I’m a c-section mama. Twice over.
The first time I delivered via emergency c-section, my beautiful, well-thought out plan for a quiet delivery was thrown out the window when the baby went into distress for no reason anyone could discern. The second time, because…well, no one wanted a repeat of my first go around.
After my first was born, I couldn’t stand straight to walk. I hunched, too in pain and too afraid to lengthen my abdominal muscles. I couldn’t get out of bed without a hand to pull me up, because throwing my feet over the side of the bed and bending at the waist was impossible.
After my second, I walked out of the hospital a day early: upright, painless, but with no sensation in my lower abs.
Each of my recoveries was different from the other, and from the recoveries of my friends who’d had either a c-section or a vaginal birth. Not necessarily easier or harder, but different. Which makes sense. A c-section is a delivery, along with a major abdominal surgery. Afterward, not only is your body healing from giving birth, but it is also healing from an incision that cut through layers of muscle.
“A cesarean section is major abdominal surgery. As with other surgeries, recovery is typically six to eight weeks,” says Dr. Blair Green, a pre/post-natal physical therapist and co-author of Go Ahead, Stop and Pee: Running During Pregnancy and Postpartum. “But it’s also important to remember that a number of other factors—including physical status during pregnancy, labor, and life demands in the early postnatal period—will affect the pace and timing of return to activity.”
Impact of a C-Section on Your Abdominal Muscles and Pelvic Floor
Whether vaginal birth or c-section, pregnancy is hard on your core, but c-sections require additional trauma. The connective tissue of the abdominals has to be cut and the muscle separated in order to reach the baby. Afterward, all those layers need time to heal.
Many women believe that having a c-section removes the risk of suffering from pelvic floor dysfunction—a common issue for vaginal births. The risk, while lessened, is not non-existent, according to Dr. Green.
The pelvic floor works as a team with the abdomen. Any trauma to the abdomen can affect the pelvic floor.
C-section mamas might also experience diastasis recti, a condition where the muscles in the abdomen split. It’s common in pregnancy and not exclusive to c-section mamas. Though it may increase healing time for some new moms.
Exercises to Help Heal During a C-Section Recovery
Dr. Green recommends a number of exercises to help during a c-section recovery—and they are all doable by anyone, anywhere. The first is simply to breathe. But make that breath deep and diaphragmatic; let it expand your ribs and belly. Let it be intentional. Taking deep breaths from your diaphragm allows your ribs and belly to expand to make room for your abdomen to lengthen.
Second—stand upright (which was easier said than done after my first c-section). In any pregnancy, the growing uterus adds extra tension to the abdominal wall. With the added stress of an incision, it’s even more important to take time to stand upright, which allows the body to heal the muscles in an elongated position.
After about four to six weeks, Dr. Green also recommends adding scar massage into your recovery routine. As long as the incision is closed and is not red or painful, you can use your second and third fingers to gently massage the area along the length of the scar and perpendicular to the scar.
And don’t forget the pelvic floor! During pregnancy, the best thing to do for your pelvic floor is to stay active. Keep walking and keep that pelvis moving. Dr. Green recommends pelvic clocks—which are exactly what they sound like. Sitting on an exercise ball or standing, facing a wall, with your arms out on the wall, move the pelvis clockwise, like you are using a hula-hoop. Then reverse. She also recommends cat/cow exercises—arching and doming the spine while lengthening and tucking the tailbone—to keep mobility in the pelvis.
After the C-section, any exercise program should also include exercises to strengthen and relax the pelvic floor muscles. For this, a pelvic health therapist might be able to help assess the function of the abdomen and pelvic floor.
Will I Feel “Normal” Again?
Yes!! That’s a resounding, double exclamation point, yes! It takes time, especially if you are not only caring for a newborn, but also other children. But yes, you will feel your version of normal and you will run again (if that’s your thing) or dance or swim or yoga. The possibilities are endless.
But, don’t forget to take your time, listen to your doctor’s recommendations, and pay attention to your body. Maybe rather than counting sit ups (which should be avoided in those first post c-section weeks) you pat yourself on the back for sitting up without help, for standing straight, for being super mom—because you are, even when you don’t feel like it. Don’t be afraid to seek the advice of a pelvic health physical therapist if that’s available to you and then to get help when you need it. If you’re struggling, getting help is the best thing you can do for yourself and your baby.
Dr. Green has one last piece of advice for any new c-sections mamas: Remember, you just gave birth to another human being. Be proud of that, give yourself grace, and do what feels best for you.