A caesarean section involves abdominal surgery to deliver your baby safely when vaginal birth is not an option. As it is a major operation, it is important to get adequate rest afterwards and ensure that you don’t push yourself too soon to allow for healing. It is a time to enjoy your baby and reconnect with your body.
The early days after caesarian delivery, especially the first 5-7 days, are a time to lie back, rest and recover. Your visible scar may have healed by 6-8 weeks, but the tissues on the inside are still strengthening and will need at least 8-12 weeks to recover.
Engage your abdominal muscles before you move, as this will help to protect your wound. Do this by relaxing your tummy, then gently drawing your belly button towards your spine. This should not hurt. If you must lift, be sure to activate your abdominals and tighten your pelvic floor before doing so. If you need to hold your breath to do something then it is too hard. If you feel any pulling or stretching pain at the scar site from your caesarian then this is a sign that you are doing too much.
Getting in and out of Bed
When getting in and out of bed it is important to engage your abdominal muscles, roll onto your side with knees bent and push yourself up into a sitting position using your lower elbow. Do not try and sit stright up from lying on your back.
Having good posture is one of the keys to remaining injury-free. You may be inclined to slouch in order to protect your scar, particularly if it is sore. This may lead to back, neck and shoulder pain. Standing tall and continuing with your pelvic floor and core exercises will gently stretch your scar, helping it knit back together. The following cues will assist with improving your postural habits:
· Relax your shoulders and keep your chin tucked in
· Imagine a string from the top of your head to the sky, lengthening your spine
· Keep your lower back in a neutral position,
· Keep your knees unlocked when standing
One of our partners, Bub & Me Physio, has a great resource on Posture!
Returning to exercise
During the first 6-8 weeks take it very slow. It is important to return to exercise gradually. Begin your pelvic floor and core exercises when you are able to, usually by about 5-7 days after birth. See our ‘Regain Control: Tips For Pelvic Floor and Core Training’ PDF for more information on strengthening these muscle groups. Going for a gentle walk outside can also be started about 5-7 days after birth and has many physical and emotional benefits. Start with 5-10 minutes and go at a pace that feels comfortable.
Avoid doing any abdominal exercises such as sit-ups as these place excessive strain on the scar and your healing abdominal muscles.
By 8-12 weeks after birth you can increase your exercise intensity and begin low impact aerobics, light strength training, swimming or bike riding. Listen to your body. If you feel any pain or discomfort after doing any exercise then it is too soon for you to be doing it. Stop the exercise and try again in 1-2 weeks. You shouldn’t commence any high impact exercise until at least 4 months after the birth.
All time frames for commencing and progressing exercises depend on your pre pregnancy fitness and strength, how your pregnancy went, how your birth went and whether you feel ready. It is really important that your core and pelvic floor muscles are strong before you progress your exercise regime.
Your scar will most likely be sensitive in the first few weeks after the caesarean. Avoid wearing clothing that sits directly over the scar to prevent pain and irritation. Once the tissue heals, you will gradually be able to reintroduce your old clothing without any problems. Keep the area dry and clean in order to avoid infection.
If you are still experiencing discomfort on the scar line by 8 weeks, then have some tummy time with your baby. Lying on your tummy can gently stretch out the scar. You can also gently massage over the area. With time your scar will shrink and become less red, but this may take many months. You may also find that it is itchy or a little numb during this period. If you experience any redness, swelling, oozing from the scar, intense pain or pain that is worsening, contact your doctor.
It is generally considered safe for you to drive when you can push the pedals without feeling any pain, move your foot quickly between pedals and look over your shoulder without pain. You need to get clearance from your doctor before returning to driving for insurance purposes.