Cesarean section is the most common major surgery for women in the US, accounting for around 1 in 3 births. But the fact that it happens frequently, shouldn’t downplay the physiological trauma your body has undergone. C-section is major invasive surgery requiring significant recovery. Giving birth, however we do it, is a huge achievement. Exercising after c-section needs to be appropriate and progressed gradually.
So you had your baby by cesarean (c-section)… what happened in there?
The surgeon makes a horizontal incision just above the pubic bone, to gain access through layers of skin, tissue, and muscle:
- Skin
- Fat
- Fascia, a tough, thin layer that supports the muscle
- The abdominal muscles are manually separated down the vertical midline using fingers
- Peritoneum, a shiny layer that encases the entire abdominal cavity is cut with a vertical incision
- The bladder is moved out of the way…
- … to reach the uterus, the amniotic sac, and your baby!
Note that the surgeon manually separates the two strips of rectus muscle (that’s the rectus abdominis, or your ‘six pack muscle) at the midline to gain access. This is important – your muscles have not necessarily been cut!
Exercising after C-section – first understand what happened in there
Layers of tissue have been cut, and then sewn back together, which creates scarring through multiple levels of tissue of your abdominal wall. This scarring affects the muscles’ ability to glide over the top of each as the muscles contract and move. The result is weakness and a lack of stabilisation.
Many factors affect your ability to recover including nutrition, hormone balance, body weight, age, posture, and muscle strength. If you have had more than one caesarean section, or quite short gaps between surgeries, then your abdomen may not have repaired completely before you went through the whole process of pregnancy and surgery again.
If you are able to start the recovery process with an already strong and functional core, this will give you some ‘muscle memory’ to make exercise after caesarean a little easier.
BUT if you’re reading this and your tummy muscles can’t remember last Wednesday, let alone how to work, don’t worry. Read on my Love, we’ve got your covered.
Exercising after C Section: first find the muscles
Feel ready for exercising after C Section? This is the most vital, effective stage of exercise – and you can do it from your bed at first. So start as soon as you can. This is literally breathing and re-connecting, to find the right muscles. You can’t even begin to strengthen what you’ve temporarily lost all connection with. And the sooner you do this after any type of birth, the better.
You can be sitting or lying in bed when you do this. As you recover and can move around a little more easily, kneel on a mat with a cushion or pillow between your knees, or sit on a block or a book with your back against a wall.
- Get comfortable and take a couple of deep breaths to settle. Drop your shoulders. Drop your ribs.
- Inhale and let your abdominal muscles and pelvic floor fully relax. Just let everything release as much as you can and breathe in
- Exhale slowly as you lift and gently squeeze your pelvic floor. To find the right muscles, imagine you’re trying really hard not to fart. Or that you’re drawing a super-plus tampon up inside you
- Breathe in again and fully relax. Don’t push away or down, just let it all go as you inhale
- Repeat the exhale and pelvic floor lift. None of these movements are at all forceful, just gentle breathing exercises to reconnect your breath to your core
You may feel your abdominal muscles drawing in or tensing slightly as you engage your pelvic floor. This is good! The system is all connected and this tells you it is working. But don’t worry if you feel nothing at all in your abs for now. Some numbness and lack of sensation after a caesarean is normal. The more consistently and regularly you can follow all these strategies, the more you will encourage your abs back to life.
Repeat for 5 or 6 breaths. Do it again later that day if you can remember.
Pelvic floor and abs together for exercising after C-section
The above breathing exercise teaches your body to reconnect and engage your core. It’s the first stage for exercising after c-section.
Your Core consists of:
- The Transverse Abdominis muscle (your deepest abdominal muscle)
- The Multifidus muscles of your spine
- Your diaphragm (separates your lungs and the organs in your chest cavity from your stomach, and facilitates breathing)
- Your Pelvic floor
…and the whole system works together. So even though you can’t feel much happening in your abdominal muscles right now, by focussing on your pelvic floor muscles for the moment, you know you’re still working your deep core. Clever.
You will need your core to function optimally to help narrow a diastasis recti gap (separation of your abdominal muscles). And because your core includes your pelvic floor, you will also need it to prevent you from wetting yourself or developing a prolapse, as well as to enjoy better orgasms and comfortable sex. You need it to be strong when you lift your baby, when you swing that car seat on your arm, as you kick the car door shut. All The Mom Things.
So hopefully we’ve established your whole core is important. Try the above breathing exercises as soon as you can and as often as you can to prepare for more activity and exercise as you recover. Re-connection is the vital link so often missed in postnatal exercise and return to exercising after c-section (cesarean birth). It’s where MUTU System starts and it why it works, so don’t miss it!
Moving around
Practice these breathing and muscle engaging exercises as you rest and recover, and as you feed your baby. Take long slow breaths, exhaling with gentle muscle contractions, inhaling with a complete release and relaxation.
Remember to always roll to your side first as you get up from lying on your back, don’t sit straight up. And totally avoid sit-ups or crunches…
Go for a walk outside as soon as you feel able, and try to make this a daily activity. Walking and fresh air will help your emotional health, as well as increase circulation to aid healing and scar tissue.
Scar tissue
After a C Section, you are likely to have some scar tissue or adhesions. This is where the connective tissue (collagen) is laying down and binding to repair and heal. You may feel an uncomfortable tightness or pulling sensation as this happens. Rub and massage the skin around the scar very gently between your fingers to help break down scar tissue. This aids healing and comfort, by encouraging oxygen flow in, and toxin flow out of, the area.
‘Connecting’ and using your deep core muscles with breathing exercises will help your recovery, along with daily walking to encourage circulation and healing.
Diet and nutrition after C Section
The food you eat is massively important for your body’s ability to heal after c-section. Try to eat a diet rich in clean protein, with plenty of green and deep coloured vegetables, berries, essential fats and fibrous vegetables and fruits for good gut health. Include anti-inflammatory foods such as garlic, green tea, turmeric and ginger.
Good hydration is vital. Drink lots of water, herbal teas and water-rich foods.
Stress, lack of sleep (I know.. unavoidable for new mums!) and inflammatory ‘comfort’ foods or drink like sugar or alcohol will slow healing. So really, really try to…
…rest!
In the early days, massage, mobilize, find and strengthen your deep muscles, eat clean fresh food to recover and nourish your body. But most important of all, relax, insist people rub your feet and bring you tea, get as much sleep as you possibly can and love your body. It’s achieved something amazing.
If you have just started exercising after C Section, please comment below and let us, and other MUTU Mamas, know how you are getting on.
