, as many sources lead you to believe. You may notice a difference in your body during the first two weeks after delivery, when much of the accumulated pregnancy related fluids is lost through urination. After that, it’s up to you.

Breastfeeding women initially lose weight faster than women who bottle feed. However, because of the hormonal factors in operation throughout breastfeeding, their body fat level remains slightly higher, their breast tissue weighs more, and they retain a small amount of extra fluid beneath their skin as a reserve. As a result, breastfeeding women tend to weigh about three to seven pounds than their pre-pregnancy weight during breastfeeding, regardless of efforts of losing weight. Having taken that fact into consideration, if you still don’t seem to be losing the weight you expected to lose, take a good look at your diet and calorie intake. A diet with excessive amounts of sweets and fats will not help you return to your pre-pregnancy weight easily. Check with your physician if planning a reducing diet while breastfeeding: many breastfeeding women can lose weight on seventeen hundred to eighteen hundred calories a day and still maintain a good milk supply; others must have two-thousand calories a day to maintain an adequate milk supply. Making milk itself takes up lots of energy [hence, uses up calories]. Add aerobic activity for twenty to thirty minutes a day, five or six days a week and you will lose weight.

Breastfeeding should not be seen as an impediment to recovering your pre-pregnancy figure-or as an excuse for not trying. On the other hand, don’t let the fear of extra weight gain keep you from breastfeeding in the first place. The few pounds of weight that can be attributed to breastfeeding will be with you temporarily; the benefits of breastfeeding will be with you forever.

Remember, it may take four to six months for your body fat to start dropping. A daily nudge with aerobic exercises will start things happening. Be patient. Many answers still lie ahead of us as more and more studies are being done to help us understand the mechanisms of the body that just gave birth to new life. One thing is absolutely certain: having a new baby is not an excuse for looking or feeling out of shape.

Reverse Sit-Up

Start with five and increase gradually.

1. Lie on back with knees bent and arms at sides, palms down.
2. Keeping knees bent, raise legs until knees are past level of breasts or above face. Raise buttocks toward upper body. Head and shoulders stay flat.
3. Return to starting position and repeat.

Note: You may notice a tendency to press down or grip the floor with the hands, or you may feel a strain in the neck or upper shoulders as you attempt to reach the desired height with the knees. This will disappear as you become stronger and more relaxed with the movement. [Remember to breathe with this exercise]
This exercise works the lower fibers of the rectus muscles as well as the external obliques. To work the horizontal fibers you should also perform the reverse trunk twists.

Reverse Trunk Twists

Start with five and increase gradually.

1. Lie on back with arms out at sides with legs raised ninety degrees from the floor. With knees bent slightly.
2. Lower legs to right and touch floor with outside of foot. Shoulders and arms must remain on floor at all times.
3. Return to starting position and repeat, alternating sides on each repetition. [After a time, you will probably notice increased flexibility of your midsection while performing this exercise.]

Advanced action:

Begin with same starting position, but with legs straight out. Legs should remain straight as they are lowered to side. Be sure to press your back to the floor as you come toward the center each time.

Note: If your shoulders come off the floor as you drop your legs to the side, have someone hold them down. This person should be on all fours with his or her hands on your shoulder joints [not the neck area], arms straight and shoulders directly above yours. As flexibility and strength increase, you will not need assistance.

On the advanced exercise, if you have difficulty in keeping the legs straight because of tight hamstring muscles bend your knees slightly but keep the legs together. The more the knees are bent, the easier it is to do this exercise. Doing it in the straight-leg position is the most effective so try to work up to it.

The reverse trunk twist works all portions of the external and internal obliques, tightening the front and sides of the abdominal wall much more than any other abdominal exercise. This exercise also strengthens the spine because it uses the small muscles-both the deep and the surface muscles-that hold the bony vertebrae together and twist the spine. Strengthening these muscles will ease the typical overuse backache and may help prevent injuries that occur when quick twisting movements are executed.

The U-Seat

Start with five and increase gradually to a maximum of twenty.

1. Lie on back with arms behind head, knees bent and feet on the floor.
2. At the same time, raise head and begin raising knees towards chest. As the head and knees are in motion, begin raising shoulders and buttocks off floor. Continue both actions and try to touch knees to chest. At the end of these movements, your pelvis and upper body should be off the floor. Do not push head and neck forward with hands-simply rest head in hands, letting the shoulders do the work.
3. Return to starting position and repeat.

