The rate of c-sections in the state of North Dakota was 28% in the year 2017.¹ I myself have fallen under this category, haven given birth by c-section to my beautiful little girl in December of 2015. I have 2 children, the first which was delivered vaginally, the second delivered by c-section due to breech position. By the time my water broke during my second pregnancy, I was fully expecting to have another vaginal birth. Having gone through labor and delivery before, I knew what to expect. When told I needed a c-section, although I understood it was what was safest for my and my little baby girl, I was still scared. Now I am no rookie to surgeries having 4 prior to this, 2 of which were “major”, I was still nervous. I had been a women’s health physical therapist for 6 years prior to my 2^nd child and had worked with many women in post c-section care, and I was still anxious.  I have never had a c-section before! How was it going to feel during and after? How different was my recovery going to be? How difficult would it be caring for myself and for my new baby, as well as my 2-year-old son?

The thought of any major surgery can be scary. The good thing is, there are things you can do following a c-section to help ease pain and make recovery easier. Below is a list of different ideas and techniques that has helped me, other moms, and patients of mine who have had a c-section in making recovery easier.

Pain control is important after any surgery. Your doctor and nurse are there to help you with pain medications. Make sure to ask them if you have any questions about any of the medications. The good thing is, there are other ways to help with pain control in the hospital that don’t involve pain medication. Ask for an ice pack to place over your incision to help reduce the pain. Bracing your abdomen with coughing or laughing can also take pressure off of the incision to help reduce pain. Take a pillow and press it against your lower abdomen while coughing or laughing. If your family is crazy like mine and enjoys laughing, this will really be a helpful maneuver! You may also benefit from using an abdominal binder for the first 10 days or so after delivery. The binder will help reduce the pull that the core muscles may place on the incision. If you need helping in finding or being fitted for one, as your local well-trained women’s health physical therapist. The abdominal binder should be used for about 10 days or so; if it is used longer than recommended your core muscles won’t have a chance to strengthen and this may lead to prolonged weakness. After your c-section, plan to wear comfortable pants. Your skinny jeans may need to wait for a while! Sweatpants, slip-ons, or leggings work best to keep pressure off your incision. I wore my maternity leggings for MONTHS after delivery. I folded the tummy band over like yoga pants and voila! It worked great! (Confession: I actually still wear maternity leggings regularly even though my youngest is 3 years old, they are just so comfy! I’m on my 4^th pair!)

If you plan on nursing your baby, you may need to try different positions to avoid pressure on your incision. The football hold may be a good option for you, or sidelying. Work with your lactation consultant on finding a comfortable position for you. Lactation consultants are amazingly helpful; I worked with them in the hospital after both of my children and for a few months following.

Your baby is here and you are out of recovery. You are comfy and cozy in your hospital room, and your nurse is now telling you it’s time to get up and moving. Although it may seem like a monumental task, do it. You will feel better and heal faster if you can get up and move. Go for a small walk down the hallway 2-3x per day. Get up and walk into the bathroom in your room. Take a shower (you can sit in the shower chair if needed); just being up and moving will help with circulation, get your muscles working, and in the long run you will feel better. Watch body mechanics when first getting up to help decrease pain. This includes rolling onto your side and then sitting up at the side of the bed. Give yourself time when first standing up off of the bed to acclimate to the feeling of standing. Of course listen to your body and don’t over-do it, but getting up and walking in little short periods in the hospital will help you feel better.

Now, you are finally home! You are starting to feel better in 3-5 days or so with less pain. Now what? It’s time to get moving! (Slowly please ) There are a few exercises you can start doing now before you are cleared for exercise at your 6-week post-partum appointment. The first would be kegels. Squeeze your pelvic floor, new mama! The pelvic floor muscles will help reduce the risk of bladder leakage (even though you had a c-section, you are still at risk from the stress on the muscles during pregnancy), as well as improve support of your pelvic organs, and support your pelvis and lower back. Once your pain from the incision starts to decrease, you can also start with gentle ab bracing exercises. These exercises are good to practice in various positions, including laying down, sitting, and standing.  Hopefully you worked with a women’s health physical therapist during pregnancy who has shown you how to correctly perform these exercises. If not, now is the time to start! A physical therapist can teach you these exercises and make sure you are doing them correctly. Also, please wait until being cleared for exercise at your 6-week post-partum appointment to really get back at it in the gym. Your body just went through something amazing and difficult and needs time to heal. Returning to exercise too early can actually be detrimental for your body; it needs time to heal.

Another great form of exercise in the early post-delivery days is walking! You can take small walks around the house, take baby outside for a walk if you aren’t in the middle of a North Dakota winter, go walk at an indoor track, at the mall, the possibilities are abundant! Start by walking just a few minutes at a time. As this feels easier, you can slowly increase the amount of time you are walking. This is a great way to slowly return to exercise, and to get out of the house for some socialization.

Now that your incision is healing, its time to start thinking of scar massage. You can start gently massaging the skin and tissues above, below, and to the side of the incision as soon as you feel comfortable. You may want to wait 3-4 weeks until the incision is closed and healed before massaging directly over it.  It is best to rub both along and across the scar and the surrounding tissue. Scar massage can help decrease pain and numbness to the incision and surrounding tissues, and help the scar tissue “lay down” in a more organized manner reduce the risk of any long-term effects. A women’s health physical therapist can teach you how to perform this massage.

Mamas, please ask for help when you need it! I had a 2-year-old son when my daughter was born via c-section. As much as I try to be a strong, independent woman, I needed help! I needed help in caring for my 2-year-old, in taking care of my house, in cooking, cleaning, everything! I know it can be hard to ask for help, but in this stage of your recovery you need it. It will make caring for yourself and your baby easier if you have help with “the other everyday stuff”.

I have also heard through the years on moms feeling “not as strong” or “not as much of a mother” for not experiencing “normal” labor and delivery. Take it from me moms, (who has experienced both a c-section and “normal” labor and delivery), c-sections are TOUGH. You are one tough mama for going through that! In my personal experience, a c-section delivery was more difficult; and I actually felt “tougher” and in a way more complete in having that experience. A c-section is no way an “easy way out”. You have a beautiful child and in the end that is all that matters.

So, there you have it mama. There are ways to care for yourself after your c-section to help your recovery be easier for both you (and in turn, for your new baby). Make sure to take care of yourself. Caring for yourself is caring for your child! Also, keep in mind your well-trained women’s health physical therapist is there to help you every step along the way. 

Sources:

1. Cecarean Delivery Rate by State. Centers for Disease Control and Prevention. https://www.cdc.gov/nchs/pressroom/sosmap/cesarean_births/cesareans.htm. January 22, 2019.