Getting back to exercise after a caesarean section

A caesarean section (also called a CS or c-section) is major abdominal surgery. Your body needs time to heal — but that does not mean you have to stay completely still. In fact, getting up and moving gently as soon as it is safe to do so is one of the best things you can do for your recovery.

Return to exercise after a caesarean is a gradual process. How quickly you progress depends on how you are feeling, how your wound is healing, and how your pelvic floor is coping — not just on how many weeks have passed. Everyone recovers differently, and that is completely normal.

The internal tissue layers from your CS (including the lining of your uterus [womb] and the layers of muscle and connective tissue in your abdomen) can take 4 to 6 months to fully heal. This is why it is so important to build up slowly and listen to your body every step of the way.

From day 1 to 2 after your operation, you can begin gentle movement — starting with short walks around the ward, as soon as your midwife or nurse says it is safe. Getting up and moving early helps reduce the risk of blood clots [when blood clumps together and blocks a vein], supports your bowel to start working again, and helps your overall recovery. Keep these early walks brief and very gentle, and always have support nearby if you need it.

At home during weeks 1 and 2, continue with short, flat walks and avoid hills. Your main activities should be caring for yourself and your baby. Try to rest between activities and avoid overdoing it, even on days when you feel well. During this first week, it is best to limit yourself to personal care and caring for your baby, and to gradually resume light home activities from around week 3.

Start your pelvic floor exercises [gentle squeezes of the muscles you use to stop the flow of urine] from day 1 — even while you are still in hospital. You can begin lying down and progress to sitting and standing as you become more comfortable. You should also start gently activating your deep abdominal muscles [the deep core muscles that wrap around your tummy like a corset] during these early weeks.

Support your wound with your hands when you cough, sneeze, or move from lying to sitting. Avoid any movement or exercise that pulls or stretches across your incision [the cut made during your operation].

From around week 2, you can start to gradually increase how long and how far you walk each day. Increase the distance slowly and pay attention to how your body responds. If you feel more tired, have heavier bleeding, or notice any pain, ease back and give yourself more time.

From weeks 2 to 6, you can also begin introducing some gentle body-weight exercises such as mini squats, shallow lunges, bridging [lying on your back with knees bent and gently lifting your hips], pelvic tilts, and cat-curl stretches. These help to rebuild strength in your legs, hips, and lower body without putting too much strain on your healing abdomen.

By 6 weeks, aim to be working towards 30 minutes of moderate-intensity walking on most days — but only if this feels right for your body. Some women get there earlier; others need more time. Both are okay.

Avoid exercises that place a heavy load on your outer abdominal muscles — such as sit-ups, crunches, or full planks — until your pelvic floor control and core stability are strong enough. Your physiotherapist [a health professional who helps with physical recovery] can advise when you are ready.

Break up any long periods of sitting throughout the day. Rest is important, but try not to sit still for hours at a time. Short, gentle movement breaks can help your recovery and improve your energy levels.

Before returning to any structured exercise program or gym-based activity, you should have your 6-week postnatal check with your doctor or obstetrician [a specialist in pregnancy and birth]. At this appointment, your wound healing, pelvic floor function, and overall health will be reviewed. Ask about a referral to a women's health physiotherapist for a full pelvic floor and core assessment — this is strongly recommended.

After your 6-week postnatal check and with your doctor's approval, you can start to introduce more structured exercise. From 6 to 8 weeks, low-impact options include stationary cycling, a cross-trainer [an exercise machine that mimics walking or skiing without impact], power walking, postnatal yoga, and Pilates classes. Keep your exercise intensity low to moderate — you should be able to hold a conversation while exercising.

Swimming, aqua aerobics, and deep-water walking can also be introduced from around 6 to 8 weeks, but only once your surgical wound is fully healed, all vaginal bleeding [called lochia] has completely stopped, and your doctor has confirmed it is safe.

