The French Postpartum Exercise Routine (reéducation)

The French are darn good at having kids, and they have a lot of them. I asked a coworker why every woman I met seemed to have at least 3 or 4 kids and she winked and giggled, saying that “the French like romanticism.” Did I mention these women all look fantastic? Seriously the pounds seemed to melt off postpartum as effortlessly as breathing. Like any good expat who shows up in another country to have a kid — I kept asking, what is their secret? And as I was soon to find out, breathing it off wasn’t far from the truth.

One of the big tenets of French obstetric care is specialized postpartum rehabilitation that is covered by insurance for every single mother. Ten visits with a kiné (physical therapist) to literally reeducate your perineum and abdomen (reeducation perinee and abdominale). Rumor has it that this tradition began after the first world war to help French women quickly repopulate the country. The joke is that it sticks around so women can quickly continue to be intimate with their husbands (before he gets a mistress!). And like every French exercise program, it can be done sans workout clothes or a gym membership (see here for other French exercise strategies). I can personally vouch for the fact that four months after my second child I am better recovered than one year after my first. Inspired by my experience with the French system, I’m posting a sample postpartum schedule and workout plan that non-French mamas can do at home.

Postpartum schedule for every mama

Immediately postpartum: REST! French hospitals can keep Moms for 3-6 (yes, 6!) days postpartum (and possibly more if birth was a bit complicated). This means that aside from the occasional walk through a maternity ward women are resting postpartum. Husbands are not allowed to spend the night, nor are other children. Moms focus on their newborns and themselves.

After discharge and up until the first postpartum visit at 4-8 weeks: Light gentle activity such as walking, household chores, and gentle yoga are allowed. After being cleared by her gynecologist a mom is given a prescription for physical therapy. Over the next few weeks she will have 10 x 30 minute visits to “reeducate” her perineum and abdominal muscles. What is pleasantly surprising is that no hardcore fitness efforts are required – you won’t even break a sweat. But you will notice your body parts starting to move back to where they used to be. At four months after my second birth, my body looks better than it did 12 months after my first. In addition to physical therapy, once you are cleared by the gynecologist activities like walking, swimming, yoga, and bicycling are encouraged. But no running until at least 5 months postpartum, due to those pesky hormones that are still loosening joints in your body!

Like everything French these physical activity recommendations are expected to be accompanied by good eating habits.  See these articles for more information:

  1. French advice for eating well during pregnancy (concepts apply for postpartum period and when breastfeeding)
  2. General French dietary guidelines

Postpartum exercise regimen (each session is 15-30 minutes, to be done after being cleared by a gynecologist for activity)

Sessions 1-3:

  • Kegels and kegels and more kegels.
  • The key is spicing it up (as much as kegels can be spiced)!
    • Start with 1 second kegels (contract your perineal muscles for one second, release for one second)
    • Work up to 5 second kegels
    • At the end of the 3rd session, end with deep breathing exercises. Inspire deeply, expanding your belly as much as you can, exhale gently, and then actively push out as much air as you can. This extra push activates deep abdominal muscles that you didn’t know existed, but support your organs.

Sessions 4 – 8: These sessions are focused on both abdominal work and perineal work.

  • Continue kegels, even going up to 10 second kegels
  • Continue deep breathing exercises. Once your perineum feels stronger you can do combination exercises
  • Lay on your back with your hands on your belly. Breathe deeply into your belly, feeling your belly expand. Contact your perineum (a kegel) and breathe out, pushing out extra air. Then suck in your abdominal muscles and contract your perineum even stronger. Release.
    • At first it will feel awkward and difficult to coordinate your muscle movements but keep practicing, and try to make these movements fluid. That actually works out your muscles more effectively than jerky movements.

Sessions 9 and 10: Boosting the abdominal workout. Once you feel comfortable with the combo exercises in the last session you can add extra little challenges.

  • Do the combos in tabletop position (on your hands and knees). Focus on keeping your shoulders relaxed.
  • Lie on your back and raise your legs, optimally rest your calves on a stability ball or cushions. Using your hands, push into your arms every time you do a kegel and suck in your abdominal muscles.

 

Bonne chance! I hope you find this routine doable and helpful.  Would love to hear your thoughts *  *  *

References

  1. http://healthland.time.com/2012/02/22/why-france-pays-for-postpartum-women-to-re-educate-their-vagina/
  2. https://www.theguardian.com/lifeandstyle/2009/mar/26/france-postnatal-care-sexual-health

 

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