This is Episode 123 of the Juna Women Podcast, Recovery After C-Section.
The Juna Women Podcast is a weekly discussion where Juna Founder, Sarah Kuhn, talks to Moms about their health, work, parenting, and all the different ways they’re keeping it together.
In this episode, Sarah talks with Katie Hunter, a pelvic floor specialist from Southern California. They talk all about recovering after having a C-Section.
What is a C-Section?
A C-section is when an OB or Surgeon cuts through the abdominal wall to in order to delivery your baby.
The surgeon typically cuts through five layers of tissue, including fascia. That involves three out of four of the muscles that make up the abdominal wall.
During C-section recovery the ab muscles “turn off” so that your wounds can heal.
As a result, this puts more stress on the pelvic floor muscles to continue to stabilize the pelvis, support the organs, and help you move, walk and take care of your newborn baby.
What happens to your pelvic floor during pregnancy?
During pregnancy the pelvic floor protects the pelvis, supports the organs, and keeps the openings closed so that you don’t lose control of bladder and bowels.
Even before pregnancy, the pelvic floor plays a huge role in how we function in everyday life. Then during pregnancy you have the added weight of the baby and the uterus putting pressure on the pelvic floor.
Our joints, particularly the joints of the pelvis become lax and loose. As a result, our muscles have to work harder to keep the joints stable.
What is the difference between a vaginal birth vs C-Section from a pelvic floor perspective?
In a vaginal delivery the pelvic floor goes through a major stretch and then requires more pelvic floor recovery than during a C-section. In a C-Section the pelvic floor doesn’t go through that same stress.
Both vaginal and cesarean are a lot of work on the pelvic floor because you’re taxing a muscle that’s been working really hard.
The first two weeks of recovery after C-Section involve the scar closing and healing.
So during the first 2-4 weeks, depending on how the scar heals, or if there’s any complications along the way, your body’s working really hard to close that incision heal the skin, heal the deeper fascia, and the uterus itself.
During that time the scar is expected to be somewhat painful. Movement is going to be painful and feel really difficult because your abs are not functioning at 100 percent.
Between weeks 4-8, the incision has healed and should be less painful. You may feel a bit more energy and like your strength is coming back. You may be more mobile, but keep in mind it takes a full 8-12 weeks for your scar to heal.
Belly Binders and Recovery After C-Sections
Belly Binders are great. They are going to hold the abdominal wall together in a way that your muscles can’t right after c-section.
Belly binding should be used only when you’re upright and moving around, walking around the house, or taking care of your baby.
If you’re sitting or resting and laying down you can take your belly binder it’s going to cinch the abdomen in a way that can potentially put pressure into the pelvis and more pressure on the pelvic floor.
How Long Should I Wear The Belly Binder?
The first four weeks are great for belly binders. Between weeks 4 through 6 you might start to feel like moving in and out of bed and getting out of a chair is starting to feel a little bit easier.
As you introduce things like walking around the house or in your neighborhood, you may want to keep it on until you feel really secure.
Pain During C-Section Recovery
If you find that normal activities like sneezing, coughing, or laughing are painful there are some things you can do to help.
- -Providing counter pressure on your abdomen. If you anticipate a sneeze or cough have a pillow next to you, grab the pillow and hug it into your belly. That’s going to help create counter pressures so that all of the force that’s coming out with a cough or sneeze is being taken by the pillow.
- -For getting out of bed, it can help to roll to your side and sit up at the side of the bed. Normally you would sit straight up, but rolling over is easier on the pelvic floor and core.
- -Breathing out as you stand up will help distribute the same kind of pressure and force. Any time you stand up, breathe out.
- -Getting your body as close to the bassinet as physically possible is going to help you pick up the baby. It distributes the weight more evenly.
- -If you have stairs, turn your body so you are stepping up sideways.
Scar Desensitization During C-Section Recovery
The point of scar desensitization is to make the skin less sensitive to the touch.
Most of the healing should be done by the six week mark, but it’s really around 12 weeks where most people are back to their normal function.
Between six and 12 weeks if you notice that your scar is more sensitive with your clothing then desensitization is a great option..
To help with desensitization start with a soft fabric like cotton, jersey or a silk.
Take that soft fabric and rub it on the scar to get your nerves used to being touched Do that every day for a couple of minutes.
As that becomes comfortable start to introduce more textured fabrics like a towel or a flannel.
Scar Tissue Mobilization During C-Section Recovery
As soon as the skin surface layer has healed you can start really gentle subluxation or massage on your own.
If you’re so freaked out about touching your scar, you can wait until you can see a professional and teach you how to do it.
To do scar tissue mobilization, start with some oil and gently rub small circles on your scar. Do this every day after taking a shower.
A shower helps warm the tissue and makes it easier to massage.
When can you start exercising after surgery?
After any major abdominal surgery in a hospital the goal is to get up out of bed, try to stand and walk.
Moving and walking helps with circulation, healing, and blood pressure. That’s the goal right away and for the first 1-2 weeks.
Everyone is going to heal differently, so take it at your own pace.
In those first two weeks if you’re moving from the bed to the bathroom that’s a great start. You’re doing the most that you need to be doing. After two weeks then you should start moving more around the house.
By Week 4 you should feel comfortable to take short walks outside in your neighborhood.
By weeks 6-8 is when exercise can usually be started, after you’ve been cleared by your provider.
Core focused exercise after c-section
After pregnancy and during c-section recovery most people need to retrain their core muscles. Some of the signs that your core is weak include:
- -mom pooch
- -lower back pain
- -pelvic pain
- -urinary incontinence
- -balance issues
- -generally feeling like you can’t regain strength in your core
What is the C-section shelf and why does this happen?
The C-section shelf is extra skin and a little bit thicker fat pad than you may have before pregnancy.
The scar looks pretty indented and there is an overlay of skin that’s hanging over the scar itself.
What is the Mom Pooch?
The “Mom Pooch” is a a concern for someone who’s had a C-section versus someone who has had a vaginal delivery.
The difference between the mom pooch VS the C-section shelf is that the mom pooch looks more like a bulging abdomen.
For more on c-Section Recovery, please listen to the entire podcast episode with Katie and Sarah.
They break down the pros and cons of having a VBAC, teach you how to advocate for yourself, and share their personal stories which led them where they are today.
Get In Touch With Katie Hunter
Katie is a physical therapist specializing in pelvic floor muscle dysfunction.
Katie has gained clinical experience by working for a hospital-based pelvic health practice and two prominent pelvic health private practices in Southern California.
Katie specialized in pelvic health immediately after receiving her Doctor of Physical Therapy from Western University of Health Sciences.
She has received additional clinical training through direct mentorship and post-doctoral education through courses hosted by Herman and Wallace Pelvic Rehab Institute, Barral Institute, Institute of Physical Arts, and the APTA Academy of Pelvic Health Physical Therapy.
Katie’s true passion is combining the science of physical therapy with the art of patient care to help people improve their most essential functions.