A cesarean delivery is a surgery where an incision is made through the abdominal wall to deliver a baby quickly and safely. Cesarean deliveries are sometimes medically necessary, but the recovery time is slightly longer than a vaginal birth. For this reason, caution should be taken. Moms should get their doctor’s OK before returning to regular exercise.

Some key muscles that require retraining after pregnancy include the transverse abdominis. These are the corset-like muscles that wrap around the midline to the spine, the pelvic floor muscles, and the abdominal and lower back muscles.

After a cesarean delivery, it’s important to activate and strengthen these areas so that they can provide support, decrease your risk of injury, and help you make a full recovery postpartum.

Try these gentle exercises after a cesarean delivery. They require no equipment and can be performed from anywhere.

This exercise is a great relaxation technique. It also helps retrain the core muscles to work together during daily activities.

Muscles worked: transverse abdominis

  1. Lie on your back on a comfortable bed or couch.
  2. Place your hands on your belly and relax your body.
  3. Take a deep breath in through your nose, feeling your abdomen expand into your hands.
  4. Breathe out through your mouth. As you exhale, pull your bellybutton in toward your spine, contracting your abdominal muscles. Hold for 3 seconds.
  5. Repeat 5 to 10 times, 3 times a day.

A layer of connective tissue called the fascia connects the muscles of the abdominals to the pelvic floor and helps them work together for optimal performance.

Kegels are an excellent exercise to strengthen and activate the pelvic floor. They have been shown to decrease stress incontinence following childbirth. After a C-section you may have a urinary catheter and these exercises will help after the catheter is removed.

Muscles worked: pelvic floor

  1. Sit on the edge of a chair with your feet on the floor.
  2. Contract the muscles of the pelvic floor. It should feel like you’re trying to hold back the flow of urine.
  3. Imagine you’re closing all the openings of the vagina, anus, and urethra. Imagine lifting them up away from the chair.
  4. Hold this contraction as long as possible. Start with 5 seconds and work up to a longer duration.
  5. Take a deep breath in and then breathe out fully, relaxing the contraction.
  6. Try Kegels in different positions like standing or lying on your side.
  7. Perform 8 to 12 times with a 2-minute rest between contractions. Repeat 2 times per day.

This full-body isometric exercise is an excellent way to get all the muscle groups to work together in unison.

Muscles worked: quadriceps, hamstrings, pelvic floor muscles, core, and lower back

  1. Stand with your feet 1 to 2 feet away from the wall.
  2. Slowly lean back toward the wall, lowering yourself into a sitting position. Your hips and knees should be at 90-degrees to one another.
  3. Engage your core. Take a deep breath in and while you exhale, feel as if you’re pulling your belly button into the wall.
  4. For an added bonus, contract your pelvic floor by doing a Kegel while holding this position.
  5. Hold for as long as possible. Rest 1 minute, then repeat 5 times.

As a cesarean delivery scar heals, the different layers of skin and fascia can become adhered to each other, limiting your range of motion.

These adhesions may lead to future problems like urinary frequency, or hip or back pain. A scar tissue massage, also referred to as scar tissue release, helps break up the adhesions and assists with proper tissue healing. Only begin scar massage after your scar is healed and your doctor gives you the green light.

Areas worked: fascia, connective tissue

  1. Lie on your back with your fingers positioned above your scar. Pull the skin with your fingertips around the scar and observe its movement. Try sliding it up and down and side to side. Notice if it moves more easily in 1 direction than another.
  2. Working in 1 direction, slowly move the scar back and forth. You will want to start off gently and gradually move up to a more aggressive massage.
  3. Move the scar up and down, side to side, and even around in circles. Small movements are better, but tissue mobilization can be done in all areas of the abdomen.
  4. If the scar is painful, stop and try again at a later date. Once you feel comfortable, you can perform this massage once a day.

Note: Be sure to consult your doctor before engaging in exercise postpartum. Always start small, working up to more challenging movements. Avoid activities that place a lot of stress on the abdominal muscles and hip joints. If possible, consult a physical therapist or postpartum exercise specialist. If you notice an increase in bleeding, fatigue, or inflammation of the scar area, stop and seek medical help.

Generally, exercise should not start until six to eight weeks after the surgery and you should always check with your doctor before beginning. Low impact exercise such as yoga, Pilates, or swimming is the best way to begin.

This beginner core exercise helps engage the core muscles in a gentle but effective way. The transverse abdominis muscle is an important area to strengthen as it supports the body core. Also, it supports the linea alba, a fibrous structure that extends from the xiphoid process down to the pubic bone and also supports core stability.

Muscles worked: transverse abdominis

  1. Lie on your back on the floor with your knees bent and feet flat on the ground. Wear socks or put a towel under your feet to allow your feet to slide easily on the floor.
  2. Take a deep breath. As you exhale, contract your abdominal muscles by pulling your belly button to your spine without changing the curve of your lower back.
  3. While maintaining this contraction, slowly extend your foot away from your body until the leg is fully extended.
  4. Slowly bring it back to the starting position.
  5. Repeat 10 times on each side. Perform once per day.

Abdomen and pelvic floor exercises are beneficial following a cesarean delivery. To increase strength and stability in the core muscles, try breathing exercises, isometric contractions, and exercises that target the transverse abdominis.

Regaining strength gradually will help you return to doing the activities you love with ease.

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