The Fourth Trimester: How chiropractic can support postpartum healing
Recovery following a cesarean or vaginal delivery:
No matter whether your body has just experienced a cesarean or vaginal birth, the first and most important next step is to focus on healing over the coming weeks. While it may be tempting to want to try and do as much as possible after giving birth, the value of rest, healing, hydration, and caring for your little one cannot be understated.
Beginning the day after a vaginal or cesarean birth, we recommend getting out of bed to walk every single day, even if it’s only for a few steps (given there are no post-birth concerns). This helps promote healing of the area by encouraging blood flow to the core and pelvic floor. During this time, it is important to get in and out of bed in a supportive way – this includes rolling onto your side followed by using your arms to push yourself up to a seated position while dropping your knees off the side of your bed or couch. Getting up this way helps to protect your healing abdominals. You can continue short walks daily and increase the length of these walks as you feel able, but pay attention to your body and scale back if pain or bleeding occurs. Give yourself grace as you transition into this fourth trimester.
Receiving the ‘all clear’ at 6-weeks post-op or birth from your doctor:
It is important to note that while this all-clear means there are no issues that require immediate medical intervention, it does not mean your body is ready to resume high impact activity.
Signs you are not quite ready to increase the intensity of your activity:
o Leaking urine or bowel contents
o Difficulty with bowel movements
o Pain
o Cesarean scar pain, numbness, or sensitivity
o Pelvic or low back pain
o Pelvic pressure, heaviness, or fullness
o Abdominal doming or coning
If any of the above are happening, it is a good time to book in with a chiropractor and/or pelvic floor therapist as these can be signs of pelvic floor dysfunction. We will assess to determine a care plan or if a referral to your medical provider is warranted.
Making slow, meaningful advancements between 6-8 weeks postpartum:
At this time, it is generally safe to return to low intensity activities like gentle core and pelvic floor strengthening activities in addition to walking. The focus should be on rebuilding your core and pelvic floor muscles during the first 12-16 weeks after birth before returning to higher impact/intensity activities. Higher intensity activities put a greater demand on the muscles of the pelvic floor and abdomen and as such, may not be appropriate until 3-6 months postpartum. This is why it is important to check in with a practitioner that specializes in postnatal care, like our Bright chiropractors! We can work through different movements and tests to determine your readiness to return to exercise.
What your Bright chiropractor will focus on throughout the postpartum healing period:
Physical healing:
1. Alignment:
a. During pregnancy, an increase in your lumbar lordosis, or curvature, occurs due to the offset in gravity changes as the baby grows at the front of the body. Research shows that this is not the cause of low back pain in pregnancy; instead, it’s a lack of strength – not posture. However, posture becomes very important in the postpartum period. We need to get the body used to its new posture - no more baby, no more need for an excessive lordotic curve in the lumbar spine.
2. Breathing:
a. During pregnancy, the lungs are compressed upwards by the growing baby, which can cause shortness of breath. Many women will develop shallow high breaths (breathing into the chest and with the upper portion of the lungs). This can lead to atypical movement patterns and, post-delivery, we have to relearn how to use our full lung capacity.
b. We must learn the difference between relaxation and diaphragmatic or active breath.
3. Core:
a. We will teach you how to think of the core as a house - with a floor, walls, and a roof - and how to regain strength in all 3.
b. The floor is the pelvic floor, the walls are the transverse abdominus, and the roof is the diaphragm.
c. We will teach you how to engage all 3 to truly regain full strength of your core.
d. As a side note, it is difficult for parents post cesarean birth to connect with the middle and lower transverse abdominus. Even 3+ years after, parents can continue to work on this connection and see improvements (it’s never too late!).
For example, have you had a c-section and while you feel you’re engaging your core or ‘sucking in’, the lower half of your stomach is still protruding?
Two very common physical complaints chiropractors hear from parents in the postpartum period:
“My stomach just won’t flatten, and it feels empty when I try to engage my core”.
“Why can’t I grow my glutes - I’m working out and doing all the right exercises, but it remains flat”.
Don’t fret! Both of these common complaints can be addressed by the above physical healing methods. Healing takes time but with the right practitioner on your team, you can feel your best postpartum!
During this healing process, we can also provide guidance on the best ways to fuel your body. This can be especially challenging to navigate post-birth, but it’s important to prioritize so that your body is getting the nourishment it needs to support your overall recovery.
WRITTEN BY: DR. TANNIS BOISVERT, DC
Watch out for more blog posts from Dr. Tannis Boisvert regarding nutrition.
Disclaimer
The advice provided in this article is for information purposes only. It is meant to augment and not replace consultation with a licensed healthcare provider. Consultation with a chiropractor or other primary care provider is recommended for anyone suffering from a health problem.