From 6 to 8 weeks, you can also begin light resistance training [exercises using your own body weight, resistance bands, or very light weights to build strength]. Start slowly, maintain good posture, and avoid holding your breath while lifting. Progress to slightly heavier resistance from 8 to 12 weeks, guided by how your pelvic floor and core are coping. If you feel any heaviness in your pelvis [the lower part of your tummy and hips], any leakage, or pain, reduce the load and speak with your physiotherapist.

Running, jumping, skipping, and high-intensity exercise [such as HIIT classes] should not be started before 12 weeks post-surgery at the earliest — and only after a women's health physiotherapist has assessed your pelvic floor, core stability, and wound healing. When you are ready, a gradual walk-to-run program is the safest way to return to running.

Once you are well recovered — generally from 6 to 8 weeks onwards — work gradually towards getting at least 150 minutes of moderate-intensity physical activity each week, spread over most days. Include both aerobic exercise [activities that raise your heart rate, like walking or swimming] and strength-based activities. Remember: any amount of movement is better than none, and it is always better to build up slowly than to do too much too soon. Full activity targets are usually achievable within 3 to 6 months for most women.

Exercise is also really good for your mental health. Getting active in the postpartum period is linked to a significantly lower risk of postnatal depression and anxiety. Be kind to yourself — recovery takes time, and every small step forward counts.

Your pelvic floor is a group of muscles that sit at the base of your pelvis [the bowl-shaped area between your hips]. These muscles support your bladder, bowel, and uterus. Pregnancy itself — not just the type of birth — can weaken them, so pelvic floor exercises are important for all new mothers, including those who have had a caesarean.

Start pelvic floor exercises from day 1 after your operation. Begin gently, lying down, and progress to sitting and then standing as you feel more comfortable.

To do a pelvic floor contraction: gently squeeze and lift the muscles you would use to stop the flow of urine. Hold for up to 10 seconds, then fully relax. Aim for 10 repetitions, 2 to 3 sets, on most days of the week. The relaxation part is just as important as the squeeze — make sure you fully let go between each repetition.

If you are not sure whether you are doing them correctly, or if you have any leakage, heaviness, or discomfort, a women's health physiotherapist can check your technique and give you a personalised program. Getting this right from the start makes a real difference to your long-term recovery.

For the first 6 weeks after your caesarean, do not lift anything heavier than your baby — which is approximately 5 kg. This includes heavy shopping bags, laundry baskets, older children, vacuuming, and mopping. These activities place strain on your healing wound and abdominal muscles and can slow your recovery or cause injury.

When you do need to lift something — such as your baby — use the right technique: engage your pelvic floor and lower tummy muscles before you lift, bend your knees, stand close to what you are picking up, and keep it close to your body as you lift.

These lifting restrictions also apply at work. If your job involves heavy lifting or physical activity, speak with your doctor about when it is safe to return.

After 6 weeks, gradually increase what you lift, guided by how your body responds and with advice from your physiotherapist or doctor.

You do not have to navigate your recovery alone. Your doctor, midwife, obstetrician, or women's health physiotherapist are there to support you — and a quick conversation with them before you ramp up your activity can make a real difference. They can help you figure out what is right for your body at each stage, answer your questions, and give you the confidence to move forward safely. If something does not feel right, or you are not sure whether you are ready for the next step, please reach out. There is no such thing as a silly question when it comes to your recovery.

Stop exercising and contact your doctor, midwife, or women's health physiotherapist if you notice any of the following signs or symptoms. Some of these require urgent medical attention — do not wait if you are concerned.

Call 000 or go to your nearest emergency department immediately if you have chest pain, palpitations [a racing or fluttering heartbeat], or severe difficulty breathing during or after exercise, or if you have calf pain, swelling, or redness (which may be a sign of a blood clot [deep vein thrombosis]).

Stop exercising and seek prompt medical review if you notice any of the warning signs listed below.