According to the CDC, in 2013, C-sections accounted for 32 .7% of US births[i]. That’s one in three births, people. No matter how fit we runners are, even we are very likely to deliver our babies via c-section.
However, as runners, there’s one thing we are also likely to do: disregard medical advice, especially when it comes to things like rest and recovery time. Those recommendations are for average people and we runners are anything but … or so our thinking goes.
When it comes to c-section recovery, doctors recommend a 6 week break from exercise. SIX weeks off?! You’re joking, right?
Let’s discuss whether this six weeks break applies to highly trained runners, too.
Turns out that the evidence behind the mandatory, across-the-board 6-week off timeframe is scant and non-specific[ii],[iii]. [editor’s note: we don’t often use footnotes, but because this is a serious medical issue, we are using them to cite our sources.] It seems strange to me that a highly trained runner who ran almost her entire pregnancy has to wait as long as a deconditioned, non-runner before she is advised to begin running after her c-section. The American Congress of Obstetricians and Gynecologists (ACOG) statement reads:
Prepregnancy exercise routines may be resumed gradually as soon as it is physically and medically safe. This will vary from one individual to another … There are no published studies to indicate that, in the absence of medical complications, rapid resumption of activities will result in adverse effects.[iv]
(Disclaimer: the statement does not specify whether it is referring to vaginal or caesarian births. My guess, though, is that they are referring to both types.)
So does that mean a seasoned runner can resume running before the 6 week mark? Not exactly. Most midwives and OBGYNs still recommend 6 weeks off to everyone, but the way I interpret this statement is that we post-partum athletes can question this advice.
This is exactly what I did. After my c-section, I asked my OBGYN when I could resume running. I LOVED the answer he gave me: “When you are ready. I am not going to give you a timeline.” So I took that VERY liberally and did not ask again, since he already gave me the answer I wanted.
I decided to make myself a case study in athlete c-section recovery! I am now 7+ weeks out, and ran 10 miles literally pain-free last Saturday. I admittedly started running sooner than I should have and I paid for it for sure! But my end result has been great and I am thrilled with how good I am feeling. I will blog my week-by-week training logs here, so you can see how I’m progressing. I also, as I discussed in a previous post, I laid several ground rules for myself in preparation for my return to running.
It’s important to understand that my decision was based on my experience. My c-section was very uncomplicated. It went as smoothly as could be. There are many scenarios which will slow return to running and recovery time, and in those cases, even 6 weeks off may not be enough.
My next post will be a summary of some of those issues, such as c-section type, incision type, and post-operative complications. I would also like to add that this post, nor none of my upcoming posts, are official medical advice. Every person, body, runner, surgery, case, pregnancy is different. The most important thing to consider when returning to physical activity is the advice of your personal healthcare provider. And equally as important as listening to your healthcare provider is listening to your own body, since we runners tend to know our own bodies very well.
What do you think, Salty readers? Has a baseline of good physical fitness helped you recover sooner from an injury? Have you ever disregarded medical advice? If yes, did this hurt or help your recovery?
[i] CDC Fast Stats. Retrieved online 4 Oct 15 from http://www.cdc.gov/nchs/fastats/delivery.htm
[ii] Evenson KR, Mottola MF, Owe KM, et al. Summary of international guidelines for physical activity after pregnancy. Obstet Gynecol Surv 2014; 69:407
[iii] Berghella, V. (2015). Cesarian delivery: postoperative issues. Retrieved online from Up-to-Date on 1 Oct 2015 from http://www.uptodate.com/contents/cesarean-delivery-postoperative-issues?source=machineLearning&search=c+section+post+operative&selectedTitle=1%7E150§ionRank=1&anchor=H2#H124488547
[iv]Exercise during pregnancy and postpartum period. American Congress of Obstetricians and Gynecologists. ACOG committee opinion Number 267, 2002. Reaffirmed in 2009.