POSTNATAL EXERCISES

DEFINITION:

A series of physical exercises that are performed by the postnatal mothers to bring about optimal
functioning of all systems and prevent complications.

PURPOSES:

To improve the tone of muscles which are stretched during pregnancy and labor specially the
abdominal and perineal muscles.
To educate about correct posture and body mechanics.
To minimize the risk of puerperal venous thrombosis by promoting circulation and preventing
venous thrombosis by promoting circulation and preventing venous stasis.
To prevent backache.
To prevent genital prolapse.
To prevent stress incontinence of urine.

PROCEDURE:

Teach exercises in the early postpartum period to strengthen the abdominal muscles and firm the waist.
The exercise can be started soon after childbirth and repeated up to five times twice a day, at first. The
number of exercise is gradually increased as the mother gains strength.

Sl.No. NURSING ACTION RATIONALE

1. Explain the procedure to patient. Minimizes anxiety and facilitates
patient and cooperation.
2. Provide privacy
Abdominal exercises
Breathings :
Instruct the woman to assume a supine position
with knees bent.
Instruct her to inhale through the nose, keep the rib Strengthen the diaphragm.
cage as stationary as possible and allow the
abdomen to expand and then contract the
abdominal muscles as she exhales slowly through
the mouth.
Instruct her to place one hand on the chest and one Ensures that the exercises are
on the abdomen when inhaling. The hand on the being done correctly and
abdomen should rise and the hand on the chest ensures adequate intake of air
should remain stationary. while inhaling.
Repeat the exercise five times.
Head lift:
This exercise can be started within a few days after
 childbirth.
Instruct the mother to lie supine with knees bent Strengthen abdominal muscles.
and arms out stretched at her side.
Instruct her to inhale deeply at first and then exhale
while lifting the head slowly, to holds the position
for few seconds and relax.
Head and shoulder raising:
Lie flat without pillow and raise head until the chin
touches the chest.
Raise both head and shoulder off the bed and lower
them slowly.
Gradually increase the number of repetitions until
she is able to do this for 10 times.
Leg raising:
Lie down on the floor with no pillows under the
head, point toe and slowly raise one leg keeping the
knee straight.
Lower the leg slowly.
Gradually increase to ten times each leg.
Pelvic tilting or rocking: Tightens abdominal muscles and
Lie flat on the floor with knees bent and feet flat, muscles of the buttocks.
inhale and while exhaling flatten the back hard
against the floor so that there is no space between
the back and the floor.
Inhale normally holds breath for up to 10 seconds
and then relaxes.
Repeat up to 10 times.
Knees and leg rolling:
Instruct woman to: lie flat on her back with knees
bent flat on the floor or bed.
Keep the shoulder and feet stationary and roll the
knees to side to touch first one side of the bed, then
the other.
Maintain a smooth motion as the exercise is
repeated five times.
Later, as flexibility increases, the exercise can be This exercise will strengthen the
varied by the rolling of one knee only (the mother oblique abdominal muscles.
rolls her left knee to touch the right side of the bed,
returns to center and rolls the right knee to touch
the left side of the bed).
Hip hitching:
Lie on her back with one knee bend and the other
knee straight.
Slide the heel of the straight leg downwards, thus
lengthening the leg. This is an easy exercise will
Shorten the same leg by drawing the hip up towards strengthen the deep transverse
the ribs on the same side. muscles which are the main
 Repeat 10 times keeping the abdomen pulled in. support for the spine and play a
Change to the opposite side and repeat. large part in prevention of long
Abdominal tightening: term back problems.
Sit comfortably or kneel on all fours.
Break in and out, and then pull in the lower part of
the abdomen below the umbilicus while continuing
to breathe normally.
Hold for up to 10 seconds.
Repeat up to 10 times.
3. CIRCULATORY EXERCISES:
Foot and leg exercises:
Sit or half lie with the legs supported. This exercise must be performed
Bend and stretch the ankles at least 12 times. very frequently in the
Circle both feet and the ankles at least 20 times in immediate post natal period to
each direction. improve circulation, to reduce
Brace both feet, knees; hold for a count of four, and edema and to prevent deep vein
then relax. thrombosis.
Repeat 12 times.
4. PELVIC FLOOR EXERCISES(kegel exercise):
Sit, stand or half-lie with legs slightly apart, close This exercise helps to regain full
and draw up around the anal passage as though bladder control, prevents
preventing a bowel action, then repeat for front uterine prolapse and ensures
passages (vagina and urethra) as if to stop the flow normal sexual satisfaction in
of urine in mid-stream. future.
Hold the contraction for 10 seconds (to a count of
six).
This is repeated up to 10 times.
Continue to do this exercise for 2 to 3 months.
After three months if the mother is able to cough
deeply with a full bladder without leaking urine, she
may stop the exercise.
If leaking occurs, she may continue the exercise for
the rest of her life.

5. CHEST EXERCISES:
Lie flat with arms extended straight out to the side;
bring both hands together above the chest while
keeping the arms straight, hold for a few seconds
and return to the starting position.
Repeat the exercise five times initially and follow the
advice of health care provider for increasing the
number of repetitions.
Instruct the mother to bend her elbows, clasp her This exercise increases strength
hands together above her chest, and press her and tone of the chest muscles.
hands together for a few seconds. Repeat this at
least 5 times.