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20 Weeks Postpartum: Physical Therapy and Ava Update

Updated: Oct 3, 2020

Since my last postpartum update 5 weeks ago (at 15 weeks) I have started physical therapy and seen more changes with my body inside and out. Of course Ava has changed a ton too! She is so close to rolling over so she is now sleeping with both arms out of the swaddle. She is very vocal now too and her personality is really starting to come out. She is a very happy baby, but a little bit of a whiny drama queen at times and wants what she wants when she wants it! The biggest change is her sleep. Once she hit 3 months her sleep schedule of almost sleeping through the night completely disappeared and it has still yet to make a come back a month and a half later.

She had her 4-month check up and all is well. Not teething yet and doctor said she is going through a sleep regression but that it should hopefully start coming to an end real soon. She recommended I start sleep training and said since she is such a smart baby and developing quicker then the average 4 month old that she might catch on pretty quickly.

20 weeks                     15 weeks                     8 weeks

I have seen great progress with my body from working out and focusing on what I eat. The biggest thing I have seen with having a baby though is I don’t have time to eat! Sometimes I don’t get a chance to have a real meal till 11am. So that I am not starving till I can eat a real meal I always keep these Peanut Butter Chocolate Power Bites on hand in the freezer so I can eat a few first thing in the morning to get me by. However, when I do eat I end up not eating a full meal because Ava wakes up or is fussing. This plus burning calories from breast feeding and working out is working in my favor, kind of. As you see above I have lost weight and inches, but where did my butt go?

Ya, that‘s right. This is what happens when you are trying to work out and burning too many calories but NOT EATING ENOUGH. This is a common thing women do when little do they know in order to hold onto muscle to have shape and definition they need to eat! Starving yourself makes it hard for your body to hold onto anything muscle related and then you lose weight yes but may not be happy with the way you look. Another reason the number on the scale can mean nothing. I am going to do better with my eating habits because I miss my muscle and strength! When I say I will do better with my eating habits that does not mean just eat anything. I know there are people who like to tell skinny people to just pick up a hamburger, but when you are trying to put on muscle and not just weight what you eat does matter. I will still focus on eating healthy fats, carbs and protein, I will just eat more of it.

I understand to some women they would look at me at think I am crazy for having any complaints for losing baby weight plus some so quickly, but I worked hard for my muscle before pregnancy. Not only is my muscle dwindling away, but also when I am trying to lift weights I am so weak, to the point where I feel like I am back to square one and that is a little upsetting to me. So I get that some women will just be happy with a number on the scale and that’s great for them, but I like muscle on my body and I have to work for that.

I also began physical therapy over the past month. The physical therapy is for my abdominal separation (diastasis recti) and my pelvic floor. I am very serious about fixing my separation, or at least correcting it to the point where my core strength can return because it is affecting my workouts by causing me lower back pain. For my pelvic floor there has been pain associated with a lot of different things, so I decided I needed professional help.

At my consultation the physical therapist assessed my diastasis recti and also pointed out that I most likely have an umbilical hernia now from pregnancy. I have read this can be caused by pregnancy and the abdominal wall not being able to take the pressure of the growing belly. Umbilical hernias can also be common in women who had C-sections. She told me I should see my primary care physician to get it properly diagnosed, but it does not hurt or bulge out, my belly button just looks funny : (. Oh the joys of pregnancy. So, I think I will wait to see my doctor about the hernia because from what I have read if a woman plans on getting pregnant again there is no point in getting fixed. Also, since I have to get another C-section for my second child they can fix it then. If I start to have pain then I will see her sooner rather than later.

I had a complete inny before pregnancy and now my belly button kind of sticks out at the top after pregnancy as you can see in the picture below. This can be a sign of an umbilical hernia. This area poking out can be on the top, bottom or the whole middle part of your belly button can stick out. It is not sore and is soft so the physical therapist said it is a very mild hernia if it is one. If your belly button looks like this or completely sticks out and is sore/hard to the touch you should go see your doctor.

As for my pelvic floor the physical therapist said that pushing for 4 hours really stressed out my pelvic floor muscles and now they are in a constant spasm and are having a hard time relaxing. I can feel this during multiple activities and even during running. I began seeing her once a week and she gave me exercises to do at home as well. During our sessions she does a lot of massaging and pushing on pressure points to help release the tightness in my muscles. She is even doing this for my abdominal muscles. After a month of seeing her and doing my exercises at home I have noticed a HUGE difference. My muscles have started to relax, my abdominal gap is closing resulting in losing more inches off of my stomach and I am able to do certain exercises without pain.

After going through this I have realized that these are issues that most women are probably not even aware of after giving birth. For the abdominal gap this can be a bigger issue if someone is not aware of it and not actively trying to correct it. I know tons of women try to get back in shape after baby and do a lot of ab work like crunches, planks and things like mountain climbers. Little do they know this is just making their ab separation worse.

This picture to the right is one I found online to show what your stomach can look like while trying to do these ab exercises if you have diastasis recti. This is something to pay attention to while doing ab work or anything that puts pressure on the abdominals. I have found out that it is not just ab work that can stress your muscles. Whenever you work out you are (or should) be engaging your core and some exercises rely on your core more than others. For example, I have had to stop doing pull ups, lat pull downs and heavy bent over rows while I work on correcting my distasis recti because these exercises aggravate it. Everyone is different though so these exercises may worsen your diastasis recti or they may not and others might.

A bigger ab separation can lead to the dreaded “mommy pooch” that women feel like they can never get rid of. They would be surprised that if they stopped doing exercises that aggravate the ab gap and instead did exercises to help close it they would actually start to lose inches off their waist.

It makes me sad that physical therapy is not a mandatory part of a woman’s care after they have had a baby. Society and doctors focus on the mom so much during pregnancy then after pregnancy it is like the woman is thrown to the side to fend for herself and all of the focus is now on the baby. Did everyone forget that our bodies just went through this stressful period for 9 months and then endured hours and hours of labor to get the baby out? Why doesn’t anyone think we need more help afterwards? Pregnancy and labor is like an injury to your body that needs to be dealt with in the right way or permanent damage may occur. Then this cycle is repeated every time a woman gets pregnant again adding to the “injury” that was never healed properly.

Really the only reason I was able to start physical therapy is because I maxed out my health insurance from having Ava. If this was not the case then I would not be able to afford physical therapy and who knows where I would be right now. It is a frustrating feeling knowing something is physically wrong, but not knowing what to do to fix it. I have already helped a couple women by showing them the exercises the physical therapist gave me and have shared my handouts. I talked to one woman who said her abdominal gap is 4 fingers width after 5 kids and it is so bad that even years and years later people ask when she is due and she can barely stand too long without feeling pain. This is not okay that she cannot afford to see a physical therapist. Women need better care after pregnancy and labor.

If you are interested in seeing some of these handouts and exercises to help you fix your gap and/or pelvic muscles (assuming you have the same issue I do) feel free to email me and I am more then happy to send them to you. Us moms need to look out for one another so that we can all start feeling better and maybe be just as good as before pregnancy.

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