Exercise after a caesarean (C-section): walking, your scar, your core and when to run again

Major surgery as well as a birth

Recovery usually takes about 6 weeks but varies, and you may have more pain and a slower start than after a vaginal birth. Go gradually, and take regular pain relief so you can move.

Sources 1, 2

Get moving early, and walk every day

You'll be helped out of bed, often about 6 hours after the birth, and a daily walk lowers the risk of blood clots. Early walking is a strong recommendation in international caesarean guidelines.

Sources 3, 4, 5

Pelvic floor exercises once your catheter is out

A caesarean doesn't fully protect your pelvic floor: up to 1 in 5 women leak urine after a caesarean, against up to 1 in 2 after a vaginal birth. Aim for 10 long and 10 short squeezes at least 3 times a day.

Sources 1, 2

Gentle tummy exercises from the first days

A deep tummy draw-in, pelvic tilts, knee rolls and heel slides are safe early. Add head lifts and knee lifts when they don't pull on the wound. The NHS advises avoiding sit-ups, planks and high-impact exercise to start with.

Sources 2, 6

Lifting, classes and the gym: about 6 weeks, or when it's comfortable

Try not to lift anything heavier than your baby for at least 6 weeks. The NHS says to start exercise, carrying heavier things and driving again only when you feel able and they don't hurt, which may not be for 6 weeks or so. These timings are expert opinion: no trial has tested them.

Sources 2, 3, 7

Running later, and the warning signs

Running usually waits about 3 months, and a caesarean is one of the UK return-to-running guideline's reasons to expect a slower return. Get help straight away for heavy bleeding, a wound that gets more red, painful or swollen, or pain or swelling in your lower leg, and call 999 for chest pain or sudden breathlessness.

Sources 8, 3, 9

The operation

A caesarean is an operation to deliver your baby through a cut, usually 10 to 20 cm across the tummy just below the bikini line, and through the womb. Most are done under a spinal or epidural anaesthetic and take 40 to 50 minutes, and around 45% of babies in England are born this way. NICE recommends a low, straight cut across the skin with the layers underneath opened bluntly, which in our reading means the six-pack muscles are usually separated rather than cut.

Sources 10, 7

The first days

You'll be encouraged to get out of bed and move around as soon as possible. A catheter stays in your bladder for at least 12 hours, and the wound is covered for at least 24 hours. Most women go home after 1 or 2 days, and NICE says you can go home after 24 hours if you're recovering well. With enhanced recovery, Nottingham's team usually helps women up about 6 hours after the birth.

Sources 3, 7, 4

How long recovery takes

The Royal College of Obstetricians and Gynaecologists (RCOG) says recovery usually takes about 6 weeks but varies, and 1 in 10 women have discomfort for the first few months. In pooled studies, wound pain was still there in about 15% of women 3 to 6 months after a caesarean and in about 11% after a year or more; at 6 months, about half of it was mild.

Sources 1, 2, 11

The scar, and healing underneath

The scar is usually horizontal, red at first and fading with time; on darker skin it may fade to a brown or white mark. Pelvic, Obstetric and Gynaecological Physiotherapy (POGP) says caesarean scars take about 6 weeks to heal, can be tender, itchy or numb at first, and can take up to 2 years to fade. The layers underneath take longer than the skin: the UK return-to-running guideline says the scar in the womb is still remodelling at 6 weeks.

Sources 3, 12, 8

Risks to know about

Wound infection and infection of the womb lining are the common ones: NICE puts infections of the womb, wound or urinary tract at about 8 in 100. A blood clot in the legs or lungs is rare, but a caesarean raises the risk, so you may be given stockings and blood-thinning injections. A hernia through the scar is uncommon: in Denmark about 2 in 1,000 women needed a repair within 10 years, half of them after the less common up-and-down cut.

Sources 13, 7, 14, 15

What a caesarean doesn't change

NICE says a caesarean doesn't raise your risk of depression, post-traumatic stress symptoms or painful sex. A gap between the tummy muscles was found in 60% of 300 first-time mothers at 6 weeks, and a caesarean didn't make it more likely. And it doesn't fully protect your pelvic floor: leaking urine is less common than after a vaginal birth, but not rare.

Sources 7, 16, 1, 17

The 6-week check

Your GP checks how you're recovering and may examine your caesarean wound. Tell them about any leaking, pain or low mood, and ask about exercise. It isn't a fitness test, so being signed off doesn't mean you're ready to run.

Sources 18, 9

The timings are expert opinionStrong evidence

We found no trial that has tested lifting, driving or exercise limits after a caesarean. NICE says you can drive, carry heavy items, exercise and have sex again when you feel you've fully recovered, including from pain, and the NHS, POGP and the UK running guideline give expert timings that differ. The grade is for that statement: the timings themselves aren't trial-tested.

