Returning to Exercise Safely After Cesarean Birth

The Truth About Healing: What to Do With That Scar, and Restoring Abs Afterwards (The First 3 Months)

Let’s say you just had a c-section to give birth to your first child.  You just underwent (probably) the most major medical event of your life (major surgery) and were instantly handed another human to take care of. You went to your 6 week check up, and the doctor tells you “yep, go ahead and start exercising, you’re all clear” and you leave, wide eyed thinking, “I can barely get off the floor without feeling like my incision is going to rip open again” totally terrified of the idea of exercise.  The surgeons have done their job (and we are thankful for their services), but that is where their guidance ends. You are left to jump on the internet to understand what is safe & what’s not, terrified to hurt yourself but also terrified to never “get your body back” (gag). Women’s Health Physical Therapists are THE people you need to see to know what’s safe FOR YOU.


Until then, here are:

3 things to do first when returning to exercise after a cesarean birth

1.  Reconnect your abs through your breath

  • This can be done immediately after the birth. I’m talking once you’re being wheeled out of the operating room.  Think about breathing into your incision. A gentle, non-forced breath, allowing air to fill your entire middle part of your body (including into your back). It is a gentle mobilization of the incision, from the inside-out. That’s all you need to think about for the first 4 weeks.  Then, work on engaging your abs more. On the exhale, SLIGHTLY draw your belly to spine, and picture you giving yourself a hug coming around each side of your back, meeting in the middle (like putting on a girdle). Avoid “sucking in” your stomach.

2. Go slow…and by slow I mean walk & walk some more

  • Walking is the best form of exercise after giving birth, ESPECIALLY a cesarean birth.  Before you leave the hospital, it is ideal that you are able to walk up and down the halls several times. Once you are home, do a little bit more each day.  Maybe you just take a few hot laps around your house or apartment. The next day walk out to your mailbox, and then farther and farther each day. Walking without a stroller is ideal, in order for your arms to swing, avoid holding breath with pushing and to minimize too much strain across your belly.

3. Start desensitizing around your belly and scar, immediately 

    1. It can be completely scary and gross to think about touching your scar.  The first 2 weeks, you should be touching around your belly, even starting just under your breasts and moving down toward incision as you are comfortable. Gradually work closer to your scar, and after day 21, you can start to touch your scar with clean hands.  Normalizing that tissue will help you return to more vigorous exercise. To learn more how to work your scar, see this blog.

    Your abs were stretched out over the last 9 or 10 months, making room for a human to grow.  That alone requires serious rehab afterwards. AND THEN you had major surgery on top of that.  In the first 2-3 months, give yourself time to heal. Snuggle your baby. Don’t even think about doing sit ups or planks (someday, just not today).  

    Give yourself a pat on the back, breathe, and know you are a serious badass mama.