Physical Recovery from C-Section

Do you long for a more subtle scar, smooth belly, and flatter stomach with no “c-section shelf”?

You’re not vain. These qualities can be a reflection of optimal health.

Most doctors don’t inform us about the physical impact of cesarean birth. Although cesarean surgery is the most common surgery in the US and Canada, it’s the only surgery that isn’t accompanied by some type of rehabilitation plan.

What are common physical impacts of cesarean surgery?

• A belly that continues to stick out, even months or years after birth. Some people call this a “mom pooch.” It’s actually a condition called diastasis recti where the abdominal muscles separate. It happens to all pregnant bodies. However, can be more severe for bodies that underwent a cesarean birth because of the additional impact on the abdominal wall. While there are no health risks associated with this condition, it can undermine our confidence. Special exercises are needed to help re-unify the abdominal muscles and rebuild the core (it’s not as simple as doing crunches…in fact, these can cause more harm if your body isn’t ready).

• Raised or hypertonic scar. Some scars are raised instead of flat. These may need different rehabilitation.

• Scar sensitivity or numbness. Even after it is “healed,” your scar or surrounding area may be numb, extremely sensitive, or some combination of both.

• Belly sensitivity above or below scar. Your stomach may be sensitive or sore well above your incision site, even above your belly button. It’s common to have strange sensations throughout your abdomen for a few months after surgery.

• Chronic pain in hips, lower back, and pelvis is extremely common for c-section moms, this pain is often caused by scar tissue and adhesions.

• Painful sexual intercourse is also very common for c-section moms. Painful sex is caused by scar tissue, adhesions, hypertonic pelvic floor (tight pelvic floor), and carrying emotional trauma in the pelvic floor.

• A c-section “shelf” of tissue above the scar. Most c-section bodies have “shelfing” that occurs above the incision site. Bodies with more belly fat may have a more extreme shelf. The c-section shelf is caused by a variety of factors, depending on how far you are postpartum: excess fluids and swelling, extra body weight, and fat and fascia that is “stuck” as a result of scar tissue.

It’s unlikely that your OB will offer any guidance for these issues: while they understand the surgery, but most are not educated about surgical rehabilitation.

The good news: while most of these conditions will not disappear on their own, with the right help and some hard work, they are all treatable and can be wholly (or mostly) resolved - even months or years post-surgery.

Luckily, there are some incredible Physical Therapists, massage therapists, and fitness trainers around the globe offering in-person and web-based physical c-section recovery — and many are cesarean mothers who have first-hand experience with their own healing.

I’ve included some of my favorite online practitioners and programs at the end of this page.

For most bodies, cesarean physical recovery will require a combination of time, scar massage, special exercise, commitment, and patience.