Note: Knees should be brought up quickly but smoothly using the abdominals to develop momentum, this action makes it easier to raise the pelvis. Think of it as two steps [1] raise head and knees, then [2] raise shoulders and buttocks. This timing allows for proper coordination and smooth movement between pelvis and chest.

When performed correctly and smoothly, the U-seat exercise maximally involves both the upper and lower portions of your abdominals.

Once you have completed the appropriate exercises for after your type of delivery, gradually replace the post-delivery exercises with the ones you did during pregnancy. These exercises also work all the muscle groups that are important during the postpartum period, with no muscle or joint strain. The pelvic rock, which can now be done while lying on your back with your knees bent, will improve your posture and ease back strain. It is wonderful for working buttocks, abdominal and pelvic floor muscles all at the same time, and provides a great back stretch. Remember to do it slowly with control and gradually increase the time you hold the tilt.

Begin with the first eight exercises for Strengthening Exercises for Pregnancy & after Delivery. When you feel comfortable with these, gradually increase the repetitions, and then add the remaining four exercises. Gradually increases your repetitions with these also, letting comfort be your guide. Don’t rush through them. Be sure to warm up [walk or march in place for three to five minutes] and then stretch for five minutes before beginning any floor exercise. Turn on music with a strong, regular beat. Music will help you move smoothly, make time pass quickly, and add an element of fun.

Extra Help

The following exercises are good for a stubborn protruding abdominal wall [potbelly].Because the rectus muscles are long, vertical muscles that run from the breastbone to the pubic bone, you need to have exercises that cause action at both ends of them. To shape and to strengthen these muscles, at least two exercises must be performed. Reverse sit-ups and reverse trunk-twists. The reverse sit-ups can be alternated with the U-seat, or all three can be done at each session. For all these exercises begin with five of each and gradually increase the repetitions as you get stronger. The key to success is controlled movements, with no “sling and fling” moves.

 

Warm-up Stretch

 Walk

Cool-down Stretch

Weeks 1 & 2

5 - 10 Minutes

5 minutes slowly

15 minutes briskly

5 minutes slowly

5 - 10 Minutes

Weeks 3 & 4

5 - 10 Minutes

5 minutes slowly

30 minutes briskly

5 minutes slowly

5 - 10 Minutes

Weeks 5 & Onward

5 - 10 Minutes

5 minutes slowly

45 minutes briskly

5 minutes slowly

5 - 10 Minutes

• Remember: Walk with your pulse in your target zone.
• Never exercise to exhaustion. End your workout at the point at which you feel you could go on for another ten minutes.
• After delivery, start at Week 1 Listen to your body-it will tell you how fast to progress.

Women often say, “I already walk a lot just caring for the baby, and I’m very tired. The last thing I want to do if I have some spare time is walk-I just want to sit down and relax or nap!” But walking while caring for the baby is a lot of stop and start movements, never really going very far from one place to another. What is needed is slow, steady, rhythmic movement for a period of five to fifteen minutes uninterrupted. This kind of activity, after you get over the initial tiredness of doing it for the first few times, will actually give you energy and release you from being tired and sluggish.

When to Begin or Resume Aerobic Exercise

This depends on a number of factors, such as how fit you were before giving birth, whether delivery was vaginal or abdominal, whether there were any complications, how much sleep you are getting, and what your emotional reaction is to the birth was.[Some women take, days, weeks, or even months to work through unexpected or unpleasant birth related events. They may feel sad, angry, or depressed. Emotional factors may sometimes prevent women from taking hold of her situation and following through with desired action].

General guidelines are as follows: If a woman exercised regularly for eight to twelve weeks before delivery, she can safely resume moderate aerobic exercise ten to fourteen days after an uncomplicated vaginal delivery, or approximately twenty-one days after a cesarean delivery. If a woman had a high fitness level before pregnancy and exercised regularly all through pregnancy, she will probably find it comfortable to begin short, brisk walks during the first week after a vaginal delivery, or after the second week after a cesarean delivery.

