Your Turn to Thrive: A Guide to Rehab and Recovery After a C-Section
By Dr. Jordan Miller, PT, DPT, PRPC, Postpartum Pelvic Floor Expert and Sakhee Advisor
Giving birth is one of the most profound physical feats a person can experience. Yet, when that birth happens via Cesarean section (one of the top 10 most performed surgeries internationally), the conversation often shifts away from the recovery and rehabilitation that any other major surgery would receive.
Currently, global data shows about 21% of people give birth by C-section, and this number is projected to grow to 28% internationally by 2030. It is about time we start talking about C-section recovery and "rehabbing" it the same way we do with so many other major surgeries.
At Sakhee, we want to help you move from simply healing to truly thriving. Here is a roadmap to help you manage your recovery with confidence.
Managing Your Recovery
In the early days, it is important to focus on wound healing and protecting your body as it repairs itself. Remember that a C-section is more than just a surface-level incision on the skin; multiple layers of tissue - including the fascia, muscle, and uterus - must heal beneath the surface of the skin.
Watch Your Healing: Monitor your scar for any signs of infection including but not limited to redness, swelling, and abnormal discharge.
Stay Active: Move to keep your blood flowing and help prevent complications. If permitted by your doctor and physical therapist, continue to take walks and maintain pain-free mobility to promote healing of your body and the wound.
When to Call Your Doctor: Contact your healthcare provider immediately if you experience severe abdominal pain, a fever, abnormal bleeding or discharge, or trouble emptying your bladder. For a full checklist of what to look for, see the "Warning Signs" section at the end of this article.
Tips and Tools to Use Immediately
I recommend these simple modifications to help reduce the strain on your core and your incision during those first few days to weeks.
The Log Roll: To protect your abdominal wall, roll onto your side, drop your feet off the side of the bed, and use your arms to push yourself up when getting in and out of bed. Use an exhale to avoid holding your breath or bearing down as you push yourself up.
Support Your Core: Wear an abdominal binder (snug, but not too tight!) or support garments to reduce strain while carrying or lifting.
The "Cuddle" Position: Keep your child close to your body when holding them to limit the work your core has to do.
Spacing for Pain: If lifting or holding things around the house causes pain at your scar, use a cushion for spacing between you and the object to reduce the pressure.
Breastfeeding Comfort: Try positions where the baby does not rest on your incision. A great option is "tucking" the baby under your arm along your side, supporting their head and body with your arms.
Brace for Coughs: Hold a pillow firmly to your abdomen to help "brace" yourself whenever you need to cough or sneeze.
Stay Dry: After showering, ensure your incision is patted dry. Consult your doctor about when to remove the Steri Strips on your incision.
Avoid Straining with Bowel Movements: Try not to strain when using the bathroom. If you’re having a difficult time toileting, talk to your doctor or physical therapist about ways to keep your stool soft. Try using a toileting stool and peri-bottle to manage pain with emptying and wiping.
Reconnecting with Your Body
Once you are cleared by your doctor to return home, you can begin these gentle exercises to keep your body mobile and prevent stiffness.
Keep Walking: Walking is the best way to maintain your posture and stop your abdominal muscles and joints from feeling too stiff.
Core Bracing: Practice "gentle bracing" by softly pulling your belly button toward your spine.
Identifying DRA: Watch for "coning" or "doming" (a ridge popping up along the middle of your stomach) during exercise. This is a sign that your core bracing system is still healing, or that you need pelvic health physical therapy to enhance recovery of your core muscles.
Scar Massage: Initially, begin using light touch on the skin above and below your wound to help the area get used to sensation again. Once your scar is fully closed (usually around 6 weeks), you can start using a gentle touch directly over the scar. By 12 weeks, you can begin rubbing gentle circles or stretching the scar and the skin around it to keep the tissue moving well.
Movement: Try pelvic tilts (moving your hips forward, back, and side to side) and gentle kegels to support your pelvic floor. Connect with a local pelvic health physical therapist to learn more about other exercises to begin your rehab journey.
Stretching: A "pec stretch" in a doorway can help open up your chest and reduce abdominal and upper back muscle irritation.
Looking Ahead: The Road to Recovery
C-section recovery is not just about the scar healing. It is about the recovery of your body’s muscles, nerves, and postural support after undergoing a major abdominal surgery.
A C-section can increase the risk for things such as diastasis recti (DRA), which is a separation of the abdominal muscles. And it is possible that you may still experience postpartum pelvic heaviness, sexual dysfunction, or bladder and bowel changes. You may need specific recovery support to help you return to your favorite exercises, sports, and daily activities.
A pelvic health therapist will be able to screen and evaluate your function postpartum and help you discover an individualized plan for full recovery. Being postpartum does not need to stop you from returning to your favorite activities or even prevent you from reaching new goals!
Full Recovery is Possible!
The goal of C-section rehab is to get you back to feeling stable and strong in your day-to-day life. You should be able to wear your favorite pants or underwear without the scar feeling irritated. You deserve to run, walk, and carry your child without pain.
Remember, you are not just recovering from birth; you are recovering from a major surgery. Give yourself the time and the expert support you need to heal fully.
Ready to start your recovery journey? Schedule a Free Consultation with Sakhee.
Warning Signs: When to Seek Medical Attention
As you heal, keep a close eye on your incision and overall well-being. Contact your care team if you notice any of the following:
Worsening Incision Site: Redness and swelling around the incision that worsens instead of improving.
Increased Pain: Pain at the incision site that becomes sharp or throbbing.
Discharge: Foul-smelling discharge or pus leaking from the wound.
Systemic Symptoms: A fever above 100.4°F (38°C) within a few days post-surgery or feeling generally unwell with chills and fatigue.
Sources & Further Reading
Trends in C-section Rates: Based on a study of 154 countries published in BMJ Global Health.
Managing Recovery Risks: Clinical guidance on C-section risks and recovery provided by the NHS.