What your 6 week postpartum doctor checkup doesn’t tell you
Most women know that after having their baby they will have a 6 week checkup appointment with their doctor. Following this checkup the majority of women get cleared and are told they are able to start all exercise again.
I’ll use myself for example. After my first child I did not do anything at all for the first 6 weeks. I don’t even think I went for a walk… Which is fine! But the reason I didn’t was because I thought I could not do a single thing before the 6 weeks... I was checked by my doctor at my 6 week appointment (which lasted about 60 seconds) then asked if I wanted to get on birth control. My doctor did not check if I had a diastasis recti (which 100% of women get in pregnancy, and it only become an issue if it is greater than 2cm and the fascia does not create tension). I was not asked if I was having pelvic pain, pressure, or incontinence. I also had no idea that a women’s health physio even existed. To be honest I was really shocked that as the mom who just had a traumatic delivery was given very little care physically, but I trusted the health professionals and ran a 5k that day since I was “cleared” to exercise. I ended up with pain and incontinence.
After my third child I started walking after one week (because I felt good and wanted some movement), core rehab exercises at 2 weeks postpartum and intentional strength training at 4 weeks postpartum. Even though I started exercising earlier this time around I did not start running until 4/5 months postpartum. I wanted to have a consistent strength training regime going and rehab for my pelvic floor and core before I started more intense high impact activities. It took me to have 3 children to be an advocate for myself and make sure I started to take care of myself physically.
If a woman does not want to or feel comfortable doing any exercise until they see their doctor then maybe waiting until 6 weeks is the right decision for her, but I do think SOME women can start moving before 6 weeks. When I say start exercise I do not mean going back to crossfit class or running a 10k… I mean moving with intention and a focus on rehab. The body does need time to heal and to progressively ease into things plus build strength over time.
Think about it. Say you injured your knee to the point you had to have surgery (c-sections are invasive surgeries). You would take some rest after surgery to recover and then most likely be going to a physio to get rehab exercises so you can workout at home to begin to help build strength again. Then most would slowly build up their intensity and impact. You would have to be very intentional with your movement early so you could return back to have full function without causing yourself setbacks. I don’t think many individuals would wait 6 weeks after knee surgery with little to no movement then go sprint a 5 k… because it makes no sense! It’s the same with postpartum women!!
We need to acknowledge that during pregnancy and postpartum the body changes a great deal and needs to be rehabbed. We need to address that our pelvic floor and core have gone through a lot of changes and possibly trama during this time. We need to treat it like we would if any other body part went through similar changes and do some rehab type work.
My point is that even waiting the full 6 weeks and being “cleared” by your doctor doesn’t necessary mean you are ready for all exercise. More importantly is how you return to exercise and the steps you take to restore your body than the length you take to return. Pregnancy is temporary and postpartum is forever! Women who have older children and have not exercised should take the same steps in returning to exercise.
Please be an advocate for yourself if you haven’t been given much information about your own recovery. Like Brianna Battles says in her The Pregnant and Postpartum Athlete group “Pelvic Floor Physical Therapy a long with a quality progression of exercise is key the healing and managing pelvic floor dysfunction of any kind.
Please contact me if you are looking for a contact in your area. J