Ask the Doc 3…

Q1:What is the ideal weight loss exercise for mothers who have had a C-section or two to  get their bodies back?

A:First of all, What is a C-Section?

A C-section or CS is short for Caesarean Section. CS deliveries can be elective i.e.planned or emergencies i.e. unplanned. During the C-section, your doctor makes an incision into your skin, through the fat cells, connective tissue, and into the abdominal muscles before gaining entry into the abdominal cavity to retrieve your baby.

A CS is not the kindest of procedures on your body and organs, making adequate rest and recovery essential. You’re going to need to be patient with the process. There is no rush. Heal well now and save yourself issues down the road in the short and long term.

A Caesarean section is a major operation, so one has to be careful not to push oneself too soon. The first six weeks after the operation is a time for healing.

What needs to be done during Recovery in The Early Weeks After C-Section

In the early days and weeks following your C-section you’re going to be focused on resting and relaxing as much as possible with your new baby. These are the main things you will want to do in the first 6 weeks post delivery:

1. Ask for help.

You’re going to want to do things yourself, but try to pace yourself. Allow yourself to receive help and offers from your friends and family. Your job as a mother is to love, feed, cuddle, and sleep. If possible, even get people to bring your baby to you at feeding time.

2. Rolling over.

Every time you go to lie down or move from a lying to a seated position, you’re going to roll to your side first. This is so we can avoid raising a tonne of pressure on the abdominal muscles and CS scar. An example of this is getting into and out of bed. Get into the habit of lying on your side and then slowly rolling to your back when getting into bed. Getting out of bed, roll to your side, lower the legs off the bed, then use your upper body strength to push yourself up to seated. If you can, get someone to help you with this, as well.

3. Restorative breathing.

Core restoration can start within the first few days after delivery. You are going to start reprogramming your core to function from your diaphragm down to your pelvic floor muscles, with the Core breath method.

On your inhale breath, feel your ribcage and your belly gently expand and relax. On your exhale breath, purse your lips and gently exhale to encourage gentle activation through your pelvic floor and deep abdominal muscles. Before you do any exertion, say getting out of bed or picking up the baby, practice your Core Breath. Start your exhale breath and then begin your movement or lift.

4. Walking.

In the first few days, you’ll want to walk as little as possible. As you begin to heal, slowly increase the amount of walking you’re doing around the house. Monitor your energy levels that day and the next, and if you’re feeling good, you can keep slowly increase your movements. Start with short outdoor leisurely walking and gradually increase your time. Use this as a time to breathe, relax, and move.

Depending on your healing process, you may begin core restoration exercises, in addition to the Core Breath, prior to your 6-week checkup. There really is no magic date of when you should begin adding in more activity, as everyone heals at their own pace.

Examples of beneficial core restoration exercises are:

  • Glute bridges
  • Clamshells
  • Heel slides

Please  view how these exercises are performed on Youtube.

The Core Breath can be integrated into each of these exercises. You’ll want to exhale on the toughest part of the exercise, just before you move. As an example, in the glute bridge, you’ll start your exhale breath to lift up and inhale as you return down.

Don’t do any strenuous exercise or heavy lifting in the first couple of months. However, you can begin practising your pelvic floor exercises as soon as you feel ready. Pregnancy can put a strain on your pelvic floor, so these exercises are important, irrespective of how you gave birth.

Every time you lift your baby, tighten your pelvic floor muscles and lower tummy muscles at the same time. This will help to protect your back, and will prevent you from leaking urine.

Once you feel comfortable with pelvic floor exercises, you can begin to work on your lower stomach muscles which will help to strengthen your back. It’s fine to do these gentle toning exercises in the first six weeks. It won’t rip your surgical stitches, or damage your caesarean surgical scar, so there’s no need to wait, unless it feels painful.

Some women notice an overhang, which is where the skin around and below your scar is tighter than the skin above it. Slowly losing weight and practising your pelvic floor and lower tummy muscle exercises can help to reduce this, and will tone things up. This may take months, so you need to persevere with your exercises, even if you don’t notice a significant difference at first.
Try this simple exercise 10 times, twice a day, building up to three times a day. If you find it difficult, start with five times, twice a day:

  • Lie on your back and bend your knees.
  • Squeeze in your pelvic floor muscles as you breathe out.
  • Pull your belly button in and up at the same time.
  • Try to hold the squeeze for 10 seconds, without holding your breath.

You may have got into the habit of stooping, particularly if the stitches in your scar feel sore. It’s natural to feel vulnerable about your belly after such a major operation, but stooping can lead to back pain, and can make your tummy stick out.

The tissues around your scar will benefit from being gently flexed. So standing up straight and doing gentle tummy exercises will help your scar to knit together more strongly.

During the first six weeks after delivery, you can gradually increase activity at a pace that agrees with you. You could start with a five minute walk, and gradually extend this time when you feel able.

Exercise that works your heart and lungs (aerobic) will also help to flatten your tummy. Ease yourself back into this type of exercise after your routine postnatal visits.

Aerobic exercise, such as brisk walking, jogging, swimming, or cycling, will help you to shed some baby weight. You may only be able to do 10 minutes of exercise to begin with, but you will gradually get stronger. The effects of pregnancy hormones can affect your joints for up to six months after birth, so don’t do any high-impact activities too soon.

After 6 weeks, you can do gentle sit-ups to tone things up, though these work on your upper, rather than lower, tummy muscles. It is often the lower tummy muscles that women find a problem after a caesarean section, and exercising these is easier and more effective.

Doing too many sit-ups can also put pressure on your pelvic floor, and cause urine leaks, so don’t overdo it. Just pace yourself. You should avoid doing more than 10 sit-ups at a time, and don’t do more than three sets of 10 sit-ups a day. Always breathe throughout the exercise, and tighten your pelvic floor and lower tummy muscles at the same time.

It may be too soon for a general exercise session or class if you are still:

  • Have pain 12 weeks or 3 months after delivery
  • struggling with walking
  • finding it hard to do pelvic floor or lower tummy muscle exercises.

If you had any complications after your caesarean section, such as an infection, please talk to your Obstetrician, and wait until you feel better, before you exercise again.

 

Q2:It’s really not easy sticking with a particular diet for a long time, what are the things we can do that can help stay persistent in wanting to achieve our weight loss goals.

A:I quite agree. Eating the same thing over and over again gets boring and tiresome especially the typical Nigerian diet which comprises mainly starchy foods.

Subscribe to a food cable channel or watch Youtube videos on a variety of healthy foods being prepared.

Try to spice up your meals with condiments of different spices to give a different flavor to already boring meals i.e try preparing basmatic coconut rice instead of just plain rice or plain basmatic rice for those who are already fed up of routine meals.

Instead of eating just rice and stew, why not strip beef into thin slices and do a healthy stir fry with olive oil, green peppers, carrots etc with a dash of pepper and garnish with olives to make meals more interesting. Garnishing or decorating meals with different vegetables ranging from sliced tomatoes to sliced carrots and lettuce leaves could make a big difference in making an already monotonous healthy dish look more appealing/appetizing.

 

Dr Akindele Goodluck is  a Medical Doctor and General Surgeon. He is the Medical Director of Goodluck Specialist Hospital based in Lagos. He offers special Mobile services to his patients. He can be reached on goodluck_specialist_clinic@yahoo.com 

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