Getting back in shape after a Caesarean section

Pregnancy is no doubt one of the most life-changing experiences of a woman's life. It changes us both physically and emotionally. Our bodies go through a lot to bring a life into this world. However, in doing so, you may end up gaining quite a few kilos! As eager as you might be to lose this extra weight, you need to be realistic. It won't happen overnight. Just as it took your body nine months to gain this weight, similarly, it will take time to lose it.

The best time to start your exercises to get back in shape depends on your type of delivery. If you have had a normal vaginal delivery, you can go back to your post-pregnancy workout regimen within a few days after giving birth. However, that's not the case if you have had a cesarean section. A C-section is a major operation, your doctor will be the best person to advise you regarding when you can start your workout.

During a C-section, your doctors make an incision on your abdominal wall & uterine muscles in order to get your baby out. Once the baby is out, they stitch the tissues back together. These tissues will need some time to heal.

Let us list down some of the exercises that can help you get back to your pre-pregnancy body:

Early exercises

Ideally, after a C-section, you need about 6 weeks to recover from the surgery & the pregnancy changes. Don't try to rush the process. In the meantime, you can perform these simple exercises that can help you kick start your recovery process:

• Walking: Try going for short walks daily. It does not mean you need to walk a mile. Instead, start with a light ten-minute walk around your house or in the garden. You can gradually increase the time depending upon your level of fitness & recovery.
• Light stretching: Lightly stretch the muscles of your shoulders, neck, arms, and legs. Make sure that you are not putting any pressure on your C-section scar.
• Pelvic exercises: You can start Kegels or pelvic tilt exercises soon after birth. These exercises do not require much effort from your side and can be done in a variety of positions such as sitting, reclining, and standing. They make a significant impact on your recovery time and abdominal firmness. Perform them twice a day for ten minutes each.

- Bend your knees as you lie on your back.
- Tighten the muscles in your pelvic floor as if you are trying to prevent passing urine & stools
- Hold for a total of 5 seconds and relax
- Do 8-10 such repetitions at least thrice a day

• Maintain good posture: Bad posture can be exacerbated by pregnancy, C-section, and breastfeeding. Sitting up with your core muscles engaged, back straight and shoulders back is a good practice. This will help you support your back while strengthening your tummy muscles.

These exercises are great for the early few weeks post-delivery because they can be done at any time and in any position. You can do them even while nursing or holding your baby! Great right? However, refrain from overexerting yourself as it can put a strain on your stitches that can lead to pain, wound infection or injury.

Exercise after eight weeks

Once you are done doing the light exercises during the initial phase post-delivery, which generally takes around six to eight weeks, you can slowly move towards exercises that focus on your abdominal muscles. But it is always advisable to get the green signal from your doctor before starting these exercises.

Here are some exercises that can help you to strengthen your abdominal muscles:

Bridge: Lie down on your back while keeping your knees bent. Abdominal muscles should be tightened. Raise your hips off the ground by pushing through your heels. From your shoulders to your knees, your body should make a straight line. Hold the position for at least ten seconds before letting go gently. Perform 4–8 repetitions.

Wall sit: The quadriceps, hamstrings, pelvic floor muscles, and lower back are all strengthened with this workout. Stand about 1 foot away from a wall, place your back against the wall and slide your back down to sit with your knees bent at a 90-degree angle. Hold the position for as long as you can with your stomach and pelvic floor muscles engaged, then straighten up & relax.

Side plank: Your inner core muscles are engaged in the side plank. Begin with a modified side plank, where you bend your knees on the mat and lift your body into a side plank posture.

Have you heard of a condition called diastasis recti? It is a condition in which the gap between your left and right abdominal muscles has enlarged, causing your belly to protrude out. Meet your doctor & make sure you don’t suffer from this condition before starting your exercise routine. When you perform abdominal exercises while you have a diastasis, you risk injuring your abdominal muscles even more. Although a gap in the abdominal muscles isn't harmful, your doctor may advise you to modify your workouts.

Exercising after delivering a baby is beneficial for a mother both physically and mentally; however, it's even more crucial to ensure that you're recovering properly before starting a postpartum exercise routine. So, listen to your body, keep yourself well hydrated and take rest when required. Do not overstrain yourself. Make sure to contact your doctor if you experience pain or discomfort around your C-section scar; wait until they advise it's safe to start exercising.

Exercises to avoid:

As you’re still recovering from a major surgery, it is important to remember that you cannot straightaway start doing strenuous exercises.

In the initial few months, you should avoid doing any exercise that puts extra strain on your abdominal muscles and over the stichline. This includes:

• Sit-ups & crunches
• Heavy weight lifting
• Push-ups
• Any exercise that involves lot of jumping, sprinting
• Zumba, body sculpting, Kick-boxing
• Any exercise which leads to stretching of the stichline or puts a strain on the stiches

After every workout, ask yourself:

• How do I feel?
• Does this exercise make me feel energized or drained out?
• Is there any pain or soreness anywhere in the body because of the exercise?

Red flags while exercising in Postpartum period:

Remember that the postpartum period is a time when your body is still trying to recover from the strain of pregnancy, childbirth & surgery. A lot of physiological & hormonal changes are still ongoing and may affect the ability of your body to perform certain physical activities. And there is no blanket rule that applies to all women recovering from the surgery. Titrate your physical activity & exercises according to your individual capacity and pay attention to the signs of over-exertion & exhaustion when your body signals so. This is not the time to push yourself hard & over-exert yourself. It is important that you should not push yourself too hard & stop exercising if:

• You have difficulty in breathing
• Have blurring of vision or feel dizzy
• Pain anywhere in the body, especially around the stichline & in lower abdomen
• There is excessive vaginal bleeding or any discharge from the stichline
• If there is severe headache or chest pain

If you experience any of the above, stop exercising & consult your doctor right away. You may need to visit the hospital for an examination and your doctor might want you to reduce the intensity or the regime of your exercises.