Physical Activities and Sex

     Exercising after pregnancy has become very popular over the past few years. There are postnatal classes in most communities, and many books exist. But it's important to know what types of exercise are best for you. You'll need to use calm movements for the first 6 months after the birth, and make sure that you don't overburden your legs. Avoid aerobics (jumping), cross-country skiing (long steps on one leg), and racquetball or competitive tennis (sudden turns). The pur­pose of exercising should be well-being and ton­ing, not training.

THE FIRST 6 WEEKS

Most importantly: Get enough rest and start walking! During this period, your body will benefit the most from normal, daily move­ments. It should be okay for you start daily walking routine. Keep in mind that your body has been through a lot over the

past 9 months! Don't exercise ^your stomach muscles yet; the^y will start tonin^g up on their own. No sit-zips! The muscles are still very stretched, which puts an extra pressure on the weakened pelvic floor. It's probably fine to walk, but don't overdo — onl^y do what's comfortable for you.

Lie on ^your stomach and rest when you can. If your breasts feels tender, put a cushion under them to relieve the pressure. This posi­tion helps to empt^y the uterus. Pelvic floor exercises, or Hegel exercises, can be started right after the birth. The pelvic floor muscles are the muscles that form the "floor" under your If the pelvic floor muscles are weak. ^you might experi­ence discomforts such as:

Bladder control problem.

Gassiness .

Hemorrhoids.

Digestive problem like constipation.

Unsatisfactory  Sex.

Back pain and tiredness in the lower abdomen and things.

Pelvic floor exercises can be done anytime and anywhere, sitting or standing. Imagine that you are pulling an elevator up inside your vagina, up your abdomen. Use the mus­cles inside you to do the job. Hold the con­traction for as long as is comfortable. If your muscles tremble, relax before doing it again. As you're pulling the elevator up, you can stop at certain points like different floorswithout coming all the way down. Imagine that you're keeping the "first-floor" muscles curved into a smile. Keep all your other muscles relaxed, and focus on the ele­vator. You can test your pelvic floor muscles by trying to stop the stream of urine when you're emptying your bladder. If you can do that, your muscles are well toned.

GOOD POSITIONS FOR PELVIC FLOOR EXERCISES

The positions listed below help you make the most of these exercises. You should choose the positions that are most comfort­able for you. It's also important to remember to breathe! If you get hot and sweaty, feel nauseous, or get palpitations of the heart, stop immediately. If the feeling doesn't go away quickly, call your doctor.

1. Stand with your legs apart. Put your hands on your buttocks to make sure

that your bottom doesn't tighten when you move the "elevator" up and down.

2.    Lie on your stomach with one leg raised above the floor, behind you. Pull your pelvic floor muscles up and in.

3.    Stand on your knees with your feet together but your knees apart. Put your arms on the floor and rest your head on them. Pull the elevator up inside your vagina.

4.    Sit with your legs crossed. Keep your back straight and lean back on your hands. Pull your pelvic floor muscles up and in.

5.  Stand up with knees and hips bent. Keep your back straight, and support yourself with your hands on your thighs. Pull the muscles up and in.

You don't need to get into any of these positions to do the exercises. You can do them anytime — while driving the car, feed­ing the baby, lying in bed, washing dishes, and so on. Also make sure to use your pelvic floor muscles when you lift heavy objects.

AFTER 6 WEEKS

     1. Lie on your back, with your knees bent.Tighten your pelvic floor muscles.Pull in your stomach,    and press the middle of your back down on the floor. Hold this position for 5 seconds.

2.    Do Exercise #1, adding rapid, tilting movements with your pelvis. This will loosen a tight back and help you regain your "pre-pregnancy" posture.

3.    Lie on your back, knees bent. Tighten the pelvic floor muscles. Stretch your arms forward and lift your head from the floor. Hold for 5 seconds, then rest.

4.    Exercise #3 can also be done while tilting your legs, together to one side and then the other side. This helps tone the abdominal muscles. You should not do this exercise if you feel pain in the pelvis.

5.    Lie on your stomach. Tighten the pelvic floor muscles and lift your head and shoulders. Hold for at least 4 seconds. Keep your legs together the whole time.

6.    Sit down, or lie on your back. Bend your ankles backward and forward. In a stand­ing position, you can go up and down on your toes, carefully maintaining your balance. This is good if you tend to stand a lot and your ankles get swollen. If your legs are swollen, rest them on a chair or footstool when you are sitting.

AFTER 2 TO 6 MONTHS

If you don't experience any physical discom­forts, you can increase your activity after 2 to 6 months. Your pelvic floor itself — and your health advisors — can guide ^you as to when you're ready to start more exercises. Start by walking or light jogging_', to see how "tight" you are. (Empty your bladder beforehand.)

LIFTING

In your dail^y routine, you probably do a lot of lifting without even realizing it. You lift the baby from laps, floors, chan^ging tables, and cribs. You carry groceries and move objects. Ever^y time ^you lift something, you use your abdominal muscles, which is train­ing in itself. However, liftin^g puts extra stress on the pelvic floor muscles, so tr^y to tighten and lift at the same time. Remember to keep your back straight, while keeping your knees and hips loose.

Because your pelvis is weak for a while after you gi^ve birth, ^your hack ^is particularly vul­nerable. Be careful not to carr^y extra weight on one side of ^your body. Distribute the weight of groceries, books, laundr^y, and so forth equally to each side. If ^you are carr^ying a toddler, keep the child close to ^you, in front of your body, with his or her legs around ^your waist. This will help ^you avoid twisting your back or hips.

WHAT ABOUT SEX?

Sex after giving birth is experienced in dif­ferent wa^ys b^y different women. What seems like a chore for ow woman could be a joyful reunion for another. How you experi­ence sex depends on your own health; your sexuality; how you feel about your partner; and your feelings about pregnancy, birth, and motherhood.The most common change in sexuality after pregnancy and birth is to feel less desire. Your erotic energy, which used to be focused around the man, might now be focused on caring for and feeling close to the baby. You might feel just too tired to even

A woman's sexual desires can be low for a number of months after the birth. For some couples, this isn't a major issue. The man may be feeling tired and strained by his new respon­sibilities, too, and he might not have the energy. Or, some men are confident in their feelings of inner security and understanding for their partner, and wait patiently for life to return to normal. But when your sexual needs are very different, conflicts can emerge. If your partner feels rejected, try to reassure him that though life isn't "the same" anymore, your lack of desire for sex probably won't last long. If the situation is putting a strain on the relationship, talk to your partner. If things don't improve, you might consider talking to a professional.

Allow yourself time and space to enjoy the sexual feelings that build up. And, try to make time for an intimate relationship with your partner. For most women, resuming a sexual life will happen naturally — it's only a matter of time.