C-section, cesarean section, or belly birth — however you relate to it — can be planned or unplanned.
During the C-section, your doctor makes an incision into the skin, through the fat cells and connective tissue, and then into the abdominal cavity. Your doctor then spreads the abdominal muscles apart and moves the bladder out of the way so that they can reach the uterus. An incision is then made into the uterus, and your baby is guided out. Shortly after your baby is delivered, your birthing team removes the placenta. The uterus is then stitched up, the bladder is put back into place, and the connective tissue, abdominals, and skin are stitched up to varying degrees. C-sections require a lot of layers of sutures, which can lead to the formation of scar tissue.
Understanding how your body heals from this surgery is essential to best care for yourself and support your tissues in their healing.
A Week-By-Week Guide to C-Section Recovery
Week 1
- The first week after your C-section, you can expect to feel some numbness and soreness at the incision site. It’s normal for your scar to be slightly raised, puffy, and even darker than your normal skin tone, so don’t be alarmed. Generally, your doctor will watch your healing process and give at-home care instructions to ensure your wound heals properly. They may also recommend some of these c-section recovery must-haves.
- Make sure to support the incision site and abdomen when coughing, sneezing, or laughing. Do this by bracing your abs (imagine pulling your belly button to your spine). You can also apply gentle pressure to the incision site with your hand.
- For the first few weeks after giving birth, you’ll have a vaginal discharge called lochia. Lochia consists of blood, bacteria, sloughed-off tissue from the lining of your uterus, and normal bleeding. This is true for women who deliver by C-section or vaginally. The discharge will be bright red for the first couple of days.
- You might have some gas pain and bloating during the first two days. Gas tends to build up because the intestines are sluggish after surgery. Getting up and moving around will help your digestive system get going again.
- On the day of or the day after surgery, you will be encouraged to get out of bed at least a few times. This will be to walk around and get your blood pumping. Wiggling your feet, rotating your ankles, and moving and stretching your legs are great ways to do this.
- Walking to the bathroom may seem impossible initially, but moving around is important for your C-section recovery. You want to ensure you keep your blood circulating to minimize your chances of developing blood clots. Also, walking will make your bowels less sluggish, which will help you feel more comfortable sooner.
- For these reasons, you’ll be encouraged to walk every day. Consider going for your walks shortly after you’ve taken pain medication so that you feel less discomfort during your outing.
- It’s also important that you urinate regularly. A full bladder makes it harder for your uterus to stay contracted and increases pressure on your C-section wound.
- Your discharge and bleeding will diminish, but both can last up to six weeks. Discharge and bleeding should gradually turn from bright red to pink and then yellow-white. Call your healthcare provider if menstrual-type bleeding continues past the first four days after delivery or comes back after slowing.
- Immediately call your doctor if you have any signs of a blood clot. This includes severe or persistent pain or tenderness and warmth in one area of your leg or one leg that is more swollen than the other.
Weeks 2-6
Many women forget that a cesarean is a major operation. You should focus on healing and recovery during the first six weeks after the surgery. This is not a time to push your body too far and too fast. Generally, most doctors recommend easing back into exercise or heavy lifting 6-8 weeks post-surgery. Still, you can begin pelvic floor exercises and core breathing immediately.
Pelvic Floor Exercise
Every time you lift your baby, tighten your pelvic floor muscles and lower tummy muscles simultaneously. This will help protect your back and prevent you from leaking urine.
In the early days, you can reprogram your core to function from the diaphragm down through the trunk to the pelvic floor muscles. You can do this by practicing your core breathing from a supine position and, when comfortable, in a seated position.
Core Breathing
Core breathing is simple. When you inhale, feel your ribcage, belly, and pelvic floor expand and gently relax. Then on your exhale breath, purse your lips (like you are blowing through a straw) and gently exhale to encourage activation through the pelvic floor and deep abdominal muscles. Before doing any activity (even before picking up your baby), pull in your abdomen, exhale your core breath, get deep tension and support in the pelvic floor, and then begin the movement or lift.
Once you feel comfortable with pelvic floor exercises, you can also start working on your lower tummy muscles, which will help strengthen your back. Try this simple and safe exercise 10 times, twice a day, gradually building up to three times daily. If you find it difficult, start with five times, twice a day.
This gentle core breathing exercise is safe and will not hurt your stitches or scar. There’s no need to wait unless it feels painful. The tissues around your scar will benefit from being gently flexed. Standing up straight and doing gentle abdominal squeezes will help your scar knit together.
During the first six weeks after having your baby, you can gradually increase activity at a pace that feels good to you. But cut yourself some slack; this is not the time to jump back into the workouts you did before or during pregnancy. Your body needs to heal and recover. Start with a five-minute walk. Once you feel comfortable with that time and distance, extend your walk to 10 or 15 minutes. Ask your doctor if you are unsure about any specific exercise or activity and how it will affect your healing.
Weeks 6+
Your healing process isn’t done just because you hit the six-week mark. Getting “cleared” for exercise by your doctor does not mean your body is completely healed from pregnancy and delivery. Start with activities that help you build a strong foundation and slowly tone and flatten your tummy. And then, when you’re ready and able, ease yourself back into weight training exercises and sprints. Read postpartum workout basics every new mom should know.
Sprints, metabolic conditioning, and proper weight training are great ways to shed some of the baby weight. You may only be able to do 10 minutes in the beginning, but you will get stronger—trust me. Just remember, the effects of pregnancy hormones can affect your joints for up to six months after birth, so stay away from high-impact activities—this is a process.
Ab Work & Diastasis Recti
Many new moms want to return to the gym and start crunching away and working their abs, but this is a BIG mistake. Rigorous ab routines can do more harm than good, causing pelvic floor and intra-abdominal pressure.
Some women develop a gap in their abdominal muscles as their bellies expand during pregnancy and labor, a condition called diastasis recti. Intra-abdominal pressure from ab work can cause the diastasis (or gap) to worsen and cause injuring those muscles. Before starting any ab routine, use caution, and check the condition of your stomach muscles.
We know that recovering from a C-section can be tough for some and easier for others. Either way, it’s a time to focus on you, your baby, and your recovery. With this week-by-week C-section recovery guide, we hope it gives you the information you were looking for and leaves you feeling prepared for your time after childbirth!
