PRACTICE TEACHING ON

POST NATAL EXERCISE

PRESENTED BY:
Banrikordor Khyriem
M.Sc (N) 1st year
Introduction
Definitions
Exercise:
It is a physical activity that is planned,
structured, and repetitive for the purpose
of conditioning any part of the body.
Post natal exercise:
Exercise that are performed by a
postnatal mother during the postnatal
period.
 Important information to be consider when beginning
Exercises:

Wear loose supportive clothing

Environment and Safety-stable
environment
Nutrition-do not exercise on full stomach
Low impact exercise is preferable during
postnatal period.
Time to start postnatal exercises
After Normal vaginal delivery:
◦ deep breathing exercise,
◦ getting and out of bed,
◦ sitting and feeding the baby,
◦ pelvic floor exercise, etc can be started from
the first day after delivery.
Contd...
After Post caesarean delivery:
 Diaphragmatic breathing and pelvic floor
exercises can be started from the first day after
delivery.
She can progress to pelvic tilt head lifting and
other exercises after few days.
She must avoid heavy exercise, lifting, etc till at
least after 6 weeks after the operation.
 Post natal exercises:
Rest
Getting in and out of bed
Sitting and feeding
Deep breathing exercises
Foot and ankle exercise
Pelvic floor exercise
Pelvic tilting exercise
Transversus abdominis (TrA) exercise
Head and shoulder raising
Leg raising
Knee bends
Knee rolling
Hip hitching.
Rest:
Adequate rest for the new mother is essential
immediately after birth.
Position of ease is side-lying, with pillows under
the abdomen and between the knees, or lying on
the back with a soft pillow under the knees.
Getting out of bed:
 Rolling over and getting out of bed is easiest if she bends her knees,
one at a time, supports her abdomen with a hand, especially if she
has had a caesarean section draws in the low tummy muscles and
roll knees, hips and shoulders all over as one onto the side.
 To get out of bed, push the body up by pressing down onto the
mattress and allowing the feet to drop down to the floor. Sit for a
few moments before standing by pushing up with both hands and
standing tall.
Sitting and feeding
While sitting, use adequate pillows to lift
baby to the breast, so that the mother’s
back is supported and shoulders are
relaxed.
Deep breathing exercise:
Lie on bed with knees bent, with a pillow
behind, breathe in deeply through nose.
Sigh out. Repeat 5 times.
Foot and ankle exercise
Keep knees relaxed for both exercises,
bend and stretch ankles vigorously up and
down for 30 seconds. Circle both feet 10
times in each direction.
Pelvic floor exercise
The mother can do this exercise standing,
sitting or lying. Pull the area around
vagina up and down. The contraction
should be held for 10 seconds (to a count
of 6) and repeated up to 10 times.
 Pelvic tilting exercise:
The mother can lie on a firm surface with
knees bent and a comfortable pillow beneath
the head.
Pull in the tummy (inhale, while exhaling,
flatten the back), press the lower part of back
down flat, hold for several seconds and repeat.
 Transversus abdominis (TrA) exercise:
 The mother should place her hands on lower part of the
abdomen.
 Take a gentle breath, breathing out, gently draw in lower
tummy
 Keeping the tummy in, continue to breathe normally a few
times. Repeat up to 10 times, trying to hold for 10 seconds,
but not holding the breath.
 Repeat this for 6-8 times a day.
Head and shoulder raising:
 On the 2nd post partum day-Lie flat and raise head until
the chin is touching the chest, hold for 3 seconds, lower
and relax. Repeat up to 10 times.
 On the 3 rd post partum day-raise both head and
shoulder off the bed and lower them slowly.
Leg raising
 Lying down on the floor with no pillows
under the head, point toe and slowly raise
one leg keeping the knee straight, lower
the leg slowly.
Knee bends
 Draw in the lower tummy, keeping the back still and
bend one hip and knee up as far as is comfortable.
 Hold for 10 seconds and slowly lower.
 Breathe easily throughout.
 Repeat, with the other leg. If able, repeat another three
