Cesarean Birth
How to Prep, Plan & Heal Like a Badass
After more than a decade of working with women and guiding their recoveries from pregnancy and childbirth, there's not much I haven't seen. And the truth is, while there are some key differences between a c-section and vaginal birth, beyond the initial healing phase, there are more similarities than you might expect. However, those key differences are important and can make all the difference when it comes to planning the best outcome and making a full and active recovery.
The 411 on C-Sections
I’ll begin with the obvious, but often glossed-over fact: A c-section is major abdominal surgery.
Your doctor cuts through your abdominal layers, muscle, fascial tissue, moves your intestines out of the way and then opens your uterus. It’s a lot for a body to recover from and if your experience was in any way unplanned or urgent, the psychological and emotional recovery can be just as intense as the physical.
So, whether you are heading into a planned surgery or are looking for answers because you unexpectedly delivered via cesarean, I’m here to support you with my game-changing tips that will help you get the care you need from your medical team, understand what has happened to your body and learn how to design your personal recovery plan.
Planned C-Section: Ask all the questions!
If you know in advance that you’ll be delivering your baby via cesarean:
Speak with you OB about the details regarding your surgery, where they perform the incision and how they close you post-operatively. Do they close you themselves or do they have someone else perform the closure? What materials do they use to close you (internal stitches and external). This will open the conversation and put you in the driver’s seat to make informed decisions and requests regarding the surgery itself.
Previously delivered via c-section? If you’re experiencing pain, bumpiness or unevenness around your old scar, your surgeon can revise the scar tissue during your new c-section and restitch you for best abdominal healing and functional recovery.
My Major Pro-Tip: Consider speaking with your OB about having a plastic surgeon in the operating room to close your incision. They are the best trained in the bizz to minimize scarring and stitch for optimal, functional recovery.
Note: This can be a delicate conversation to have as it's outside of a physician's normal operating procedure—they may think it’s unnecessary. However, a great plastic surgeon can make a huge difference in your abdominal recovery and if you want to explore this option, you have the right to request it.
An exceptional resource for the Plastic Surgeon route is Dr. Sophie Bartsich who has pioneered educational resources for women preparing for planned c-sections. D
Post Operative: What to expect and what to do in those early days.
Just like any other major surgery, expect a period of healing and rehabilitation, followed by targeted muscle re-education and integrative strength exercises.
In the first few days post-surgery:
While the incision is still healing, you will want to follow your doctor’s guidelines carefully. Keep it clean, rest as much as you can, and when you feel ready and able to begin standing and walking, go slowly.
Expect some digestive discomfort, bloating and gas, as well as limitations to your ability to stand, sit, walk, and carry your newborn. In brief, you’ll need some help tending to your and your baby’s needs for a few weeks—be ready to ask for help!
Emotional Check In:
You will most likely feel grateful and frustrated having other people help tend to your baby’s needs. This conflicting emotional landscape is totally normal and it’s ok to want help, but also want to be the only person taking care of your baby.
Buckle up! This tug will be with you for the rest of your life—welcome to motherhood. Accepting it will help you navigate your need for close intimacy with your sweet baby and space for yourself; year over year and decade over decade.
Improve Healing In The First Weeks: Go slowly and listen to your body.
The first effort you will make in recovering movement and sensation in your abdominal wall is…breathing.
All pregnancies change the dynamics of your breath and hijack your diaphragm. Plus, newly post-op, you will instinctively want to curl around your incision, which can lead to compressing your already weakened core muscles and increase pelvic floor pressure.
This mindful breathing video will improve circulation, relax the trunk muscles, and begin the recovery of your nuero-musclar connections (how your brain triggers specific muscles to move or not!). From these simple breath practices, you can begin to add some intentional and gentle muscle contractions through the rib cage, waist and Transversus Abs.
