How to Exercise While Recovering From Caesarean Birth

As both a postnatal fitness instructor and a birth doula, I've seen firsthand what is involved in a cesarean birth and how women have successfully recovered their bodies afterwards. I'd like to share some simple techniques that I teach my clients, since many women are under the impression that no exercise of any kind is appropriate for months after cesarean surgery, which is untrue.

If you've had a cesarean birth or know of a woman who has (that is most of us, since the c-section rate is between 30-35% in the Bay Area by some estimates), please pass this on:
- The Cesarean section operation is major abdominal surgery, so you may feel pain, soreness, gas pains, bladder issues, difficulty moving or sitting up, or a pulling sensation on your belly, so take care not to overdo anything.

While it may seem contradictory, gentle but frequent MOVEMENT is actually one of best recovery tricks you can do for your body, as it reduces swelling in the incision and gets the blood flowing to all your body parts. Remember to "RICE" - Rest, Ice, Compress, and Elevate.

The exercises:
1. Deliberately and loudly - COUGH at least 10 x an hour, pulling your belly button into your spine as if you are a mama kangaroo trying to hold in her baby 'roo - this will help heal your transverse abdominals, the deepest and lowest part of your tummy - the part that was pulled aside when they made the incision

2. Pull your belly to spine and squeeze your pelvic floor UP to your belly as you say "HUP HUP HUP HUP HUP HUP HUP HUP HUP HUP" (10 HUPS) loudly. Again, 10 HUPS x an hour.

3. Imagine the face of a clock extending out from the center of your bellybutton, with the 12'o clock towards your pubic bone, and the 3'o clock at your right hip, the 6'o clock at your breast bone, and the 9'o clock at your left hip. Pull your belly up and in to the center as you imagine starting the movement from each hour on the clock, working the entire abdominal area literally around the clock!

4. Getting out of bed - make sure you plant both feet firmly on the bed with knees and heels together, then roll gently to one side and come up to a bent elbow as you push yourself with your arm strength to a side sitting position, then legs roll over the side and sit up on the bed.

5. When your scar tissue is healing well (between 8-12 days after surgery) AND your sutures or staples have dissolved or been removed, you can begin to do some gentle self-scar massage OR hire an experienced postnatal massage therapist who can provide scar tissue massage and cesarean healing massage for you, and teach you and your partner how to do it for you. You should perform scar massage DAILY, at least 3-5 times per day for at least 15 minutes in the first three months (yes this is a lot, but believe me it works and you will be grateful you did a year later!). Your scar will start to flatten out instead of feeling like a raised bumpy line across your belly, and if performed successfully after several months you will no longer be able to FEEL your cesarean scar, you may only see it.

Lastly, if you are re-joining a regular fitness program or starting one up for the first time and you have had a cesarean birth, be sure to let your fitness instructor know, and get medical clearance from your provider no sooner than EIGHT WEEKS after the birth (usually six weeks for vaginal births), and begin at a very light intensity level. Pilates-based exercises are the absolute BEST at helping you recover your abdominal strength and shape, so join a class that includes those exercises.

If you'd like to contact me with any specific questions about this topic or any others regarding pre- and postnatal fitness or recovery, feel free to email me at!

Great cesarean recovery exercises we can all use

Thanks for the exercises Denise! I've just tried them and wish I had done them after the births of both of my boys (I didn't have a cesarean but I was surprised by the pain and extended recovery). It's going to take me some time to feel like I'm really doing the clock one but I like the imagery. Thank you for also mentioning the need to massage scars. I've had to do it in the past and once I got over the initial queasiness about touching the scar, the massage really helped. Our oldest has a bump on his nose from a late night tumble into a table and I just went into his room to massage it. I've been trying to do it when I put sunscreen on but you've reminded me that I need to do it more frequently.

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