10 C-Section Recovery Must-Haves

No matter how carefully you prepare, your fourth trimester can be more challenging than you ever expected. If your birth was via a C-section, you're expected to care for a newborn while you're recovering from major abdominal surgery. As busy, exhausted, and physically uncomfortable as you're likely to be, it’s critical to protect your healing incision and take the steps you need to heal and prevent complications.

A cesarean incision that doesn't heal properly can lead to:

• Scar tightness, itching or pain
• Deep abdominal scar tissue and adhesions
• Restricted movement and muscle issues
• Abnormal scar appearance including keloid scarring, hypertrophic scarring, or even the cesarean “shelf belly” which is when flesh hangs down over a restricted scar

We're here to help! With some expert-recommended tricks up your sleeve and a few recovery products on hand, you'll be well on your way to a smooth and confident C-section recovery.

10 C-Section Recovery Must Haves

Take it from a pelvic floor physical therapist who has helped hundreds of individuals recover after a cesarean birth, these tips, products, and people can make your healing process as easy as possible.

1. A First Aid To-Do List

The post-surgical care instructions you bring home from the hospital can sometimes be vague, confusing, or incomplete. Go over them with your provider to make sure everything is clear, and ask if there's anything else you can do to ensure that your incision heals properly.

Here are a few generally recommended to-dos:

• Soothe pain with ice packs. Try to ice your incision for about 10 minutes, every couple of hours for the first few days. Just make sure to put a layer of clean cotton between you and your ice pack to protect your incision. Use hospital ice packs or bring your own. If you run out of ice packs at home, frozen peas work great.
• Check your incision daily. Keep your incision clean and dry, and look for changes such as increased redness, heat, swelling, or bleeding. If you notice anything new or different, let your healthcare provider know, ASAP.
• Start gentle movement. If your doctor says it’s safe, you can begin walking on the day of surgery. This will help boost circulation and reduce swelling. It will also get your bowels moving (more on this below). Walking around the hospital is a great way to start. Move very slowly at first while focusing on keeping your posture upright. Pick up the pace only when you feel comfortable.

2. A C-Section Recovery Kit

Frida Mom products are truly a new parents best friend, and their C-Section Recovery Kit is no exception. It comes with a lot of little things that will help you get through your first few days of recovery, including high-waisted/disposable undies, a belly band to help support your healing abdominals (more on this below), and silicone scar sheets to encourage proper incision healing.

3. A List of Symptoms to Watch For

With all that is going on in the first weeks after having a baby, it’s easy to be neglectful of your own needs. Make sure to check in with your surgeon so that you are aware of any specific precautions that you need to take when recovering. Also, if you notice any of the following, reach out to your healthcare provider right away so that they can make sure all is going well during your recovery:

• Fever
• Chills
• Leg pain
• Draining or leakage from the incision
• Heavy bleeding
• Worsening pain
• Shortness of breath

4. Expert Tips for Bowel & Bladder Care

Swelling and pain in the lower abdomen, trauma to your bowel and bladder, and changes in drinking and eating patterns or disruption of normal muscle function due to anesthesia can all make your trips to the bathroom a bit tricky after surgery. Try these tricks to reduce bloating and/or increased bladder expansion which can strain your incision and increase your discomfort.

• Focus on water & fiber intake. Remember to hydrate and eat plenty of fruits and vegetables.
• Try peppermint. Try adding a few drops of peppermint to your toilet water before you pee to help you start your flow of urine.
• Chew gum. There is some evidence that chewing gum in the early postpartum hours will speed up your ability to pass gas and have a bowel movement.
• Prop your feet up. When on the toilet, try putting your feet up on a squatty potty, a small stool, or even a trash can turned on to its side. This will help relax the muscles that need to lengthen to release stool.
• Push out poop effectively. Good pushing technique is important when having a bowel movement. This involves relaxing your pelvic floor muscles while gently pushing with your abdominals. Try not to hold your breath while you're pushing, instead exhale like you are blowing out a birthday candle.
• Hug a pillow while you poop. Apply gentle pressure to your incision when pushing to have a bowel movement. Take a small pillow into the bathroom with you, place it on your lower abdominals to cover the incision, and then gently hug the pillow while you are pushing. This may be helpful for sneezing and coughing as well.

5. A Postpartum Abdominal Binder

Postpartum abdominal binders are compressive/supportive wraps or belts that are commonly used after cesarean section to help support overly lengthened abdominal muscles and minimizes swelling, while healing in the postpartum.

The use of abdominal binders postpartum has been shown to help to decrease patient distress after cesarean and will likely help you get up and moving after abdominal surgery faster. Binders may also help cue posture, and increase proprioceptive input for abdominal muscles.

There are several different abdominal binders on the market — some are made of an elastic/stretchy material, and some are non-elastic. So many options are easily available with just a quick Google search, but proper fit is key so make sure you check in with your healthcare provider to make sure you are wearing it correctly.

