All About Belly Binding Postpartum
And a cheat sheet on how to use A BInder!
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Postpartum belly binding has been in practice for a long period of time and spans many cultures. It is commonly practiced in Thailand, Vietnam, Cambodia, Mexico, Guatemala and among the Hmong, according to this scientific review, to help the abdomen return to its original size and assist with uterine shrinking. And I believe the practice is continuing to grow in popularity in the West. Just look at the number of choices you have for binding if you search ‘postpartum abdominal binders’ on Amazon! My search returned SEVEN pages of products! But which of those hundreds of products is good, and do these things actually do what you want them to? My answer, as always with my articles, is that it depends. But I want to make some clear guidelines to help you choose for yourself (there are definite cases where they benefit OR harm), and you will definitely find that as you read, along with the easy-to-read infographic cheat sheet below.
Other posts you might like:
Postpartum Exercise: The First Six Weeks (with a freebie workout!)
Postpartum Essentials
The Ergonomics of Breastfeeding
It is so wonderful that women are more aware of what products are available to help support them in the postpartum period. And I am surprised it has taken so long for us in the U.S. (I can’t speak for trends in other areas) to catch on to the thought of abdominal binding after birth, especially in regards to cesarean sections. C-sections are major abdominal trauma and surgery, and for many other types of abdominal surgeries men and women are automatically prescribed abdominal binders because it is well known that they are helpful in reducing pain and improving mobility. I still have patients who have planned cesareans, and when I ask them if their doctor plans on prescribing a binder after birth most have come back at their next visit to tell me no, the doc did not plan to do this. What? This makes no sense. Especially when research shows that it can reduce a mom’s need for pain medication (you don’t need to be passing that on to your newborn if there are alternatives to pain management!) and increase her mobility-hello being able to get up and pick up baby! Takeaway: after a cesarean, an abdominal binder is almost always appropriate! If you have a planned c-section, purchase one or two just before birth and bring them to the hospital. Try both on and see which one is more comfortable (this is going to depend on your preference, and how sensitive your incision is, etc.).
Vaginal birth is where abdominal binders get a little tricky. I can tell you that they have been used historically for a long time, and you will probably agree with me and may suggest that they should continue to be used. But this is where we might disagree. Because what hasn’t been used for generations are forceps and vacuums (termed operative vaginal deliveries), or labor inductions, or the many other countless ways childbirth has been medicalized. There are also methods to reduce shoulder dystocia, called McRoberts maneuvers, that involve repositioning baby by hand to help move baby’s shoulders past the pelvic bones. In no way am I arguing against these things, they are often reserved for emergency situations or to prevent such situations. But my point is, abdominal binding is common in areas where, historically, access to these medical interventions has been low. And babies tend to be smaller in developing countries, related to a multitude of factors. A smaller baby is likely going to cause less stress and injury to a pelvic floor than a larger baby.
The Take Away
What, you might be asking, do all of these medical factors have to do with abdominal binding? While most of these birth interventions are directed at the pelvic floor, they damage a component of the abdominal cavity. A healthy abdominal cavity is important for maintaining intraabdominal pressure that is appropriately distributed between the diaphragm, abdominal wall, spinal extensors, and pelvic floor. Injury to ANY COMPONENT changes the dynamics of pressure distribution within the abdominal system. SO, injury to your pelvic floor with birth will disrupt its ability to control the pressure exerted on it with NORMAL activity (ie: walking, picking up baby, etc.). Increasing your intraabdominal pressure with an abdominal binder after an injury to your pelvic floor will not help you heal faster, and may actually delay or prevent complete healing! The biggest factor in interrupted healing is likely the tension placed through the belt, especially as some types can be made to be very tight.
As a quick side note, ladies with cesareans: damage to ANY COMPONENT of the abdominal cavity includes the abdominal wall with a cesarean. Please seek pelvic PT to address your abdominal wall as I see so many women years out from c-sections who have never re-learned to use their abs properly and present with back pain AND/OR prolapse. A cesarean results in lower incidence of prolapse versus vaginal birth, but the risk is still present and menopause is great at ‘leveling the field,’ so to speak! Now back to binders…
In the case of pelvic floor or perineal injury (the perineum is the area between the back wall of the vagina and the front of the anus), it is best to use binding with caution. If you want to try it, see the infographic guide to determine if you might be an appropriate candidate. Then follow the steps outlined below:
HOW TO USE A belly BINDER
Start with a binder that offers adjustable compression or light compression. Wear it for a few hours, noting how you are feeling in the pelvic/perineal area before putting it on. Remember, the goal is not to ‘get your figure back,’ it’s to support your abdomen. Do not tension it like you are getting ready for an evening in shape wear and a form fitting dress!
Check in with your body every few hours. Do you have increased discomfort in your pelvic floor? If so, loosen the belt or take it off. OR Are you feeling increased comfort with movement? If so, leave the belt as is, or you can try tightening it to see if you get more benefit.
If you had success with improved comfort with your abdominal binder, wear during the day for the first few weeks postpartum, taking off for night time to give your body a rest. You should also check in with your body to see how you are feeling without the belt. Is your tolerance to activity improving? Wear the binder during the day up to 4 weeks postpartum.
At around 4 weeks postpartum (or up to 6 weeks) you may start wanting to wean from the binder, dropping your wear time by 10-20% every few days. It is important to try to wean gradually from the binder as it has been supporting you in your tasks for some time, and you don’t want to injure yourself just as soon as you’re starting to feel like your regular self! If you are not improving in your tolerance to tasks without the belt, consider scheduling a consult with a pelvic health physical therapist to determine if there is a root cause you should be addressing that the belt is hiding.
If you did not improve with the binder try again in a few days, especially if you feel like you have a diastasis recti (separation of the abdominal wall). If your tolerance is low or non-existent again, schedule yourself an appointment for a pelvic health PT consult. Your symptoms may be consistent with pelvic organ prolapse, and you will see the most healing in the postpartum period if you learn how to optimize your mechanics and body to allow for healing. To read more about prolapse, see this article.
Belly Binder Options
Choose a few types of binders before birth so that they are ready. There are so many cool options available now. I will list a few below with some of their advantages. The main goal is that they are comfortable for your body while providing support, so maybe you need to scroll through all seven pages on Amazon…just kidding. A comfortable binder will be much easier to use though, no need to have the ‘no pain, no gain’ mentality here. But in the summer, especially, getting a breathable fabric is going to be essential. Also, you will want something that doesn’t interfere with breastfeeding (if that’s the route you’re going), and something that doesn’t make toileting any harder than it already is. Remember, initially you will likely be wearing a large pad for the most epic period of your life. Lochia, as it’s termed, can last up to 6 weeks so make sure your binder accounts for an accessible method to get to your underwear!
Please comment below if you have a belt you loved and want to share, or just have a general comment or question! And don’t forget to share this post on Pinterest or social media if you found it helpful. As always, thank you for reading.