Sources 7, 3, 2, 8

Moving early is recommendedStrong evidence

The 2025 international Enhanced Recovery After Surgery guideline for caesareans strongly recommends getting up and walking early, though it rates the evidence as low quality. The NHS advises a daily walk to lower the risk of blood clots.

Sources 5, 3

Pain sets the paceEmerging evidence

In 98 women after a planned caesarean, daily steps rose steadily over 2 months, and on more painful days women took fewer steps: about 119 fewer for each extra point of pain out of 10. Taking regular pain relief helps you keep moving.

Source 19

Physiotherapy and tummy exercise trials are smallEmerging evidence

A review of 9 trials found physiotherapy after a caesarean, mostly electrical treatments with some massage and exercise, eased pain and helped daily activities. In a pilot trial of 24 women 4 to 6 months after a caesarean, adding kinesiology tape to tummy exercises gave bigger gains in tummy strength, pain and waist size than the exercises alone. The tummy programme on this page is borrowed from general postnatal advice.

Sources 20, 21

A caesarean doesn't fully protect the pelvic floorStrong evidence

RCOG says up to 1 in 5 women who give birth by caesarean leak urine, against up to 1 in 2 after a vaginal birth, and that pelvic floor exercises can help. In NICE's figures, about 1 in 5 women had urinary incontinence more than a year after a caesarean.

Sources 1, 17

Before a planned caesarean

West Hertfordshire's enhanced recovery leaflet asks women to be as healthy as they can before a planned caesarean, with daily walks building towards 150 minutes of moderate activity a week, starting gradually if you weren't active. Our pregnancy guide covers exercise in pregnancy.

Source 22

Days 1 to 7

Up and walking as soon as you can, a daily walk, the circulation and breathing exercises, pelvic floor exercises once the catheter is out, and the gentle floor exercises. Support your wound when you cough and roll onto your side to get up.

Sources 3, 2, 4

Weeks 1 to 6

Build up the time and pace of your walking every day, with the pram handles at the right height. Add knee folds, knee fall-outs and bridges when they're comfortable. Avoid straining for the first few weeks: long periods of standing, vacuuming, and heavy objects or bags. Lift nothing heavier than your baby, and let toddlers climb onto your lap rather than lifting them. Let pain set the pace.

Sources 2, 3, 19

Weeks 4 to 6: a static bike, if it's comfortable

The UK running guideline suggests a static bike or cross-trainer from about 4 to 6 weeks after a birth, depending on your recovery and type of birth, once sitting on a saddle is comfortable. After a caesarean, keep to walking and the floor exercises until the bike doesn't hurt your wound (our suggestion).

Source 8

From about 6 weeks

If it's comfortable: exercise classes, the gym, lifting more than your baby and light strength work, starting deadlift practice no heavier than your baby in a car seat. Harder tummy exercises if the middle of your tummy doesn't bulge. Swimming once your bleeding has stopped and your wound has healed, which may mean after your 6-week check.

Sources 3, 2, 8, 23

From about 12 weeks

Running and jumping, once the readiness checks are comfortable, and heavier weight training. Royal Berkshire's leaflet asks for at least 12 weeks before any impact exercise or weight training.

Sources 8, 23

Through the first year

The UK Chief Medical Officers say it's safe to be active after a birth, starting gently depending on your delivery, and to build towards 150 minutes of moderate activity a week, with strength work twice a week and pelvic floor exercises every day. The 2025 Canadian guideline says to build from light to harder activity once your wound has healed and your bleeding doesn't increase.

Sources 24, 25

Why it matters after a caesarean tooStrong evidence

Pregnancy itself stretches the pelvic floor. Leaking after a caesarean is less common than after a vaginal birth, but up to 1 in 5 women have it, and pelvic floor exercises can help.

Sources 1, 17, 2

How to do them

Imagine you're trying to stop yourself passing wind and passing urine at the same time: you should feel a squeeze and a lift inside the vagina. Don't hold your breath or clench your buttocks. POGP's aim is 10 long squeezes, each held for up to 10 seconds with 10 seconds' rest, then 10 short squeezes, at least 3 times a day, starting lying or sitting. Royal Berkshire starts with 3-second holds and suggests the NHS Squeezy app to remind you; don't practise while you're on the toilet. If your muscles were weak, POGP expects an improvement in 3 to 5 months.

Sources 2, 23

When to get help

See a pelvic health physiotherapist or your GP if you leak, feel heaviness or a bulge in the vagina, or can't feel the squeeze. Royal Berkshire says your health visitor or GP can refer you to maternity physiotherapy. Our pelvic floor guide has more.

