After a Cesarean Birth

Your health care provider will review with you the value of exercises, deep breathing and good body mechanics for the best recovery after your Cesarean birth. Exercises are the key to successful rehabilitation. You will progress through your exercises the first five to six days or until you can successfully demonstrate the routine below. Do not start any exercise program unless advised by your doctor.

Day 1

If general anesthesia is used during a Cesarean delivery, or if you do shallow breathing because of pain from the incision, secretions may pool in your lungs. You need to take frequent deep breaths, so your lungs completely fill with air.

Diaphragmatic breathing

Support the incision with your hands or a pillow. Take deep breaths so it feels as though you are filling your stomach with air. Your incision will not open, so do not worry.

Mid-chest expansion

Place your hands on your lower ribs. Take a deep breath and try to expand your lungs in the area under your hands.

Upper chest expansion

Place your hands over your upper chest, breathe in deeply and direct the air to the area under your hands.

Deep breathing

  • Support your incision with your hand or a pillow. Breathe in through your nose and breathe out saying “Ahhhhhhh.”
  • Tighten and relax the muscles around your vagina (birth canal). Tighten the vagina and draw up the rectum as if you are stopping a bowel movement. At the same time, take a deep breath.
  • Tighten up the muscles of your bottom and at the same time, squeeze your thighs together. Tighten the vagina by drawing up the muscles as if to stop the flow of urine. Hold for three to five seconds.

Posture

Keep your spine and joints in good alignment. Keep your head and shoulders back and over your hips.

Days 2 and 3

Repeat Day 1 exercises and add:

Pelvic Tilt: Lie on your back with your knees bent and feet flat on the bed. Flatten your lower back against the bed. Tighten your buttocks. Hold for three to five seconds.

Leg slides

Lying on your back, bend one leg so that the sole of your foot is flat on the bed. Slide the other leg up and down while keeping the bent leg still and your lower back flat. Repeat with the other leg. Do five to 10 times.

Hip hikes

Lying on your back, legs flat, hike your hip up and down. Repeat on both sides five to 10 times.

Days 4 through 9

If you are now up and about without too much discomfort, begin the following exercises.

Head sit-ups

Cross your hands over your abdomen, and pull your stomach muscles together toward your bellybutton. Lift your head while leading with your chin. Hold for three seconds and repeat five to 10 times.

Pelvic rocking

Lie on your back and bend your knees. Keep your feet and shoulders flat on the bed. Keep your knees together then roll them from one side to the other. Your feet should stay in the same place as your knees roll from side to side. Repeat five to 10 times.

When your doctor recommends, do all the exercises already listed and add:

Pelvic tilt

Get down on your hands and knees and pull your stomach up to arch your back. Hold this position three to five seconds. Repeat five to 10 times.

Curl-ups

Lie on your back and bend your knees. Lift your head, chest, and shoulders slightly off the bed (45° angle). Repeat 10 times. Breathe out as you lift up your head.

Oblique curl-ups

Same as above, but reach to one side, then to the other side. Repeat 10 times.

Body Mechanics

  • After a Cesarean birth, you may find yourself leaning forward to protect your incision. You will feel the need to do this even more as you carry and care for your baby. Typically, you will be asked to get up to walk within the first 12 to 18 hours to improve digestion, decrease muscle stiffness, and prevent blood clots that result in inflammation of a vein.
  • Support your incision as you walk. Walking and gentle exercise will not pull apart your incision. Exercise and activity help healing by increasing circulation.
  • Gradually add activities every day once your strength and endurance improve. When you go home, check with your doctor about increasing your activities.
  • Stand with your shoulders back, chin in and stomach muscles tightened.
  • Avoid sitting on soft chairs. They require too much effort to get up from and usually do not give good back support. Sit in a firm, straight-back chair. Do not slouch or arch your lower back. A cushion can be used for extra lower back support. Put the pillow near your lower back and hips.
  • To get up from the bed, do not sit up by bending at the waist. Slowly roll to one side and swing your legs over the edge one at a time. Push up your upper body with the elbow on the side you are on. Use your other hand to help yourself.
  • Go up and down stairs slowly, one step at a time, to avoid becoming tired. Use your thigh and hip muscles to step. Keep your back straight and your weight over your feet.
  • When bending over, keep one foot in front of the other. Bend your knees and lower your trunk. Keep your lower back slightly curved. Your legs should take most of the weight.
  • To lift an object, put one foot in front of the other and keep the object close to your body at about waist height. Only lift small loads and make frequent trips to avoid overexertion.
  • Reach for high objects by using a stool to avoid overstretching. Keep frequently used items at closer reach until your recovery is complete.