Get more of my post-op recovery guidance in : The RM 4th Trimester Program (all on the RM APP)
Scar Care: Reduce adhesions and improve your ab function
Once your incision has healed and your doctor has given you the “green light” for some gentle movement, you can begin scar massage which will improve nerve regeneration, reduce swelling and adhesions, and increase blood flow (= quicker and better tissue healing), all of which leads to better overall function of your abdominal wall
My Massage Hack:
Take a little bit of your regular moisturizer and lightly massage your scar when you get out of the shower. Begin with gentle, circular fingertip movements, then, over several weeks, you can increase the pressure and begin moving up and down across the scar. There’s no doubt you’ll feel things—numbness, tingling, emotions…go slowly. About 60 seconds of tender, self-attention to feel, hear and be present in your recovery.
STOP IF: You feel pain. That’s your guardrail to how deep you can go. You’ll be able to take a little more pressure for longer as you progress in your healing. If pain is ever persistent, sharp or just feels “off,” call your doctor and get it checked out.
Pelvic PT: Yup, for a c-section…
Depending on your healing and doctor’s clearance, around weeks 6-10 post-op, make an appointment with a Pelvic Floor specialized PT who practices manual, visceral manipulation. You can ask your doctor for a prescription and even if the PT is out of network, you may be able to receive some reimbursement from your insurance provider.
Why + What to Expect:
First, your pelvic floor PT should talk you through everything, from listening to your birth and health history, to telling you how they will touch and treat you.
Internal work is very common and often very effective for aiding and accelerating c-section recovery. This is because your trunk muscles and pelvic floor muscles are all connected. When you undergo low abdominal surgery, the scar tissue can adhere to itself, other tissues, and even to organs—which often leads to tightness and feeling restricted across the groin and throughout your pelvic floor. A skilled Pelvic PT will release triggered or spasming pelvic floor muscles and re-mobilize internal and external fascial tissue. This will allow you to begin engaging your Transversus Abs (or TVA) and what I call ‘the pelvic corridor’ for a fully functional, strong pelvic floor and abdominal system.
Generally, a few sessions with a great pelvic PT is enough. But, if you sustained other injuries while delivering (ie. tearing, organ prolapse, incontinence) you may need a longer course of treatment coupled with targeted exercises. Again, this should be an ongoing conversation with your PT so that you are aligned every step of the way.
From Healing to Strength Training : How to start and how to stick with it
Once you have been cleared by your physician and are feeling ready to begin exercising, it’s important to remember that your fitness needs and schedule are different in these initial months (and years!) postpartum. You'll want tools (like the RM Soft Foam Roller) to release tight muscles, flush out swelling + stiffness while reducing the physical impact of daily mom'ing on your body.
Mom Truth:
Motherhood is hard on your body. Daily mom’ing left me tight and achy for years. This is why moving every day - even for 10 Min. - makes a huge difference in your recovery. Every time you take a deep breath, open up your shoulders or roll out your feet on the ball, you are reducing the build of stress and allowing your muscles to move better, heal faster and get stronger in the applied athleticism of your daily mom-life. Then, on days when you have a little more time, you do a longer sequence of deep core, glutes, upper body or back work. Your workouts should be progressive - meaning push you a little beyond what you can fully do comfortably. But, they should also teach you how to identify your edges so that you can push right up to your strength capacity (which changes daily) safely and with confidence.
Emotional Check-In:
It’s scary to have your body be so compromised, just when you need it to be strong and care for your baby. The fear and fatigue you feel is completely normal, but it doesn’t have to restrict you. Go slowly, listen to your body and your daily physical practice becomes the fear-disruption you need. Instead of all the “can’ts” you begin to focus on the “cans” as you feel and witness your incremental healing and increased strength every day.
Birth is a powerful gateway to motherhood—the pull between anticipation, preparing for the unexpected, and letting go with resilience and a friendly pivot…it never stops.
There is so much value in preparing your body, mind, and spirit for giving birth. But, when the moment arrives, both trust and surrender are needed—trusting yourself and your body, surrendering to a force that is much bigger than the confines of your physical body, and expecting that the unexpected will definitely occur.
And, so, for whatever journey you have had or are about to embark upon, I’m so happy you’re here and am thrilled to guide and support you.