Sources 2, 23

Your muscles are usually separated, not cutStrong evidence

In a standard caesarean the layers under the skin are opened bluntly, which in our reading means the six-pack muscles are usually separated rather than cut. In 300 first-time mothers, a caesarean wasn't a risk factor for a gap between the tummy muscles.

Sources 7, 16

Sit-ups and planks: not to start withStrong evidence

The NHS advises avoiding sit-ups, planks and high-impact exercises to start with, and straining on the toilet and heavy lifting. Begin with the gentle floor exercises. Royal Berkshire says you can start more progressive core exercises after 6 weeks, as long as the middle of your tummy doesn't bulge when you try to sit up.

Sources 6, 2, 23

If you have a gap

A gap between the tummy muscles is common after any birth. Our diastasis recti guide shows how to check it and build up, with harder core work from about 6 weeks after a caesarean once your scar is comfortable.

The "C-section pouch"Strong evidence

Tummy exercises strengthen the muscles but can't burn fat from one spot: training one area didn't reduce the fat over it in 13 studies with 1,158 people. Whole-body activity, time and scar massage after your 6-week check help most. See a GP about a lump, a bulge or pain near the scar.

Source 26

Scar massageMixed evidence

POGP suggests starting scar massage after your postnatal check, at about 6 weeks, once there's no infection, at least 4 times a week for 5 to 10 minutes, and the UK running guideline lists it from 6 to 8 weeks. Royal Berkshire says after 12 weeks, once the scar has fully healed. Our scar tissue guide shows how.

Sources 12, 23, 8

Belly bands and bindersEmerging evidence

In 13 trials, an abdominal binder eased pain by about 1 point out of 10 in the first 2 days and helped walking in the first day, with no more complications. It's optional, for comfort, and doesn't replace walking and your pelvic floor and tummy exercises (our suggestion).

Source 27

Pain that lastsStrong evidence

About 15% of women still have some wound pain 3 to 6 months after a caesarean, and about 11% after a year or more; at 6 months, about half of it was mild. See a GP if pain is getting worse or stops you being active.

Source 11

LiftingMixed evidence

The NHS: nothing heavier than your baby until you feel able, which may not be for 6 weeks or so. NICE: when you feel fully recovered. POGP: nothing heavier than your baby for at least 6 weeks. Royal Berkshire: nothing heavier than your baby or a kettle of water for 6 weeks. The UK running guideline: deadlift practice from 6 to 8 weeks, no heavier than a baby in a car seat.

Sources 3, 7, 2, 23, 8

DrivingMixed evidence

We found no fixed legal wait. The NHS says when you feel able, which may not be for 6 weeks or so; NICE when you feel fully recovered. RCOG says the standard advice is to allow 6 weeks and not plan to drive in that time, and Royal Berkshire says no driving for 6 weeks. POGP says check with your insurer, usually 4 to 6 weeks, and make sure you can wear a seatbelt comfortably, look over your shoulder and do an emergency stop without pain.

Sources 3, 7, 1, 2, 23

Exercise classes and the gymMixed evidence

The NHS: when you feel able, which may be 6 weeks or so. POGP: build up gradually over 6 to 8 weeks. Royal Berkshire: progressive core work after 6 weeks, but no weight training until 12. The UK running guideline: low-impact exercise from 4 to 6 weeks and resistance training from 6 to 8.

Sources 3, 2, 23, 8

SwimmingMixed evidence

POGP says you can swim once you've had 7 days with no bleeding or discharge, but after a caesarean you may need to wait until your 6-week check. The UK running guideline puts swimming at 8 to 12 weeks, once bleeding has stopped and your wound has healed.

Sources 2, 8

Our rule of thumb

About 6 weeks, or when it's comfortable, for classes, the gym and lifting more than your baby; swimming once your wound has healed and your bleeding has stopped; about 3 months for running and jumping. Ask at your 6-week check if you're unsure.

The UK guideline: about 3 monthsMixed evidence

The 2019 UK return-to-running guideline says running isn't advisable before 3 months after a birth, or later with pelvic floor symptoms, and names a caesarean among its reasons to expect a harder return. Its authors grade the rule as expert opinion.

Source 8

A more flexible consensusEmerging evidence

A 2024 international consensus agreed that, after at least 3 weeks of rest and recovery, an individual timeline can be considered after checks. A companion consensus backed starting with walk-run intervals, increasing gradually and including strength training.

Sources 28, 29

The readiness checks

Before you run, the guideline's checks include walking for 30 minutes, standing on one leg for 10 seconds, 10 single-leg squats each side, jogging on the spot for a minute, and 10 hops on each leg, all without pain, heaviness or leaking. Our postpartum guide and its return-to-running workout take you through them.

