1ST CITY CLINICAL HOSPITAL

Author: obstetrician-gynecologist of the obstetric physiological department of the health care institution “1st City Clinical Hospital” Alekhno D.M.

The recovery of the body after childbirth is called the postpartum period. Its minimum duration is 6-8 weeks. During this time, the female body adapts to its new state: the uterus, vagina and other genital organs undergo a process of involution (reverse development), the mammary glands change for feeding, changes occur in the process of hormone production, muscles and skin acquire prenatal tone, the figure is restored, Over time, the menstrual cycle resumes.

The first thing you should do to recover from childbirth is to set aside free time for yourself. It is important not to be shy about asking for support from loved ones: husband, parents, friends. At this time, it is necessary to pay attention not only to the child, but also to your own physical and psychological health.

The body's recovery after childbirth will be smoother and more natural if you breastfeed your baby. Breastfeeding helps to gradually normalize estrogen levels and prevents sudden changes in hormonal levels, reduces the risk of developing malignant neoplasms, diabetes and cardiovascular diseases.

One of the main conditions for the full recovery of the body after childbirth during breastfeeding is a balanced diet. A nursing mother does not need a special diet. She should have a healthy diet with enough essential nutrients, because they primarily go into milk. It is important that the baby does not experience a deficiency of vitamins and minerals necessary for his active growth and development.

Successful restoration of breast shape largely depends on proper care during pregnancy and breastfeeding. You should take into account such nuances as: wearing a special bra for feeding, avoiding stagnation of milk, alternately placing the baby on each breast, and following the rules of pumping. At the same time, specific training is recommended to maintain optimal health and well-being. They should be aimed at maintaining lactation and preventing breast sagging. The best practices for nursing mothers are yoga and Pilates. Classes should be conducted under the guidance of a specialist who will select exercises in accordance with the recovery period and tell you what should not be allowed during breastfeeding. There are many ways to strengthen the pectoral muscles: massage, water treatments, swimming, special gymnastics. However, it should be borne in mind that the muscular frame can eliminate or reduce the manifestations of flabbiness and sagging, but is not able to change the shape and size of the breast.

As for the menstrual cycle, normally the recovery time varies from 2 months to a year. First of all, it depends on the way the baby is fed. When breastfeeding, stabilization of menstruation may occur after the introduction of the first complementary foods or at the end of the lactation period. In non-lactating women, the cycle is restored after 1.5-2 months. Complete involution of the uterus, leading to the resumption of menstrual function, can take different times due to various reasons: the state of the body after childbirth, what kind of pregnancy, age, hormonal levels, nutrition, physical and emotional well-being.

An important point in postpartum recovery is physical activity. The first time after childbirth, it is advisable to perform feasible physical exercises or gymnastics, since the ligamentous apparatus of the postpartum uterus has not yet recovered. Our maternity hospital employs competent physical therapy instructors who teach a set of exercises as soon as possible after childbirth. You can return to your usual physical activity 8 weeks after birth, after visiting an obstetrician-gynecologist. If a woman was involved in sports before pregnancy, then regular workouts can be gradually resumed by the 4th month.

Special attention should be paid to the condition of the pelvic floor muscles. It is known that any pregnancy lasting more than 20 weeks, regardless of the mode of delivery, increases the risk of pelvic organ prolapse. Kegel exercises will help maintain the pelvic floor in a normal state. These are exercises to improve the tone of the pelvic floor muscles. In everyday life, these muscles are practically not used, and over time they can lose their elasticity and become weak.

To properly feel the pelvic floor muscles, you need to hold the stream of urine once while urinating.

Kegel exercises are:

• slow compressions: tensing the muscle for 3-5 seconds, as to stop urination, then slowly relaxing;
• contractions: tensing and relaxing muscles at a rapid pace.

You need to start training with 10 slow compressions and contractions, repeating each exercise 5 times a day. If your muscles get tired quickly, you can rest for a few seconds and continue the exercise again. Over time, the number of repetitions should be gradually increased. At the beginning of classes, it can be difficult to tense the muscles with slow contractions and perform contractions quickly and rhythmically, because the necessary muscles are not yet toned. Over time, the skill will improve. You need to perform exercises at least 3-4 times a week. Noticeable results can be achieved after 6-12 weeks of training. When performing these exercises, only certain muscles should be involved; you should not squeeze the muscles of the buttocks, abdomen and anal muscles. Currently, there are many mobile applications that will help you avoid missing workouts and make them more interesting. You can exercise anywhere: while driving, while walking, sitting in front of the TV, at the table, in bed.

Kegel exercises can be supplemented with sets of vaginal simulators, which are loads of various weights for long-term retention in the vagina (vaginal cones or balls). You can start exercising with simulators after childbirth only when the genital tract has completely healed; during childbirth without complications, this happens after about 2 months. At the same time, classical Kegel gymnastics are recommended to be practiced during pregnancy and, in the absence of injuries, can be done immediately after childbirth.

Another effective method of restoring the pelvic floor muscles after childbirth is the laser correction procedure. This is an effective modern way to get rid of discomfort without surgery.

The main feature of laser therapy is that as a result of exposure to laser energy, tissues are heated and the mechanism of collagen synthesis is triggered. Thanks to this effect, there is a decrease in the volume and diameter of the vagina without changing its length, restoration of tone, firmness and elasticity of the walls, elimination of their sagging, restoration of the mucous membrane, smoothing of postpartum and postoperative scars, elimination of symptoms of urinary incontinence.

This technique is safe for subsequent pregnancy and childbirth, is performed without special preparation, is painless, guarantees the absence of complications and does not require rehabilitation. Laser treatment can begin 6 months after birth.

Wishing you a quick recovery and happy motherhood, dear mothers!