The Barbell Mamas Podcast | Pregnancy, Postpartum, Pelvic Health
The times are changing and moms have athletic goals, want to exercise at high-intensity or lift heavy weights, and want to be able to continue with their exercise routines during pregnancy, after baby and with healthcare providers that support them along the way.
In this podcast, we are going to bring you up-to-date health and fitness information about all topics in women's health with a special lens of exercise. With standalone episodes and special guests, we hope to help you feel prepared and supported in your motherhood or pelvic health journey.
The Barbell Mamas Podcast | Pregnancy, Postpartum, Pelvic Health
Your Body After Baby: What Nobody Tells You About Early Postpartum
Have you been told to wait six weeks before returning to exercise after having your baby? This long-established guideline is being challenged by new research and expert consensus. As a pelvic floor physical therapist, CrossFit athlete, and mom of two, I'm pulling back the curtain on what early postpartum recovery really looks like and why that six-week rule deserves a serious update.
The postpartum period often feels like whiplash—from constant medical attention during pregnancy to suddenly feeling abandoned once baby arrives. While your newborn gets thoroughly examined, your recovery becomes an afterthought, typically reduced to a brief check at six weeks postpartum. But what about those crucial early weeks when everything feels strange and uncertain in your body?
In this deeply personal episode, I share my own Mother's Day reflections (including the moment my child spilled water on my laptop!) before diving into the transformative potential of early pelvic floor physical therapy. Around two weeks postpartum, these appointments provide more than just physical assessment—they offer space to process your birth story without judgment, clarify which sensations are normal versus concerning, and develop a personalized plan for returning to movement.
You'll learn why feeling heaviness around your vagina doesn't necessarily mean prolapse, why your core feels foreign after birth, and why gentle early movement can significantly benefit your mental health without harming your recovery. Drawing from both research and clinical experience, I explain how my own family history of postpartum depression shaped my approach to postpartum exercise and why current evidence supports a more individualized timeline for return to activity.
Whether you're currently navigating the fourth trimester, planning for a future pregnancy, or supporting someone who is, this episode provides crucial information that's often missing from standard postpartum care. Ready to transform how you think about recovery after birth? Listen now, and let's reclaim the postpartum journey together.
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Hello everyone and welcome to the Barbell Mamas podcast. My name is Christina Previtt. I'm a pelvic floor physical therapist, researcher in exercise and pregnancy, and a mom of two who has competed in CrossFit, powerlifting or weightlifting, pregnant, postpartum or both. In this podcast, we want to talk about the realities of being a mom who loves to exercise, whether you're a recreational exerciser or an athlete. We want to talk about all of the things that we go through as females, going into this motherhood journey. We're going to talk about fertility, pregnancy and postpartum topics that are relevant to the active individual. While I am a pelvic floor physical therapist, I am not your pelvic floor physical therapist and know that this podcast does not substitute medical advice. All right, come along for this journey with us while we navigate motherhood together, and I can't wait to get started. Hello everybody and welcome to the Barbell Mamas podcast. Christina Previtt here. I hope that you are all doing so so well and had a wonderful Mother's Day.
Speaker 1:I was totally spoiled. I got breakfast in bed and our family so my kiddos are three and six and we did like a 5K-ish just over three mile. They were on their bikes and my husband and I were walking with our dogs and it was one of those moments when I looked at my life and I looked at my family and I just thought this is what I've always dreamed of, when I thought about my family when I was growing up and what I wanted. And it's so easy sometimes to get just so overwhelmed with the day-to-day or your kids are driving you absolutely bonkers because they're always asking for snacks and treats and do this and do that. But when you look back or when you kind of reflect or take a moment to pause, it was just one of those things on Mother's Day where I just had this overwhelming sense of peace and calm and just contentment, because this is a family that I've always dreamed of and there's always hard days, but it was a really wonderful time to just be with family. And then my kid dropped water on my laptop and fried my circuit board. Moment gone, let's be fair. My laptop was on its final legs but yep, and then I was like this is the duality or the yin and yang of motherhood, where I could be so content and think my kids are so cute. Then two seconds later they fry my circuit board and have to get a new MacBook. But anyways, new technology is fun Today.
