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C-Section Delivery and What Does This Mean for Your Core?

physicaltherapy womenshealth May 31, 2022

The joy of bringing a child into the world whether vaginal or via C-section is no small feat. This blog is focusing on the next steps to transition into the recovery stage post C-section with confidence, strategies and hope. 

 

Let’s start with a few basics. A Cesarean delivery (C-section) is a surgical procedure used to deliver a baby through incisions in the abdomen and uterus. A C-section might be planned ahead of time, unscheduled. It may be a decision made during the labor and delivery process for reasons determined by the medical team and/or parents. Regardless, we want to acknowledge there can be a lot of emotions in this outcome whether it was in your birth plan or not.  You are a strong mother for bringing a child into this world no matter the circumstances.

 

Anatomy of a C-Section and What Does This Mean for Your Core?

 

Let’s take a closer look at the anatomy of a C-Section.  If you’re curious about some more details as to what actually happens and why having a recovery plan can help with your healing and strength and function outcomes. 

 

A C-section is an abdominal surgery. How many layers are cut?

 

In general, there are 6 layers that are cut starting from the skin down to the uterus.

  1. Skin
  2. Subcutaneous Tissue
  3. Fascia
  4. Rectus Abdominal Muscles
  5. Peritoneum
  6. Uterus

 

In majority of the cases, the only muscle tissue that is cut is the uterus. Of these 6 layers listed above, the rectus muscle is the only layer that isn’t routinely cut. Every other layer has to be cut to enter the abdominal cavity.

 

C-Section Myth: The rectus abdominal muscles (think you’re ‘six pack’) are cut during C-sections. This is actually not true in the vast majority of cases. The only muscle that is always cut during a C-section is the uterus.

The uterus is a MUSCLE.  This is the only muscle that must be cut in order to get your baby out.

 

You may be wondering, if the abdominal muscles are rarely cut during a C-section…

 

Why Is My Core Weak?

 

Your core may feel weak after a c-section for several reasons.

 

1) Your rectus muscles are stretched apart as your uterus grows throughout pregnancy. This will weaken the muscles of your abdomen.

 

2) As your core muscles lengthen throughout pregnancy the quality of contractions and efficiency of contractions can reduce. The less muscle activation the weaker your core can become. 

 

3) For a C-section, the layers cut through are stitched back together and will need time to heal and can impact the strength and contraction quality and nerve firing efficiency of the core muscles.

 

How Long Does It Take To Heal After A C-Section?

 

Every woman is different. You may or may not heal as quickly as other women.  On average it can take 6 weeks to start feeling like your normal self again. This means no strenuous activity, heavy lifting, or serious abdominal training.

 

For your c-section scar, After 8-12 weeks, your c-section scar will be fully healed and most women begin to feel comfortable doing more activities.  This is where learning how to do scar massage techniques can be very helpful for improving the tissue pliability (movement), improve sensation around the scar and reduce areas of sensitivity or pain. 

 

Let’s go through strategies for recovery regarding movement, nutrition and helpful tips: 

 

Exercises & Movement: 

 

Core Connection Breathing - is one of the most gentle and helpful exercises to start with your recovery. By establishing appropriate breathing patterns it can assist in recovery with improved muscle activation for the dynamic core system of the diaphragm, pelvic floor muscles and abdominal muscles.  This should not be painful, it should be calm breathing and not strenuous. 

 

 

Hut Exercise - is a way to ‘jumpstart’ the deep abdominal muscle the transverse abdominis. This muscle is like a corset of muscle we have. This is lengthened throughout pregnancy and can take time to effectively contract and engage appropriately during the postpartum time and beyond to reduce onset of pain, abdominal wall dysfunction, pelvic floor dysfunction or symptoms. 

 

 

Pelvic Tilts - By gently moving the pelvis and restoring motion around your core, low back and pelvis it will mobilize connective tissue and fascia to reduce pain and restore basic and foundational functions.

 

 

Abdominal Binder - Postpartum women will be offered an elastic band abdominal binder shortly after delivery. This can be helped in the initial time postpartum (2-4 weeks). This isn’t something that should be used long term as we want your core muscles to learn how to engage, stabilize and support your core on their own without assistance of the brace. 

 

There’s inconsistent data on the impact of recovery, but this can be a way for women to potentially get some pain relief, or help feel better moving around psychologically in the early recovery stage.

 

Log Roll TechniqueGetting in and out of bed can be challenged post c-section. By using the log roll technique you can protect your core and incision site while moving around. In the first week or two after delivery, moms remember you should be resting and recovering as much as you can to provide the best healing environment for your body. 

 

 

Nutrition:

Hydrate! Drinking adequate amounts of water and liquids (soups, coconut water, non-citrus fruit juices, and other non-caffeinated drinks) to assist in the tissue healing process as well as keeping bowels regular. Check out our Bowel Management Blog to learn why minimizing constipation in your recovery can be a key to improve your recovery.

 

Focus on eating less processed foods, quality sources of protein, vitamins and minerals to assist in the tissue healing process and milk production if you’re choosing to breastfeed. Limit and avoid foods that you experience bloating or other GI symptoms.

 

Now that you’ve learned some of the basic strategies for the initial recovery you can also follow the link to the iO Mama Method: 5 Minute C-Section Scar Massage to learn more about how to improve your scar mobility and recovery. 

 

Although I am a doctor of physical therapy, I am not your doctor. This information is for informational purposes only and should not substitute the advice from your healthcare professional. All kinds of exercise and dietary changes are potentially dangerous, and those who do not seek counsel from the appropriate health care authority assume the liability of any injury which may occur. 


If you have questions or want to learn more about ways to strengthen your body postpartum and post c-section -  connect with us by signing up for a free consultation with our Inside Out women’s health specialists to address your symptoms and create a plan to feel strong and confident as a mother.

Frustrated with your current care or dealing with a pain or injury that just won't go away? Talk with one of our Docs today to find out the best way to get back to your best self.

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