C-section recovery advice is often pretty rubbish. It just amazes me that my clients get given a couple of token exercises and then are told
- don’t lift anything for 6 weeks (ummm…what about my baby?)
- don’t drive for 4-6 weeks
- after 6 weeks, just “gradually get back into doing what you did before”
Now, as someone who has worked with literally hundreds of new mums, I get that it is difficult to give more specific guidelines. Some women find that they have minimal pain after a c-section and are up and about quite quickly. Others have a lot of pain and find that their day-to-day activities are a real struggle. There is no one answer.
But I reckon we can do better.
Let’s just think a little bit about tissue recovery first.
So let’s go through the first 6 weeks
But first, let’s just take into account the actual surgery itself. We’ve got some superficial skin cuts to heal, but also the deeper layers of the abdominal wall. The linea alba (the connective tissue between your 6-pack muscles) is separated, but often not stitched back together. Now mother nature does do a wonderful job at scarring this tissue back up again, but I’m fairly certain that that tissue isn’t back to normal strength by 6 weeks!
In these early stages we want:
- lots of rest. I don’t want to get all preachy here ladies, but you’ve GOT to rest in the early weeks wherever possible. Listen to your body and don’t feel guilty about lying down and putting your feet up (literally!). Pregnancy, labour (some will labour prior to having c-section), surgery, general anaesthetic, sleep deprivation, feeding your baby, hormones ….woah, that is a LOT for someone to go through. So please please please…give yourself the time and space to rest and heal. I find that women actually recover FASTER by starting out SLOWER!
- optimal breathing patterns. I find that many women have altered breathing patterns postnatally (well – at any stage of life, but definitely postnatally!). I do think part of this is due to the changes that occur during pregnancy – the rib cage lifts and separates, and the diaphragm is pushed up by the baby, placenta, extra fluid etc! After birth, it can take a little while for the rib cage to settle back down again. Also, postnatally many new mums like to suck their tummies in! Yes, yes I get it – we all look a little pregnant after giving birth and the temptation is to pull your belly in. But you’ve gotta let it go, mamas! Tensing your abdominal wall makes it very difficult to breathe naturally and may put more pressure down through the pelvic floor. Discomfort after abdominal surgery can also make people nervous about taking deep breaths, but these are super important for our lungs and should definitely be encouraged! So try taking different types of breaths – feel your tummy move, feel your rib cage move, take shallow breaths and take deeper breaths. Try them all!
- some effort on posture. Now I don’t mean “sit up straight and pull your shoulders back”. Those that know me know that I am not rigid when it comes to posture. I believe that there are many different variations of posture that are suitable and I don’t prescribe to there being a “perfect posture”. However… post abdominal surgery, the temptation can be to curl up into a ball on the couch in an effort to “protect” the scar. Grow tall through your spine when you are sitting and standing. Change postures frequently. Slumping from time to time is a-okay! Just don’t do in 24/7!
- some pelvic floor muscle activation. I can hear you thinking, “but I didn’t have a vaginal delivery!” But guess what? You’ve had the weight of the baby sitting on your pelvic floor for 9 months. New mums also have to contend with a pretty physical new role in life – lifting and carrying for the new few years! We need and want good pelvic floor muscle control. In the early few weeks you can try and get some connection happening between your brain and the pelvic floor muscles and work on the endurance of these muscles. Please note that many women have pelvic floor muscles that are too active though, so if you can’t feel a difference between “on” and “off” then go see your friendly Women’s Health Physio!
- to start some gentle walking…as able. Many women will find that ten minutes is the maximum that they can handle in one bout when they first start walking. Start with a small walk in your neighbourhood and then gradually increase this as your energy allows. You may find it easier to do two lots of short walks rather than a long walk. If you can get out and about sometimes without your pram, that is a bonus. Get the arm swing happening and feel that beautiful rotation through your spine as you walk.
- look after your bowels. It is really important that you avoid constipation and adopt good pooping habits early on. Have you seen the Squatty Potty unicorn video? Get yourself a stool (I use the ikea kids stool) to get those knees up high. Make sure that you stay well hydrated (esp if you are breastfeeding). If your poop starts to get hard and cracked, go see your doctor or pharmacist for advice. Do NOT strain to empty your bowels!
- get moving…gently! Our bodies like to move, so adding some basic movements and stretches will probably make you feel better. This might mean some pelvic tilts and shoulder rolls when you’re sitting down. It might be some of your pregnancy pilates/yoga stretches in standing. Try moving your body gently in all directions and see how you feel.
Once you crack that six week mark, then yes you are probably more likely to be ready for a structured exercise program. But this doesn’t mean that you are ready to jump straight back into boot camp or running!
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