How can Postnatal Pilates and Yoga help with recovery from birth? What are the four Postnatal Recovery Phases? – Senior teacher Sally Parkes answers these valuable questions in this article.
What does it mean to be postnatal and how can postnatal pilates and yoga help you through this time? The postnatal phase of a persons life is a unique, wonderful and profound time. The mind and body of a birthing woman will undergo a massive change. Now there is a baby to care for, and possibly other children too.
In our society these changes are often not honoured in a supportive way. This is a new chapter for mother and baby, and no doubt new family dynamics will unfold. In general there is not enough acknowledgement of this time of transition and change.
While we are seeing some support for body positivity and mental health on various social media platforms and through popular culture, there is still often expectations of a new mother. There is pressure to ‘always be happy’, ‘carry on as normal’, drop the ‘baby weight’ or even go back to employment before the body is anywhere near recovery.
In my 15 years of teaching pre and postnatal people, I have seen how detrimental this narrative can be to the physical and mental health of the mother and as a result, the overall health of the family.
Here’s the thing…
The reality is that something huge has happened, a whole human has been grown and birthed!
No matter how the baby enters the world earth side, the ripple effect of this is vast. Whilst the mothers body detoxes from pregnancy hormones and possibly medical painkillers, she is also managing an influx of postnatal and lactation hormones. Top this off with feeding her new-born, sleep deprivation, and adjustmenting to a new identity. Add to this expectations put on the mother by society, and we have the perfect recipe for postnatal stress.
How can postnatal pilates and yoga help?
We know that increased stress levels stimulate the sympathetic nervous system (also known as our flight or flight system), this leads to our senses being heightened and on alert. Whilst this can be helpful in short bursts, it can lead to burn out if this state is sustained for long periods. Added to this, sustained levels of stress can lead to a slowing down of the healing process.
What can we do to lower the stress?
- Reframe the postnatal process and acknowledge this as a time to honour the female body and spirit for what it can and has achieved. We can acknowledge the work the female post-natal body continues to do on a daily basis.
- Remember that the new mother is recovering from a huge physical and emotional upheaval.
- Remember to be kind and allow time to restore energy levels. This is paramount as it allows space for the mother to drop back into her rest and digest state or parasympathetic nervous system. It is in the parasympathetic nervous system where deep rest and healing happens.
Once the healing process starts, we can start to think about adding in a little movement. Generally around the six week postnatal phase (or ten weeks for caesarean birth), it is a good time to begin to introduce some gentle post-natal pilates and yoga.
- The practice of yoga is to empower and nurture the post-natal mother, as opposed to further deplete here precious energy stores.
- During this time the intention is to work from the inside out in order to reset the physical and energetic foundations.
- The abdominal muscles and the pelvic floor need time to recover. With gentle exercises these muscles can gradually build strength and begin to work once again as a support system for the body in motion
- The production of relaxin needs to rslowly educe so the joints become more stable again.
The four phases of postnatal recovery
For simplicity, I break down the postpartum journey into four phases: Reconfiguration, Recovery, Rehabilitation and Rebuilding.
Phase 1: Reconfiguration 0-6 weeks
This is an ideal time to focus on breath awareness. Note that breathing through the nose is helpful as this has a more calming effect than breathing through the mouth.
- Ujjayi (Victorious) Breathing and Golden Thread Breath are great at this stage for centering and helping to engage the pelvic floor.
- Humming Bee Breath disperses knots of mental tension. I recommend doing this without the hands on the face, as covering the face can cause anxiety for some people.
- Exercising the pelvic floor can be done from this early stage. Any contraction of these muscle fibres will increase blood and oxygen flow to the pelvic area and accelerate healing.
- It is important that the pelvic floor is ‘lifted’ and not ‘pushed down’ as this will increase pressure on the uterus and bladder. Try to lift up on an exhale rather than on the inhale, this will reduce tension in the diaphragm.
Suggested Exercise for Phase 1
- Pelvic Tilt and Lift:
Simply lay on the back with legs bent and cushion between the knees. Exhale, squeeze cushion with the legs, and press the lower back into the floor, lifting the tail bone from the mat. Inhale and relax. Repeat x 20 daily.
Phase 2: Recovery 6-10 weeks
By this phase it is likely that the new mother is feeling a little stiff and tired from broken sleep and new physical demands. There is a huge influx of Oxytocin when a baby is born, but by now this hormone is starting to subside and levels rebalance. All these factors together can result in exhaustion. A gentle stretch at this point can be very therapeutic for the mothers body, because it is often stiff from adopting the same physical position for long periods.
Helpful areas to focus on are the shoulders, spine and hips. Remember, gently does it, and avoid putting body weight on the joints in this phase.
