Week 1 postnatal

If you’re directed here by myself from the postnatal ward, welcome. I have so much to advice however it is hard to convey it all in a 20 mins visit.

This post is the first of six post on what a pelvic floor physiotherapist would focus on postpartum, and I’ll lead you through it week by week.

During this important recovery period, taking care of your body—especially your pelvic floor and core—is key.

1. Take your pain medications.

• Whether you’ve had a vaginal or cesarean delivery, you’re body has gone through a lot.

• Aim to have your pain on movement under a 3/10, this would give you adequate cover to care for yourself and your newborn

• If you have not been prescribed stronger pain relief, and you feel that need it - please contact your GP and get a script.

2. Move gently, but stand up straight.

• In the first couple of days it might be hard to move around, but it’s important to set your posture right from the start

• This will help prevent any shoulder and lower back pain.

3. Avoid lifting heavier than your newborn, and avoid repetitive movements

• If able, avoid lifting the laundry basket, baby capsule, bending to load/unload the dishwasher and vacumming/sweeping

• These repetitive movements put additional pressure on your pelvic floor, core and lower back muscles

4. Rest lying down

• Resting in a horizontal position (on your back - finally, or on your sides) help with reducing swelling in your perineal region (for vaginal deliveries), or abdomen (for cesarean deliveries)

• This is especially important to maximise recovery

4. Wear Compression for Support

• You may have received tubigrip from the hospital (neutral tubing like fabric). Tubigrip is medical grade compression and is completely safe to use from 2-3 days postnatal

Compression garments help your core and pelvic floor recover. Wear them daily, except when sleeping or showering. Compression is safe for both vaginal and cesarean births immediately postpartum.

• Options are: bellyband, tubigrip, or compression shorts/leggings.

• I recommend tubigrip/bellyband for the first couple of days, then swap to compression garments for more support.

• If you have pregnancy compression wear, you can wear it for a few days after birth until your belly settles before swapping to a postnatal garment.

• Choose a garment that is supportive but easy to put on and take off.

Recommended brands:

Medical grade: SRC, Everform, Solidea (great for summer babies)

Non-medical grade: Active Truth, Made To Milk, Bare Moms, 2XU

• It is recommended that you continue wearing compression for up to 12+ weeks.

• Tip: Pick up 2nd hand compression garments on marketplace!

4. Limit Repetitive Movements

• Tasks like vacuuming, hanging laundry, or emptying the dishwasher may feel light, but repetitive movements put strain on your lower back and pelvic floor.

• Avoid them, but if you must do these tasks, limit them to 10-15 minutes at a time.

5. Stay hydrated

• Drinking enough water helps prevent constipation and reduces the stinging sensation when urinating.

• Drink at least 2L of water daily (more if breastfeeding).

6. Avoid constipation and straining

• If you are constipated, try 1 sachet of Movicol with a big glass of water, twice a day.

• Eating kiwifruit and its skin can also help with improving bowel movements.

7. Bathroom Tips

• After a cesarean: If bowel movements cause discomfort, press a flat palm or a rolled-up towel against your incision for support as you pass stool.

• After a vaginal birth +/- stitches or an episiotomy: Hold soft toilet paper against the perineum for support while using the toilet.

• If wiping is painful, use a squeeze bottle with water to gently clean the area, and then pat dry.

8. Pelvic Floor Exercises

• Start pelvic floor exercises 3-4 days postpartum, when you feel ready.

• Do them once or twice daily:

o Week 1: Squeeze and hold for 1 second, then fully relax. Repeat 10 times.

o Each week, increase the hold time by 1 second, up to 6 weeks. Reduce reps as needed to maintain good form, with focus on the release.

• If you’ve been assessed and have a tight pelvic floor, focus more on relaxation and release instead.

• At 6 weeks, you will have your pelvic floor assessed by your pelvic floor physiotherapist and be given a specific set of pelvic floor exercise to complete.

9. Safe Core Exercises

• We now have good evidence that starting core rehabilitation early is essential to speed up abdominal separation recovery.

• You will start gentle core exercises from 2 weeks postpartum, guided by your pelvic floor physiotherapist.

• Your pelvic floor physiotherapist will guide you through this via a telehealth appointment (you are more than welcome to attend in person if able).

When to see your pelvic floor physiotherapist and what are the exercise guidelines?

• 0-6 weeks: Focus on rest, mobility, flexibility, and early core rehab—not strength work. If you would like to start exercising, the recommendation is 1:1 supervised exercise.

• @ 2 weeks: Start specific core exercises (via telehealth or in person) to ensure good abdominal recovery.

• @ 6 weeks: Pelvic floor assessment and commence pelvic floor strengthening exercises.

• 6-12 weeks: You can return to light, supervised exercise (e.g., mom & bubs pilates, light strength training), as advised by your pelvic floor physiotherapist.

• 12+ weeks: Return to running and higher-impact activities.

When else to come in?

- If you are experiencing lower back, wrist, neck and shoulder pain that does not resolve within a few days.

This can be from postural issues, or from the repetitive lifting nature of motherhood.

- Pelvic floor concerns e.g. incontinence that is not improving/worsening, sensation of heaviness/dragging or any other pelvic floor/core concerns.

- Mastitis – therapeutic ultrasound and gentle lymphatic drainage has been shown to have a good effect.