So you’ve had a surgical birth. You’re feeling better, getting the hang of this newborn baby thing, and climbing the walls to get moving again and socialize. You want to feel normal. You want to minimize your fitness loss and start shedding some baby weight. When is it ok to start exercising, and specifically, hiking? Let’s start off with some biology review. Cesarean Section Birth is major abdominal surgery. Your uterus needs to heal from pregnancy and the incision, and your connective tissue, skin, and abdominal muscles need to heal from the incision.
There are 3 phases of tissue healing:
OK, so I’m good after 3 weeks? Not so fast. A few qualifiers:
There are a lot of options out there for core rehab. You may want to see a physical therapist that you have worked with before. Some other options I know of are:
Numerous other therapists who specialize in women’s needs. I’m sure there are other exercise programs out there that I don’t know of. “Sweet!” you’re saying, “I’m ready to go! I’m not bleeding anymore, not taking pain medication, my OB has given me permission to do exercise as it feels ok. My core and pelvic floor feel fine.”
Great! Let’s consider loading. In other words, starting easier and progressing in difficulty. The points below will give you an idea of what is easier loading, and progressing in difficulty. This is not meant to be an exact progression. Your own progression varies upon your individual birth recovery and your pre-birth fitness level - we all have our own journey. Remember the story of the tortoise and the hare? You want the slow and steady, gentle and consistent progress of the tortoise. The hare did too much too soon and got side-lined.
Easier
Moderate
Harder
Strongest
One last thing to consider: pressure to be a “Super Mom.” In our competitive society, it’s become fashionable to “recover” from pregnancy and birth so quickly, it’s as if it never happened. In reality, by not giving ourselves the rest we need, we can allow recovery never to happen. I’m not saying you need to partake in the “don’t leave your house for a month and don’t do any chores for 40 days post birth” advice (though kudos to you if you follow this!), but be considerate of yourself.
You spent the last 9 months creating and growing a new person, then birthing that person into the world. You’ve got a newborn and you’re not sleeping well. You’re recovering from major abdominal surgery. Maybe you labored for a whole day or more before that surgery. You’re dealing with the new role of motherhood and role changes with your partner. Perhaps there is financial stress. Maybe breastfeeding has gotten off to a rocky start. Yes, you need to get out of your house, socialize, meet other new Moms, get some fresh air, get some exercise. But be careful of doing too much too soon. Be true to yourself and be clear with yourself and others what is appropriate for you today, right now. Be slow and steady. Be kind to yourself. You’ll be ready to rock it soon enough!
Jenn Haunold, DPT is a physical therapist living in Corvallis, OR and is the branch leader of Hike it Baby Corvallis. She had a cesarean birth with her son Aiden in February 2013 and has successfully healed a diastasis recti with the help of The Tummy Team. Her Cesarean Journey: Jenn had a planned cesarean at 37 weeks due to a complete placenta previa, where the placenta implants over the cervix, making a vaginal birth impossible. After returning home, Jenn took minimal pain meds because she knows from past injuries that without some discomfort, she will push herself too much and take longer to heal. She found that ice packs over the incision were very helpful the first week. At 2 weeks post cesarean, she couldn’t even walk around the block yet due to soreness! At 5 weeks, she walked 3 miles without baby on Leif Erikson (a fire road) slowly and it took 1.5 hours. At 6 weeks she started Mom & Baby yoga, but was modifying postures until 8 weeks due to her core feeling weak. By 12 weeks, she was walking 3+ miles with baby and lifting weights at the gym again.
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