Speaker 1:What I thought that we would talk about is a very early postpartum appointment with a pelvic floor physiotherapist, what that might look like, why you may want to have that appointment, what we would do in that appointment and talk from there. Over the last couple of weeks I've been talking about these new guidelines that have come out that were really against the one, the six-week medical clearance so having to wait six weeks of doing nothing or doing very little movement around the house outside of activity, daily living and parenting tasks, and then waiting to your six-week appointment, usually with your midwife, obstetrician or primary care provider, your physician, and how. That isn't really founded in the evidence. Even ACOG, the American College of Obstetricians and Gynecologists, do not say that everybody has to wait six weeks and that postpartum wellness checks can start as early as a couple of weeks. Postpartum wellness checks can start as early as a couple of weeks postpartum. We know that in our midwifery groups that it's not usually the six-week clearance but they're seeing you several times and checking on baby at the same time in their care model. What that meant was that, with our international Delphi and with the new guideline that got published for the Canadian Society of Exercise Physiologists that we really advocated away from the six-week appointment. We really advocated for a personalized, individualized approach to rehab and what that means is is that some individuals may start running, for example, four weeks postpartum and some people may start at four years postpartum, and some people may start at four years postpartum because of just circumstances around their life, events, their kiddos at home, all those types of things that really come into the equation and really are big determining factors for how individuals can engage with exercise.
Speaker 1:As a pelvic floor physiotherapist, I do not believe that everybody needs to see a pelvic floor physiotherapist postpartum. I think that that messaging around need and necessity can be problematic because it isn't always possible for people to see a pelvic floor physiotherapist in that postpartum period and it can create unnecessary barriers for returning to exercise. But I do believe that there is benefit to seeing a pelvic floor physiotherapist and that it can make your postpartum journey a little bit smoother, not necessary, absolutely a privilege for many to be able to see a pelvic floor physiotherapist postpartum. But I want to talk a little bit about what we offer, what we bring to the table, what a postpartum appointment looks like and talk through options of where care can go. I am and the group that I work with through the Institute of Clinical Excellence, our pelvic division, we are very, very big advocates for the two-ish week appointment postpartum. I love, if I'm seeing you in pregnancy, to get that appointment on the books roughly about two weeks postpartum, knowing that baby is going to be the determining factor of when he or she comes out and meets the world and that there is a lot that can be done very early. Lot that can be done very early.
Speaker 1:When we are thinking about early postpartum, the ongoing kind of joke or criticism is that in pregnancy mom gets so much care right, they are constantly checking blood pressure, how your body is feeling, asking you about your pregnancy, and then postpartum that tends to flip a lot so that the emphasis is only on the baby and less so on postpartum recovery. Maybe there is, you know, some constant screening for perinatal mood disorders. So postpartum depression, definitely Anxiety maybe, but it's not really consistently done and oftentimes moms feel like as soon as I hit that postpartum period, all the emphasis goes on to baby and a lot of emphasis goes off of them and their postpartum recovery. I always say that you know when you're doing your postpartum pelvic floor assessment or your pelvic floor appointment with me. This is the appointment that is purely on you, on how you are doing and allowing that postpartum recovery piece for mom to be front and center. It's definitely front and center in my mind. I will coo over a little baby, of course as well, but my focus is on you and how you are doing in the postpartum period.
Speaker 1:If you are coming to see me for an appointment, the first thing that we often do is a debrief on your birth, telling me about your birth, how your birth went, how did it live up to what your expectations of birth was, how do you feel about your birth when you're reflecting on your labor and delivery story, what emotions are coming up for you, and asking then about your transition home, how that is going, and just kind of debriefing on this very big life event. And I am this unbiased third party that allows you to feel all of the things right so often when especially when labor does not go the way that you want right, when you want to have a home birth that is unmedicated and you end up having to go into the hospital, or you want to have an epidural vaginal delivery and you end up having to go into the hospital or you want to have an epidural vaginal delivery and you end up with a cesarean section. Or when you wanted to go into labor naturally naturally meaning without an induction agent and you end up having to be induced. When those disconnects happen, there's a lot of emotions that can come up and a lot of disappointment and grief that can happen. When we talk about those things, however, a lot of times the response is well, at least you have a happy. Well, at least you have a happy baby, at least you have a healthy baby and, of course, of course you are feeling thankful that your baby is okay. But you can also feel sad or grief or disappointment that your labor and delivery did not go the way that you wanted to, and both those things can exist at the same time, and I just tend to see that there's a lot of dismissiveness around people having very negative emotions around their birth. That I can be this unbiased third party and sit with those sad emotions or those negative emotions, knowing that it does not make you a bad mom. It does not mean that you are not thankful that your baby is okay, or, if your baby ended up in the NICU, that hopefully baby is doing all right. It allows still that time and space, so that can be the entirety of your first appointment talking and debriefing about that or it can be a component of the first appointment.
