About a year ago, I gave birth to a punctual and healthy seven-pound son, Indiana. Before he came into my life, I was a triathlete, and a long-distance runner aiming to crack a 1:35 half-marathon. So postpartum, I was eager to return to the “old me” and start working out again. I assumed I’d be running within six weeks, and calculated that the baby weight would be gone within three months, tops.
My expectations were way too optimistic. I soon learned that just walking after childbirth is hard for weeks. I learned that undergoing an episiotomy (the surgical incision made in the perineum) and forceps delivery means the healing process takes much, much longer. And I learned that my experience—like every woman’s—would be full of its own unique challenges and setbacks.
Here, the real talk on what happens to your body after baby. Plus, the good news: you got this.
THE REAL TALK
1. Your pelvic floor has been traumatized.
A few months after I gave birth, I was examined by a pelvic floor physiotherapist. Before I was pregnant, I didn’t even know I had a pelvic floor. Unless you’ve had a baby, you probably don’t either. But for many new moms, the pelvic floor is the biggest barrier to getting fit again.
“The pelvic floor is a group of muscles, nerves and connective tissue structures,” explains Angelique Montano-Bresolin, registered physiotherapist and clinic director at Proactive Pelvic Health Centre in Toronto. “And all of these, as well as some ligaments, create the bottom of the pelvic region.”
In other words, it’s more or less the entire region surrounding your lady bits.
As such, it performs several important functions. The pelvic floor supports your internal organs (including the bladder and uterus), says Montano-Bresolin. Its muscles provide stability for the pelvic bones, and they allow you to properly close your urethra, anus and rectum. Not least of all, they play an important role in orgasm.
During pregnancy, these muscles become very stretched. Plus, during labour and delivery, they can undergo additional trauma. Sometimes, afterwards, they just don’t work like they used to.
“These muscles can become very weak, and the weakness can compromise a lot of support for internal organs,” says Montano-Bresolin. The result can be pain in your vagina or rectum; urinary or fecal incontinence; and pain during exercise or sex.
For me, it was pain in my rectum. You see, after a few hours of intense but normal labour, Indy’s heart rate dropped suddenly. My OB told me I had no time to waste, and instructed me to bear down like I was going to the bathroom—as hard as I could. My baby’s health was on the line, so I exerted more energy than I ever have for anything in my life. Indy was out within a minute, but I did some damage along the way.
In the months afterwards, it hurt—sometimes a lot—when I ran. I was still able to train for and complete a half-marathon, but it came with much discomfort. So despite achieving a near-PB less than a year after Indy’s birth, I knew I needed to take a long break from running, and do some pelvic floor rehab. More on that, later.
2. The weight might not melt off easily, no matter how fit you were before baby.
According to my many pregnancy apps, the general guideline for “healthy” pregnancy weight gain is 25-35 pounds (I gained about 35), but many women gain twice that, or more. Most of us want to eat right and stay active while carrying baby, but the realities of pregnancy—extreme nausea, constant hanger, food aversions, lethargy, back pain—can make it difficult to maintain balance.
For a good chunk of my pregnancy, the only foods that didn’t make me vomit (if I wasn’t eating, or hadn’t just eaten, I was terribly nauseous) were cheese and carbs 24/7—delicious, but not nutritionally ideal.
I’d heard that I’d lose 15 pounds with the baby, and that the rest would “fall off” during breastfeeding. Neither were true. I lost the last few pounds of baby weight at about eight months postpartum, after lots of gym sessions and a couple hundred kilometres of running.
3. You probably won’t be back to normal after six weeks.
Six weeks is the magic number—for sex, for exercise, for basically everything that matters. After six weeks, your OB can clear you to resume normal activities. And at my six-week checkup, mine did.
But I wasn’t even close. Physically, my vagina was perfectly healed, but I was still sore long after that, and it was another month or two before I was emotionally ready for sex.
I attempted my first run at four months, only to endure the same shooting pains through my bum that I’d had during labour. I wasn’t regularly running pain-free until seven months postpartum.