Source 8

Call 999

Call 999 or go to A&E (accident and emergency) if it feels like an emergency. Don't drive yourself:

• Sudden or very heavy bleeding, especially if you feel faint or dizzy.
• Chest pain, or sudden shortness of breath.
• Pain and swelling in your leg with breathlessness or chest pain, or coughing up blood (possible blood clot).
• Thoughts of harming yourself or your baby: get urgent mental health help.

Sources 9, 30, 14

Contact your midwife or a GP straight away

The NHS lists these after a caesarean, as they may be signs of an infection or a blood clot. Out of hours, call your maternity unit or NHS 111.

• Severe pain.
• Leaking urine.
• Pain when peeing.
• Heavy vaginal bleeding.
• Your wound becomes more red, painful and swollen.
• A discharge of pus or foul-smelling fluid from your wound.
• A cough or shortness of breath.
• Swelling or pain in your lower leg.

Sources 3, 22

Also get advice the same day

• Your wound starts to open.
• Bleeding that gets heavier or comes back after it had settled, or passing clots.
• A fever or shivering, flu-like symptoms with a temperature, or tummy pain with a discharge that smells unpleasant.
• A headache that is severe or won't go away.
• Red, swollen breasts that don't settle within 24 hours.

Sources 9, 22

If exercise makes things worse

If your bleeding turns red again, gets heavier or restarts after exercise, you've probably done too much: drop back, and tell your midwife if it continues (our rule, from Canadian and NICE guidance). The 2025 Canadian guideline says to talk to a doctor if harder exercise makes your caesarean symptoms, such as wound pain, worse.

Sources 25, 9

Ease off, and see someone soon

See your GP, health visitor or a pelvic health physiotherapist if you have:

• Leaking urine, wind or poo.
• Heaviness, dragging or a bulge in the vagina.
• Pain during sex.
• A tummy gap that's still obvious 8 weeks after the birth.
• Pelvic or low back pain that's still there at 6 weeks.
• Wound pain that's getting worse, or that stops you being active.
• Feeling low, anxious or unable to cope.

Sources 8, 6, 18, 2

A bulge or lump near the scar

A hernia through a caesarean scar is uncommon, but a bulge near the scar needs a GP's check: our hernia guide lists the signs that need urgent help. A painful lump in the scar that swells or hurts around your period needs checking too, as our scar tissue guide explains.

Source 15

If you can't keep yourself safe

If you're thinking about suicide or can't keep yourself safe, call 999 or go to A&E. For urgent help, call Samaritans free on 116 123, any time, or in England call 111 and select the mental health option. In the US, call or text 988.

"No exercise until your 6-week check"Strong evidence

Walk every day from the start and begin pelvic floor exercises once your catheter is out. POGP's gentle floor exercises are safe in the first days and weeks. The check is the time to ask about harder exercise.

Sources 3, 2

"A caesarean protects your pelvic floor"Strong evidence

Leaking is less common after a caesarean, but up to 1 in 5 women have it, and NICE's figures show about 1 in 5 with urinary incontinence more than a year later. Pelvic floor exercises help.

Sources 1, 17

"Signed off at 6 weeks means ready to run"Strong evidence

The check isn't a fitness test. Running usually waits about 3 months, and a caesarean is one of the UK guideline's reasons for a slower start; the 3 months itself is expert opinion.

Sources 18, 8

"Your tummy muscles were cut, so they'll never be strong again"Strong evidence

In a standard caesarean the six-pack muscles are usually separated, not cut, and a caesarean wasn't a risk factor for a tummy gap. Build their strength back gradually with the exercises on this page (our suggestion).

Sources 7, 16

"Crunches will get rid of the C-section pouch"Strong evidence

Training one area doesn't burn the fat over it (13 studies). Whole-body activity, time and scar care help most; see a GP about a bulge or lump.

Source 26

"You must wear a binder to heal properly"Emerging evidence

Binders eased pain by about a point out of 10 in the first 2 days in 13 trials. They're optional, for comfort, and don't replace the exercises.

Source 27

"Picking up your toddler will give you a hernia"Strong evidence

A hernia needing repair after a caesarean is rare: about 2 in 1,000 within 10 years. The advice to lift nothing heavier than your baby for about 6 weeks is for comfort and healing; let toddlers climb onto your lap in the meantime.

Sources 15, 2

"It's illegal to drive for 6 weeks after a caesarean"Mixed evidence

We found no fixed legal wait. Drive once you can wear a seatbelt comfortably, look over your shoulder and do an emergency stop without pain, and check your insurance: POGP says this is usually 4 to 6 weeks. Some hospitals advise 6 weeks.

Sources 2, 3, 1