"What stats are telling us is that 50 percent of women who have been through pregnancy and childbirth have some degree of prolapse. There are many degrees of prolapse—grade 1 through grade 4 is how they're scaled and that can be that the organs are starting to fall a little bit in the pelvis, and in some women we see the organs pushing out of the vagina," says Mundell. "We need to be aware of this, and that's the biggest thing that we're concerned about in the postpartum return to exercise—making sure the organs stay up where we want them to be."
It can be challenging mentally and emotionally to delay a comeback to running, CrossFit and other high-impact exercise during the early postpartum phase when all you want is to get out of the house, release stress, incinerate calories and do something positive for yourself.
Try to look at it this way: Your body morphed dramatically over the course of about 10 months to nurture the development of another human life. Bouncing back to a state that closely resembles your pre-pregnancy self can take just as long—if not a little longer than 10 months. Your body needs a few months to recover from the changes and trauma of delivery, not to mention that you'll be pining for sleep and relaxation after caring for a newborn.
Even if you decide not to take Mundell's cautious approach of waiting six months to resume running after childbirth, invest as much time and energy as you can in strength training—particularly in core and pelvic floor conditioning. It will do you a world of good when you decide you're ready to lace up and head out for a run.
Squat Your Way to a Restored Pelvic Floor
The traditional prescription for strengthening the pelvic floor: Complete 2 to 3 sets of 10 kegels three times a day. But kegels tighten the muscles of the pelvic floor and, according to Katy Bowman, biomechanist, author and director of the Restorative Exercise Institute, pelvic floor weakness results from too much tension, so further tightening those muscles can be counterproductive. Instead, Bowman favors alignment work, hip and calf stretches, and the squat for lengthening the muscles of the pelvic floor and strengthening the glutes. Start with an assisted squat; here's how:
1. Hold on to both sides of a doorknob or pole and extend your arms--this is how far away from the door you should be for the squat. Place a rolled-up towel under your heels to keep the shins in a vertical position.
2. Move your knees back until they're aligned with your ankles to untuck your pelvis.
3. Squat down as far as you can go until your knees feel like they need to move; keep holding on to the doorknob for assistance.
4. Squeeze your glutes as you slowly lower back up to the starting position.
Aim for 5 to 10 squats to start and progress as you get stronger. You want to target your backside, not your quads; this is why untucking the pelvis and keeping the shins in a vertical position is emphasized—it transfers the bulk of the work to your glutes. As you get stronger, let go of the doorknob.