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Having a baby is one of the most transformative experiences in a woman’s life. As a Licensed Massage Therapist who has specialized in maternity massage (both prenatal as well as postnatal), I have thoroughly enjoyed supporting women through this experience and helping them to navigate the physical as well as emotional changes that come along with it.
This will be a rather long post. I recommend that you pour yourself a cup of tea and carve out some time to sit down and read- I want this to read just like you were my client- how I would advise you in each stage of this journey, as someone who is very invested in your well being.
I am also sharing things that I have done that have worked extremely well for me. I am a student of nutrition and not a nutritionist. One disclaimer is this is not a substitute for medical advice- please consult your OB before making any dietary changes, embarking on exercise, and receiving any therapies.
Day 0- Your Baby’s Birthday
Things to have with you in the hospital:
- A Belly Bandit. I usually put this on as soon as I can (after that first shower) Use their size guide online to find the right size for postpartum- you may need to size down after a few days- this is a good thing! I always buy two! I prefer the Original Bandit) I also bring the 2 in 1 Bandit to wear around my lower hips to help stabilize my pelvis. I wear these day and night for 6-8 weeks postpartum (sleeping in them too!) If you’ve had a C section, wear the bandit above your incision and make sure you check with your OB that compression is appropriate for you.
- Comfy PJ’s, Slippers and a Robe– You want to be as cozy as possible and definitely not in a scratchy hospital gown for longer than you need to be!
- Body Wash, Shampoo and Conditioner– I usually purchase these in a scent or brand I’ve never used before. I love to associate the scent with my newborn. (Also, each of my girls has a different perfume that I couldn’t get enough of during my pregnancy with them!)
On this day, replenish your macro and micro nutrients as best you can- I usually order a chicken breast and broccoli and a potato from the hospital. If you lost a lot of blood in delivery (C section or not) consider eating some red meat. Most likely you weren’t eating during your labor and you are probably starving! Drink lots of water, rest when you can, and soak up the moments!
Day 1- Coming Home from the Hospital
This timeline may vary depending upon your health and mode of delivery. I always tell my clients, do not set high expectations for yourself during this time. Your job is to feed your baby (in whatever form you choose) and to rest and heal. Do not try to rush losing weight during this time. The first 6 weeks are about replenishing your nutrients and healing the space that the placenta has left in your uterus. It will take your uterus 6-8 weeks to fully heal and involute (shrink below the pelvic bone back to its pre-pregnancy size) Make sure you follow your OB’s instructions about when you can lift objects heavier than 15lbs. If you find that your postpartum bleeding increases, you may be doing too much! Always call your OB if you notice any clots larger than the size of a quarter or if you soak a pad in one hour.
Rest, drink water, eat whole, nourishing foods (lean protein, complex carbohydrates, vegetables and fruit), sleep whenever you can, cuddle and snuggle and get to know your baby! Leave the household duties. They will be there when this fleeting newborn haze is over! (Or, have awesome family members who help!)
Practice diaphragmatic breathing (gently!) and with OB’s approval. ( As well as Kegel’s!) Here is a great article on how to properly do postpartum breathing exercises.
If you have delivered vaginally, your vulva and perineum may be very sore and swollen. You may possibly have a tear. You may be affected by hemorrhoids. Ice ice ice! Ice will be your BEST friend. And take any medications such as ibuprofen and stool softeners that your OB advises. Ask your OB about sitz baths using postpartum herbs (these are a lifesaver!) as well as putting a preparation of Lavender Infused Witch Hazel and Aloe in your ice pack (also lovingly called a “Padsicle”)
Check with your OB about when you can take a bath. I know that from pushing, every muscle in my body ached and I relied on Epsom Salt baths for the first week postpartum!
If you’ve had a C section, try to walk as soon as they allow you to. You can even walk the floor of the hospital pushing your baby in the bassinet so you have something to hold on to. The first walk may be very hard and you may have to take breaks. That is OK! Walking and getting the blood flowing will help with both being able to move your bowels (essential after abdominal surgery!) as well as starting the healing process of your incision. I also recommend eating warm soups that are easy to digest.
No one wants to talk about it, but let’s talk about using the bathroom those first few times. If you’ve had a C section, I recommend rolling up one of the baby swaddles that they provide in the hospital to brace your incision while you use the loo. (I also recommend using it if you have to cough or laugh in your hospital bed!)
The remote for the hospital bed is your best friend- use it to help you get in and out and do not try to roll or bend to one side for a while. Be very patient with yourself- you’ve just done an incredible job and healing takes time!
