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If you’ve just had a C-section (or you’re preparing to have one), chances are you have a lot of questions about the recovery process.
If you feel a little in-the-dark about what to do next (or what to expect), you’re certainly not alone. Did you know that nearly 1.3 million C-sections are performed each year in the U.S and over 20% of women worldwide deliver their babies via C-section?1,2 Yet most women get little to no instruction on post-surgery care, how to return to exercise, or how to help themselves heal from a C-section.
While we wish every single woman returned home from a C-section with not only a healthy baby but also a complete guide to recovery, plus a handful of excellent physical therapy referrals, for now we’ll do the next best thing: arm you with information!
In this article, we’ll share the key details on C-section recovery so you’ll know exactly what you can do during the first six weeks post-op to promote a safe and healthy postpartum recovery.
In this article, you’ll learn:
(By the way, we believe women, and the coaches who work with them, deserve to know how to keep themselves healthy, safe, and strong at every stage of pregnancy, including postpartum.
That’s why the Girls Gone Strong team worked with 20+ trailblazing pre- and postnatal experts from 12 fields of study — including pelvic health physiotherapists, OB-GYNs, nutrition coaches, and strength and conditioning specialists — to create the GGS Pre- & Postnatal Coaching Certification.
This Certification is designed to help you learn the knowledge, skills, and confidence to help women stay safe, healthy, and strong during and after pregnancy — whether that's you or your clients. When you’re done reading, check that out here.)
A C-section may be a common procedure, but it’s still major abdominal surgery!
During a C-section, your doctor makes an incision through the skin, underlying fat, and connective tissue to access the abdominal muscles, which are then gently separated (not cut) to reach the uterus. An incision is made in the uterus to deliver your baby and placenta. After the birth, each of these layers is carefully closed, typically with dissolvable sutures or sometimes staples.
This means that in addition to the visible incision on the outside, there are several layers of tissue beneath the surface that also need time to heal. As you can imagine, this process takes time.
Your healthcare professional will have given you instructions on how to clean and care for your incision at home. Follow those closely. (If you did not receive instructions, call your doctor and ask them for best practices.) And if their instructions differ from what you read here, default to your doctor’s recommendations.
For the first few days, your incision area will need to be cleaned to minimize infection. Keep the wound area clean by washing it with mild soap and water. (Don't scrub, just let the soapy water run over it).
Your incision may be painful for days or weeks following your procedure. Your body will launch an inflammatory reaction — but the good kind! During those first few days of recovery, your systems are sending fluids and beneficial chemicals to the injured area. This makes you feel stiff and swollen, but it helps prevent you from moving around too much and protects the area from any further damage.
Your incision will close and heal in stages as your body builds new collagen and tissue in the area.
Mild redness, swelling, pain, and limited mobility in the first week or two are normal and expected side effects of your body healing. But if you experience any of the following signs or symptoms (at any point in time), call your doctor:
These might be signs of an infection or complication and need to be evaluated by your doctor as soon as possible.
And of course, same as with a vaginal birth, call your doctor if you experience:3
As your new tissue rebuilds, it also needs to regain mobility and strength. Too much movement or exertion can compromise healing, so here are a few tips.
Having regular bowel movements can be difficult after surgery, as lack of movement, change in eating and hydration habits, and medication can all impact bowel function. Here are a few tips that may help:
And finally, slowed gut motility, changes in nutrition habits, and decreased movement can all lead to increased gas after surgery, which can be very painful. The good news? Gentle movement can help! Which leads us to…
In general, you’re encouraged to get up, resume your normal activities of daily living (e.g., getting up to go eat meals), and start moving a bit each day, as tolerated. Keep in mind, though, that you’re still recovering from major surgery! Keep recreational walking to a minimum until your incision has scabbed over. You’ll also need to avoid excessive activity (e.g., heavy housework, lifting heavy loads of wet laundry, strength training) until you receive your doctor’s clearance, likely at your six-week checkup.
Of course, this can be difficult if you have another young child at home, or if you’re a single parent. If possible, ask your partner, other family members or a neighbor to help you with reaching, bending, lifting, or carrying. Or if it’s accessible to you, consider outside services, like using a laundry service or a dog walker. As you ease back into more extended periods of time on your feet, keep an eye on the incision to make sure it doesn’t break open or show any of the red flags listed above.
