10 Things You Should Know Postpartum: A Guide for New Moms
Becoming a mother is a life-changing experience that brings immense joy and some unexpected challenges. With each new birth, a new mom is also born, facing unexpected changes to their physical, mental, and emotional health. Understanding what to expect postpartum can help you navigate this chapter of life with confidence and self-care. Collectively we have come up with some things we think you should know about postpartum recovery from a pelvic floor physical therapist.
1. Prioritize Scar Tissue Mobilization
Scar tissue can form after childbirth, especially if you had a cesarean section or experienced vulvar, perineal, or vaginal tearing. Gentle massage and mobilization techniques can help prevent stiffness and promote healing. When it comes to scar tissue, there is an 18-month window to create as much elasticity and mobility in the tissue as possible. This tissue can be very tender and raw due to hormonal and physical changes, as well, so using gentle pressure as tolerated is a great baseline to start massaging.
We feel it is important to our community to share our resources with you all, so below you may find a free handout on Perineal Tissue Mobilization. You may also find it under the tab Education > Free Handouts > Perineal Tissue Mobilization.
2. Movement Progression Postpartum
YAY! You just got cleared from the OB at your 6 week check up! But now what?
The 6-week clearance from your OB means you are no longer bleeding, and your cervix is closed, but it doesn't mean you should jump right back into your pre-pregnancy exercise routine. Your body needs time to heal after childbirth, and movement progression is key.
Start slow, even if you are an advanced athlete or just an average person who enjoys their hot girl walks. In the first week postpartum, focus on breathing mechanics and gentle stretching poses that do not exacerbate abdominal opening and extreme forward trunk flexion as to avoid overstretching the tissue. Gradually introduce core activation exercises over the next 4-6 weeks to reinforce abdominal wall closure and core stability. We believe it is best to start with pelvic floor physical therapy at Tonic & Phasic 2 weeks postpartum to introduce a recovery phase, scar tissue management, breathing mechanics, core stability and an exercise progression program.
Below you may find a free handout on Abdominal Core Bracing 101. You may also find it under the tab Education > Free Handouts > Abdominal Core Bracing 101.
3. Introducing Penetrative Activities
Postpartum hormonal changes can make your vaginal tissue feel more irritated due to the changes of estrogen and from breastfeeding. If you want to reintroduce penetrative function into your life, acknowledge that it may feel a little different down there. Consider using lubricants like Good Clean Love, UberLube, or Slippery Stuff.
We also believe communication with your partner is crucial during this time. This can be very informative for both parties when navigating new waters. We highly recommend starting with non-sexual affection such as massage or cuddling, which can also be comforting and intimate.
While healing (which can take up to 18 months), keep the area clean, use gentle products, and moisturize regularly with your favorite vaginal moisturizers. If your perineal tissue is not healing, please consider consulting with your OB or physician.
4. Maximizing your Bowel Movement Efficiency
How hard can it be? Well quite literally and figuratively, the days following your birth, a bowel movement (BM) or even peeing can be challenging. Let’s break it down on how to have the most effective BM:
Use a squatty potty
Grab a pillow to hug to your abdomen
Turn your knees into touch slightly (without any excessive pulling to your vaginal tissue), with your feet out wide
Lean forward
Take deep 360 breaths allowing the pelvic floor to open with elimination
But what if you still need help with stimulating the bowels? We recommend:
Walking and gentle movements
Stay very WELL hydrated
Eat fiber-rich foods
Consider a magnesium citrate supplement
If you had a c-section, postpartum pain medication can delay bowel movements, increasing the strain on pelvic floor muscles, so give yourself grace and continue to practice good BM hygiene. If you are constipated for longer than 5 days, please consider consulting with your OB or physician.