4. Your abs may or may not look the same again.
Kelly Taphouse, founder of Move, a boutique women’s-only fitness club in Toronto, offers strength programs that can be tailored to brand-new moms, as well as on-site child-minding. She often sees women with diastasis recti, a.k.a. abdominal separation.
The condition happens when your rectus abdominis muscles—the two sides of abs that run vertically on your torso—separate during pregnancy to make room for your expanding uterus. For some women with diastasis recti, their abs go back to relatively normal relatively quickly. But for others, closing those muscles can take months or longer. In the meantime, the separated abs can sometimes give you a belly pooch that looks like you’re still pregnant.
How common is it? Research reported last year in the British Journal of Sports Medicine found that 60 percent of the first-time moms in the study had diastasis recti six weeks postpartum, and 32.6 percent still had it a year postpartum.
Taphouse prescribes clients with diastasis recti (typically defined as a gap of 2.7 cm or more) a list of safe exercises, and often they improve. The idea is not to do any movements that can push the belly out (sit-ups or planks, for example), and to focus on movements that pull the belly in. “I have one client who’s been with us for four months now. We’ve taken her down from a three-finger separation to two fingers, so I’m really impressed,” Taphouse says.
For some women, however, the gap in their abs doesn’t close on its own, or with exercise, and surgical stitching might be the only way to do it. But depending on the severity of the separation, this is not necessarily a minor procedure. The abdominoplasty (or tummy tuck) comes with the inherent risks of any surgery, and must be weighed carefully with your doctor.
THE BRIGHT SIDE
5. You’ve never looked forward to the gym like this before.
Maternity leave can be long and tedious, and the gym can not only break up your day, but become your sanctuary (where else can you take a 15-minute shower—guaranteed to be interruption-free?). I approached my mat leave as an opportunity to get into the best shape of my life, since I had time to work out almost any day I wanted.
Incorporating childcare into her gym ($8 per visit, for up to 1.5 hours) was essential for Taphouse, who was frustrated by baby-and-me bootcamps that require you to work out with baby, or use baby as an implement.
Child-minding is also available at many major gyms, such as GoodLife. Indiana’s membership is $32/month—some of the best money I’ve ever spent.
6. There’s physiotherapy for that.
Whether your sensitive bits have been traumatized, or you had a bad tear during delivery, or you find that you pee a little when you exercise, or—like me—you have a literal pain in your ass, pelvic floor physiotherapy can help you and it’s often covered under extended health insurance plans.
Montano-Bresolin says her clients can improve pretty quickly: some are ready to stop seeing her after three months of once-weekly sessions, and can transition to doing physio at home on their own. “They’ve reached all their functional goals, and they’re back to exercising,” she says. “Others stay in the treatment longer. But it’s always based on what the goals are for fitness.”
Ultimately, she says, pelvic floor therapy should be treated like any other rehab. “We’re working with muscles here, which are just like any other muscle… I’ve had a woman with a fourth-degree tear [the most severe kind] who was able to return to running. Regaining fitness post-baby is definitely possible.”
7. You don’t have to rush it.
How sad that after the physical and emotional marathon of carrying a child to term, birthing and then caring for him or her, many moms feel immense pressure to “get back into shape” ASAP. Maybe because tabloids breathlessly exalt every celebrity’s body after baby. (Actual people.com headline: “***Flawless! Beyoncé Shows Off Post-Baby Body 3 Months After Delivering Twins Rumi and Sir.”) Maybe because it’s seemingly no sweat for others. (Who can forget the controversy over fitness blogger Caroline Berg Eriksen’s washboard selfie mere days after giving birth?)
But it takes nine months to gain the weight, so there’s no reason it shouldn’t take you as long to lose it, or more: let’s face it, packing it on is a lot easier to do.
“I always tell mamas coming in after having the baby: give yourself one year,” says Taphouse. “One of our mission statements is ‘Let us be your next long-term relationship.’ Because we’re not a quick fix. One year. Enjoy the process. Get reconnected to your body.”
Julia Lipscombe is an Edmonton-based journalist and the parenting columnist for the Edmonton Journal.