No matter how uncomplicated her pregnancy is, every woman is faced with the chance that her labor will end in a cesarean delivery, or C-section. As of 2007, a record-breaking 32 percent of all babies born in the U.S. were delivered by C-section, according to the Centers for Disease Control and Prevention. Because a C-section constitutes major abdominal surgery, recovery time is longer and carries the potential for more complications than does recovery after a vaginal delivery.
Procedure
C-sections typically don’t last longer than 30 to 45 minutes from start to finish. Your obstetrician must make several incisions to deliver your baby, starting with your skin and subcutaneous fat. Many doctors make a low, horizontal incision close to your bikini line. Such incisions heal more quickly and are less painful than vertical incisions. The first incision exposes your fascia, which your doctor cuts with a pair of sharp scissors to expose your abdominal muscles. The tissue that connects each side of your abdominal wall is pliable, and is pulled apart to separate the wall and reach the next layer. The next cut, through two thin layers called peritoneum, exposes the uterus where the final incision results in delivery.
Recovery
Most health-care providers recommend you recover for six full weeks after a C-section, limiting your activity to a few specific exercises and easy walking. Moving around helps facilitate recovery because it increases blood flow to the surgery site. For the first two weeks postpartum, you shouldn’t lift anything heavier than your newborn. It’s also important to support your abdomen by practicing good posture and bracing yourself with your hands during a bout of coughing or sneezing. Listen to your body as you recover; you may start to feel that you can do more, only to find yourself fatigued and sore the next day. Overexerting yourself in the initial weeks of recovery can cause internal bleeding or other complications.
First Exercises
Because your abdominal wall was separated during delivery, you should adhere to certain guidelines as you begin to recondition them. Start slowly and focus on your entire core, including your abdominal muscles, pelvic floor and lower back. Practice Kegel exercises to strengthen your floor muscles. Even though you didn’t deliver your baby vaginally, these muscles were weakened while supporting the growing weight of your uterus. Pelvic tilts gently strengthen your lower abdominal muscles while stretching your lumbar spine. Sit on an exercise ball or get down on your hands and knees to practice slowly pulling your abdominal muscles in. Avoid crunches or situps until your doctor makes sure any separation has fully healed.
Core Training
Because cesarean surgery doesn’t entail incising your abdominal muscles, you can strengthen, tone and tighten them afterward, once your body has recovered. Exercises including planks, side planks, opposite arm and leg raises and lunges with trunk rotations can all help you firm up your stomach muscles. If your body feels different after the surgery, you might consider taking Pilates mat or reformer classes. Pilates teaches you how to activate and use the muscles constituting your core, or powerhouse, as a way to efficiently and precisely initiate movement. Working out with an exercise ball can also help you find that connection, as you develop muscular strength, stability and endurance.
References
- “What If I Have a C-Section?”; Rita Rubin; 2004
- “Your Health After Birth”; Judy Sadgrove; 1998
- BabyCenter: Your Post-Baby Belly: Why It's Changed and How to Tone It; October 2006
- Centers for Disease Control and Prevention: Recent Trends in Cesarean Delivery in the United States; Fay Menacker and Brady E. Hamilton; March 2010
