Exercise after cesarean section: When to start and how to proceed.

Getting back to that perfect shape is a formidable task specifically after childbirth, more so if you had to undergo the knife (cesarean delivery). No doubt there is a lot of speculation around resuming exercise after cesarean section. What is allowed and what is not? When to start and how to start?

Maximum confusion surrounds the timing and intensity of workouts. I, too, spent days behind the screen, dipping my nose in a plethora of women magazines, articles and books. It became exhausting finding that perfect road back to my pre-pregnancy dresses. All frustration confounded by the limitations imposed by corona.

Been there, done that! Lemme take you through a very safe weight loss strategy that I followed after my c section.

Safe timing of commencing workout/exercise after cesarean section.

Maintaining an active body is of core essence right from the day you undergo the knife. You must understand that being confined to the bed is neither the need nor what experts advice. As soon a pain is bearable, walking is allowed and promoted. Pelvic and abdominal exercises are encouraged throughout your recuperation.

The stress exerted on the healing wound must match its healing state. Medical literature asserts with authority that it takes a minimum of 6 weeks for any wound to heal. Too early or too much stress on this delicate wound can lead to a lifetime of trouble.

The simplest and widely acceptable recommendations are:

Type of exercise	Normal delivery	C.Section
Low impact (Brisk walk/light jog /swimming/pilates/yoga)	40 days	3 months
High impact (running/Gym/ weight training)	3 months	6 months

All those who became mommies in strict lockdown will relate well to my journey. My bundle of joy, little monster Aarayna, was born on day 1 of lockdown. Having ripped off the luxury of a maid/or governess for my kids, the baby-care and house-chores kept me active, suited to my level of tolerance, right from the start.

Progressing towards the aspired goal. ‘The coveted pre-pregnancy wardrobe’.

Take it easy (1-4 weeks)

Be content with walking around the house and managing bathroom trips on your own. Dont attempt anything funny yet. Support your lower abdomen well whenever out of bed. Post-natal belts offer much relief from standing pain and help in wound healing.

KEEP PRATICING-

• Pelvic floor exercises: Seated kaegels can be started as soon as the catheter is out.
• Abdominal muscle strengthening: Belly breathing: Gently lie on your back with a slight bend at knees. As you breathe out, pull in the abdominal muscles and squeeze your pelvic floor inwards. Hold for 5-10 seconds, repeating about 5 to 10 times a day.

Build up your core strength (4 to 12 weeks)

Depending on pain and comfort, start walking at a slow pace for 5 to 10 minute at a time, either inside or outside. Remember to keep repeating the above exercises.

Carefully gulp down your prescribed supplements, and eat a well balanced diverse diet. Your body is healing from a significant traumatic event and needs to regain its strength and vitality.

Let the show begin (12 to 24 weeks)

Your body is now ready for some low impact (A brisk walk, yoga, swimming, pilates, even low impact jogging), suited to your comfort level.

Walk at home

I started with the ‘walk at home’ program by Leslie Sanon, affiliated with the American heart program. Staring with a daily 10-minute walk, I progressed to 3-miles by the end of my 6^th month.

Just walk to the tune for 10 -15 minutes initially (keeping abreast with the pace). Build 5 minutes add-ons’ every few weeks. Get comfortable with walking before you start other moves, although most moves are very low impact, and you can adjust the impact as per your tolerance.

It has proved to be a highly effective way of resuming the workout for me.

Walk at home has a pleasing collection of free videos, and a nice collection of workout DVDs for purchase, making this a great option for consideration. Additionally, it’s a great way of spending quality family time while getting fit together. My kids loved to walk with me, and I loved it more!

Team body project

The ‘team body project’ is also an impressive alternative, but the impact is higher and my knee started to hurt even while doing their low impacts. There is an innumerable online collection of cardio and strength training dedicated to post-natal weight loss. All it needs is a bit of hit and trial to find the one that suits you the best.

Yoga

Yoga is an excellent choice when adapted to the fitness level offered by your recovering body. Some poses like Suryanamskar may actually be quite strenuous and fall in the high-impact category. Staying unadventurous is the need of the hour unless you are a yoga pro..

You should avoid

Abdominal crunches, weight training, running, and squatting should be avoided early in recovery. Preferably attempted after you have mastered low impacts, and/or are beyond your 24-week mark.

Time to strike the hammer (24 weeks onwards)

It’s a green signal to start high impacts and gym training, slowing building your way to that brutal attack on the to-be-shed-fat.

I started during cross-trainer sessions indoors, weight training, and floor exercises for toning my back and abdomen. It hurts a little initially, as you step up your game before your body adjusts to the new level of stretch and effort.

This may not instantly gift you that perfect beach body, but I can assure you of making significant progress along the way. Getting back in those pre-bump dresses feels just amazing. Not to mention, the ecstasy of fitting in some hidden in wardrobe treasures.

Be mindful, and seek medical advice before commencing the workouts or significantly increasing the impacts.

Take care of the lactating breasts and your healing body.

Breast-care: Intensity, support and hygiene.

Intensity:

Like me, most mommies are lactating at this time and I advise against doing upper body strength training/ exercises. Friction and impacts can lead to sore nipples, blocked ducts, and mastitis. Frankly, I did try and the result was as expected. I had to nurse a sore, inflamed breast for more than a few days.

Support:

Wear a good supporting bra whenever you work out, no matter the duration or impact. Your maternity/nursing bra (with good bust support) shall serve the purpose very well for the lower impacts.

Once you hit the high impact zone (like gymming), remember to support your bosson a ‘right-fit’ sports bra. Match it to your level of activity (low/high impact bras). Nike offers a graceful collection of maternity wear, that can become your perfect companion in this journey.

Choose the right fit. Too loose, it will not serve its purpose. Not only will it be painful for you, but it can also lead to nipple/breast trauma due to repeated impacts.

Tight fits lead to blocked ducts and mastitis. Chronic back problems and nagging pain are common accompaniments of misfit bras.

Hygiene:

I always wore disposable breast pads while exercising/walks. Breast pads reduce nipple friction, absorb any leaking milk and help maintain good hygiene. Not to mention, it saves your clothes from soiling and repulsive display of your lactation. Pigeon and Avent, offer sleek and breathable choices with good adhesive strength at back.

You should take a shower and change the underclothes after every sweaty session.

My blog, ‘Breastfeeding dos and don’ts: A mother’s perspective’, addresses the common breastfeeding concerns of nursing mothers.

Wound care: Listen to your body, ‘DO NO HARM’.

Avoid any posture, exercise, and/or movement that excessively hurts the healing wound (beyond the discomfort of some stretch). Don’t try to ignore pain, being overtly brave is unnecessary and potentially harmful.

For the initial period, and till you feel comfortable, wear a good post-natal belt to support your lower abdomen. There are many good options available with firstcry, amazon etc. I personally used tynor belt, XL size, till about 6 months postnatally.

Don well-cushioned and proper fit shoes for your exercise sessions. Doing brisk walks, jogging, running, jumping and other high impacts put a lot of stress on your lower joints (ankle/knee/hip), more so in presence of ligamental laxity arising as the result of pregnancy.

Always be safe, and stay steadfast with your aim. Place the focus on being healthy, not just shedding off the added pounds. There is no miraculous shortcut here. It will befall with patience and hard work, not overthinking and frustration. What, when and how not to do is probably more important than what, when, and how to do.