Five days in bed, five on bed, five near bed.
On social media, new mothers are constantly exposed to pictures of women who are back in shape only a few days after the delivery. The images have masked the fact that labor and delivery are very traumatic physiologically and to some extent, the trauma is similar to a major surgery. We focus on health first and foremost at Lin Health Europe Clinic, even if we also do aesthetic work like the Mommy Makeover. We can’t stop at the outside if the inside is not working well after a body.
The 5-5-5 Rule is a very basic and structured recovery plan to help new mothers gradually slow down the pace of their lives. It is not a medication but a very simple method of managing physical activity that has received the endorsement of midwives, doulas, and pelvic floor therapists around the globe. The rule divides the first two weeks of postpartum life into three five-day segments: 5 days in bed, 5 days on bed, and 5 days near bed. Getting under the 5-5-5 rule won’t just make your scar tissue and pelvic floor muscles more susceptible to healing; you will also be less likely to require corrective surgeries for uterine prolapse, severe diastasis recti, or postpartum hemorrhage.
The First 5 Days: In the Bed
This is the recovery phase which must be implemented as soon as possible after the delivery and which is necessary for the prevention of acute complications. The expression “in the bed” means little physical activity, enough rest, and most of the time in a lying-down position. On those days, the placenta has left inside the uterus a wound of about 1 foot in diameter. The more you stand and walk, the more you allow this newly-healed wound to become stretched as it is pulled down by the weight of gravity. Besides the danger of bleeding (lochia) becoming heavy again, you are also postponing the shrinking of the uterus to its pre-pregnant size (involution of the uterus).
From the point of view of hormones, breastfeeding and creating a bond between the mother and the baby are the focus of this period. Oxytocin, also known as the love hormone, is at its highest concentration when the mother is relaxed and physically close to the baby. There are only a few occasions when you can get up. They include going to the toilet, having a quick bath, or eating food that has been brought to you at the bed (someone else), changing the baby’s nappy. The return of the pelvic floor muscles to their pre-pregnancy state, after having been stretched to their limit, is made possible by this time of rest without the downward pressure of the abdominal organs beyond the contraction of the pelvic floor muscles themselves.
The Second 5 Days: On the Bed
By the time you feel the need to move around freely without any pain and discomfort, you would have entered your sixth day and the “on the bed” phase. It means that your presence is no longer aligned with the bed horizontally all the time, but you are still avoiding standing upright for hours. You become aware of the touch of a chair or a sofa more than the bed and at the same time, you get up to nurse, read, or hold your baby. But routine and household management are not your concern.
The attention is now on getting back to a little bit of physical activity without overdoing it. As an illness or injury falls under the three exceptions to the workplace smoking ban, you are neither vacuuming, standing and cooking nor lifting anything that grows heavier every day except the baby. The main concern here is the pelvic floor because it is still delicate. If a woman rushes back to standing and cleaning the house after the delivery, the muscles at the base of her pelvis that form a weakened hammock can sag, giving her a feeling of “heaviness” and even leading to bladder leakage. By sitting “on the bed” or sofa, you are allowing these tissues to regain their tone so that they will be able to support the full weight of your internal organs when it is time for them to do so again.
The Third 5 Days: Near the Bed
Protocol days 11-15 or “near the bed” is a phase where you are allowed to gradually go back to enjoying your vertical world. You are no longer confined to your room and the bed, and you do some short (5-10 min) walks around the house or prepare a simple sandwich, but the distance between you and your bed continues to be short. It is preferable not to use the stairs more than necessary and standing or remaining upright for long periods should be avoided.
To be on the safe side, the “near the bed” rule is required. What it guarantees is that you will be able to lie down immediately if you feel faint all of a sudden or if you experience the gush of bright red blood (the warning sign that you have done too much) or if you feel pelvic pressure. You are on the right track if by the time day 15 rolls around, you have bled much less, have a good milk supply, and are much stronger in terms of core stability than if you had tried to be a “supermom” for the past fortnight.
Preventing Diastasis Recti and Prolapse
A significant number of medical reasons for which we at the Medical Facility advocate for the 5-55 rule is how it helps in avoiding severe Diastasis Recti (“abdominal separation”). Moreover, the narrowing and thinning of the connective tissue (linea alba) that separates your abdominal muscles occurs in pregnancy. If you use your core muscles before they are fully recovered, such as by lifting a toddler, carrying groceries, or sitting up vigorously, you risk permanently increasing the size of this gap.
Natural tension can only be regained by the connective tissue through rest. Likewise, mechanical reasons for Uterine Prolapse (the uterus drops into the vagina) frequently get aggravated by early physical activity. Healing pelvic floor’s enemy is gravity. The more you lie down or get support during the 5-5-5 period, the better you essentially add to the account of future good pelvic health. Patients who have come for a Tummy Tuck treatment later generally allow surgical repairs to the abdominal wall to be done more easily and to last longer if they have given themselves enough time after delivery to rest and heal.
The Long-Term View: Preparation for Surgery
The 5 5 5 step is only a starting point for many women aiming at postpregnancy body recovery. Besides its ability to heal the tissue, resting is not always sufficient to tighten the loosened skin or get rid of the stubborn local fat deposits that don’t respond to diet and exercise. These conditions require a Mommy Makeover. However, we do tell patients not to think about or get cosmetic surgery before 6 to 12 months postpartum at least.
The 5-5-5 rule is all about how to prepare your body and mind for that transformation down the road. Proper early days’ care means that late days’ cosmetic surgery will be done on a healthy patient. General anesthesia and surgery will be well tolerated by a healthy patient. A patient with a chronic prolapse or hernia is a high-risk surgical candidate. Thus, we are not just viewing the 5-5-5 rule as a recuperation method but also as a pre-habilitation strategy because it keeps you structurally safe and if eventually down the line you decide to undergo Cosmetic Surgery in Turkey, we will be shaping a healthy body, not fixing a damaged one.
Frequently Asked Questions About The 5 5 5 Rule Postpartum
The 5 5 5 rule postpartum is not a strict medical regulation but rather a very common recovery guideline by midwives and pelvic therapists to keep the risk of hemorrhage and prolapse at a minimum.
In the first 5 days after the birth, the only reason for walking should be going to the bathroom. After that, during the second 5 days, you can make slightly longer movements, and in the last phase, you may take short 5 to 10 minute walks.
Definitely. Since both stress and physical exhaustion can lead to less milk production, solid sleep and regular skin-to-skin contact during those days facilitate a strong breastfeeding connection between the mother and the baby.
Resting horizontally significantly lowers the pressure exerted by gravity on the weakened muscles of the pelvic floor, which results in a decreased likelihood of the uterus or the bladder prolapsing into the vagina.
Ideally, you should not. To help the full healing of your internal wounds and the separation of your abdominal muscles, you should stay away from lifting, vacuuming, and standing for long periods during the 15 days after the birth.
Romero-Morales, C., et al. (2021). Current concepts in postpartum pelvic floor anatomy and physiology. Journal of Clinical Medicine.
Memon, H. U., & Handa, V. L. (2013). Vaginal childbirth and pelvic floor disorders. Women’s Health.
Abenhaim, H. A., et al. (2011). Incidence and risk factors of postpartum hemorrhage in developed countries. American Journal of Obstetrics and Gynecology.