Speaker 1:If you are seeing a midwife, you are probably getting your if you had a vaginal delivery getting your external genitals checked, your vulva checked to make sure that everything is healing well. If you did not have a midwife, then you may not have had any checks and therefore we can do an external look at how any stitches or any healing is going and can do a look-see to make sure that everything is feeling good, especially if you have concerns or you don't know if something is normal or not. But many times the first appointment, or if you had a cesarean section, then I definitely will check, because it's very easy for infections to creep up and we just want to make sure everything's feeling good. But most of the time we're not doing an external check. But we are starting to get maybe a bit of an understanding of how you are feeling postpartum One of the best things that I can do and I posted about this a couple of days ago on social media because I had an early postpartum visit I had a couple.
Speaker 1:I actually had two with the last time I was in clinic and one of my clients was just so thankful that her and I were able to connect because she was starting to have like bulging symptoms in her vulva and I said, hey, like this is kind of what you should expect, these are the sensations that are normal. Here's when I would tell you to modify something because these are lasting or hanging on for too long. And she said to me she's like, as soon as you said that these are all normal, like healing sensations, those sensations started to go away, and so what I was saying was that sometimes the best thing that I can do for you is to give you an idea of this is a sensation you're feeling. You're telling me about this sensation and I can see if, like, yeah, maybe that's something that we want to pay attention to, or no, this is completely normal. For where you're at this level postpartum, this time postpartum here is when I would give you a buoy, saying like, if you feel this times, this amount of time or this amount of intensity, then that's probably something that I would be a little bit more concerned about, that we would want to watch. But right now, where you are is very much on par with where I would expect you to be postpartum.
Speaker 1:One of the things that I think our medical system does not do well, that I am and other people who are pelvic floor physiotherapists are able to do, is fill this void around setting expectations for how you feel within your body postpartum, recognizing that everybody's going to feel a little bit different, but there are certain sensations that are very normal, that are very common to feel postpartum and that are so often not talked about at all. For example, like you are going to feel that heaviness around your vagina when you're standing up for a prolonged period early postpartum, right. For example, like you are going to feel that heaviness around your vagina when you're standing up for a prolonged period early postpartum, right, there is blood flow, stuff is still swollen, your pelvic floor is still recovering from an injury. That's not you prolapsing, that's not you having issues. That's your body tired in an area that just went through an injury and therefore it's not something that I am concerned about. It is not something that I am getting you to hyper fixate on. It's just a gentle nudge that you know.
Speaker 1:You probably should rest in the next little while. Give your body a bit of time to recover, if you can, and then, when that sensation is starting to go away, you can get up and move around again. Or the first time you're exercising, if you're feeling that heaviness sensation around your vagina it's like doms of your pelvic floor 24 to 48 hours you may have a bit of heightened sensitivity down there as you start exercising more. When you start to feel that sensitivity is going to get like I don't want to say bigger, but like longer and longer, before you start to feel that sensation as you recondition postpartum from that injury and it'll start to go away and your sensitivity will start to go down. Like that is very normal.
Speaker 1:Feeling like all of a sudden you had all this core strength in pregnancy to feeling this sudden change or sudden weakness in the core wall that feels very foreign again is normal, because your abs were stretched around baby but you had baby to like kind of I don't know the right terminology that I'm thinking about, but you're kind of. When you're hugging that baby you feel that something is helping you recruit. Maybe I don't know if that's the right word, but that baby is there and you're feeling that that stretch against baby. But then that stretched ab wall when you're postpartum doesn't have that baby rooting it there, and so sometimes the way that your abs are contracting or how you're moving around in space can feel very foreign. Because pregnancy develops slowly, right. Baby's growth is relatively slow, even though it feels really fast at times.