Whatever aerobic activity you choose to begin with, be sure to monitor your pulse; work at about sixty percent of your SHR for the first few weeks. Do not start a level of seventy to seventy-five percent. Remember that you have just had a baby [and if by cesarean, major surgery as well]. Remember also, that you are almost certainly getting less sleep than usual. Start your exercise program at sixty percent and work gradually to seventy-five. If you are new to exercise, take twelve weeks to make this transition. To develop stamina and endurance and to retrain your body to burn fat as fuel, you never need to work at a pulse rate higher than eighty percent of your SHR. The old “no pain, no gain” slogan is not true-pacing, regularly, and persistence are the keys to successful exercise.

The very best guideline for resuming aerobic exercise is to tune into your body. And remember, never exercise to exhaustion. If you find yourself tiring, slow down and stop. End your workout at the point at which you could go another ten minutes. Learn to pace yourself.

This is the time to think about joining [or rejoining] an exercise class. A pregnancy/new mother class is ideal. You have the support, advice, and caring of women in your same life situation. Although you may not do all the exercises in the class during your first weeks of attendance, getting out of the house, forcing your self to be organized, being with other mothers, and being in a formal class can do you wonders, beyond the benefits of the exercises themselves.

Begin the day of delivery [as soon as you return from the recovery room]. Do them in bed. Perform them until you are up on a regular basis.

Deep Breathing

Five times every hour you are awake.

1. Breathe slowly and deeply to expand the upper, middle, and lower portions of your chest.

Huffing

Two or three times every hour you are awake.

This is especially important if you had general [gas] anesthesia. In response to the anesthetic, the lungs produce mucus, if which not removed, can clog the small air sacs and breathing tubes of the lungs. “Huffing” should be used instead of coughing.

Here’s how:

A huff is a quick outward breath. It is like saying “ha”-a short, quick breath, with force from the abdominal muscles. The outward breath must be done quickly. Otherwise the force is not sufficient enough to dislodge any mucus. Spit out the mucous you cough up, don’t swallow it.

If huffing still doesn’t bring up any mucous and you still hear a rattle in the chest, try deep breathing again to loosen it.

With huffing, the abdominal wall is pulled in instead of out; therefore, huffing is more comfortable than deep breathing. Still, you may want to support the abdominal wall with your hands or a pillow. Be reassured that the stitches will not be pulled out.

Foot Exercise

Five times every hour that you are awake.

1. Do five ankle circles to the right and five ankle circles to the left. Make them slow and big. Repeat with the other ankle.
2. Slowly point and flex the foot. Repeat with the other foot.

Pelvic Floor Squeeze

Twenty a day, moving toward sixty, in sets of three or four. Begin when the catheter is removed.

1. Lie or sit [later you will be able to stand] comfortably with the legs apart. [The farther the legs are apart, the more challenging.]
2. Thinking about the vagina and perineum. Tighten the pelvic floor as if to lift the internal organs or to stop urination in midstream. Hold as tightly as possible for a slow count of three [gradually work up to a count of ten]. Be sure to breathe.
3. Relax completely.
4. Note: Because these muscles fatigue easily, repeat in sets of three or four squeezes throughout the day, anytime, anywhere.

Concentrate on the sensations of tension and lifting, relaxing and lowering within the pelvis.

Leg Squeeze

Three times every hour you are awake.

1. Lie on back with one leg bent and the other leg straight with the foot flexed.
2. Slowly press the straight leg to the bed and tighten all the muscles in that leg, gently pulling the toes toward the face.
3. Repeat with opposite leg.
4. With both legs straight and ankles crossed, tighten all the muscles in your legs-press knees down, tighten thigh muscles, and squeeze the buttock muscles. Hold while you slowly count to five [don't hold your breath].
5. Release.
6. Repeat.

Note: If needed, prop yourself up on pillows.

Pelvic Tilt

Three to five times every hour you are awake.

1. Lie on back with knees bent and heels close to buttocks.
2. Inhale and press your back to the bed. Hold for a slow count of five [working toward ten]. Concentrate on pressing the back to the bed by using your abdominals-do not push with the feet. For an extra benefit, squeeze your buttock muscles and the pelvic floor.
3. Relax, and then repeat.

Note; Slow, controlled movements are the key to success with this exercise. In the beginning, abdominal pain will let you do only a third or a half of this movement. That’s fine-listen to your body. Improving pelvic circulation is important-do the best you can with this movement. As your body heals more and more each day, hold the tilt longer and longer. Remember to breathe. Add a pelvic floor squeeze to.

