Postpartum and Physical Changes

Buff Moms: The Complete Guide to Fitness for All Mothers
by Sue Fleming

Safely shed those postpregnancy pounds-and keep them off

Motherhood is a demanding twenty-four-hour-a-day job that leaves little if any time for exercise. Now there are no excuses! Sue Fleming, author of the popular fitness guides Buff Brides and Buff Moms-to-Be, has specially designed a book for mothers who want to get back in shape but feel overwhelmed by their hectic schedules. Buff Moms features simple, effective exercises that can be done conveniently at home. By focusing on these exercises and maintaining a healthy diet, mothers can regain their prepartum body. Inside you'll find

• essential tips on making the time, starting a routine, and staying the course

• upper-body, lower-body, abdominal, and cardiovascular workouts

• a special program for women recovering from cesarean births

• an exercise regimen tailored to ward off postpartum depression

• success stories from real-life moms who have lost weight and feel great

Fully illustrated and geared to all fitness levels and abilities, Buff Moms will help you achieve your fitness goals and feel healthy, leaving you with increased endurance to keep up with your busy family.

Chapter 1

CHAPTER 1

Postpartum and Physical Changes

Some of the most common physical changes that occur after having a baby make it especially difficult to start exercising. They are:

Bleeding

Lochia, or bloody vaginal discharge after birth, will start to disappear after several weeks. It is very common for the bleeding to stop and start intermittently during this time. Vaginal bleeding after a cesarean birth will usually be less than after a vaginal birth.

After-Birth Contractions

After giving birth, your uterus is still undergoing a series of changes in order to get back to its original size. The uterus shrinks from approximately the size of a basketball during pregnancy, to the size of a grapefruit after delivery, to the size of a pear six weeks postpartum. You will have a sensation similar to contractions, although not as painful. Breast-feeding may make these contractions worse, as the baby's sucking releases a hormone called oxytocin that contracts the uterus. These contractions should disappear after a couple of weeks. Lying on your stomach may help with the pain (unless you've had a C-section), as may keeping your bladder empty.

Breast Engorgement

When your milk supply comes in, two to four days after delivery, your breasts may become painful and firm. Fullness is a result of an increase in blood flow, which prepares your breasts for increased milk production. If you are not breast-feeding, the pain and swelling may subside within a few days. Snug-fitting bras may help; try to avoid getting warm water directly on your breasts, as this may increase milk production. If you are breast-feeding, frequent nursing will help keep your breasts soft. It may take a few days to get on a schedule with your baby to prevent engorgement. Using a breast pump to release a little breast milk may help, as may applying ice several times a day.

Pain When Urinating

Since the bladder and urethra are next to the bruised birth canal, difficulty urinating is common for new moms. If you were under anesthesia during a C-section, you may also have problems urinating. Drinking water immediately after delivery will help. Be sure to soak your bottom in warm water to promote healing.

Episiotomy

If you've had an episiotomy, good hygiene is essential during healing. Soaking in warm water three to four times a day will help soothe the soreness. Ice packs are recommended until the swelling is gone. A mild pain reliever or medication prescribed by your doctor will also help.

Perineum Pain

You may be sore and swollen in this area after birth. Keeping the perineum clean with soap and water will encourage healing.

Hemorrhoids

Hemorrhoids can develop due to the weight and the pressure of the baby, from the force of pushing during labor, and from constipation. Taking a hot bath three to four times a day, applying cold packs containing witch hazel, and sleeping on your side to take pressure off the veins of the rectum may help.

Fatigue

All new mothers experience some fatigue postpartum, whether they exercised throughout pregnancy or not. This may last for weeks, as your body tries to recover from the marathon that is pregnancy. Exercise will help (see suggestions in Part 2); however, recognize that your body has gone through a lot of changes. Give yourself time-and a break!

