From 34 weeks start massaging your perineum (the area between your vagina and anus), as this may help it to stretch better on B-day. ‘Try it after a bath, as the blood vessels are more dilated and the area is softer,’ says Nikki Khan, Prima Baby’s midwife. ‘Use an unscented oil, such as sunflower oil, and massage for five minutes a day, according to your midwife’s instructions.’
On the day
Listen to your midwife when pushing to help the baby come out slowly and gently and avoid tearing. ‘If she tells you to stop pushing and pant, this is to control delivery of the head. If you can do as she says, it’ll really help,’ says Dr Daghni Rajasingam, consultant obstetrician and spokesperson for the Royal College of Obstetricians and Gynaecologists.
You may have grazes or stitches and you’ll feel sore and uncomfortable, particularly when you wee. ‘Pour a jug of water over the area as you go to the toilet to dilute urine and take away the sting. It also helps to avoid infection,’ says Nikki. ‘Drink lots of water – if you’re dehydrated, your urine will be more acidic and cause more discomfort.’
Walking, even just around the bed, will help boost the blood flow to the perineum and help it heal. ‘If you’re in pain while sitting, ask your midwife to help you find a position to feed your baby while lying down,’ says Nikki.
Day after the birth
Drink lots of water, especially if breastfeeding. ‘By keeping hydrated you’ll help to avoid constipation, which can cause piles,’ says Nikki.
You might find you leak a bit of wee for the first few days because of weakened pelvic floor muscles after the birth. This is normal and easily fixed with pelvic floor exercises.
Three days later
Have several professionally-fitted nursing bras for when your milk comes in, says Nikki. ‘If your breasts become engorged, slip chilled savoy cabbage leaves into your bra to relieve swelling and that ‘hot’ feeling. Also beware of mastitis – an inflammation of the breast that can progress to infection. See your GP if you feel fluey, have a high temperature and hot areas on your breast.’
Your lochia (the blood and mucus discharge you get after birth) should be slowing now, but change maternity pads regularly to avoid infection.
Two out of three women experience changing emotions, known as the baby blues, in the days after birth. ‘The most common experiences include mood swings, disturbed sleep and negative thoughts about your baby,’ says Professor Carmine Pariante, head of perinatal psychiatry at the Institute of Psychiatry. ‘It’s likely these are due to hormonal changes and tend to fade by the end of the first week, but if they continue, talk to your midwife.’
A week later
Your uterus (womb) has been shrinking by 1cm each day and by 10 days, it should have disappeared behind the pubic bone. Your midwife will check this and your perineum at each appointment, ‘You should stop feeling sore after four days, and start to feel more comfortable by 10 days,’ says Nikki.
Now’s the time to start doing those pelvic floor exercises. ‘Begin by lying down and progress to a sitting, then a standing position when you feel able,’ says Samantha Gillard, a physiotherapist specialising in women’s health. ‘Tighten the ring of muscle around your back passage, then your front passage and hold them both for five to ten seconds – release and repeat up to ten times, and follow by five to ten quick squeezes. Do these three times a day – you’ll soon feel the benefits.’
Three weeks later
You may have heard horror stories about split tummy muscles, but this very rarely happens, says Samantha. ‘The connective tissue between your tummy muscles does stretch to accommodate your growing baby during pregnancy, but most women find it goes back,’ she says. If you’re concerned, talk to your midwife.
Around this time you can do some exercises to help your body return to normal. Samantha advises, ‘Re-align your spine and tone deep tummy muscles by lying on your back with your knees bent up and feet flat. Slowly tip your pelvis forward, arching your back, then tip it back, curling your tailbone underneath and flattening your back.’
Your six-week check
When your doctor says it’s OK, you could join a postnatal exercise class, go swimming, or use the stationary bike, hill-walking and cross trainer machines at the gym. However, it’s best to avoid high-impact exercise, such as running, for a while longer. Samantha explains, ‘The pregnancy hormone relaxin, which loosens your joints, is still present, and your body needs to return to normal after the birth.’ So take it easy for those first few weeks!