Fit After Cesarean

 

Fact : One in four babies born in the United States are born cesarean section. (That’s about 1 million deliveries per year)

Cesareans have been part of human culture since ancient times. According to Greek mythology Apollo removed Asclepius, from his mother’s abdomen.  The term is commonly believed to be derived from birth of Julius Caesar. Roman law under Caesar decreed that all women who might die in childbirth must be cut open; hence, cesarean.  No matter the origin, the fact is that cesareans account for nearly 30% of births in the United States.

Cesarean birth is the birth of a baby through surgical incisions (cuts) made in the abdomen and uterus.

There are multiple possible reasons for Cesarean including:

  • ·       Multiple Birth
  • ·       Failure to progress
  • ·       Concern for baby
  • ·       Problems with placenta
  • ·       Previous cesareans

After delivery, you can expect the hospital stay to be anywhere from two to four days. It takes a few weeks to heal abdomen. It’s not uncommon to feel:

  • ·       Mild cramping
  • ·       Bleeding or discharge for 4 – 6 weeks
  • ·       Bleeding with clots / cramps
  • ·       Pain at incision

To get more comfortable, do your best to walk soon after delivery, even if just across the room (get the ok from your medical team at the hospital). The more often you do, the easier it will be. Some moms feel comfort if they splint the incision. Avoid leaning forward. Do your best to stand tall. You will want to learn to log roll so that you can get up with minimal discomfort.

A cesarean is major abdominal surgery. You will need support when you go home. Make sure to get adequate rest.  Eat nutritious, high fiber foods. Drink lots of water. Don’t lift anything heavier than baby.

This set of exercises can be done immediately so long as there is no pain or discomfort. Take baby steps – go slow!

1 )Huffing  - Exercise to clear lungs if general anesthesia was used. Helps clear mucus from throat and lungs. Huffing will help improve transverse abdominal muscles. You take quick, forceful outward breaths while bringing abdominals and pelvic floor muscles up and in. This is different than coughing and less painful.

2) Kegels  - These are designed to strengthen pelvic floor muscles. These muscles are weakened by pregnancy and birth process even if cesarean. Start gently.
• Squeeze the pelvic floor muscle for three seconds, relax the muscle for three seconds, then squeeze again.
• Begin with 10 three-second squeezes, three times a day. Increase repetitions gradually.
• Work up to doing 50-100 Kegels each day.

*Note: Do not do all of the kegels in one session, as these muscles fatigue quickly. Each week, reassess your holding time and increase your hold until you are able to perform a 10 second hold.

3) Diaphragmatic Breathing

Diaphragmatic breathing  is essentially abdominal tightening on outward breath.  Lying on your back, place your hands over your abdomen. Inhale and allow your belly to rise as it fills with air. Exhale through your mouth as you tighten your abs, pulling them in towards your spine. Your stomach should flatten, not bulge, as you exhale.

3) Pelvic Tilt

While it may seem basic, this simple exercise can be quite difficult if you have lost strength in your core. Lie on back, knees bent, feet flat on floor. Exhale, engage abs and tilt pelvic upward, flattening small of back. Return to neutral and repeat.

4) Ankle Circles                  

While this exercise won’t help you get your pre-pregnancy body back, it is important to prevent thrombosis. Ankle circles increase circulation and prevents swelling. Do 10 circles on each foot, 3-5 times.

5) Leg Slide

Lie on back with knees bent. Engage abdominal wall.  Slide one leg out away from body. Slide back and repeat. Do 10 leg slides on each side, 3-5 times.

While you may be eager to get back to traditional exercise, it’s important to take it slow. Most doctors will recommend you wait 6 – 8 weeks for traditional exercise. They are waiting for the uterus to resume to normal size and for your incision to heal. When the time comes, progress slowly.

Lisa Druxman is the founder of Fit4Mom (formally Strollerstrides), and one of our original PAM Advisers.

*** Lisa is an exercise specialist, especially for prenatal and postpartum.  However, none of us at PAM are medical experts, so please always use your common sense, and consult with your medical provider before initiating any exercise program.  As well as in the event you encounter some pain or discomfort once you start that exercise program.

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