Because having a cesarean involves major surgery, you will be sore after¬wards and will require longer to fully recover than if you had delivered vaginally. Postpartum exercises will need to be delayed for a couple of weeks, and you will need to check with your doctor before beginning them. However, you can start some simple exercises immediately. These will help your body get back to normal more quickly.
Since you may spend the first 24 hours in bed, you should begin doing ankle rotating and foot flexing and stretching as soon as possible after surgery—in the recovery room when sensation returns after regional anesthesia or as soon as you are alert after general anesthesia. These two exercises stimulate circulation and decrease the chance of blood clots and dizziness.
You will also need to begin deep breathing to expand your lungs. In the recovery room or as soon as you wake up, take 10 slow deep chest breaths. Repeat once an hour to loosen any phlegm and mucus that may have collected in your lungs during surgery. This deep breathing is important to prevent pneumonia. Along with deep breathing, “huff’ to bring up phlegm. To huff, hold your incision with both hands, take in a deep breath, and breathe out with a short, sharp “ha” sound. Huffing is not as uncomfortable as coughing and will be very effective if you take in enough air first. Do not worry about your stitches breaking. Stitches are done in a number of layers and are very strong.
To relieve gas and help the incision heal, practice abdominal tightening. While sitting, lying down, or standing, slowly tighten your abdominal muscles as you exhale and hold them tight for 1 to 2 seconds. Gradually increase the holding time to 5 seconds or more. Doing this exercise may be difficult at first, but the increased circulation will help the incision heal, and the muscle contractions will actually draw the ends of the incision closer together. The first few days that you do this exercise, sup-port the incision with your hands for added comfort.
Proper body mechanics can help ease the strain on your abdomen as you roll over and sit up in bed. To turn to your left side, bend your right knee and bring it over your straight left knee. As you turn your body, reach for the left side of the bed with your right arm. This maneuver is called log tolling. If you want to turn to your right, reverse the procedure. If you want to sit up, you can easily raise yourself using your arm and shoulder muscles, swinging your legs over the side of the bed, without putting undue strain on your abdomen.
If you are still in bed most of the time on the second day, continue doing your ankle rotating and foot flexing and stretching. You should also continue huffing until your lungs are clear.
Deep breathing along with the pelvic tilt and Kegel exercises will stimulate intestinal activity and reduce the discomfort from gas. To do the pelvic tilt, lie on your back or side with your knees bent, and gently rock your pelvis backwards and forwards using your abdominal and buttocks muscles. Begin doing super Kegels, contracting the muscles of your pelvic floor for 20 seconds. Do 1 super Kegel ten times a day.
To begin strengthening your abdominal muscles, practice knee reaching. Sit semireclined (at a 45-degree angle) with the bed raised or your back and head supported by pillows. Breathe in deeply, then exhale, tucking in your chin and reaching for (but not touching) your knees with both hands. Breathe in again, lowering your head to the pillow, and relax. Repeat several times. Start slowly and gradually increase to 10 repetitions. If necessary, support your incision as you raise your head.
Before you go home, check for separation of the recti muscles. You must restore the separation to normal before you do any further abdominal strengthening exercises.
Progress at your own pace with postpartum exercising when your doctor gives his permission. Avoid lifting, straining, and unduly exerting yourself. Be sure to get plenty of rest to speed your recovery.