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Physical problems after pregancy

Having a baby changes your body. Some things may never be quite the same again, but other changes don’t need to be permanent.

You can tighten your tummy with exercise, for example, and any weight you’ve gained will gradually drop off if you eat healthily and exercise.

It won’t happen overnight. It took nine months to make a baby, and it could take at least that long to get back into shape again.

Some women have physical problems after having a baby. These can be related to pregnancy or birth, or because of the things you do while caring for young children, such as lifting and bending.

For some problems, you can do a lot to help yourself. For example, if you’re experiencing a leaky bladder (incontinence) or a heavy feeling in your perineum (the area between your vagina and anus), you may need to strengthen the muscles around your bladder, vagina and anus with pelvic floor exercises.

Back pain can often be helped by exercise and learning to look after your back, too.

If something’s bothering you, don’t hesitate to ask your GP or health visitor for help at any time. They can advise you and refer you to a specialist if necessary.

Your postnatal check at around six to eight weeks after the birth is a good time to talk to your GP about any physical or mental health problems you’ve had since the birth - see what’s offered in your postnatal check .

It’s common for the two muscles that run down the middle of your stomach to separate during pregnancy. This is sometimes called diastasis recti, or divarication.

The amount of separation varies from one woman to another. It happens because your growing womb (uterus) pushes the muscles apart, making them longer and weaker.

Most women don’t notice any problems as their stomach muscles separate in pregnancy. But you might notice a bulge developing down the front of your bump, above and below your belly button.

After you have had your baby, you can check the size of the separation with this simple technique:

  • Lie on your back with your legs bent and your feet flat on the floor.
  • Raise your shoulders off the floor slightly and look down at your tummy. Using the tips of your fingers, feel between the edges of the muscles, above and below your belly button. See how many fingers you can fit into the gap between your muscles.

Do this regularly to check that the gap is gradually decreasing.

The separation between your stomach muscles will usually go back to normal by the time your baby is eight weeks old. If the gap is still obvious at eight weeks, the muscles may still be long and weak. This can put you at risk of back problems.

Have a word with your health visitor or GP. Your GP can refer you to a physiotherapist, who will give you some specific exercises to do.

Regular pelvic floor and deep stomach muscle exercises can help to reduce the size of the separation between your stomach muscles. It’s also important to stand up tall and be aware of your posture now you’re no longer pregnant.

Pelvic floor muscle exercises strengthen the muscles around your bladder, vagina and back passage. This can help to stop incontinence, treat prolapse and make sex better, too.

You can do this exercise lying down, sitting or standing. With practise, it can be done anywhere and at any time – even while you’re watching TV:

  • Squeeze and draw in your back passage as if you’re holding in wind.
  • Squeeze around your vagina and bladder tube (urethra) as if you’re stopping the flow of urine or squeezing during intercourse.
  • Now relax. This is a short squeeze. Rest for a second, then repeat these squeezes until you feel the muscles get tired.
  • After a short rest, squeeze again as above. This time, hold the squeeze for as long as you can, but no longer than 10 seconds, then relax.
  • It’s important to keep breathing normally while you do these exercises. Make sure you don’t pull in your stomach or squeeze your buttocks when you squeeze.
  • Aim to build up to 10 repeats of each exercise, four to six times a day.

In the past, women were taught to practise these squeezes while having a wee. This isn’t the best way to do these exercises as you may not empty your bladder completely.

Sitting on the toilet can be a good reminder to do your exercises, though. Just make sure you do them after you’ve finished.

Visit the Chartered Society of Physiotherapists website for more tips to strengthen your pelvic floor.

These exercises can help you tone up your stomach muscles:

  • Lie on your side with your knees slightly bent
  • Let your tummy relax and breathe in gently
  • As you breathe out, gently draw in the lower part of your stomach like a corset, narrowing your waistline
  • Squeeze your pelvic floor muscles at the same time
  • Hold for a count of 10, breathing normally, then gently release
  • Repeat up to 10 times

These practical tips may help to relieve an aching back:

While feeding your baby, always sit with your back well supported and straight. Put a small pillow or cushion behind your waist to support your lower back. Make sure your feet can reach the floor.

  • Kneel or squat to do low-level jobs, such as bathing your baby or picking things up off the floor. Avoid bending your back. Make your knees do the work instead.
  • Change nappies on a raised surface. You could kneel on the floor next to a sofa or bed. Never leave your baby unattended on a raised surface, in case they fall off.
  • To lift heavy objects, such as a baby car seat or an older child, bend your knees, keep your back straight and hold the object close to your body. Make your thigh muscles work as you lift. Squeeze your pelvic floor and deep stomach muscles as you prepare to lift.
  • Keep your back straight when you push your pram or buggy. Alternatively, carry your baby in a well-fitting sling.