Add on Third Day

Bend and Straighten Legs

Repeat variation A three to five times, twice a day. Using comfort as your guide, progress through variations B and C to variation D as soon as possible.

Variation A

1. Lie on back with both legs bent, feet flat on the bed.
2. Slowly straighten the right leg and bend back to place.
3. Repeat with opposite leg.

Variation B

1. Lie on back with one leg bent and the other leg straight.
2. Slide the bent leg out straight and then back to a bent knee position.
3. Repeat with the straight leg, returning to a straight leg position.

Variation C

1. Lie on back with one leg bent and the other leg straight.
2. Bend one leg as you straighten the other [Both legs are moving at the same time, slowly in opposition.]

Variation D

1. Lie on back with both legs bent.
2. Move both legs down and up at the same time.

Add on Seventh Day

Head-Up Lift

Three to five times twice a day. Add more as comfort guides you.

1. Lie flat on back with no pillows, knees bent.
2. Press back down [pelvic tilt], inhale slowly and lift just the head. Hold for a count of three.
3. Lower head and relax.

Note: Using comfort as your guide, progress to lifting head and shoulders on exhalation. Concentrate on lifting head and shoulders as a unit toward ceiling, just an inch or two of floor. Do not thrust head forward on the lift.

Begin the day of delivery, while in bed. Do them on the floor once home.

Head Curl Up

Begin with five to ten twice daily, move toward twenty.

1. Lie on back with knees bent and feet close to buttocks. Press back down. Inhale slowly and deeply.
2. Exhale slowly; at the same time lift up just the head. Hold as you complete the outward breath.
3. Relax.
4. Repeat for a total of five times.
5. Note: Do this as many times during the day as you can. Then progress to head and shoulders curl-up.

Head and Shoulders Curl-Up

Begin with five twice daily, move toward twenty.

1. Lie on the bed or floor, with knees bent and feet close to buttocks. Pres the back down and inhale slowly and deeply.
2. Exhale slowly, at the same time, lift head, and then shoulders. Hold as you complete the outward breath. Perform slowly with control [no jerky movements]. Head should stay in line with the spine, do not throw hawed forward! The “lift” comes from the shoulders and should be straight up, about six inches maximum, face toward ceiling.
3. Relax, return to starting position, and repeat.

Pelvic Floor Squeeze

Do sixty or more each day in sets of three or four.

1. Sit or stand comfortably [you can do this exercise in most positions]. The farther the legs are apart, the more challenging.
2. Thinking about the vagina and the perineum, tighten the pelvic floor as if to lift the internal organs or to stop urination in midstream. Hold as tightly as possible for a slow count of three [gradually work up to a count of ten]. Be sure to breath.
3. Relax completely.

Note: Because these muscles fatigue easily, repeat in sets of three or four squeezes throughout the day, anytime, anywhere. Concentrate on the sensations of tension and lifting, relaxing and lowering, within the pelvis.

Pelvic Tilt

Begin with ten a day and work toward twenty.

1. Lie on back, with knees bent and heels close to buttocks.
2. Inhale and press back to the floor. Hold for a slow count of five [working toward ten]. Concentrate on pressing the back to the floor by using your abdominals-do not push with the feet, for an extra benefit, squeeze your buttock muscles and the pelvic floor.
3. Relax, and then repeat.

Note: This is a wonderful stretch that will help relieve a tired or achy back.

Bend and Straighten Legs

Start with ten a day, progress to twenty. Start with Variation A. Using comfort as your guide, progress through Variation B and C to Variation D, as quickly as possible.

Variation A

1. Lie on back with both legs bent, feet flat on bed or floor.
2. Slowly straighten the right leg and bend back to place.
3. Repeat with opposite leg.

Variation B

1. Lie on back with one leg bent and the other leg straight.
2. Slide the bent leg out straight and then to a bent knee position.
3. Repeat with the straight leg, returning to a straight leg position.

Variation C

1. Lie on back with one leg bent and the other leg straight.
2. Bend one leg as you straighten the other [Both moving at the same time, slowly, in opposition].

Variation D

1. Lie on back with both legs bent.
2. Move legs down and up at the same time.