Author| Dr. Maureen O’Keefe, DPT Specialist in pregnancy and postpartum recovery
C-Section Recovery Tips
Congratulations on the arrival of your baby! If you had a C-section, you may be looking for some c-section recovery tips. We’ve got some suggestions here. We are Purple Mountain Physical Therapy, a specialty pelvic health PT clinic, in Grand Rapids, Michigan. We offer a postpartum recovery program that comprehensively helps you build back your core, pelvic floor, posture, breathing and cesarean scar recovery. If you are interested in learning more about our care, contact us here.
C-Section Recovery Tip 1: Recovery Begins Day One! Bladder & Bowel Function Should be Monitored
In your first day after a C-section you will be at the hospital, receiving care. The first urination and bowel movement can be challenging. Our first of thirteen C-section recovery tips is that you monitor your Ins & Outs! By this we mean, write down how much you eat and drink and write down when you urinate or pass a bowel movement. Over the years we have worked with numerous people who sustained a bladder injury after giving birth when they did not feel an urge to urinate, so their bladder overfilled. This can happen due to medications, anesthesia and your body having gone through so much. We recommend that you assign your partner or a family member to monitor your urinary output. Even if you have a catheter, monitor the output! We have treated patients whose catheters got kinked and this caused an overfilling of the bladder. Before you give birth, we suggest you assign someone to be in charge of monitoring and recording your bladder and bowel. They should write this information down, because it will be forgotten. In the notes detail the timing of everything and the quantity and type of food or liquid consumed as well as the volume and color of the urine and stool. Your provider will advise you on best methods to avoid constipation. Commonly Colace is prescribed. Dietary strategies to reduce constipation should also be implemented.
Tip 2: Movement Helps Your C-Section Recovery
Movement always helps, but it may take you some time to get out of bed and walking the halls of the hospital. Our next C-section recovery tip is that you should move gently and purposefully as soon as you are able and it is safe to do so. Begin with gentle movement in your bed. Pump your ankles. Gently slide your knees bent and straight. Do some glute sets, just squeezing your glutes. Bend and straighten your elbows, circle your wrists. Partially raise your shoulders. There is a good amount of movement you can perform that will not stress or strain your abdominal wall and back. C-Section Recovery should be very gentle in the beginning stages and slowly and carefully advanced over the weeks. Working with a pelvic PT to best advise you is recommended.
As the weeks progress, begin to include walking into your movement routine. You can also gently add shoulder movements and trunk movements. If you feel comfortable performing light exercises, such as a minisquat or a bridge in bed, you can do these things. Even though you had a cesarean, we know that your pelvic floor, core and posture completely changed with your pregnancy. So, you would benefit from pelvic floor rehabilitation, also. If you want to learn more about the benefits of PT, check out this blog we wrote about the benefits of PT. Walking is an excellent way to facilitate the return of pelvic floor function. You should be able to walk without urinary incontinence and without any cesarean or pelvic pain. Go slowly and for short distances at first and by 6 weeks you can be walking at a more normal pace for longer distances, if your recovery has been uncomplicated. If you are interested in learning more about our postpartum recovery program for cesarean healing, contact us here.
Tip 3: Roll to your side to get out of bed. Consider bracing your abdominals with a pillow.
The third of our C-section recovery tips is for those of you who are scared to get out of bed. We know you are in pain. We know it looks daunting when you need to get out of the bed and into the chair or bathroom. When you do decide to get out of bed, we recommend that you roll to your side very carefully and consider using a pillow to brace your abdominal wall when you complete this movement. Someone else should always be holding your baby as you move, don’t expect to adjust yourself, even slightly, when nursing the baby. The c-section incision and pain you will experience is the obvious reason for rolling in bed. And, also, pregnancy changes the abdominal wall, causing it to be elongated and in just about everyone a diastasis recti abdominis occurs. These anatomical changes to the abdominal wall render it safer for you to carefully roll to your side when getting out of bed.
C-Section Recovery Tip 4: Rest is your friend always, especially in the beginning stages of healing.
If you feel comfortable with your baby staying in the hospital nursery so you can rest, do this. This next C-section recovery tip is easy to say and hard to implement. Prioritize your sleep! There can be so much celebration, visitors and excitement, it is easy to not get the rest you need. Hospitals are notorious for interrupting your sleep numerous times in an evening; do your best to ask your nursing staff if they can consolidate their visits to your room. Once you are home, you still need adequate rest to promote optimal recovery. The baby’s feedings will disrupt your sleep. Do what you can to provide yourself rest during the day and at night. There are numerous things you can do to create time and space for your recovery. Some suggestions:
Going to bed at a reasonable hour, freezing meals before giving birth, hiring a cleaning person, receiving help from friends and family.
Tip 5: Monitor for Signs of Infection.
