C-Section and Physiotherapy

Every pregnant woman hopes to have a short labor and delivery with no complications, but it doesn’t always work out this way. Some babies should be delivered through C-sections, which can be planned, or are done when unexpected problems happen during delivery.

A cesarean section (C-Section) is defined as a surgical procedure in which the delivery of a baby is through an incision in the abdominal wall and uterus rather than through the pelvis and vagina.

Some of the reasons why a C-section is done are due to health problems of the mother, the mother is carrying twins, the position of the baby is not adequate, the baby is big in size, the health of the baby is in danger or the labor is not moving along as it should.

How to recover from a C-Section?

Women who’ve had C-sections stay at Reanimation till the anesthesia wears off and the doctors are sure that the mother is safe. Usually the mother and the newborn will stay in the hospital for about 3 or 4 days.

As with any surgery, there’s usually some degree of pain and discomfort after a C-section. The recovery period is also a little longer than for vaginal births, healing after the surgery will take at least 6 weeks.

For the first few days and even weeks after the delivery you may feel tired, have soreness around the incision, be constipated and gassy, have a hard time walking around, getting up from the bed, and lifting your baby.

Why you need Physical therapy?

Physical therapy can help you in your recovery after a C-section by giving you skills to regain optimal body function and help you get back on your feet, doing the activities you value in addition to taking care of your baby.

What will your physical therapist teach you to do?

Scar management

C-section scars are surprisingly small and they are made below the pubic hairline. In the beginning the scar looks red or pink for several months, but eventually it fades to a pale, flat, thin line.

Usually the first two weeks while the scar is fresh, you can have showers using mild soap without scrubbing the scar. It is fine to get the scar wet, but you should avoid submerging your scar in a bathtub or swimming pool during the early days.

As part of the treatment the physiotherapist will teach you how to massage the scar, to help prevent the scar tissue from bulking up.

The benefits of scar massage:

• can help reduce symptoms of pain, itch as well as anxiety and depression
• improve color and elasticity of the scar
• increase of blood flow in the area of the incision
• activate the remodeling of the scar structure
• soft tissue manipulation may soften scars and increase pliability
• may help flatten certain bulky scars; nevertheless, keloid scars are unlikely to benefit

How to massage the scar?

Once the incision site is closed (usually around 2-3 weeks), you can begin scar tissue massage.  Massage the scar 2-3 times per day for 2-3 minutes.

• Lie on your back and start by applying lotion to your finger pads and scar.
• Start massaging the scar is different directions.
• Circle motion, with two fingers make small circles over the length of the scar
• Horizontal motion, with your fingers massage the scar from side to side
• Vertical motion, massage the scar up and down
• Press the scar as you can tolerate. If the scar is painful, stop and try again later.

Click the video for the scar massage tutorial.

Pelvic floor exercises

Most of the women who deliver via C-section have pelvic floor dysfunction compared to the women who deliver vaginally. Every physiotherapist should educate their patient regarding risk factors and types of pelvic floor dysfunction.

Exercises that can help improve pelvic floor dysfunction are:

• Kegels exercises, are exercises that can help you strengthen the muscles that support the bladder and the uterus. When you’re first starting Kegel exercises, finding the right set of muscles can be tricky, that’s why you need the advice of a physiotherapist.

• Diaphragmatic breathing, can improve the posture, by improving the core muscle stability. Here you can find the steps for a diaphragmatic breathing.
• Pilates, is a method of exercise that consists of low-impact flexibility and muscular strength and endurance movements. Pilate’s routine generally includes exercises that promote core strength and stability, muscle control, and endurance, including exercises that stress proper posture and movement patterns and balanced flexibility and strength.

These types of exercises can help you regain the core control and return to the exercise you love after pregnancy.  Also these exercises can help you reduce the risks of pelvic floor dysfunction such as low back pain, pelvic pain, hip pain, bowel problems and urinary problems.

What exercises to avoid?

Avoid any traditional abdominal exercises such as crunches, planks or full push-ups for at least 6 weeks, but expect much longer! The time for the wound to heal is 6 weeks, but for the next few months after that it will be a steady rehabilitation process to get you back to full pace at the gym.

Diastasis recti rehabilitation

Diastasis recti mean your belly pops out because the space between your left and right belly muscles has widened. This condition is most commonly seen in women following pregnancy. Having more than one child makes this condition more likely, especially if they’re close in age.

A trained physiotherapist will provide you with corrective exercises to help stabilize your core and to help the abdominal separation to come back together partially or completely.

Conclusion

Whether you had a vaginal delivery or a C-section, physiotherapy is important for getting you back to feeling like your best self after the birth of your baby.

Abdomen and pelvic floor exercises are beneficial following a C-Section delivery.

Regaining strength gradually will help you return to doing the activities you love with ease.