Feel-Good Care for Your Fourth Trimester

Your OBGYN will likely clear you for return to exercise at your 6 week postpartum check-up. However, once cleared, the return should be gradual and should factor in your pregnancy and birth experience, your current level of activity, the exercise type, your goals, and your pelvic floor's response to activity.

Your OBGYN will likely clear you for return to exercise at your 6-8 week postpartum check-up once the incision has fully closed. However, once cleared, the return should be gradual and should factor in your pregnancy and birth experience, your level of activity, the exercise type, and your core and pelvic floor's response to activity.

The pelvic floor works to support your pelvic joints and organs and to prevent leaking gas, urine or stool. Pregnancy and childbirth can lead to changes in these muscles. Pelvic floor physical therapists are experts at assessing your pelvic floor function and providing tools, guidance and exercises to help you restore their ability to work.

Immediately postpartum, you may experience pelvic pressure related to swelling, hemorrhoids or tissue healing, especially if you received an episiotomy or tore during delivery. Once these wounds have closed, pressure or heaviness may be linked to various issues including pelvic floor dysfunction, vulvar varicosities, or pelvic organ prolapse.

Wound healing following a c-section typically takes from 6-8 weeks. However, recovery has to do with more than simply wound closure. If your core and pelvic floor need strengthening, if your posture has suffered, if your incision causes you pain or discomfort, and if you are sleep deprived with caring for a baby, these factors can all impact your recovery.

Physical therapy following a c-section is there to help you rebuild your core and pelvic floor muscles' strength and endurance, to improve your scar tissue's flexibility and decrease sensitivity, and to provide guidance for good body mechanics during childcare tasks that will reduce your risk of injury and promote healing.

C-section scar massage is a hands-on technique used by physical therapists to reduce your scar's sensitivity and improve its flexibility. Depending on your phase of healing, whether you are 1 day or 1 year postpartum, your physical therapist will guide you through the most appropriate massage strategy for your c-section scar.

You’ll want to avoid deep bending, lifting more than your baby, or otherwise stretching or straining your abs until your incision is fully healed around 4-8 weeks after delivery. While your c-section is healing, remember to bend at the knees and waist and try to keep your back tall in order to protect the incision. Try to avoid movement or activity that causes pain at the scar site.

Diastasis recti or DRA is the separation of the "six-pack" muscles and the stretching of the connective tissue between them in order to make space for a growing abdomen. This separation is considered normal in pregnancy and should resolve within 6 weeks postpartum. If the muscles remain separated or the connective tissue remains lax beyond 6 weeks, this is considered a postpartum diastasis.

The most obvious sign of a diastasis recti is "coning" or "doming." Coning is seen in the space between your six pack muscles typically between the sternum and belly button when doing a crunch-like movement. The increased pressure in the abdomen caused by crunching pushes against the over-stretched connective tissue making it bulge outwards.