On this webpage you will find information on the following:
- Advice following the birth of your baby by vaginal delivery
- Advice following the birth of your baby by Caesarean section
- Abdominal muscle separation
- 3rd and 4th degree perineal tear
- Incontinence (leakage of urine/pee and faeces/poo)
- Postnatal exercise
Vaginal Delivery
It is important to look after yourself following the birth of your baby.
What can you do?
- Follow the advice in the Fit for the Future leaflet.
- Start your pelvic floor exercises early. This will aid your recovery Pelvic Floor Exercises POGP leaflet.
- Download the NHS Squeezy App for reminders to do your pelvic floor exercises.
- Avoid constipation which will put more strain on your pelvic floor. Read the NHS Fife Constipation leaflet or watch the Toilet Positioning video.
- These tips are great for immediate recovery following your delivery. For information about returning to exercise, look at the postnatal exercise section at the bottom of this page.
Caesarean Section
Casearean section is major surgery to the abdominal wall. It is important to gradually get back to normal activities, allowing time for your body to heal and recover. You may be seen on the postnatal ward by a physiotherapist and given advice and education on your posture, activities of daily living and how to prepare for your return to work and exercise. We will also show you some gentle exercises to begin to help your tummy muscles recover.
What can you do?
- Follow the advice in this Scottish Government video about Enhanced Recovery After Your Caesarean Section.
- Watch this NHS Fife video about the importance of following Physiotherapy Advice After Your Caesarean Section.
- Follow the advice and exercises in the Fit for the Future leaflet
- For information on returning to driving read: Driving following a c-section
- These tips are great for immediate recovery following your delivery. For information about returning to exercise, look at the postnatal exercise section at the bottom of this page.
Abdominal Muscle Separation
Also known Diastasis Recti, Diastasis Rectus Abdominus Muscles, DRA or DRAM.
During pregnancy and labour it is normal for the abdominal muscles to stretch and separate to accommodate your growing baby. 100% of women have some degree of separation at 35 weeks pregnant and 39% at 6 months postnatal (Mota et al 2014). This is called Diastasis Recti.
You may notice your tummy “doming” or a gap in your tummy muscles when you do things that require lots of abdominal activity e.g. sitting up from lying, coughing or straining to move your bowels.
What can you do?
- Follow the advice and exercises in the Fit for the Future or you can ask your midwife or health visitor to refer you to physiotherapy if you are concerned about your tummy muscles.
3rd and 4th degree perineal tear
If you have had a 3rd or 4th degree tear during the delivery of your baby, you will be contacted by one of the specialist urogynaecology nurses at approximately 8-10 weeks following your delivery. You should also have received a leaflet whilst you were in hospital with information on how to look after your tear.
What can you do?
- Follow the information in the NHS Fife 3rd and 4th Degree Tear Leaflet.
- Read the RCOG Patient Information Leaflet on 3rd and 4th Degree Tears.
- Starting pelvic floor exercises early is an important part of your recovery Pelvic Floor Exercises POGP leaflet.
- If you are having any issues at your review appointment the specialist nurse will refer you to pelvic health physiotherapy for assessment and treatment.
Incontinence (leakage of urine or faeces)
Incontinence in the postnatal period is common but NOT normal. It is estimated that up to one third of women will suffer from some degree of incontinence following childbirth.
Stress urinary incontinence (SUI) is the most common type affecting women during pregnancy and in the postnatal period. It can lead to leakage of urine during coughing, sneezing, laughing or during activities such as lifting or bending.
What can you do?
- Pelvic floor muscle strengthening is important in the recovery of your pelvic floor and it is important that you do them correctly. For information on correct techniques please read Pelvic Floor Exercises POGP leaflet.
- It can take 3-6 months of daily pelvic floor strengthening for it to be effective. You might find this challenging with a new baby. The NHS Squeezy App may help you with technique, motivation and consistency.
- If you are experiencing any problems with incontinence or are concerned about your pelvic floor then please see you midwife or GP for a referral to the pelvic health physiotherapy service.
Postnatal exercise
Physical recovery postnatally will take time, but there is a lot you can do to help you recover and regain your fitness which could reduce the risk of physical problems later.
What can you do?
- Read the Chief Medical Officers' Guidance on Physical Activity After Childbirth.
- Try these exercises POGP Pilates Exercises in Womens Health Physiotherapy.
- Follow the advice in the This Mum Moves website.
- Read this blog and look at the infographic about Returning To Running After Having A Baby.
- If you have had a late miscarriage or still birth, this is a useful leaflet to follow POGP Exercise and Advice after Pregnancy.