Everything you need to know about c-section recovery

So you had your baby by C-Section. You might be wondering what exactly happened in there and what you need to know for your C-Section recovery.

Just because lots (that’s millions) of women have C-Sections, 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. C-Section recovery is a huge undertaking and it’s important to know what you can do to help support your body during recovery.

What exactly happened during the C-Section?

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…

The derma, or outer layer of skin
Fat
Fascia, the tough, thin layer that supports the muscle
The rectus abdominal muscle – manually separated using fingers
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.

C-section scar dark skin — Image used with permission from Pelvic Guru®, LLC as a member of the Global Pelvic Health Alliance. www.pelvicglobal.com

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! But they still go through a lot – and pain and inflammation around the muscles and ligaments near the back can often lead to post-cesarean back pain.

so TLC for the core muscles is important during your c-section recovery.

Check out how to start to reconnect to your core and pelvic floor muscles after a C-section right HERE.

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 synchronize with your pelvic floor, don’t worry! As you work on it that connection comes back!

Scar tissue mobilization

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. During your C-Section recovery 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. Mobilizing the incision area will help with this.

Moving around after c-section

The way you move during C-section recovery is really important. You need to support your body so you can heal, and heal well.

Some examples are…don’t try to get straight up from lying on your back – always roll to your side first. And avoid sit-ups or crunches. These type of movements will put a lot of strain onto your incision so it’s best to modify these movements and eliminate where possible.

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 during your C-section recovery. Your walk doesn’t have to be long. Start with a walk to the end of your driveway and back. Then aim to make it around your block. Then continue building up to longer walks as you feel capable.

Diet and nutrition for C-Section Recovery

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 colored 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 drinks like sugar or alcohol will hinder healing.

So…Rest!

Takeaways to help during C-Section Recovery

In the early days:

massage
mobilize
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.This will help you heal, restore and strengthen your abdominal muscles.

You are doing great. Give your body time to heal, it will be worth it!

Wendy Powell

Wendy Powell, Dip PT is Founder and CEO of MUTU System. Wendy is a highly certified postpartum specialist and master trainer, as well as a speaker, Femtech entrepreneur and mentor.

FAQs

What is ceasarean surgery?

A caesarean surgery, also known as a C-section, is a surgical procedure used to deliver a new baby through incisions made through abdomen and uterus. These c-section incisions are typically done when a vaginal birth would put the mother or the baby’s health at risk or when a vaginal delivery is not possible or advisable. Caesarean surgeries can be planned in advance (elective) or done in an emergency situation. They are considered major surgeries and carry some risks, including infection, bleeding, and blood clots. However, they can also be life-saving for both mother and baby in certain situations.

Will I have a c-section?

There’s a lot that goes into determining the likelihood your baby (or babies) will be born via caesarean surgery. There has been a big drive to lower the rates of caesarean sections in many Western countries, and to raise the rates (by way of increasing access to quality medical care) in modernising countries around the globe.

From individual-to-individual, the factors determining chances of caesarean delivery can fall under a few categories:

Health risk
Hospital vs home or birth centre birth
Midwife vs Obstetrician care
Independent community midwife vs hospital-based midwife
VBAC or multiples pregnancy
Insurance type
Level of prenatal care
Emergency circumstance
Care provider preference
Maternal preference

Some of these factors are things to prepare for, but many aren’t down to preference and choice. Caesarean births are common and necessary in several circumstances. There is no one “right” way to bring a baby into the world, that’s for sure.

Can I lower my chances of having a caesarean birth?

Honestly, the evidence is mixed on this issue.

There is no way to bring your chances down to zero, and there’s good reason for that. Caesarean surgery whilst a major abdominal surgery is a literal life-saver for many. When it comes to having a c-section for safety, it is wonderful that it exists and is constantly getting safer.

In terms of lowering your chances of having a caesarean, there is good evidence to suggest that having a trained support person — like a doula — at your birth makes a big difference. It is still your birth and many things can happen in it, so they can’t guarantee a reduction in likelihood you will give birth vaginally, but they can help you advocate for yourself in any birth scenario.

What are some c-section statistics?

Roughly 26% of births in the UK are via cesarean. That’s roughly the average for a European country. The cesarean section rate is 33% in the United States and Australia. There are countries where that rate is significantly higher or significantly lower.