Suggested Exercises for Phase 2
- Roll Down:
Stand with feet apart, knees a little bent. Drop chin to chest and curl down, let the arms hang heavy. Slowly roll back up. Repeat x 3.
- Shoulder Stretch with Chair:
Place hands shoulder width apart and step back, bring the body to a right angle. Hold for 5 breaths. Keep knees bent to protect the lower back.
- Seated Pigeon Pose:
Sit on a chair with the spine straight, and place one foot up on to some yoga blocks keeping the knee lower than the hip joint. Exhale and let the leg drop out to the side. Relax here for 5 breaths. Repeat other side.
- Cat Stretch:
In Box Position, place padding underneath the knees, round the spine and breath out, gently drawing the belly button in towards the spine. Inhale return to Box Position. Repeat x 5.
- Low Lunge with Twist:
From Box Position, move the right foot forwards and place it flat on the ground so the leg is at a right angle. Move the upper body to an upright position and gently turn to the right. Resting the hands on the thigh and lower back. Pause here for five breaths. Repeat other side.
- Pelvic Tilt and Lift – see phase 1
Phase 3: Rehabilitation 10-16 weeks
Now we can start to awaken the muscles, to get blood and oxygen flowing and increase energy levels. Some muscles will be hypertonic (over tight) as a result of the changes in the mothers postural alignment from pregnancy and the early postnatal stages.
Common areas of tightness are the upper and lower back, shoulders and chest and hips and hamstrings. Now is a great time to introduce a little strength work and to really energise the body.
Suggested Exercises for Phase 3
- Shoulder Stretch with Chair – see phase 2
- Seated Spine Twist:
Sit on a chair with the spine straight. Place hands together, thumb tips touching the sternum. Exhale and draw the belly button in towards the spine as the torso rotates away from centre. Inhale return. Repeat other side. Repeats 2 x 12
- Seated Leg Lift:
Sit on chair with spine straight (try to avoid leaning back). Keep torso static as the opposite arm to leg is raised on an exhale. Gently contract the abdomen and pelvic floor. Inhale relax. Repeats 2 x 12
- Chair Pose:
Place the feet at least hip width distance apart with the hands at the chest in prayer position. Bend the knees and drive the hips backwards. Press the feet firmly down in to the ground. Hold for five breaths.
- Tree Pose:
Place one foot on the lower inner leg, keeping the hips level. Draw the tail bone downwards. Float the arms arm with elbows a little bent and allow the shoulders to drop. Soften the floating ribs inwards towards the spine. Hold for five breaths.
- Foot Slide:
Lay on the back with legs bent and the spine and pelvis in neutral. Inhale and extend one leg away, exhale bring it back whilst you simultaneously press the heel into the floor. The aim is to keep the pelvis completely static throughout. Repeat x 20.
- Pelvic Tilt and Lift – see phase 1
Phase 4: Rebuilding 16 weeks to 6 months
Sixteen weeks postnatal is a good time to begin to rebuild strength and movement. At this point the mother is likely to have a routine with her baby and she is able to get some extra sleep. This means she is in a better position to work on rebuilding herself.
In this phase we can:
- Start to increase the ranges of movement for the body
- Use the weight of the body as a form of progressive overload.
This progression in-part comes from increasing lever length. E.g. by moving the arms and legs away from the body’s centre as well as holding positions for longer.
Suggested Exercises for Phase 4:
- Standing Leg Lift:
Float the arms out to either side, palms face up, and transfer the body weight on to the left side. Exhale and lift the left leg, keeping the hips level and draw the front rib in towards the spine. Stay steady here for five breaths. Repeat other side.
- Chair Pose – see phase 3 (and add arm extension)
- Eagle Pose:
Wrap the arms or place the hands in prayer position. Bend the knees and wrap the legs, right over left, with the right toes on the floor for extra support. Press the thighs together for extra strength work.
- Gentle Triangle Pose:
Step the feet roughly a meter distance apart and turn the right foot out. Bend the right knee a little and place right hand on the right shin. Wrap the left arm behind the back and drop the gaze to help relax the neck and shoulders. Pause here for five breaths. Repeat other side.
- Low Lunge with Arm Raise:
From Box Position, move the right foot forwards and place it flat on the ground so that the leg forms a right angle. Move the upper body in to an upright position whilst floating the arms upwards. Soften the front ribs, hold for five breaths.
- Pelvic Tilt and Lift followed by Foot Slide – see above
It is important to always take time to rest at the end of any practice, even if you’ve only done five minutes. And if you ONLY have five minutes, just take those five minutes to take a much needed rest.
Also remember that these phases and suggested exercises are only my recommendations (based on my 15 years of experience of teaching pre and postnatal yoga).
No matter what, it is important to always listen to your body and the messages it is giving you throughout this time of healing. If you have any questions you can reach out to me, or any other teachers or professionals.