bump physio c section recovery

In Canada, C-sections aka belly births make up approximately 28.2% of births and the rate is steadily increasing (Gu et al., 2020). More support needs to be provided to those who have had a belly birth because let’s be honest, recovering from a C-section is a challenging process. In this post, we will provide provide some tips and tricks to help you through those early days to make your recovery as easy and as optimal as possible. 

Rest

First of all, we need you to take it easy! Rest is the most important thing to aide you in your recovery. Your body has undergone major surgery, and your tissues need time to heal. In those first few weeks, you should be focused on getting to know your little one, ensuring proper sleep, hydration and fuelling your body with nutrient dense foods to help your tissues heal. As well, it’s important to make sure your pain is well managed and you take your medication as prescribed. Ask for help when needed. Recovering from a C-section can be difficult. Don’t be afraid to ask family and friends for assistance with childcare, household chores, or running errands.

Early scar care 

Be sure to watch for signs of infection around your scar which includes developing a fever, keeping an eye out for increased pain in the area, bleeding or discharge, increased heat, redness, or swelling. Splinting for movement is also important to support your scar as it heals. Apply light pressure to the scar area during transitional movements such as: turning over in bed, sitting up from sidelying or going from sit to stand. Splinting over the scar is also important when having a bowel movement, coughing, or sneezing. Try to avoid straining as it can pull on the scar or cause incisional pain. 

Another important early scar care technique is scar tissue desensitization. Introduce light touch, around, not on the scar, in the early stages of healing. Ensure you use different textures to help your nervous system heal such as a clean sponge, satin/silk, fleece and your fingers. This may help to avoid numbness around your scar. 

Silicone scar sheets can help soften and flatten the scar tissue and reduce redness (Bleasdale et. al., 2015). Another scar care option is Earth Mama Organics, skin and scar care balm.

Pelvic health considerations 

C-section births involve making incisions in the abdominal and uterine walls, which can impact the pelvic floor muscles. It’s important to retrain your pelvic floor muscles to decrease your risk of developing pelvic floor dysfunction including incontinence, pelvic organ prolapse or dyspareunia (pain with sexual activity) to name a few. Here’s what you can do to get started. 

Breathwork

Perform 10 deep, diaphragmatic breaths every time you feed your little one. Think about breathing into your scar. Gentle belly breaths provide early mobilization to the incision and your abdominal fascial. This can help prevent the scar tissue from ‘pulling’ later on. After a week or so, try adding in a gentle pelvic floor contraction as you exhale to encourage the pelvic floor muscles to activate and move through their range of motion. 

Bladder Health

Ensure you are drinking half your body weight in ounces of water per day at a minimum. You might need a bit more if you are breast or chest feeding or pumping. When voiding, ensure your pelvic floor muscles are allowed to relax, and you are not pushing or straining to void. 

Bowel Health

Smooth and regular bowel movements can be challenging to achieve after surgery for a number of reasons: pain, effects of pain medication or decreased mobility. Ensure you are consuming enough soluable and insoluble fiber as well as water to make sure your bowel moments are soft and smooth and straining is not needed to void. If you find yourself wanting to strain, elevate those knees and place your feet up on a stool or a Squatty Potty. Being constipated can put additional pressure and discomfort on your incision as well as your pelvic floor so it’s best to stay regular. If you have a tendency to be on the constipated side, chat with your medical provider on safe supplements or laxatives you can take to help in those early few weeks.  

Movement

Movement and rehabilitation after a belly birth should be slow and intentional to start. We are not competing against anyone and it’s okay to take things slow. It’s important to move your body in a way that feels good to you. Here’s a few tips to help get you started. 

Posture

Focusing on your posture is key in those early few weeks. While slouching may feel better on your scar initially because it approximates the scar tissue, and avoids pulling on it, however,  in the long run it can create scar tissue build up and a pulling sensation when you eventually do try to improve your posture. In focusing on your posture early on, it also helps with proper alignment of your spine and encourages proper pelvic floor muscles mechanics and activation.

Light walking

From 1-2 weeks postpartum, we encourage you to get outside and enjoy some easy walks, on flat surfaces somewhere between 15-30 minutes in length. If you start to experience any pelvic floor symptoms such as heaviness, pressure, pain, or bladder leakage its best to stop and try again another day. Slowly increase your distance and incline as it feels good to you and you remain symptom free. Walking helps with healing as it improves circulation, prevents blood clots, improves lung function, cardiovascular health and decreases infection risk (Dewi,  Maesaroh, Sulasih, Rahmadhani & Novyriana, 2022). 

Returning to Exercise 

When is it safe to return to exercise postpartum? Well, the answer is, it depends. Everyone’s pregnancy and birth is unique, and so are their postpartum recoveries. While it might be okay for one person to be able to plank at 3 weeks postpartum, it might take someone else 3 months to generate enough tension in their connective tissue of their abdominal wall to do so safely. When you are looking to get back into exercise after your belly birth, we recommend consulting with a pelvic health physiotherapist in your area who can provide a detailed and specific recovery plan tailored to you. 

Lacey Forsyth, MPT

Bump Physio & Co is a community of health care providers dedicated to changing the way pelvic health and obstetrical services are delivered. Our two clinics locations are Port Moody and Langley BC, where we treat beyond the Bump and welcome clients from all stages and phases of life. Our team has advanced training in Pelvic Health, Orthopedics, Obstetrics, Clinical Pilates, and Active Rehabilitation.

Please follow us along on our socials @bumpphysio.co keep updated on all that is going on and for more information about how the Bump Community can help YOU!

Citations 

Bleasdale, B., Finnegan, S., Murray, K., Kelly, S., & Percival, S. L. (2015). The Use of Silicone Adhesives for Scar Reduction. Advances in wound care, 4(7), 422–430. https://doi.org/10.1089/wound.2015.0625

Dewi, A. P. S., Maesaroh, S., Sulasih, U., Rahmadhani, W., & Novyriana, E. (2022). The Role of Early Mobilization on Wound Healing After Sectio Caesarea. Journal of Sexual and Reproductive Health Sciences, 1(1), 7-14.

Gu, J., Karmakar-Hore, S., Hogan, M. E., Azzam, H. M., Barrett, J. F. R., Brown, A., Cook, J. L., Jain, V., Melamed, N., Smith, G. N., Zaltz, A., & Gurevich, Y. (2020). Examining Cesarean Section Rates in Canada Using the Modified Robson Classification. Journal of obstetrics and gynaecology Canada : JOGC = Journal d’obstetrique et gynecologie du Canada : JOGC, 42(6), 757–765. https://doi.org/10.1016/j.jogc.2019.09.009