Speaker 1:Postpartum is sudden, right, one day and you go from being nine months pregnant to being postpartum and hopefully a day, and what that means is that you kind of get rocked a little bit from the core perspective and how you feel like you're doing moving around in space, and so that can feel really different. And those are conversations that we're having in that early postpartum visit and then from there, right, I might see you move around. If we're going to do the external gentle check or do the belly check, we will. And then usually what I'm doing is getting you started on early, early gentle movement right, giving you buoys around, returning to exercise, asking you what your exercise goals are, getting you what your exercise goals are, getting you started on some early core strengthening and pelvic floor muscle strengthening work so that you feel like you're kind of on that road for rehab and recovery. Maybe giving you some body weight exercises to do squats, lunges, getting up and off the floors, lunges, getting up and off the floors and aka burpees, you know, whatever it may be, so that you can feel good moving around. Usually in that appointment I am encouraging some amount of early postpartum exercise and again this goes in line with our new exercise, return to exercise and physical activity guidelines showing that getting some movement in that early postpartum period can be so, so, so advantageous for your mental health. I'm not getting you back to CrossFit, though I have some people who do want to get back into the gym at two or three weeks postpartum at a very reduced capacity, because that is their community, that is their tribe. They feel better when they're around those group of people and absolutely I'm going to help facilitate that. But what we know is getting some of that early movement in, even if it's five or 10 minutes movement snacks throughout your day, can definitely help with perinatal mood disorders and that's one of the strongest things that I am advocating for which.
Speaker 1:A lot of people think that I am very hardcore about high intensity exercise. I definitely am and for people who want to get back to that, I'm super on board with it. But I've talked about my own personal journey. Like my mom had really bad postpartum depression. Her mental health was a prominent story and theme in my early childhood and it made me almost not to want to have kiddos. And I knew that exercise was a positive stress resiliency factor for me. It helped me manage stress and so I was going to be exercising early postpartum, even if I did have a little bit more pelvic floor dysfunction, because, seeing my mom's mental health issues throughout my life, I would rather, even if I knew that I was going to have more issues with my pelvic floor, I would choose that exercise because of the mental health piece and not everyone is going to make that decision.
Speaker 1:Thankfully, what we see now right now, you know, go forward six years is that we don't have any evidence that your pelvic floor is going to get worse if you start returning to early movement postpartum, which is great news. We didn't know that when I was early postpartum with my daughter, which is great news. We didn't know that when I was early postpartum with my daughter. But that perinatal mood disorder piece, I think is a really important reason why I'm going to be a very strong advocate for early movement, whatever that early movement looks like for you, especially before that six weeks, and so from there we kind of set up a game plan.
Speaker 1:So you come in, we talk about your birth, we kind of do a debrief, a powwow, talk about how you are doing, how you are feeling mood. I should probably be taking your blood pressure if I don't tell me that I need to, because postpartum preeclampsia is something that could be serious. We want to make sure we're checking for that. We'll do a belly check, can do a functional movement check, see how you're feeling moving around, and or check your vulva to see make sure everything stitches wise, is looking good, if that is something that you want. From there we're going to get you started on an early program, the power of the early appointment or just things that my clients say to me.
Speaker 1:A lot is that that's, being able to have a sounding board of I'm feeling this way, is this normal? I'm feeling like this, should I be feeling like this? And being able to have those conversations is super important. It's super important because, whether this is your first child or your fifth, every postpartum journey can feel different, and knowing it's okay that I feel this way this is a normal sensation can definitely help to bring down the stress and anxiety around navigating a body that feels different than it ever has before, and so if you are on the fence about doing an early postpartum pelvic floor visit and you have the capacity, you have the people nearby I highly encourage you to reach out to your providers. It has definitely been one of the things that has because I'm still in clinical practice. It's definitely made me think a lot about where our research is going in this space and I'm trying to create this bridge between research and practice, and so much of it is in the peace of mind, the qualitative, like how you're feeling and your emotions around those appointments, and so can overall be super, super helpful.
Speaker 1:If you have any other questions about what early postpartum pelvic floor care can look like, let me know. If you have any questions about how you are feeling in the early postpartum period and you do not have access to pelvic floor physiotherapy, please let me know. I would be glad to go through and just ease your mind if that's something that you need, or guide you to a resource. If that is what you need, let me know. Otherwise, I hope you all had a wonderful Mother's Day. I will talk to you all next time and see you soon.
