Healing Your Lower Body after Cesarean Birth

Healing Your Lower Body after Cesarean Birth

 

After a caesarean birth (C-section), your body needs time to heal, and get back the strength and control that you had before pregnancy and giving birth. These changes can take at least 8 weeks, but may sometimes take longer. There are many ways you can care for yourself during this time, and there are people and places that can help. A few are listed below and more can be found through your provider (OB/GYN, midwife, or primary care doctor).

Muscles that need to recover

Pelvic Floor Muscles

Your pelvic floor muscles run from the front of your pubic bone to your tailbone. These muscles:

  • Help keep your body stable by working as a part of your core.
  • Keep your bowel and bladder from leaking. 
  • Are involved in sexual response.   
  • Can be torn or stretched if you were pushing for any length of time before your C-section.

What you can do for them: 

Make sure these muscles are healed first. Once they are, you can start doing Kegels with the guidance of a pelvic health physical therapist, your OB/GYN, primary care doctor, or your midwife. Sitting and standing with good posture helps, too!

Abdominal Muscles

Your abdominal muscles (abdominals) attach to the top of your pelvis and run back to your spine. The deepest layer is called the transverse abdominal muscles. These muscles were cut, along with your uterus, to get the baby out when you had a C-section.

These muscles: 

  • Support your pelvic organs, spine and pelvis, with help from your pelvic floor muscles.
  • Work with your diaphragm muscles for breathing.

When you squeeze these muscles, you will feel gentle tension in the lower half of your side and abdominal wall. Do not hold your breath when you do this.

What you can do for them: 

Incision Healing: It can take a while to fully heal, and you may stay tender, itchy, or numb along the scar for a while. This is normal. 

  • Belly Band Use: (You may have been given one at the hospital.)
    • Helps support your abdominal muscles while the incision heals. 
    • Should be very snug and worn low on your stomach so the bottom edge reaches your hips.
    • Wearing for most of the day for up to 6-8 weeks as your abdominal muscles heal is helpful. 
  • Lifting: Talk with your midwife, OB/GYN, primary care doctor, or physical therapist before you lift, push, or pull anything heavier than 8 to 10 pounds.
  • Coughing and sneezing:
    • It is normal for this to be uncomfortable. 
    • Wearing your belly band can help. 
    • Holding a pillow to your stomach to help brace your abdominals can help, too. 

Posture and position changes

  • Rolling over and sitting up:
    • Can be challenging and uncomfortable. 
    • Avoid sitting straight up from lying down. 
    • Instead, roll to your side, and push yourself up with your arms. 
  • Wearing your belly band or bracing with a pillow can help. 
  • Making sure you are sitting and standing with good posture can help gently use the abdominals and remind them how to do their job. 
  • A women’s health physical therapist can help you with a more specific plan, and you can request a referral from your midwife or physician provider. 

What else to expect during recovery from a C-section

While you are recovering, you may have:

  • Mild cramping.
  • Vaginal bleeding or discharge for 4 to 6 weeks.
  • Bleeding with clots and cramps.
  • Mild pain, soreness, tenderness, or numbness at the incision.

Vulva health 

The vulva is the outer part of the female genitals. It includes the opening of the vagina, the outer lips (labia majora), the inner lips (labia minora), and the clitoris.  

Episiotomy or Tear

It is possible to have an episiotomy or a vaginal tear if you have had a C-section, especially if you pushed for a long time before the C-section was done. If this happens, you will likely have scar tissue around that area after it has healed. This may cause some soreness with activity, bowel and bladder functions (pooping and peeing), and sexual activities. Your abdominal muscle incision can make these things harder, too. 

Some tears can be seen and some are below the surface of your skin. These tears can sometimes go into the muscle of your pelvic floor. 

  • You can learn to do gentle scar massage around the incision or tear, once your health care team tells you it is safe to do this. 
  • A pelvic health physical therapist can help guide you with massage, exercises, or other ways to improve uncomfortable activities.

Bowel and bladder tips

  • Avoid going to the bathroom “just in case.”  This can train your body to think it has to go more often than needed and can become a problem for you over time. Sticking to a routine of urinating every 3 to 4 hours can help with this. 
  • Make sure you are drinking enough water. Your urine should look almost clear in color. If it looks dark or neon yellow, you may not be drinking enough water. 
  • Avoid straining with bowel movements. If you have a C-section, tear, or episiotomy, straining can be painful and may keep the area from healing well. It can also cause problems with the healing of your C-section incision. Over time, it can affect the muscles of your pelvic floor, making it harder for you to have a bowel movement. You should not have to hold your breath to have a bowel movement.
  • Use good toilet posture. Lean forward, rest your elbows on your thighs, and keep your knees higher than your hips. You can do this by putting your feet flat on a small stool. This can help you relax, making it easier to have a bowel movement without straining. 

If you are having bowel or bladder issues, bring this up with your OB/GYN or primary care doctor and discuss working with a pelvic floor physical therapist. 

General postpartum care

Rest and Relax

  • Practice taking deep, full breaths to keep oxygen flowing to your muscles and help you relax.
  • Rest and sleep as much as possible, especially early on. 

Stay Active

  • Do 5 to 10 minutes of ankle, foot and knee bending and straightening each day to keep your blood moving in your legs and feet. This helps prevent blood clots. 
  • Stand and walk around your home or yard, or take short walks in your neighborhood, as your body allows.
  • Discuss returning to exercise and other activities with your physical therapist, midwife, OB/GYN or primary care doctor.

Use Good Posture and Body Mechanics

  • Standing Up Tall - Small curve in your low back, shoulder blades squeezed back and down, and head tucked back over your shoulders. This can be challenging, but will allow you to move more efficiently and decrease pain over time.
  • Sitting Up Tall - Small curve in your low back, shoulder blades squeezed back and down, and head tucked back over your shoulders. When sitting, placing a rolled towel or a small pillow behind your low back can help support the natural curves in your spine. This can be especially important, but harder with any sitting activity. Do your best to keep good posture when you are able  to. If you can’t, trying to keep it during the rest of the day can help. 

Use Good Sleeping Positions

  • Sleeping flat on your back with one pillow under your head is best for your spine. If you are dealing with breast milk engorgement, it will likely be more comfortable than lying on your stomach (and sometimes your side). 
  • When sleeping on your side, make sure your neck is fully supported. You can do this by using two pillows, or folding your pillow in half. If you need to, you can also place a pillow between your knees to decrease the stress on your knees, hips, and back. 
  • It is okay to wear your belly band to sleep if it makes you more comfortable.

When to seek medical advice

Contact your OB/GYN, primary care doctor, or midwife if you notice any of the following signs:

  • You have a fever; an increase in pain; or see redness, oozing, or swelling around your C-section incision.
  • Vaginal discharge (lochia) was brown, yellow or white, but suddenly becomes bright red.
  • Passing clots of blood larger than marbles.
  • Burning pain with urination or urine that looks dark or red.
  • Frequent urges to urinate, but very little urine comes out. 

© 2021 – April 5, 2021, The Ohio State University Wexner Medical Center.

This handout is for informational purposes only. Talk with your doctor or healthcare team if you have any questions about your care. For more health information, call the Library for Health Information at 614-293-3707 or email: health-info@osu.edu.