6. High-Waisted Yoga Pants

Another great option to act as a proxy abdominal binder? A snug pair of high-waisted yoga pants. These can be really helpful in giving you the input you need to help support and use your abdominal muscles when you move and care for your new baby. Plus, you already likely have these on hand, so you aren’t needing to spend the extra money.

Pressure on your scar not your thing? Compression doesn’t feel good for everyone, and may in fact feel the total opposite of helpful. Try folding your high-waisted yoga pants below your hip bones, to free up your incision instead!

Pro Tip: pack a black pair to help disguise any postpartum bleeding or urinary leakage (this can totally happen after a cesarean too).

7. Exercises for Your Abdominals & Pelvic Floor

Your abdominals and pelvic floor muscles have been through a lot recently. It can feel scary to use your muscles after a C-section, but safe, proper muscle use during body mechanics and baby/self care activities, will not only protect your healing incision, but encourage healing by reducing swelling and encouraging blood flow.

Practice using your pelvic floor with some gentle kegels:

• While resting in bed, practice squeezing the muscles around your vaginal and anal openings as if you are trying to hold back gas and stop the flow of urine at the same time.
• Try contracting as you exhale and relaxing as you inhale — this can make it easier, and even get your abdominals working.

Gently activate your abs:

• Breathe deeply while resting in bed. As you exhale, try to tight and draw-in your stomach below your belly button, as if you were zipping up a tight pair of jeans.
• Engaging your deep abdominals in this way is really helpful to support your posture, stabilize your back, and support your healing incision as you hold and move with your baby.

8. Scar Care Know-How

Give special attention to your c-section scar, so that you can set a foundation for healing. Some ways to give it TLC:

• Keep it cushioned. Your incision may be very sensitive initially and even the lightest pressure from your clothes may irritate it. Cushion your incision by placing a folded washcloth between your scar and clothing to prevent rubbing, or direct bumps to the area.
• Try a silicone scar sheet or gel. Silicone scar care products are often recommended to help with healing and the appearance of your scar. Silicone scar sheets like the ones found in the Frida Mom kit (above) are helpful, but if not used properly may actually contribute to an infection. A helpful alternative is using a silicone gel to apply to the scar.
• Start massaging your scar. Once your incision is fully healed, scar massage is key to preventing long term complications like pain, or the development of adhesions. There are plenty of DIY scar massage recommendations on the internet, but it’s best to see a pelvic PT who is properly trained in safe scar massage, and can help you learn to best massage techniques for you.

9. Strategies for Moving Safely

Lifting, carrying, feeding, and cleaning up after your baby can take a toll on your muscles, joints, and incision. Use the posture and movement strategies below to prevent injury, reduce fatigue, and feel better in your body.

Ease muscle tension when standing or sitting:

• Aim to keep a small arch in your lower back and let your shoulders relax down and away from your ears.
• Gently draw your shoulder blades back and together, toward your spine.

Get in and out of bed without straining your abdominals:

• Start by sitting on the edge of the bed (right about at the middle), and inhale as you get ready to move.
• Exhale and gently squeeze your abdominal and pelvic floor muscles as you lean sideways onto the elbow of the arm closest to your pillow and lower yourself down onto your side. At the same time, raise your legs onto the bed, keeping your knees slightly bent.
• Hold your head in line with your spine and roll like a log from your side onto your back. As you roll, keep your knees together and your abdominals and pelvic floor engaged. Your hips, shoulders, and knees should move as a single unit.
• Use this same technique in reverse when it’s time to get out of bed.

Lift baby in and out of their crib:

• Lowering baby down: With baby held against your chest, stand as close as you can to the crib. Place a pillow between the crib and your incision. Your feet should face the crib, at least hip-width apart. Engage your abdominals and pelvic floor as you hinge forward at the hips to lower your upper body. Keep baby against your chest and your back straight for as long as possible. As you bend with your abdomen against the crib rail, use your arms to lower baby to the mattress.
• Lifting baby out: Place your body as close as possible to where baby is laying in the crib. Engage your abdominals and hinge forward at the hips as you scoot baby toward the edge of the mattress. With your core and upper back muscles engaged to help keep your back straight, reach down and bring baby into your arms. Then use your leg muscles to lift baby up and out of the crib.

Remember to breathe as you lift! Holding your breath prevents your muscles from moving naturally and deprives them of oxygen. Inhale first, then exhale as you lift or move your baby. Bonus points if you also engage your abs and pelvic floor muscles to stabilize your back and pelvis while protecting your incision.

10. A Referral to a Pelvic Floor PT

On average, your baby will be seen by their pediatrician 6 times, before you meet with your obstetrician to check in even once. This is unacceptable after a cesarean section. Schedule an appointment with a pelvic physical therapist in the meantime. They are highly trained in pregnancy and postpartum recovery, and have the tools you need to help you feel your best.

It is completely safe to start seeing a pelvic floor PT as soon as you get home from the hospital, and you can even be seen virtually as you recover in bed, by one of our pelvic floor PTs as part of the comprehensive, evidence-based Fourth Trimester Care at Origin. They will provide you with expert, individualized advice to help your body recover, while guiding you gently back into movement and exercise — no guesswork required!