Exercises 

- Instruct the woman during her pregnancy in all appropriate exercises, with indicated precautions. 

- Instruct the woman to begin preventive exercises as soon as possible during the recovery period. 

- Ankle pumping, active lower extremity range of motion, and walking are used to promote circulation and prevent venous stasis. 

- Pelvic floor exercises are used to regain strength, function, and control of the muscles of the perineum. 

- Deep breathing and coughing or huffing are used to prevent pulmonary complications. 

- Progress abdominal exercises slowly. Check for diastasis recti, and protect the area of incision to improve comfort. Initiate nonstressful muscle- setting techniques and progress as tolerated, based on degree of separation. 

- Teach posture correction as necessary. Retrain postural awareness and help realign posture with indicated therapeutic exercise. Develop control of the shoulder girdle muscles as they respond to the increased stress of caring for the new baby. 

- Reinforce the value of deep diaphragmatic breathing techniques for pulmonary ventilation, especially when exercising, and relaxed breathing techniques to relieve stress and promote relaxation. 

- Inform the woman that she should wait at least 6-8 weeks before resuming vigorous exercise. Emphasize the importance of progressing at a safe and controlled pace and not expecting to begin at her pregnancy level. 


Coughing or Huffing

Coughing is difficult following a C-section section because of incisional pain. An alternative is huffing. A huff is an outward breath caused by the upper abdominals contracting up and in against the diaphragm to push air out of the lungs. The abdominals are pulled up and in, rather than pushed out, causing decreased pressure in the abdominal cavity and less strain on the incision. Huffing must be done quickly to generate sufficient force to expel mucus. Instruct the patient to support the incision with a pillow or the hands and say "ha" forcefully and repetitively while contracting the abdominal muscles. 

Interventions to Relieve Intestinal Gas Pains

Abdominal massage or kneading - Have the patient lie supine or on the left side. This is very effective and typically done with either long or circular strokes. 
Begin on the right side at the ascending colon, stroking upward, then stroke across the transverse colon from right to left and down the descending colon. 
This can also be particularly beneficial in stimulating peristalsis and improving constipation in general. 

Pelvic tilting and/or bridging- These can be done in conjunction with massage. 

Bridge and twist - Have the patient maintain a position of bridging while twisting her hips to the right and left. 

Scar Mobilization 

Cross-friction massage should be initiated around the incision site as soon as sufficient healing has occurred. This will minimize adhesion that may contribute to postural problems and back pain. 
                   
Bridging exercise