PHYSICAL ACTIVITY FOR NEW MOMS

Mar 13, 2013 – Research indicates that physical activity declines after pregnancy. This article discusses some of the barriers to physical activity after childbirth and presents several research-based recommendations. Although many women express interest in being physically active in the weeks and months after childbirth, they often face challenges or barriers.

In fact, for many stay-at-home moms and women on maternity leave, the job of caring for a newborn or infant becomes pretty much a “24/7” responsibility.

As caring for a newborn takes priority, a new mom is likely to experience lifestyle changes or changes to daily habits. Such changes often limit the amount of time or energy a woman will have for physical activities. At the same time, a new mom may also be dealing with physical or bodily changes postpartum.

Given such factors, it’s not surprising that Fell, Joseph, Armson & Dodds (2008) found that pregnancy is a life event that leads to decreased levels of physical activity, particularly through reduced participation in structured sports and exercise.

What I have found surprising is how few evidence-based recommendations are available to new moms, to help guide them through the profound changes after childbirth.

For this article, I have pulled together the best research I could find that included recommendations for new moms. I’ve also added some recommendations based on my own experiences as a mother and qualified exercise professional.

Evidence-Based Recommendations

Current research literature tends to focus on the physiological demands on new moms. Here are some of the basic evidence-based recommendations:

  • For the average woman, resumption of physical activity (except for light walking and/or stretching) is recommended only after four to six weeks postpartum.
  • Women who have had a caesarean section should wait a little longer, to about eight weeks postpartum. Medical clearance is advised to ensure no complications exist (Dewey & McCrory, 1994; McCrory, 2000).
  • New moms should ease progressively into physical activity, with activities individualized to best fit a very changed lifestyle (Artal & O’Toole, 2003).

In the clinical practice guidelines published by the Society of Obstetricians and Gynaecologists of Canada and the Canadian Society of Exercise Physiology (Davies et al., 2003), there are two relevant recommendations for new mothers:

  1. Initiation of pelvic floor exercises specifically in the immediate postpartum period may reduce the risk of future urinary incontinence.
  2. Women should be advised that moderate exercise during lactation does not affect the quantity or composition of breast milk or impact infant growth.

The guidelines published by the American College of Obstetricians and Gynecologists (Artal & O’Toole, 2003) offer two additional insights:

  1. Nursing women should consider feeding their infants before exercising to avoid the discomfort of engorged breasts.
  2. A return to physical activity after pregnancy has been associated with decreased postpartum depression, but only if the exercise is stress-relieving and not stress-provoking.

With the above-noted general guidelines in mind, Larson-Meyer (2002) found a range of benefits from physical activity after childbirth:

  • Prevents obesity through promotion of weight loss.
  • Promotes aerobic fitness and strength, leading to an improved ability to perform activities of mothering.
  • Optimizes bone health by increasing bone mineral density (BMD) and prevents lactation-associated bone loss.
  • Improves mood and self-esteem.

Actions for New Moms: How to Include Physical Activity
Here are some of my personal recommendations and strategies for new moms to consider.

1. Time
Caring for a newborn requires a mother’s full attention, especially if the mother is nursing. My recommendation is to follow the old adage of “sleep when the baby sleeps” and resist the urge to “get things done” in that short period of calm.

With this approach, you’ll need help; don’t be shy about involving others. If you are lucky enough to have supportive relationships (e.g., partner, family or friends), someone else can mind your little one for a short period while you are physically active.

Alternatively, be creative by incorporating your baby into your physical activity routines. For instance, keep your newborn safely near you on a blanket, or in a car seat or stroller, while you workout at home or perhaps at a local exercise class for new mothers.

2. Fatigue
Adjusting to the ever-changing schedule of a baby can make getting enough sleep difficult (Gay, Lee & Lee, 2004). Night feedings, loads of laundry and life’s other responsibilities can require a lot of energy.

Fatigue is a common state for new moms, which can impact motivation to be physically active.  My recommendation is to keep in mind that being physically active gives you a good energy boost and is one of the best ways to combat fatigue.

3. Recovery from surgery or traumatic birth
Depending on the childbirth experience, a new mom may have some pain or physical limitations;  this may continue for many months after delivery. Before starting a physical activity routine, talk to your physical therapist. Find out which physical activities are safe for you and that help to achieve proper function and rehabilitation.

4. Body Changes
Satisfaction with one’s body can be low after being pregnant (Gjerdingen et al., 2009). The body has changed significantly and many new moms are looking to “get their bodies back.”  This may be an unrealistic expectation, as the body has undergone some fundamental changes.

A better goal is to steadily improve your physical fitness. Being physically active is a great way to be good to yourself!

Note: Women who have experienced diastasis recti (separation of the abdominal wall) should consult with a medical professional before choosing physical activities.

Moving Ahead With Baby

Enjoy all the milestones your baby achieves and continue to include lots of physical activity in your lifestyle. Keep on moving and your whole family will benefit!

More Physical Activity Tips

  • Build a network of other moms who share similar physical activity goals.
  • Join a group exercise class for new moms and their babies.
  • Shorts bouts of activity are good! Every little bit helps, even in segments as little as 10 minutes.
  • Keep your baby and fitness accessories readily at hand, so you can step out to join in a physical activity at a moment’s notice.
  • Stroller time is physical activity! Whenever possible, take your baby with you for a walk, as you complete errands or visit others.

by Lisa A. Workman, Exercise Specialist, Edmonton Southside Primary Care Network
http://www.centre4activeliving.ca/publications/wellspring/2013/mar-new-mom.html

See also the CAAWS Mothers in Motion section.