When trying to return to exercise after giving birth, it is important to take into account various factors. Every birth is different, so it is important to evaluate your individual needs. In this context, we will examine which exercises can help with recovery and which should be avoided for the time being.

Cesarean Delivery

The rate of cesarean section deliveries, also known as C-sections, has been rising globally since the 1990s. In 2018, 21% of all births were via C-section, as reported by data from 169 countries. In North America, over 30% of all births are C-sections. Although C-sections are common, they are still considered a major surgery and require proper recovery time. Similar to other surgeries, it takes several weeks for recovery after a C-section. Physical activity should be avoided for a longer period of time after a C-section than a vaginal delivery. It is also important not to push yourself too hard in order to avoid complications and prolonging recovery.

When is it safe to exercise after cesarean delivery?

It is recommended to wait at least six weeks after a cesarean delivery and after visiting a healthcare provider before starting any post-pregnancy exercise regimen. Even if the delivery was smooth, it is important to be cautious about exercise after childbirth and cesarean deliveries as it can be traumatic to the body and cause problems if overexerted. Prior to the 4-6 week postnatal check-up, low-impact activities such as walking can be done. Once getting the green light from the healthcare provider, a regular workout routine can be slowly resumed over a few weeks or months. Keep in mind that postnatal exercise after a C-section may be different from pre-pregnancy exercise regimen, but that is okay.

Some light exercises

For the first six weeks after a cesarean delivery, high-impact exercises, tummy-toning workouts, and intense cardio should be avoided. Instead, the following can be done:

• Walking: as soon as you are able to move around, taking a walk around the block can be beneficial.
• Pelvic floor exercises: Kegel exercises can be resumed as soon as the catheter is removed, to strengthen the pelvic floor muscles that support the bladder, bowel, and uterus.
• Good posture: pregnancy, c-section, and breastfeeding can affect posture, so practicing good posture by sitting up straight with shoulders back can help strengthen stomach muscles and support the back.
• Light stretches: focusing on stretching the neck, shoulders, arms and legs, without putting pressure on the c-section scar.

Pelvic floor exercises

After a cesarean delivery, engaging the pelvic floor muscles is crucial. Pregnancy puts a lot of pressure on these muscles, which support the bladder, bowels, and uterus. During surgery, the bladder is moved, causing trauma to these organs and muscles, so it is important to focus on strengthening them. Here are some exercises to target the pelvic floor muscles:

• Kegel exercises - To perform these exercises, contract the same muscles used to stop urination midstream, hold for 5 seconds, release, and repeat 10 times a few times a day.
• Squats - Stand with feet slightly wider than shoulder-width apart, bend knees and squat down with hips pushed back, hold the position with weight in heels, then straighten legs and repeat 15-20 times.
• Bridge - Lie on back on an exercise mat, with knees bent at a 90-degree angle and feet planted firmly on the floor, push through heels and raise hips off the floor, squeezing the gluteus muscles and engaging the pelvic floor muscles. Hold for a few seconds, then release, repeat 10-15 times, then rest for one minute and perform another set of 10-15.

Exercises to strengthen your back

Pregnancy and delivery can cause strain on the back, and the hormone relaxin, which is present during pregnancy, causes the ligaments in the lower back and pelvis to relax, soften and shift in preparation for childbirth. Whether the delivery was vaginal or not, the body is affected by this hormone. To protect and strengthen the lower back after pregnancy, it is recommended to:

Avoid lifting heavy objects and weight-bearing exercises for some time after delivery.

Focus on strengthening the core and pelvic floor muscles to better support the back.

Pay attention to posture by sitting straight with shoulders back.

Avoid sleeping on the back and instead, lie on the side with a pillow between the knees to maintain a neutral position in the spine.

Do exercises such as pelvic tilt, bridge, and lower back twist. To do the lower back twist, lie on the back on a mat with knees bent at a 90-degree angle, feet planted flat on the floor, and extend arms out to the sides. Lower knees to one side until they are stacked on the floor, keeping shoulders on the floor and hold for 30 seconds, return to the starting position and repeat on the other side.

Cardio exercises

To reduce belly size after pregnancy, cardio exercises are important to include in a post-pregnancy exercise regimen. For the first four to six months after a cesarean delivery, low-impact cardio workouts should be the starting point such as walking, swimming, water aerobics, cycling, and elliptical training. As fitness level improves, the intensity of workouts can be gradually increased.

Compression garments

Using compression garments can aid in protecting the C-section scar as it heals. These garments come in various forms such as tights, shorts, and corsets, and provide pressure that supports the stomach muscles, lower back and improves blood flow during the healing process after surgery. These garments are not intended to shape or slim the body, but have a medical purpose. Compression stockings can also be worn during pregnancy to prevent or slow the development of varicose veins.

What is the importance of postnatal exercises?

Postnatal exercises are an essential part of recovery after childbirth. When done correctly, they support and strengthen muscles and bones, speed up healing process, boost energy, and benefit mental health. Exercise can combat feelings of postpartum blues and depression by promoting better sleep. It is important to start slowly and not to push yourself too hard as overexertion after cesarean delivery can lead to complications such as wound infection or injury.

Exercises to avoid after C-section

Your body needs a few months to heal after a C-section delivery before reintroducing high-impact activities and certain abdominal exercises. To protect your body it's best to avoid the following workouts for a few months:

• Abdominal-strengthening exercises that cause the stomach to bulge out, such as sit-ups, crunches, as well as exercises that put a lot of stress on the abdominal wall, such as front planks, leg raises, and bicycles.
• Exercises that involve jumping such as jumping rope, squat thrusts, jumping jacks, and plyometric exercises.
• Sprinting or running
• Strenuous exercise classes such as body sculpting, Zumba, kickboxing, etc.
• Any exercise that pulls at or puts pressure on your C-section scar
• Any exercise that causes pain
• It's best to focus on no-impact and low-impact workouts for the first few months after a C-section delivery. If unsure about the intensity of an exercise, it's best to avoid it.

The takeaway

It is important to engage in postpartum exercise for both physical and mental well-being, however, it is even more crucial to ensure proper healing before starting a post-pregnancy exercise regimen. If experiencing pain on or around the c-section scar while walking, consult with a healthcare provider before beginning any exercise routine. It is recommended to hold off on exercising until the healthcare provider confirms it is safe to do so.