By Katie Stewart, an accredited exercise physiologist in Mosman Park Perth.

In 2011, the Australian Institute of Family Studies reported a 20% increase over two decades in the number of women having their first child over the age of 30. Around half of those women were classified by the Australian Institute of Health and Welfare as overweight or obese.

Ms Katie Stewart

The period after a woman gives birth is known to affect mental and physical health, both acutely and in the long-term. Traditionally, postpartum recovery usually involves acute Kegel and physiotherapy exercises to restore pelvic floor integrity, pelvic stability and joint integrity as the uterus returns to its non-pregnant state.

Kegel exercise and Pilates play an important and successful role in this process, but there’s also a place for exercise medicine prescription around the hormonal disruption that happens post-partum.

Hormones can have a big impact on postpartum fatigue, depression and additional weight gain, and fatigue is one of the realities of having a baby after 30.

As a mother of four children aged between six and 16, I can speak from experience about how fatigue changes as you age.

I had my first child at 26; my second at 28. No fatigue concerns at all. By the time I had my third I was 32 and my fourth 37, and my fatigue increased dramatically with each.

Post-partum fatigue can contribute to the incidence of post-natal depression. If you add in the metabolic concerns of excess weight, there is a strong argument for post-natal, low-moderate aerobic exercise to be included in the postpartum exercise prescription.

We know that low-to-moderate intensity aerobic exercise can significantly reduce depression symptoms. There is also some evidence which shows that low-to-moderate aerobic exercise may even be as effective in reducing symptoms as psychological or pharmaceutical therapies.

As an Exercise Physiologist with an interest in mental health, I would never recommend against psychological treatment. I would, however, recommend appropriate low-to-moderate aerobic exercise alongside the traditional Kegel and Pilates-style exercises.

The ideal prescription to reduce the increased heart and breath rate brought on by anxiety in the six weeks after giving birth should include a combination of Kegel, Pilates and mindfulness and breathing exercises three times a week. This combination will help improve transverse abdominal activation and pelvic floor integrity, while stabilising mood and coping mechanisms.

Resistance exercises that restore and rebalance the spinal muscles and the hips’ strength, stability and function, along with aerobic exercise can help reduce fatigue, increase energy and improve mindset.

The best support a post-partum woman can secure is through a combined allied support team of physiotherapy, psychology and exercise physiology. It will deliver the best mental and physical patient outcomes over that first postnatal year reporting to the central managing GP.

It is treatment, prevention and promotion, all in one tidy prescription, and tantalizingly efficient and rewarding for the GP, the patient and the national pocket.

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