What got cut?
How does this affect the strength and the look of your stomach?
Which exercises will help and how soon can you start?
So you had your baby by C section. What happened in there?
Just because lots (that’s millions) of women have a C Section, that doesn’t mean it’s not major surgery. Don’t underestimate the physiological trauma your body has undergone, and don’t let anyone make you feel like it’s no big deal or an easy ride. Giving birth, however you do it, IS a big deal.
When you have a C Section, the surgeon makes a horizontal incision with a scalpel, just above the pubic bone, through five layers of skin, tissue, and muscle…
1) The derma, or outer layer of skin
3) Fascia, the tough, thin layer that supports the muscle
4) The rectus abdominal muscle – manually separated using fingers
5) Peritoneum, a shiny layer that encases the entire abdominal cavity
… to reach the uterus, the amniotic sac, and your baby.
A ‘bikini line’ transverse (side to side) cut is more common, as this results in less scarring and chance of infection or complications. A vertical cut is usually now used only in emergency situations and can be slower to heal, with more scarring.
The surgeon manually separates the two strips of rectus muscle at the midline to gain access. This is important – your muscles have not necessarily been cut!
What does that mean for your belly?
Layers of tissue are cut and then sewn back together, which creates scarring through multiple levels of tissue of your abdominal wall. This scarring affects the muscles’ ability to glide over the top of each other during muscle contraction. The result is weakness and a lack of stabilization.
If you have had more than one C Section, with a gap of fewer than two years in between, then your abdomen may not have repaired completely before your body went through the whole process of pregnancy and surgery again. Your recovery and ability to regain physiological balance is related to hormones, body weight, posture and alignment, and muscle tone.
Starting with stronger abdominal muscles will help with recovery, and strengthening the deep muscles of your core and pelvic floor during pregnancy will give you the “muscle memory” to make it easier to do the exercises after the birth.
But if you’re reading this and your stomach muscles can’t remember last Tuesday, let alone how to synchronise with your pelvic floor, don’t worry!
Exercise 0-6 weeks after C Section: Just find the right muscles
Start as soon as you can. You’re not ‘exercising’, you’re breathing and re-connecting your brain to your tummy and your pelvic floor.
The sooner you do this after any type of birth, the better.
You need your core if you want to stand up, sit, move, twist, pull, push, bend or turn. It’s connected (literally) to the muscles of your pelvic floor, which you need to prevent you from wetting yourself or having a prolapse. You also need functional core muscles to help close diastasis recti or separation of your abdominal muscles. And if you want a flatter tummy after having babies, you need all of the above.
After a C Section, you will experience numbness around your scar site, and so the visualisation of ‘gently drawing belly button to spine’ may be unhelpful as you may not be able to feel this movement.
Instead imagine your abdomen as a clock, with your belly button at 12 o’clock, your pubic bone at 6 o’clock, and your hip bones as 3 and 9. Imagine you are slowly and gently drawing the hip bones, or 3 and 9 o’clock, together. It will also work if you imagine you are drawing them apart! Don’t worry that you can’t feel much happening for now. Go gently and do the movement on a long, slow exhale.
At the same time, engage your pelvic floor muscles.
Practice these breathing exercises with coordinated pelvic floor muscle contraction as rest and recover, and as you feed your baby. Take long slow breaths, exhaling with gentle muscle contractions, inhaling with a complete release and relaxation of the muscles.
Don’t try to get straight up from lying on your back – always roll to your side first. And avoid sit-ups or crunches.
Get outside for a gentle walk as soon as you feel able. Activity will help your emotional health, as well as increase circulation to aid healing and scar tissue.
If you have had one or more C Sections or other abdominal surgery, there will be scar tissue or adhesions. This is where the collagen (connective tissue) is laying down and binding, to repair and heal. The process can result in tightness or pulling sensation around your scar. Massage can help relieve this and aid comfort and healing. Rub and massage the skin gently between your fingers around the scar to help to break down scar tissue, encourage oxygen flow in, and toxin flow out of, the area.
Whilst muscles have not been cut, ligaments and fascia have been, and this all takes time to heal. The more you can ‘connect with’ and use your deep core muscles with breathing exercises, the quicker the recovery will be. Scar tissue and adhesions can cause a tummy overhang, and body fat may appear to be unevenly distributed around your middle.
Diet and nutrition after C Section
What you eat plays a HUGE part in your body’s ability to heal after C Section! You should aim for a diet rich in clean protein, with plenty of green and deep coloured vegetables, berries, essential fats and fibrous vegetables and fruits for good gut health. Choose anti-inflammatory foods such as garlic, green tea, turmeric and ginger – these foods will help your body and C Section scar site to heal and recover.
Hydration is super-important too. Drink lots of water, herbal teas and water-rich foods.
Stress, lack of sleep (I know.. unavoidable for a new mom!) and inflammatory ‘comfort’ foods or drink like sugar or alcohol will hinder healing. So…
In the early days:
- find and strengthen your deep muscles
- eat clean fresh food to recover and nourish your body
- try to get plenty of sleep
- and love your body a little.This will help you heal, restore and strengthen your abdominal muscles.