5. Warm Foods for Comfort
Consuming warm foods can be soothing and aid digestion postpartum. Soups, stews, and herbal teas are comforting choices that support your body’s recovery. Ideal first meals include bone broth, CCF tea (Coriander, Cumin & Fennel), lentil soups, and one-handed snacks like power bowls and foods rich in iron (e.g., spinach, beef, green vegetables, beans, lentils, etc).
6. Breastfeeding and the Pelvic Floor
Breastfeeding is a beautiful way to feed, nurture, and bond with your baby, but it doesn’t always come easy to everyone. We HIGHLY recommend getting a lactation consultant before giving birth to find what works best for you. They will be able to analyze and assess based on your breast size, nipple shape and positions, as well as your body mechanics. An IBCLC (international board certified lactation consultant) will be able to navigate breastfeeding with you for colostrum support, mastitis, or latch support.
7. Take It Slow with the 5-5-5 Method
5 Days in bed
5 Days on the bed
5 Days near the bed and around your home
We understand that everyone is different, however we find that this time period is crucial for recovery and maximizing healing. Your body needs time to heal, especially where the placenta detached. There truly is no rush in getting back to everyday life, you have these few days to truly pause, and nurture your body and baby.
During this time we encourage watching for warning signs of overactivity, such as increased bleeding or large clots, and prioritize rest. Some exercises that are great to incorporate on the bed are: ankle pumps, quad contractions, pelvic tilts, and snow angles with arms.
Though we are Pelvic Floor Specialists, we are not YOUR pelvic floor specialists. Please always consult with your medical provider before choosing which method is best for your body.
8. Prioritize Sleep in the First 8 Weeks
Sleep is crucial for healing and emotional well-being during this time. Again, easier said than done (especially for sleep regressions). But if this is your first, establish a sleep routine with your baby and try to stay consistent.
Try some of the following:
Try to avoid phone use at least 2 hours before you go to bed or after 10pm
Get morning sunlight for at least 10 minutes
Give yourself an evening self-massage
Take a hot shower or bath before bed
Keep the sleeping environment cool
Stay hydrated throughout the day
Wear a sleep mask
Lastly, if none of this is working, consider working with your support network to ensure you get adequate rest, possibly by scheduling naps and sleeping in shifts with your partner to ensure some time for uninterrupted sleep.
I personally have found enlightenment through Dr. Matthew Walker’s book, Why We Sleep, and would highly recommend it if you continue to have difficulty sleeping. Knowledge is power!
9. Long-Term Postpartum Healing
Sometimes our bodies don’t fully return to their baseline until up to 18 months postpartum. We really need to understand that whole-body healing isn’t complete in 6-12 weeks after birth, so please give yourself grace and patience as you recover. Remember, you are still everything to your baby, and it is critical that you care for yourself.
As women and mothers we tend to give a lot of ourselves, so turning back inward, ask yourself what brings YOU joy. Is it nature walks, pickleball, brunch with your girlfriends, reading a good book? And we want to lean into that during this time and make time for the things that bring us joy.
I personally like to prescribe joyful activities as “homework”, for at least 10 minutes a day!
10. Prolapse Prevention
This one is a big one for people…People think they are out of the water and there are no more changes that can possibly happen.
Well we have seen an increase in poor regulation of postpartum people who experience prolapse/pressure symptoms months after postpartum. This is due to poor breathing and pressure mechanics, when lifting and carrying heavier than our body can handle at that moment in time. This is often seen when the baby or child is getting bigger and mom’s core strength can’t tolerate it at that time. We recommend consulting a Tonic & Phasic pelvic floor physical therapist to educate and demonstrate proper postural biomechanics, and lifting mechanics.
Final Thoughts
Postpartum recovery is a journey that requires patience, self-care, and lots of support (we’re looking at you Ms. Independent). By understanding these key aspects and seeking help when needed, you can navigate this period with greater ease and confidence. Remember, your body has done something amazing, and it deserves the time and care to heal fully. Embrace this journey, take care of yourself, and enjoy the beautiful moments of motherhood.
