How do I get rid of the “shelf” above my c-section scar? Does a c-section cut through your abdominal muscles? Do c-section patients have a harder recovery than vaginal births in reference to physical activity? Or just a longer road to recovery? And is a bikini cut c-section really unnoticeable?
You should not begin exercise until your OB has given you permission (which can occur at your 6 week postpartum appointment.) A C-section is a surgical procedure so there will always be some scarring, but unlike what most women think, your doctor will not be cutting through muscle with the exception of the uterus. When a C-section is performed two sets of abdominal muscles are separated from one another but are NOT cut. A transverse (horizontal) cut—the so-called Bikini Cut C-Section—actually causes fewer complications. Since it is below your bikini line it will be far less noticeable than a longitudinal (vertical) incision.
If you had a C-section some exercises could bother your incision site, so back off until you are ready and only do exercises you are completely comfortable doing. If you feel some discomfort try saying “hut” while doing the work. And/or support your abdominal area with a pillow for more comfort. You should be able to exercise around the 6 week postpartum appointment when your doctor releases you. You will just need to start out a little slower than if you had a vaginal delivery. And you may feel numbness for a few months after your procedure. Why? Your nerves were cut and will take a bit to recover.
C-Sections vs. Vaginal Birth
A C-section is like having a cast on your arm. It will take longer to recover, but the good news is you can have the same end result as a vaginal delivery. As you read above, a bikini cut c-section does not cut through your muscles. The fascia is one of the 5 layers cut as your doctor goes in to get the baby. Fascia covers the muscles and acts as a sheathe to keep our waists compact. Of course if your muscles are not tone underneath there is a lot more compacting for the fascia to do! After birth your fascia will be back to 90% of its original strength within in 6 weeks, the other 10% will come back within a year. You cannot strengthen or tighten your fascia without surgery…so preventative measures are necessary…staying within the recommended weight gain is a must!
You will have to train your Pelvic Floor and Transverse Abdominis, both muscles of the core, to create a flat stomach again. You can find these exercises on Lindsay’s Postnatal DVDs. Vaginal deliveries with midline episiotomies, especially 4th degree (1st being smallest) can create dysfunction of the pelvic floor, which also interrupts core function. Several of the tools and instruments that doctors use to assist you in giving birth, vacuums and forceps, for example, can cause PF dysfunction. Whether you have a vaginal delivery or a c-section the Pelvic Floor and the TA act as a sling to your baby. Which is why you need to train these specific muscles to get back the integrity and strength of your core before returning to traditional abdominal exercises.
Do you worry about the shelf that protrudes over your c-section scar? The good news is you can and will get rid of it if you make your muscles do some work! Dr. Kent Snowden, Ob/Gyn, specifies that the shelf is most likely fatty tissue damage. And after all the swelling goes down and you are back to normal (maybe 6 months down the line) all you should be left with is scar tissue. Now if you have multiple c-sections this scar tissue will obviously be larger than a single c-section.