Cesarean Recovery and Yoga

A few weeks ago, Alexandra convinced me to try “Burn Boot Camp” classes.   (Hint: it’s nothing like yoga)  I’ve never been a fan of gyms, or, really, of sweat, and I so prefer child’s pose to chatarunga any day.  However, I just turned 40 and I am beginning to recognize the value in maintaining bone density.  Not so interesting, but pretty crucially important.  Also, current events have motivated me to find ways of expressing internal rage through means that don’t involve punching posters of misogynists in the face. 

I’ve been going fairly consistently since my initial visit.  Most of my body is happy about it, but there are some things I have had to learn to work around in this new practice of mine.  Apparently down dog has nothing on repeated push-ups as far as carpal tunnel is concerned.  Also, I quickly learned that repeated jump backs from a standing forward fold to plank pose aren’t so great for the cesarean adhesions I generated during my two deliveries.  After one day that was really heavy on these jump-backs, the nerve pain on the lower right side of my abdomen was pretty intense, and the next day was core work. Attempting to lift both legs in a V position while lifting my upper body at the same time wasn’t the remedy that my scar tissue required and I figured this out pretty quickly.  Having given birth the last time more than 3 years ago, this new challenge was a reminder that childbirth stays with us, longer than what might typically be considered the postpartum period.  

Over the past few weeks, I’ve have to re-remember to do what I tell everyone else to do.  I’m very familiar with what works for my body and what doesn’t when it comes to yoga, but with interval training I have been presented with an entirely new practice of self-awareness.  I modify, and go more slowly, and walk back instead of jump back.  Though very different from yoga, in some ways it is exactly the same.  

Women often have questions about what exercises work after a cesarean delivery and which are best to avoid. The avoidance answer is a little more straightforward and falls in line with the rest of Whole Mama Yoga’s thinking about almost everything.  If it doesn’t feel good, and especially if it causes any pain, don’t do it.  Quick, jerky movement that involves the lower abdominal region (like the above mentioned jump back) can cause micro-tears in scar tissue (scar tissue is much less flexible than healthy tissue) and, in more severe instances, those small tears can lead to infection.  The further you are away from your own abdominal surgery (3 years perhaps?) the less aware you might be of your cesarean scar, but injury is still possible.  It’s a lot easier to protect something that feels like it still needs protecting.  In all cases, though, gentle stretching of the area is better than any sudden, jerky movements.  

Core engagement remains as important for women who have given birth via cesarean as it is for women who have delivered vaginally, though it can often be a little more tricky. Incision pain can remain for months or years after and exercises that target the abdominal region don’t always help. Gentle consistency is likely key in both increasing tissue malleability and abdominal strength.  

The following is a short, 10 minute practice that can help gently stretch the lower abdominal region, as well as start to strengthen some of the deeper core muscles.  As usual, both strengthening and stretching are crucial in postpartum recovery. 

  • Begin lying on your back. Take a few deep, belly breaths and connect with your lower abdominal area, allowing it to gently lift and expand with your inhalation (or picture it doing so).  Stretch your arms back behind you and stretch long through your legs.  

  •  Draw your knees up to your chest and alternate hugging them in with your arms and pressing them away from your body.  After a few breaths, bring your thighs perpendicular to the floor and your shins parallel.  Place your hands on the tops of your thighs and, engaging your lower abdominal area, press your hands into your thighs while resisting your thighs into your hands. Hold for 3 – 5 breaths and release. Repeat for 5 rounds.  

  • Extend your arms out to either side.  Keep your shins parallel to the floor and your thighs perpendicular.  Lengthen your arms out to either side and try to keep your knees together as you shift them slowly to the right (this should be less of a twist than it is work for your oblique abdominal muscles), back up to center and then over to the left.  Repeat this 5 times to either side.  

  • Come up to a hands and knees position and move through cat and cow tilt a few times.  If you’d like, you can lift and then lengthen the opposite arm and leg off the floor as you breathe in and them lower them as you breathe out, switching sides with your inhalation.  

  • Move your hands over to the right slightly and bring your left foot forward to the front of your mat. Keeping both hands on the floor, walk your right knee back a few inches until you begin to feel a slight stretch in the lower abdomen.  Rise up and place both hands on your front thigh.  Press your hands into your front thigh and forward in the direction of your knee and use them to brace yourself as you allow your hips to sink forward. If this feels okay, you can stretch both arms up overhead.  Repeat on the other side.

  • If the stretch in the lower abdominal region wasn’t too intense in the last pose you can try a twist to one side, moving slowly as you rotate.  With your left foot forward again, stretch your right arm overhead and begin to twist to the left.  Steady yourself with your left hand on your left leg as you twist and stop if you feel a deep pulling in the lower belly.  You can hook your right elbow on the outside of your left thigh and stack your palms if that makes sense for your body.   Repeat on the other side.  (Note: usually one side of the cesarean scar is more sensitive than the other – be mindful of this throughout this practice)

  • Come back to hands and knees and place a rolled blanket in front of your knees.  Lower your thighs on to the blanket and come into either cobra or sphinx pose.  To further open the front body, press your hands into the floor and isometrically draw back toward your hips.  Stay here for as many breaths as you’d like. 

  • Flip over on to your back and take another long stretch before coming in to savasana.  

Lauren in C-birth pose.JPG

A yoga practice, while one tool for cesarean recovery, is not the only one. Alexandra and I are both huge proponents of visiting a pelvic physical therapist after giving birth, whether you delivered vaginally or via cesarean. In addition, a type of massage called Mayan abdominal massage can be hugely beneficial in helping to break up scar tissue and work out cesarean adhesions. For information on care providers who offer these services, please visit our resources page.