times for each side.
 Knee rolling
 Pull in the abdomen and roll both knees to one side as far is
comfortable, keeping shoulders flat.
 Bring them back to the middle and relax, breathing easily
throughout.
 Repeat the same and rolling the knees to the other side. Repeat
three times on each side.
 Hip hitching
 In back lying with one knee bent and the other knee straight,
slide the heel of the straight leg down word thus lengthening
the leg.
 Shorten the same leg by drawing the hip up towards the ribs
on the same side.
 Repeat up to 10 times.
 Change to the opposite side and repeat.
Post caesarean exercise:
 The following are the exercises a post caesarean
mother can perform:
 Day 1: Diaphragmatic breathing (mother should
splint incision site while performing breathing
exercises) and pelvic floor exercise.
 Day 2 and 3: Pelvic tilt in side-lying or sitting
position, knee bending.
 Day 4 and 5: Head lifting, knee rolling
 Day 6: do all exercise plus pelvic tilt on all fours
and gradually more challenging abdominal
exercises can be added.
 Body mechanics guidelines:
When sitting, avoid soft chairs. They are
hard to get up from and have a poor
back support. Sit on a firm straight chair
and use a cushion for back support.
Stand with chin in and contract
abdominal muscles.
Climb stairs slowly, one at a time, to
avoid exhaustion. Propel the body up
the stairs using thigh and buttock
muscles, keeping the weight over the
feet.
Contd...
 When bending over, keep one
foot in front of the other foot.
Bend knees and lower the trunk.
Legs should take most of the
weight while the back maintains a
vertical position.
 To lift, maintain one foot in front
of the other, bringing the object
close to the body at waist level.
 When reaching, use stool for
overhead objects. Do not over-
extend when reaching.
 Benefits of postnatal exercises:
Accelerate the postnatal recovery
Protect from body aches and pains
Helps to lose the weight gain during pregnancy
Helps in gaining bladder and bowel control control,
preventing incontinence
Boost the mood by increasing the level of
endomorphins in the brain, thereby decreasing risk of
postnatal distress
Boost the energy levels
Contd...
Improve stamina and strength which will make
taking care of the newborn easier.
Improves circulation and digestion
Reduces the risk of deep vein thrombosis
Enhances the mother-infant relationship.
Summary
 Evaluation
1. Which exercise can be started on the first day of
postpartum?
a) Hip hitching b) Leg rolling
c) Pelvic floor exercise d) Knee bends
2. Which exercise should be avoided on the 1st day of post
caesarean section?
a) Diaphragmatic exercise b) pelvic tilt
c) Pelvic floor exercise c) deep breathing
3. The benefits of post natal exercises are the following
except?
a) Boost the energy levels b) speed the postnatal recovery
c) Promotes contraception d) Protect from body aches
4. When sitting on a chair, avoid
a) Firm chair b) cushions for back
c) Soft chair d) arm rest chair
5. When bending over, which part should be
bending?
b) Knee b) hip
c) Back d) shoulders
Answer Key

1. c
2. b
3. c
4. c
5. a
References:

Fraser D M, Cooper M A. Myle’s Textbook for Midwives. 15 th Edition; 2009,

Elsevier publications, Edinburg:251, 258-260
Stephenson R G, I’ Connor J L. Obstetric and Gynaecologic Care in Physical
Therapy. 2nd edition; 2000. SLACK Incorporated, Massachusetts: 265-283
Chiarelli P. Promoting urinary continence in women after delivery: a
randomised controlled trial. BMJ; 2002; 324:1241
Armstrong K, Edwards H. The effects of exercise and social supporton
mothers reporting depressive symptoms: a pilot randomized controlled trial.
International Journal of Mental Health Nursing; 2003; 12(2): 132-138
Currie J, rich M, McMahon C. Physical exercise and the lactating woman: a
qualitative pilot study of mothers’ perceptions and experiences. Breastfeeding
review; 2004, 12(4): 7-11
www.medical-dictionary.thefreedictionary.com>exercise
www.babycentre.co.uk/postnatalexercise
www.momjunction.com>articles>benefitsofpostnatalexercise.
Conclusion:
THANK YOU