Why we need to view postpartum as a recovery time

Jill Heath, PT, DPT

Having a baby is a natural process that our bodies were made to do. The body goes through considerable changes during pregnancy to allow the baby to grow, and prepare us for delivery. Though a natural process, it is a change from how our bodies are used to working and feeling. As a physical therapist, I look at physical structure and alignment, how muscles are working optimally, and how the brain, nervous system and muscles are working together. From this point of view, some of the changes I see after baby is born are:  

  • Posture - forward head, rounded shoulders (ie slouchy)
  • Low back arched, bum tucked under
  • Widened pelvis = changes down the kinetic chain (ie different angles at the knees and feet)
  • Glutes aren’t able to work as well as they should because of the pelvis position
  • Ribcage expanded and diaphragm not going through its full excursion
  • Pelvic floor and abdominal muscles in a prolonged stretch
  • Reduced awareness and control of pelvic floor muscles
  • Connective tissue of abdomen is lengthened (separation of muscles)
  • Increased ligament laxity (ie looser connections)
  • Possible scar tissue from C-section or pelvic floor injury during childbirth  

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That’s a lot of stuff! Unfortunately, these issues often aren’t given the attention they deserve after having a baby. Transitioning to motherhood is busy and full of emotions. Our bodies go into survival mode and figure out how to move (often in compensating ways that don’t work so well) to take care of “all the things”. Or we feel the societal pressure to get in shape and lose the weight so we challenge our bodies too much and too soon, despite all of the changes that have occurred.  

Fortunately, there is a lot we can do about this. Giving our bodies the time and attention to recover from these changes can go a long way. Retraining our breathing patterns can help the diaphragm work more efficiently (can’t we all use some calming breaths as moms?) Specific exercises for the abs and pelvic floor - working together in a gradual progression - can get rid of the “mom pooch” and keep us from leaking while we jump on the trampoline. Working on scar tissue by a therapist or learning to do it ourselves can alleviate pain and prevent further issues. Helping all the muscles to work well together can help us not feel “clunky” when we try to run again.  

In a perfect world (hopefully in the not too distant future), during the fourth trimester we would receive this kind of care in the same way an orthopedic surgery is rehabilitated - with specific instructions, education, and respect for the healing time frame. We’re not there yet, but the good news is that regardless of how long we’ve been “postpartum” we can still help these issues. Our bodies are capable of change and are always evolving. Helping them remember how they moved pre-pregnancy can help us to move and feel better as moms.

About the Author

Jill Heath is a licensed physical therapist and owner of She PT, LLC. She received a Doctorate of Physical Therapy and B.S. in Exercise Science from Northern Arizona University. During years of practice helping individuals of all ages recover from a variety of conditions, she developed a passion for working with women. She opened She PT, LLC with the purpose of meeting not only the unique physical needs of women, but also empowering women to take charge of their well-being by making care accessible.