Your provider wants to be called if you suspect you may have an infection. You are never bothering them. Always call. This c-section recovery tip sometimes is overlooked by all of us. We don’t want to look at the wound, we don’t want to know what is going on “down there”. This is not wise. Following cesarean you want to monitor your wound to make sure it is healing without an infection. You also want to monitor your bladder for signs of a urinary tract infection. If you pushed vaginally before having a cesarean, you also should be monitoring your perineum to ensure it is recovery fine. A fever is a major sign of an infection. Excess drainage that smells or appears pussy or not the right color is another sign. Pain levels that are higher than expected are red flags for infection. In the early stages of healing allow shower water to thoroughly run on the wound to keep it clean. When you finish your shower, gently pat it dry. As the weeks progress your cesarean scar should not be painful. Yes, commonly, my patients tell us they don’t like their scar touched, but it is not painful to have it touched. If it is weeping fluid or excessively painful, this is not optimally cesarean recovery and you should contact your provider.
C-Section Recovery Tip 6: Exercise should begin at a very basic level. Low impact, gentle movements
Begin with Breathing exercises
After C-section, to promote recovery begin with breathing exercises, using your diaphragm. The pregnancy completely changed your ribcage, abdominal muscle attachment to the ribcage and your diaphragm position. As a result, completing breathing exercises is a very helpful way to facilitate recovery.
We recommend breathing exercises be performed in all postures, including standing, sitting and lying down. You may elect to perform these lying down to begin, as that is most relaxing. When you engage your diaphragm, intentionally aim to have your lower ribs inflate with each inhale and deflate with each exhale. As best you can breathe in & out using your nose. If possible, prolong your exhale so that it is longer than the inhale. This will calm your nervous system and bring up your parasympathetic nervous system activity, which is soothing and helpful for recovery. We provide a combination of hands-on treatments to your thoracic spine, rib cage, low back, hips and abdomen to promote effective breathing mechanics. If you are interested in learning more about our postpartum recovery program, contact us here.
For Cesarean Recovery advance to basic isometric core exercises:
Performing things like mini squats, mini lunges, hip circles, heel raises, side lying hip abduction (hip raises) can be helpful. Include some isometric deep abdominal engagement. You can pair the breathwork with the abdominal engagement: as you exhale contract your abs.
Tip 7: Your C-section recovery fitness program can begin to advance to include more core exercises, more dynamic leg movements and weight lifting
Recovery of the elongated abdominal wall + diastasis recti abdominus + cesarean surgery = a lot of work. But, you’ve got it in you! I know you can do it. We have helped countless women recover their core and we know the strength of mothers! The seventh of our c-section recovery tips includes that we recommend you create time to complete your workouts. Otherwise, you know they don’t get accomplished. Many times our patients do not know which exercises are beneficial, what exercises would be safe for them to do and the specifics of which exercises are harmful to their recovery. If you would like to partner with a doctor of physical therapy, to receive an in-depth assessment of your body and a customized program for your cesarean recovery, contact us here.
C-Section Recovery Tip 8: Pelvic Floor Recovery is important with Cesarean Birth
The pelvic floor muscles work all day long as postural muscles. When someone has a cesarean birth, it is common that their posture is altered, either from the pregnancy or the birth. Restoring your posture will help facilitate the automaticity that your pelvic floor should be having all day long, so you don’t lose urine or gas unexpectedly.
The pelvic floor needs to be able to let go in order for you to pass a bowel movement, urinate or comfortably be intimate. We often find that people who underwent a cesarean birth may develop a stiffness and tension in their pelvic floor. The symptoms of pelvic floor dysfunction can include a number of things, such as
Pelvic pain, urinary incontinence with cough, sneeze or laugh, urge urinary incontinence, urinary retention, constipation, recurrent hemorrhoids, pelvic pressure, perineal pain, pubic pain, tailbone pain, intimacy pain, urinary frequency and urgency, bladder pain, nocturia (getting up at night to urinate). If you have any pelvic pain, we have written an article about pelvic pain that you may be interested in reading.
Tip 9: Your Scar Tissue Needs to Be Mobile
We check every scar for it’s mobility and adhesions. Cesarean scars, like all scars, will lay down scar tissue in response to the forces you give it. This means that to promote optimal scar tissue formation, you need to be moving in a variety of directions and adopting high quality, upright posture. If you stay in a guarded, curled up posture you may have difficulty with your scar tissue. If standing up with good posture is hard for you, because you are in pain, we recommend you work on lying down on the floor instead. You can begin lying down with a pillow under your head and your knees. Reach your arms out to the side and overhead. Then return your arms to your sides and remove the pillows. Lie flat on the ground while you do your breathing exercises. If you feel comfortable, consider bending your knees again and then dropping them down to the side; this will create a gentle spinal twist. To be clear, you do not want to complete this in the early stage of recovery, it is too much on your sutures and healing wound. Our doctors of physical therapy provide expert scar mobilization hands-on treatments. These are gentle, effective and so many of our patients notice an immediate improvement in how their scar feels or how effectively they can take a deep breath. If you are interested in learning more, contact us here. Alternatively, you can call our office at 616-516-4334 and our front desk patient care coordinator is happy to answer any of your questions.
