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Cesarean Section: What I wish I had known

A Physical Therapist's perspective on what to know before the birth

5 Tips to guide and support you: know before you go!

One in four first time births in Washington state are cesarean section (c-section) births

1. Get educated and make a plan

- Research shows people report a more positive birth experience when they have more understanding of what is happening and some sense of choice and control. Though none of us can control every aspect of a birth, or even choose the birth method necessarily, even something as simple as picking the music in the operating room can help decrease stress and improve the birth experience.

- Several studies, show that physical therapy improves patient satisfaction and recovery time post-cesarean section and I would posit that understanding a little bit about what a c-section is can help make the experience better for most folks, even when the surgery wasn’t “plan A”.

2. Massage your viscera (organs) and scar

C- section is a challenge for core muscle recovery: the surgery involves cutting through about 10 layers of tissue. This includes skin and subcutaneous tissue, the core muscle layer (aponeurosis of transversus abdominis, internal and external obliques as well as rectus abdominis), the uterus (three layers of tissue), amniotic sac, and if needed bowel, adhesions and bladder may be moved during surgery. From first incision to birth is usually only 8-12 minutes! It’s closing all those layers that takes 40 minutes- 1 hour on average. Clearly there is a lot to “put back together”. Working with a physical therapist who does visceral (organ) massage can really help to keep the layers of tissue moving well and support a faster recovery. Additionally, any core strength and mobility work you do during pregnancy will also be helpful for recovery after a c-section birth!

3. Rest

Rest is key to recovery- after a c-section you’ve been through a major surgery, often after being in labor (sometimes for many hours)! Your body has been through a lot and deserves some rest and TLC. Ask for and accept help with child care, meal preparation, house work and driving. It’s not one of the “push through the pain” situations- rest is best to let your body heal.

4. See a Pelvic Floor Physical Therapist

Pelvic floor dysfunction is common post c-section, both in planned and unplanned c-sections. Pregnancy itself is a challenge for the pelvic floor, regardless of how the birth happens. Pain with sex, pain with using a tampon, urine leakage, slow gut motility/ constipation and high hamstring pain (often referred pain from tight pelvic floor muscles) are all very common after c-section births. The good news is that pelvic floor physical therapy can help recover from all of these conditions.

5. Ice and Undies

High waisted comfy underwear is worth the splurge for c-section recovery. Ice pack pocket in the front is a bonus. Icing is key over that incision for pain and swelling management! Have a couple of ice packs ready so you can switch out for fresh ones when you need them.

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