Physical Changes Due to Hormones Levels

After birth, your hormones continue to shift. These are common symptoms as your hormones stabilize:

• HOT FLASHES
• SWELLING
• DRY SKIN
• MOOD SWINGS
• INFOMNIA/NIGHT SWEATS
• HAIR LOSS (TEMPORARY)

The American College of Obstetricians and Gynecologists reminds new moms that many of the physical changes that took place during pregnancy will persist four to six weeks after giving birth.

So, with all of these things going on at the same time, just how does a new mom begin to exercise? Gradually! During my career as a personal trainer, I've advised many women just how to get started during this crucial time. Getting rid of that "bundle of fat" may not be easy, nor may it be on your top-ten list. The first thing I say to my anxious clients is "Relax, don't worry, and get started!" Now is the time to investigate an exercise program to get back into pre-pregnancy form-not only for the moms who stayed fit and active during pregnancy, not only for the moms who are exercise beginners, but also for the moms who have children already and have not been able to lose the weight from their last pregnancy.

Now that you've had your baby, exercise and good nutrition are the keys to returning to your pre-pregnancy shape. The longer you wait to exercise after you've had your baby, the longer it will take to drop the extra weight gained during pregnancy. For those who remained active for the whole nine months, great! It will be that much easier to shed the weight. However, also know that you may not be able to pick up where you left off. Start slowly, and ease into an exercise routine. If you've just started exercising, good for you. However, keep it manageable and start slowly. Ten minutes a day may be enough in the beginning. Remember, as with any exercise program, consult your doctor before starting.

Good nutrition and eating habits are also imperative for shedding the excess pounds after having a baby. Breast-feeding and non-breast-feeding moms will have different nutritional needs; however, the term "dieting" should be removed from the vocabulary of all moms. This book will give nutritional tips and suggestions for moms, whether breast-feeding or not.

Recovery after pregnancy can take a long time. All bodies are different; some women can take longer than others to return to their pre-pregnancy shape. I tell all of my clients to give themselves a year to regain their bodies. Exercise should not be put on the back burner, however, as it is a crucial component in getting on the road to recovery. A balanced, safe, goal-oriented exercise program can help women get back their strength as well as tone and tighten muscles that were stretched during pregnancy. Generally, if you were active during pregnancy, you can resume a light workout a few days after your delivery. If you had a cesarean section, you will need more time to heal. If you're a newcomer to fitness, you'll need to start exercising more slowly.

Weight Gain/Loss After Pregnancy

The average weight gain during pregnancy is twenty-five to thirty-five pounds. During birth, moms lose about twelve to fifteen pounds, leaving about thirteen to twenty pounds of excess weight to lose in the postnatal period. This is when it gets tough. The last extra pounds can be hard to get rid of. However, there's good news: The consistent, safe exercise program described in this book can help you do that.

Research has indicated that women who begin to exercise right after (uncomplicated) delivery tend to lose more weight in the first six weeks than mothers who do not exercise then. Only about 35 percent of women exercise after giving birth. Studies indicate that if you worked out during pregnancy, you will tend to start exercising right after delivery.

Some women are concerned that exercise may impact their ability to breast-feed. No research supports that notion. Your body will tell you how active to be.

Not only do new moms have to deal with shedding excess weight gain, but the physical demands of motherhood take a toll on the body. New moms have to deal with lifting and carrying their baby and heavy diaper bags, strollers, and car seats, which can leave them vulnerable to pain and injury. This book will suggest techniques for strengthening those affected muscle groups, such as the lower-back and abdominal areas. The core muscle groups are areas of the body that should not be overlooked after delivery. Strengthening them helps restore the body to optimal functioning and helps prepare women for the many physical demands of motherhood.

Excerpted from Buff Moms by Sue Fleming Copyright © 2004 by Sue Fleming. Excerpted by permission of Villard, a division of Random House, Inc. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.

About the Author

Sue Fleming earned her B.S. and M.S. in physical education and has been a certified personal trainer for the past ten years. The author of Buff Brides (now a series on the Discovery Health Channel), she is currently the director of physical education at Riverdale Country School in Riverdale, New York, and continues to work with private clients. She lives in Manhattan. Sue Fleming can be reached at www.buffbrides.com.