Rest is important to help with your recovery. Rest on your back or side to minimise discomfort, reduce swelling and take the weight off your pelvic floor and tummy. If your perineum is sore when sitting, put a rolled towel or small pillow under each thigh and buttock so that your perineum is not in contact with the chair.
Gently pull your lower tummy in. Bend your knees and roll onto your side. Slide your feet over the edge of the bed. Push yourself up to sitting using your elbow and hand.
Gently pull your lower tummy in. Sit your bottom down square on the bed and then lower your head and shoulders onto the pillow. At the same time lift your legs up onto the bed.
Move your feet forwards and back and around in circles 20 times every hour while resting in bed.
Pelvic floor and deep abdominal exercises help you return to your pre-pregnancy shape and will help with healing of stitches. They can be safely started 1 - 2 days following the birth of your baby, provided there is no increase in your pain.
Pelvic floor muscles are very important as they control the bladder and bowel. During pregnancy they become weakened due to pregnancy hormones and the extra weight of your baby. It is important for all women whether they have a vaginal or caesarean delivery to strengthen their pelvic floor muscles.
To begin with, lie on your back with your knees bent and your feet hip width apart.
Quickly squeeze and hold your pelvic floor muscles BEFORE coughing, sneezing, laughing and when lifting your baby. This will give you more control of your bladder and will help to keep your muscles strong. To be effective you need to do your pelvic floor muscle training 3 times a day.
Knowing how to do your pelvic floor muscle exercises is really important and can help you prevent or stop urine from leaking.
The physiotherapists in the Rotunda Hospital have made five videos on learning about pelvic floor muscles, doing your pelvic floor muscle exercises, leaking urine and doing exercises after you have your baby.
We made the videos so that all women can receive reliable, trustworthy, free information and to let women know that::
Leaking urine or wetting yourself when you do not mean to (also known as urinary incontinence), can be treated with pelvic floor muscle exercises (PFME). PFME help reduce symptoms of urinary leakage; in some cases leading to temporary or even permanent relief.
Each video is just 3-6 minutes long. Please click on the relevant video to watch:
Introduction to the videos from the Rotunda's physiotherapy manager, Cinny Cusack
Video 1: Getting to know your pelvic floor
Once you have watched the videos, we would love to hear what you thought of them, and in particular, if you found them a good way of providing information.
We would also like to know if you did pelvic floor muscle exercises in the past and if you have ever experienced leaking of urine. To give us your feedback, please click on this PFME Survey link to provide it.
You should empty your bladder within 6 hours of your delivery. If you have difficulty emptying your bladder, talk to your midwife.
Drink 1.5 - 2 litres of fluid during the day (water is preferable to tea and coffee which may irritate your bladder). Eat plenty of high fibre foods (e.g. fruit, vegetables).
Don’t ignore urges to empty your bowel in the first few weeks. For comfort when opening your bowels, hold some folded toilet paper over your stitches in front of your back passage. If you had a caesarean section, support your tummy with your hands or a folded towel.
Avoid straining – take your time. Sit leaning forward, with your elbows on your knees, and let your tummy relax. Use a foot stool or lift your heels up off the floor so that your knees are above your hips. Don’t hold your breath.
If you have any leakage from your bladder or bowel, contact the physiotherapy department to make an individual appointment on 01 817 1787.
1. Deep abdominal muscle exercises
Abdominal muscles are important for back support and in maintaining good posture. During pregnancy, your abdominal muscles stretched and became weakened.
Lie on your back, knees bent and feet hip distance apart.
Breathe in: let your tummy rise.
Breathe out: gently tighten your lower abdominal muscles by pulling your lower belly in towards your spine (as if getting into tight trousers).
Keep your upper abdominal muscles relaxed throughout the exercise, breathe normally. Hold the position for 5 seconds.
Repeat 5 times, 3 times a day.
Pull in your deep abdominal muscles during activities like lifting your baby and walking.
As you get stronger, you can do the exercise in sitting, on all fours and when standing. Gradually increase the hold time up to 60 seconds.
2. Knee rolls (start as in exercise 1)
Tighten your lower abdominal muscles, slowly lower both knees to the right as far as is comfortable.
Use your tummy muscles to slowly bring your knees back to the middle and relax there. Repeat to the left.
Repeat 3 times each side, 3 times a day.
Slowly increase your repetitions till you can do 10 each side.
3. Pelvic tilts (start as in exercise 1)
Tighten your lower tummy and flatten your lower back into the bed.
Hold for 5-10 seconds and let go.
Repeat 10 times.
If you are not experiencing any problems you can start as soon as you feel ready. Choose a comfortable position, use lubrication and start gently. If you have persistent pain or discomfort, discuss this with your doctor at your 6 week check up.
When lifting, bend your knees, keep your back straight and always tighten your pelvic floor and abdominal muscles. Hold the object firmly and close to your body. Make sure your work surfaces are at waist height (e.g. bathing & changing your baby).
Create a supportive position for feeding. Sit well back in the chair, make sure your feet are supported and use pillows help lift the baby up to your breast.
Start gentle walking as pain/discomfort allows; gradually increase your distance and then your speed up to a 30 minute walk each day. You can start swimming when you have had 7 days in a row free from vaginal bleeding or discharge. Wait 3 months to return to heavy exercises, sit ups or weights.
We recommend that you attend the postnatal exercise class within 6 weeks if you had a vaginal birth and within 8 weeks if you had a caesarean section. It is very important to attend the class if you are having problems with your bladder or bowel control or with back or pelvic pain. It is an opportunity to learn how and when to return to exercise and to meet other mums. You are welcome to bring your baby with you to the class, which is held every Thursday from 11.30 am to 12.30 pm in the physiotherapy department. Please ring 01 817 1787 to make a booking.
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