6 Weeks Postpartum What to Expect and What to Do

A 6 weeks postpartum, you may start to feel somewhat like a human again. If not, it's totally fine. However, you may be getting some stretches of sleeping and notice that baby is starting to fall into a bit of a routine.

6 Weeks Postpartum: Core

Your core, like the rest of your body, is continuing to heal at 6 weeks postpartum. If you had a C-section the incision should be closed and healing as well. While it may be sensitive, it's important to do gentle touching around the incision so that it does not become overly sensitive.

• Abdominal Muscle Separation- It's normal for the muscles of our core (the "6 pack abs") to separate during pregnancy. This has to happen to make room for baby to grow. As any swelling starts to go down and the uterus shrinks, you may notice doming or gapping in the middle of your belly.
• Weakness- It would be unreasonable to expect to have your total core strength back at this point. You may notice feeling weak or "mushy" around your core at 6 weeks- especially as you start to become more active.
• Back Pain- Back pain from more sitting than normal and a weaker core is very common. Try to change positions every 30-60 minutes when you're awake and gently engage your belly muscles when you bend, lift, or twist.

6 Weeks Postpartum: Pelvic Floor

Your pelvic floor is continuing to heal at this stage. If you had an episiotomy or tearing, the stitches have likely healed and vaginal bleeding should have stopped or be minimal at this stage. The following are some common issues some women experience at 6 weeks postpartum.

• Pain with Sex- At the 4-6 week mark, many women are cleared by their midwives or doctors to return to sex. While things may be healed enough to return, it's possible you could experience discomfort or even pain with intercourse. This could be due to scar tissue from healing, muscle tightness, or decreased lubrication.
• Leakage- While urinary leakage is common at this stage, it's not normal. If you experience leakage, it's often with coughing, laughing, sneezing, or jumping/ running. This is called stress incontinence and can occur because of weakness in your pelvic floor. Some experience urgency that causes a very strong urge to get to the bathroom without much time to delay.
• Pressure- Pelvic pressure could be something you experience at this phase. If you're experiencing pelvic pressure or a bulging sensation, it's possible that this could be a sign of prolapse.

Exercise at 6 Weeks Postpartum

Again, you may have been cleared by your healthcare provider to return to "business as usual" at this phase. While that is great and likely means on the surface everything is healing well, it doesn't meant to jump back into pre-pregnancy exercise. During exercise, there should be no pain, no leakage, and no feeling of pressure or dragging in the pelvis or abdomen. If you experience any of those, take the exercise down a notch. If that doesn't help consider trying another exercise. Regardless of the exercise, definitely seek help from a pelvic floor specialist to address these issues.

• Kegel on All Fours
• Kegel
• Seated Kegel (it's important to practice in a variety of positions)
• Bridges
• Deep Core + Marching
• Side Lying Deep Breathing

https://www.youtube.com/watch?v=hqxFnHjvf84

As you start to dip your toe into the world of exercise, it can be helpful to have guidance either from a pelvic floor therapist or a reputable program. Guiding women back to their normal activity level is something we help with at Simpli Whole and In-Home or Telehealth visits may be appropriate. You can read more about how pelvic floor therapy might help here.

If you're not experiencing any issues but just want someone to tell you what to do and when, then a workout app with pre-made workouts tailored to each phase postpartum may be the answer. Expecting and Empowered has developed a fitness app that seamlessly guides you through each phase postpartum, with modifications as needed. Head over to this link and enter code SIMPLI to get your discount!

Normal vs. Not Normal at 6 Weeks

Sometimes, it's hard to know what is normal and not normal postpartum. Especially if this is your first time. The following are some signs/ and symptoms that are normal and not normal at 6 weeks. Fatigue is totally normal at this stage though it shouldn't prevent you from doing basic daily activities.

Not Normal

Any of the following would be reasons to talk to your doctor or healthcare provider. While they aren't all signs of an emergency necessarily, these are not normal things to be experiencing at this stage.

• Vaginal discharge that has a foul odor, itches, or is green/ yellow
• Cramping that is sharp in nature or is steady instead of coming and going
• Leakage- this is COMMON but not normal. Even a small amount of leakage is not normal at this stage and anything related to childbirth should have resolved by now. If you have leakage with coughing, laughing, sneezing, exercise or bowel leakage (leaking gas or stool), seek help from a pelvic floor specialist.
• Not being able to perform normal daily tasks like showering or making yourself breakfast
• Fever
• Pain with urination
• Redness or swelling in one or both breasts or breast pain

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