Rates may vary depending on the specific hospital, region, or demographic group. According to a study published in the journal BMJ Open in 2020, black and Asian women in the UK were more likely to have a cesarean delivery than white women. While the overall caesarean rate was 26.2%, but the rates were higher for certain groups:

Black women had the highest caesarean rate at 32.8%.
Asian women had the second highest rate at 27.5%.
White women had the lowest rate at 24.4%.

The same is true in the US. According to a report from the Centers for Disease Control (CDC) published in 2020, the overall rate of caesarean delivery in the US was 31.7% in 2019, but the rates were higher for certain groups:

Non-Hispanic black women had the highest caesarean rate at 34.1%.
Non-Hispanic white women had a caesarean rate of 31.6%.
Hispanic women had a caesarean rate of 31.2%.
Asian or Pacific Islander women had the lowest caesarean rate at 27.3%

What is healing from a caesarean like?

Recovering from a caesarean delivery takes time and varies from person to person. This is due to factors such as: the type of delivery, the woman’s overall health, and whether there were any complications during or after the surgery.

Some common aspects of healing from a c-section:

Pain: It is common to experience some pain and discomfort after a cesarean birth. This is often managed with pain medications prescribed by your doctor or midwife.
Activity: Most mums are encouraged to rest and limit their physical activity for the first few weeks after a c-section. However, it is important to get up and move around as soon as possible to prevent high blood pressure, blood clots and speed up recovery.
Incision care: The incision site will need to be kept clean and dry to prevent infection. Your care provider will provide instructions on how to care for the incision site.
Breastfeeding: You can still breastfeed your baby after a caesarean if you choose, but you may need to try different positions to find one that is comfortable and does not put pressure on your incision.
Emotional recovery: Some mums experience a range of emotions after a c-section like sadness, disappointment, or anxiety. This can happen while feeling grateful for having access to this sort of care or even electing to have a planned c-section. All birth recovery has emotional ups and downs. It’s okay to seek support if you’re having a hard time coping with your caesarean recovery or any other healing in postpartum.

What are the Do’s and Don’ts after a caesarean?

Caesareans are common and largely safe, but they are still major surgeries. From the recovery room to home life post childbirth the following are some basic guidelines for taking care of yourself after a c-section birth.

Do’s after a cesarean:

Follow the instructions from your health care provider around pain relief, caring for your incision and managing discomfort. If there are signs that something is off, reach out to them.
Rest as much as possible in the first few weeks, but balance that with moderate activity. Moving helps with overall healing and preventing blood clots.
Drink plenty of water or other hydrating liquids like bone broth or coconut water.
Eat a healthy diet with plenty of protein, iron, and other nutrients to support healing.

Don’ts after a caesarean:

Don’ts:

Lift anything heavier than your baby, as this can put strain on your incision and slow down your recovery.
Have sex or insert anything into your vagina until you & your health care provider feel it’s okay and really want to.
Take baths or swim for several weeks. Soaking in water can increase the risk of infection.
Drive until you are able to move around without discomfort and can react quickly if needed.
Neglect your emotional and mental health! Seek support from loved ones and professionals as soon as you feel you need it.

Can you exercise after caesarean?

After giving birth via caesarean section, it is important to take proper care of your body while resuming exercise. Here are some important things for new mothers to consider in your postpartum period:

Time is your friend: Typically, you will need to wait 6-8 weeks after your caesarean surgery to resume harder physical activities. You can walk as soon as you are able and move around as much as feels right. However, more extensive postpartum exercise should wait till after you’ve had your follow-up appointment at 6 weeks.
Start slowly: Even if you were in good shape before your pregnancy, you need to start slowly and gradually increase the intensity and duration of your exercise routine. Your body has been through a major surgery, and it needs time to heal.
Focus on your core and alignment: After a C-section, your core muscles — mainly your abdominal muscles, but also possibly your back and pelvic floor muscles, too — will be weaker. It is important to focus on exercises that strengthen your core muscles, including your pelvic floor, to prevent injury. Learn more about pelvic floor exercises after caesarean.
Listen to your body: It is important to listen to your body and stop exercising if you feel any c-section pain, discomfort, or fatigue. If something doesn’t feel right, it’s best to stop and talk to your doctor

Remember that everyone’s recovery after a C-section is different, so it’s important to take things at your own pace and not compare yourself to others. By taking care of your body, you can safely and gradually get back to functional movement and beyond.