Exercise Immediately after a Cesarean Delivery
Begin the day of delivery [as soon as you return from the recovery room]. Do them in bed. Perform them until you are up on a regular basis.
Deep Breathing
Five times every hour you are awake.
- Breathe slowly and deeply to expand the upper, middle, and lower portions of your chest.
Huffing
Two or three times every hour you are awake.
This is especially important if you had general [gas] anesthesia. In response to the anesthetic, the lungs produce mucus, if which not removed, can clog the small air sacs and breathing tubes of the lungs. “Huffing” should be used instead of coughing.
Here’s how:
A huff is a quick outward breath. It is like saying “ha”-a short, quick breath, with force from the abdominal muscles. The outward breath must be done quickly. Otherwise the force is not sufficient enough to dislodge any mucus. Spit out the mucous you cough up, don’t swallow it.
If huffing still doesn’t bring up any mucous and you still hear a rattle in the chest, try deep breathing again to loosen it.
With huffing, the abdominal wall is pulled in instead of out; therefore, huffing is more comfortable than deep breathing. Still, you may want to support the abdominal wall with your hands or a pillow. Be reassured that the stitches will not be pulled out.
Foot Exercise
Five times every hour that you are awake.
- Do five ankle circles to the right and five ankle circles to the left. Make them slow and big. Repeat with the other ankle.
- Slowly point and flex the foot. Repeat with the other foot.
Pelvic Floor Squeeze
Twenty a day, moving toward sixty, in sets of three or four. Begin when the catheter is removed.
- Lie or sit [later you will be able to stand] comfortably with the legs apart. [The farther the legs are apart, the more challenging.]
- Thinking about the vagina and perineum. Tighten the pelvic floor as if to lift the internal organs or to stop urination in midstream. Hold as tightly as possible for a slow count of three [gradually work up to a count of ten]. Be sure to breathe.
- Relax completely.
- Note: Because these muscles fatigue easily, repeat in sets of three or four squeezes throughout the day, anytime, anywhere.
Concentrate on the sensations of tension and lifting, relaxing and lowering within the pelvis.
Leg Squeeze
Three times every hour you are awake.
- Lie on back with one leg bent and the other leg straight with the foot flexed.
- Slowly press the straight leg to the bed and tighten all the muscles in that leg, gently pulling the toes toward the face.
- Repeat with opposite leg.
- With both legs straight and ankles crossed, tighten all the muscles in your legs-press knees down, tighten thigh muscles, and squeeze the buttock muscles. Hold while you slowly count to five [don’t hold your breath].
- Release.
- Repeat.
Note: If needed, prop yourself up on pillows.
Pelvic Tilt
Three to five times every hour you are awake.
- Lie on back with knees bent and heels close to buttocks.
- Inhale and press your back to the bed. Hold for a slow count of five [working toward ten]. Concentrate on pressing the back to the bed by using your abdominals-do not push with the feet. For an extra benefit, squeeze your buttock muscles and the pelvic floor.
- Relax, and then repeat.
Note; Slow, controlled movements are the key to success with this exercise. In the beginning, abdominal pain will let you do only a third or a half of this movement. That’s fine-listen to your body. Improving pelvic circulation is important-do the best you can with this movement. As your body heals more and more each day, hold the tilt longer and longer. Remember to breathe. Add a pelvic floor squeeze to.
Add on Third Day
Bend and Straighten Legs
Repeat variation A three to five times, twice a day. Using comfort as your guide, progress through variations B and C to variation D as soon as possible.
Variation A
- Lie on back with both legs bent, feet flat on the bed.
- Slowly straighten the right leg and bend back to place.
- Repeat with opposite leg.
Variation B
- Lie on back with one leg bent and the other leg straight.
- Slide the bent leg out straight and then back to a bent knee position.
- Repeat with the straight leg, returning to a straight leg position.
Variation C
- Lie on back with one leg bent and the other leg straight.
- Bend one leg as you straighten the other [Both legs are moving at the same time, slowly in opposition.]
Variation D
- Lie on back with both legs bent.
- Move both legs down and up at the same time.
Add on Seventh Day
Head-Up Lift
Three to five times twice a day. Add more as comfort guides you.
- Lie flat on back with no pillows, knees bent.
- Press back down [pelvic tilt], inhale slowly and lift just the head. Hold for a count of three.
- Lower head and relax.
Note: Using comfort as your guide, progress to lifting head and shoulders on exhalation. Concentrate on lifting head and shoulders as a unit toward ceiling, just an inch or two of floor. Do not thrust head forward on the lift.