Tip 10: Mobilize your C-section scar after your incision has completely healed.
Scar tissue is fragile! Be gentle with yourself. Do not drag the tissue or create tears in the tissue. Scar mobilization can be performed safest above and below the scar, rather than directly on top of it. The tenth of our c-section recovery tips is to very delicately move the tissue that is above the scar and below the scar. This should be able to move all directions without pain. If you feel restriction in one direction you can consider breathing while you hold this tissue and invite the tissue to have some give.
Tip 11: C-section scar mobilization and desensitization can help old scars, too.
We commonly work on scars that don’t feel great. Even old scars can benefit from hands-on treatment to get them less adhered and to reduce pulling and sensitivity. One thing that can help some people is gently rubbing a sensitive scar with a variety of fabrics that have different textures. Our eleventh of our thirteen c-section recovery tips is to try silk, satin, corduroy, velvet, cotton, paper towels, etc. Again, be gentle with your scars, they can be delicate. If you would benefit from expert scar desensitization, our PT specialize in this. Call our office at 616-516-4334 to speak with our patient care coordinator or contact us here.
Tip 12: C-Section Recovery can feel overwhelming. You deserve customized recommendations and treatment that holistically helps you.
This c-section recovery tip validates what you are going through. This was major surgery. Recovery from any major surgery, such as hip surgery, always includes a referral to physical therapy afterwards. Something has gone wrong with our society; we do not support the mother’s recovery in the same way we support recovery from other surgeries. We focus nearly entirely on the baby and very little support is provided to the healing mother. Postpartum recovery, whether vaginal or cesarean birth, takes diligence and progressive advancement. Everyone’s body is different. We assess and treat anything that is bothering you, from head to toe. People are often surprised that a pelvic PT includes this level of holistic care, but pregnancy changes the entire body and we are experts at helping you resolve those changes. When we work with you, each appointment is private, in a comfortable treatment room and upt 55 minutes in length. We never bounce you around amongst providers so that you develop a trusted relationship with your doctor of physical therapy. This also ensures that your care will be progressively advanced each week in therapy. We provide every patient a complete home program and other recommendations for self care at home. Many of our patients tell us that completing the postpartum recovery program with our physical therapist has been the most important thing they have done. To learn more contact us here.
Tip 13: Optimize your overall health and pregnancy recovery before getting pregnant again.
This may be one of our most important c-section recovery tips: adding a next pregnancy onto a body that has not optimally recovered is not recommended. We advise all of our pregnant and postpartum patients to prioritize their health, fitness and recovery so that if you decided to have more children, your body is ready to handle the load of the pregnancy. If you decide to not have any more children, your recovery is also important. You deserve to feel your best. High quality pelvic PT, like what we offer at Purple Mountain PT, can be life changing. Don’t put off getting started, there is never a good time. Just do it! Contact us here to learn more.
Purple Mountain Physical Therapy is a specialty pelvic health clinic located in Grand Rapids, Michigan. We treat all pelvic conditions and TM joint disorders. We are pregnancy and postpartum specialists and have helped countless women through their journey towards feeling good, strong and whole, including women who underwent cesarean birth or repeated cesarean births. We hope these c-section recovery tips are educational and get you thinking about how you can optimize your recovery. If you experience any pelvic floor dysfunction during pregnancy or when postpartum, please know you don’t have to live with it. To read more about pelvic floor therapy, you may be interested in this article we wrote. We offer birth preparation, guidance in safe pushing, practice in breathing and releasing your pelvic floor, exercises for diastasis recti abdominus and more. You should not have pelvic girdle pain when pregnant or postpartum. You should not have urinary incontinence, frequency, urgency or retention. You should not have fecal or flatulence incontinence, constipation, fissures or pain. You should not have pain with intimacy, reduction in responsiveness or decreased sensation. You should not have abdominal pain, cesarean scar restrictions or pain or perineal scar pain. You should not feel vaginal or pelvic pressure. If you have any of these symptoms, we can help you. We offer expert care that is compassionate, trauma informed and based in years of experience helping women just like you to overcome their pelvic and TM joint problems. Call 616.516.4334 to connect or reach out to us here to learn more!
All of our suggestions here are general educational information and not meant to be medical advice or recommendations specific to you. Work with your provider to determine the appropriate course of recovery for your body.
Peace,