Deep fatigue may start to set in if you have been waking every 2-3 hours in the night. This may start to affect your mental state. Your spirits may feel lower and you may feel weak and weary. Hang in there! You can best support yourself by avoiding caffeine during the day (I drink plain water or herbal teas/nursing teas) eating nutrient dense foods- lean protein such as eggs, poultry, fish, loads of high volume, high fiber leafy vegetables, berries, nuts such as almonds, and also high quality dark chocolate (72% or higher! less sugar and really helps with mood!)
Do not weigh yourself until at least 2 weeks post partum. I’ve seen women step on the scale on the labor and delivery floor at the hospital immediately after having a baby- this is so self punishing! You have a LOT of fluid from your IV’s as well as postpartum edema in the legs. You won’t start to see shrinking and fluid loss for at least 2 weeks. You also may notice you sweat profusely at night and urinate more often- this is your body’s way of getting rid of all of the excess fluid from pregnancy.
Ok! It’s been 6 weeks and you have been cleared for exercise! You may be anxious to get your pre-pregnancy shape back, and your baby may be spacing out her feeds so that you are getting a little more sleep (I hope!) Make sure you address any concerns with your OB at your postpartum visit!
The topic everyone wants to know about is getting back to your fighting shape post pregnancy. I am going to let you in on a secret to gradual, healthy weight loss. You do not need to kill yourself at the gym. Start slowly. You actually only need to WALK for 300 minutes per week in order to lose weight. That’s one hour a day Monday-Friday. This WILL provide weight loss in conjunction with a healthy, plant based diet (think Mediterranean diet)
I personally don’t start counting calories until I am 10 lbs away from my pre-pregnancy weight. This method works best for me. Before then, after the 6 week mark I practice Intermittent Fasting, eating between 11am and 6pm, with lunch being my largest meal (protein, carb, veggies). I do this because I bottle feed my babies. You know what method will work best for you. You can look up your specific caloric needs (especially if you are nursing!) here. The CDC has a great nutrition guide for nursing mothers here. You can also use a weightloss app such as My Fitness Pal or Lose It! to help track your food throughout the day. I’ve also personally had a LOT of success with Fitness Carli’s meal plan. It’s great for whether you are nursing or not! Click here to try it!
At this point, you won’t need to wear your Belly Bandits day and night. The reason I recommend wearing them for 6 weeks is that the hormone Relaxin (the hormone responsible for stretching your ligaments during pregnancy and delivery) peaks during delivery and stays in the body for 6 weeks post partum. You can utilize this to your advantage to help everything shrink back gently and gradually through compression garments. My hips are actually more narrow postpartum than when I was 18 years old due to wearing the 2 in 1 around my hips after each baby.
Time for a massage
At this point, as long as you have your OB’s approval, this is a GREAT time to get a full body massage. It will help to continue draining excess fluid, boost your immune system, provide stress relief by activating the body’s relaxation response. I am also a HUGE advocate for a type of Ayurvedic Massage called Vishesh Massage postpartum. In Vishesh and Abhyanga Massage, ancient oils are used on the skin based on your personal Ayruvedic profile (Dosha, Pitta, Vata) The treatment is over 90 minutes long and involves long, draining strokes. It can be tricky to find a practitioner in your area since it is such a specialized treatment. I recommend Google and researching the practitioner’s reviews- if you can find someone you have struck postpartum gold. You will feel SO much better after this treatment! I also recommend other complementary therapies at this point postpartum- Acupuncture and Chiropractic care can do wonders!
Your pelvic floor and abdomen
During this last phase of the fourth trimester, continue your diaphragmatic breathing and Kegel exercises. You may notice that you have a condition called Diastasis Recti, where the Rectus Abdominus muscles and fascia separate as your belly expands with the baby. (If you lay on the floor and do a crunch and feel 2 fingers width of space between your ab muscles at the mid line, talk to your OB about officially diagnosing this condition.)
If you do, indeed have it, you can actually help to reverse it yourself! The key is to splint while doing crunches. As you do a crunch, massage the two sides of your abdominal muscles towards the center, or use both hands to splint each side as you do a crunch to avoid tissue protruding through causing a “pouch” muscle. I typically do these crunches with massage/splinting twice per day for weeks 6-10 and it is very helpful! The gap will never fully close without surgery but this can help a lot!)
If you are suffering from Stress Urinary Incontinence still at this point (if you leak urine when you exercise, sneeze or cough) consider getting a prescription for pelvic floor PT from your OB. Rehabilitating the pelvic floor will provide immense relief from this condition! Don’t be embarrassed to get help!
Continue to rest as much as you can, stay hydrated, eat well, and snuggle that babe! You did an AMAZING job Mama. Be patient with yourself as your body shifts and changes through the coming year. Don’t forget to look in the mirror and tell yourself that you are beautiful (because you are!) at every stage of this postpartum journey.
Thanks for stopping by! XOXO, Ashli