It’s C-Section Awareness Month and one of the most common questions we get from our audience is: are these exercises safe if I’ve had a C-section?
It’s an important question to ask. All of the postpartum routines on the Baby2Body app are designed to support your recovery and ease you back into exercise after childbirth, whether that is following vaginal or Caesarean birth. However, a critical thing to keep in mind is that before starting back up with our full exercise routines, you do need to have full exercise clearance from your doctor. Exercise clearance can vary widely from woman to woman and is based on a lot of different factors, so before we dig into what you need to know about exercise after C-section, we want to talk about exercise clearance after birth and what that recovery period entails.
When will you get exercise clearance?
There isn’t a one-size-fits-all answer. The recovery period and return to exercise are unique to every woman’s body, her preferences, and her birth experience. Six weeks after birth is when most women receive exercise clearance, but that’s because your 6-week checkup is usually the first scheduled appointment after childbirth to check in on your physical and emotional health. But in truth, there is nothing sacred about that 6-week mark when it comes to exercise. In fact, ACOG recommends that postpartum care be an ongoing process rather than only a single visit after your delivery to get exercise clearance. If possible, the ideal recommendation is to meet with your healthcare provider within the first 3 weeks after delivery and then again between 6-12 weeks after delivery for a comprehensive postpartum evaluation.
Beyond that, your own personal readiness for exercise can vary. Some women may get exercise clearance at their 6-week checkup and not feel remotely ready to take on a full workout. Others may be scanning for gentle exercises after a week at home. A recent article published in the New York Times on exercising after childbirth quoted Dr. Raul Artal, M.D. and author of the postpartum exercise guidelines for ACOG, saying of women who give birth vaginally, “one could return to exercise at her own pace — in consultation with a medical provider — the day after delivery.” Now, this isn’t to say you should start a modified exercise routine the day after delivery (especially after a C-section), but it goes to show how much the recovery timeline can vary from woman to woman.
What determines exercise clearance after birth?
Your personal birth experience, including any trauma* that you experienced during labor and delivery, will influence the way your body moves and feels, and what’s safe for you. *Trauma during birth is defined as any stress experienced by the mother during childbirth and can be physical, emotional, or psychological.
Conditions like severe anemia, high blood pressure, gestational diabetes, or other heart, lung, or kidney conditions can impact your recovery and may delay your return to exercise as well.
Your pregnancy experience and prenatal activity level will also factor into your doctor’s assessment.
Following a C-section delivery, your doctor will assess your abdomen, incision scar, and overall mobility to determine what’s safe for you when it comes to exercise clearance.
What is the average duration of recovery following a C-section?
Most professionals suggest a full 6 weeks (at minimum) to allow your body to recover. The Association of Chartered Physiotherapists in Women’s Health (ACPWH) suggests women who have had a C-section wait 8-10 weeks before commencing “vigorous exercise”. Other organizations recommend waiting 12-16 weeks before resuming with any higher-impact exercise.
With all of these different guidelines, it can feel hard to know when and where to start. You probably don’t need us to tell you a C-section involves cutting through layers of skin and tissue to create an opening for the safe delivery of your baby. It’s important to know that your abdominal muscles will not be cut through, as the most common incision is made just above your pubic bone, but this is still a surgical procedure that requires recovery time to allow your incision and surrounding tissues to heal.
Existing research shows that women who have a Caesarean section are more likely to have pain that interferes with their activity at 8 weeks postpartum compared to women who delivered vaginally. Of course, the pace at which you heal and how comfortable you feel moving around may be different from another woman who also gave birth via C-section. So we want to free you from thinking of the timeline and instead focus on your timeline. As always, your best resource is listening to your own body and the guidance of your healthcare provider. We’ll be here with gentle routines to help ease you back in whenever you are ready.
Is exercise after C-section painful?
When you ease into it gradually and safely, postpartum exercise should not be painful in itself. We never want you to push through the pain, as that’s never the goal. If you are recovering from a C-section, you may experience pain throughout your recovery period. In one study of over 970 women, those who had C-sections were more likely to experience bodily pain that interfered with their daily activities 8 weeks after birth. Three months after delivery, studies found women with C-sections were more likely to have abdominal pain than those with vaginal births. What’s more, some studies found 60% of women still experience wound pain near their incisions at 24 weeks post-birth. The main takeaway is that exercise should not exacerbate your pain; it should only serve to support your mobility and quality of life going forward.