When your doctor first stitched up your incision, they likely sewed it up tightly to ensure a solid closure. This can lead to a feeling of tightness and pulling throughout your incision when you stand up, and it can be tempting to bend forward a little when you’re up and about to avoid that pulling sensation, or feel like you’re protecting your scar.
Instead, don’t be afraid to resume an upright posture. Instead, you’ll want to get a gentle stretch through that tissue throughout the day so your scar heals at an appropriate tension. It can also help regain tissue mobility if you allow the scar to gently slide and glide as you rotate and laterally flex your trunk. Some good exercises for this are knee rolls or gentle side bends.
That said, avoid overextending your back or leaning back too far (for example, over a Swiss ball), which can put too much tension on the incision — you’re still healing, after all!
Basically, avoid any movement that puts pressure on the abdominals and your incision site. Instead, every time you want to get up from a supine position, use the “rollover technique.” First, roll from your back onto your side. Lower your legs if you’re getting out of bed, and then use your upper body to push to a seated position. When you want to lie down, descend onto your side, using your arm for support, and then slowly roll onto your back.
Place a pillow over your abdomen and apply gentle pressure before you cough or sneeze. Alternatively, bend your knees, rest your forearms firmly across the abdomen, place your fingers over the pubic bone, and apply gentle pressure with your hands over the scar.
Abdominal wrapping involves a wide, elastic compression belt which wraps around your midsection to help support the incision and abdomen and minimize pain. It's not the right choice for all postpartum folks, but many women find that they have less pain and better function with some abdominal support. Make sure that whatever you choose to use is not rigid- you should be able to breathe normally!
Once the incision is fully closed and there’s no bleeding or weeping you can do some things to decrease scar sensitivity. Gently rub your scar with different textures, beginning with soft items (e.g., a feather or cotton ball) and working up over time to mildly rough textures (e.g., a washcloth). Increase the time and pressure level over the course of days and weeks. Around six to eight weeks postpartum, you can consider adding scar tissue massage.
The purpose of this massage is to reduce pain sensitivity and increase blood flow to the area and to provide some immediate hypoalgesia or pain relief.4 Contrary to popular belief, there’s no evidence that massage will "release" adhesions or minimize the risk of adhesions. In fact, it would take over 1000+ pounds of force to break through an adhesion, which is impossible with massage or without a scalpel!5
If you have concerns about the appearance of your C-Section scar, there are a number of things you can do to potentially help support the healing of your scar including:
In addition to the physical aspect of healing from a C-section, you may also need time to emotionally recover and process the feelings surrounding your birth experience.
For instance, if you had an unplanned or emergency C-section, you may feel disappointed, confused, overwhelmed, dejected, or traumatized. You might even feel like you’re grieving. All of these feelings are totally valid.
You’ve gone through a huge life transition, your body is physically recovering from both pregnancy and a major procedure, and you’re now responsible for caring for another life.
Take the time you need to heal mentally and emotionally as well as physically.
If you’re struggling to process it all — or if you’re feeling anxious, depressed, lethargic, or disconnected from other people or your baby, which may be signs of postpartum depression — consider talking with a therapist or counselor who works with postpartum women. You can ask your OB-GYN for a referral.
Remember: There is no shame in seeking additional support or guidance. If you’re struggling, there are resources out there that can help.
Above all, listen to your body and be kind to yourself, mama! You’ve been through a huge physical and emotional transition and you deserve to take the time to heal.
85% of women will have a baby at some point in their life. If you work with women, you work with pre- and postnatal women.
Whether your clients are currently pregnant or have already had their baby, they’ll have questions about everything — how to exercise safely in each trimester, which foods they should and shouldn’t eat, how to exercise the right way post-pregnancy.
And they’ll look to you for the answers.
That’s why we created our Pre- & Postnatal Coaching Certification: So current and aspiring professionals have the tools, knowledge, and confidence they need to help their pre- and postnatal clients navigate their health and fitness — both during and after pregnancy.
With the industry’s most extensive pre- and postnatal exercise, nutrition, and coaching certification available anywhere, you’ll learn exactly how to:
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