If exercise does cause you pain after you’ve received exercise clearance from your doctor, please be sure to contact them and share what you are experiencing so they can effectively assess and monitor your situation.
5 things to know about exercise after C-section
Your body goes through a lot during pregnancy and childbirth, and even more so if you have a C-section. The biggest thing we want to remind you is the importance of self-compassion and patience as you move through postpartum recovery and exercise. Your body will feel different than it did in pregnancy, and it’s going to feel different from your pre-pregnancy days as well. You may find some movements are surprisingly more difficult or uncomfortable after having a C-section. To help you stay safe and know what to look for, here are 5 things to keep in mind:
1. Keep your stretches extra gentle
Stretching is a great way to stay lightly active and increase mobility after birth, but if you’ve had a C-section, you may find some stretches or yoga poses uncomfortable. The skin on your stomach has been stretched and stitched back together, and scar tissue will form around the incision as part of the healing process. Upper body stretches that raise your arms overhead are often included in postpartum exercise routines to help keep your chest open and reduce shoulder tightness, but this can also stretch your abdomen and strain the incision area. You should never push through a stretch if you’re feeling pain, and the same applies here. You can modify upper body stretches by keeping your arms below your head, pelvic floor engaged, and abdomen relaxed.
2. Be mindful of intra-abdominal pressure
One thing you want to be mindful of is creating too much intra-abdominal pressure, which was what your 2nd and 3rd trimeter exercises were careful of as well! Intra-abdominal pressure occurs when your core muscles engage in a way that pushes out on your abdominal wall and down on your pelvic floor. This pressure can put undue strain on your incision and weakened abdominal wall and delay the healing process overall. Motions where you have to lift, bear down, push, or sit up, can contribute to added pressure on these sensitive areas. You’ll likely encounter these motions in your day-to-day life, so it’s good to be mindful of how you move to reduce pain overall. Bend your knees and use your legs to lift, avoid bearing down where possible, gently pull your core in when you have to push something, and roll to your side before sitting up.
On the Baby2Body app, we’ve indicated any moves that can increase intra-abdominal pressure by adding ‘Skip if DR’ to the title. This is because you also want to avoid such moves if you are managing DR (diastasis recti) as well. We’ve featured alternative exercises in your next tip.
3. Focus on pelvic floor and light core
You can still work on your core in your post-C-section exercise routine! Your core comprises your glutes, obliques, lower back, and stabilizing muscles, as well as your abdominal muscles. While you’ll want to avoid direct, traditional core work, you can focus on those supporting core muscles to take pressure off your abdominal wall and give your incision area the time it needs to heal. Some of our favorite light core work exercises include gentle stomach pulls (these create the opposite of intra-abdominal pressure!), glute bridges, supported squats, and pelvic floor exercises. Of course, if any of these things do cause pain, we recommend skipping them as well.
4. Give higher intensity routines a back seat
Regular, low-impact workouts can (and should!) go a long way in your post-C-section exercise routine. If you’ve reported a C-section on the Baby2Body app and received full exercise clearance, we’ll still recommend beginner-level workouts. We know this can feel frustrating, especially if you were highly active before and during pregnancy. However, the focus is to gradually introduce your body to exercise and avoid high-impact motions (such as jumping or twisting) that can place added and unnecessary strain on your incision. We promise that steady consistency always wins when it comes to postpartum exercise.
5. Cardio is a go
One thing that shouldn’t be too different is your cardio routine! You’ll still want to keep it low-impact and wait for full health clearance from your doctor, but walking, swimming, or using the elliptical are great ways to promote good heart health and circulation following childbirth. These activities shouldn’t cause any added pain that you are experiencing in or around your incision, so if they do be sure to notify your doctor.
It’s estimated that 1 in 3 women in the United States, Australia, and Canada give birth via C-section, and 1 in 4 deliver via Caesarean in the United Kingdom. We want all women in our community to feel supported with the resources they need regarding labor and delivery, regardless of how they give birth. We’d love to know what other questions you have on C-sections or postpartum recovery, so please leave your thoughts in the comments below!