Having a C-section requires a touch more recovery time and TLC than a vaginal delivery, but ultimately, it does not mean catastrophe—not in the least! A transverse cut, or bikini cut, usually does not penetrate the abdominal muscles. A C-section can create the distended belly pooch or the baby belly after birth. More than likely, this will go away with the proper core training and healing.
When can I resume exercise?
You might experience numbness for a few months after birth; the nerves were cut! Your resumption of exercise will be slower, but the end result of getting back your core musculature is the same as with a vaginal delivery.
At your 6-8 week postpartum appointment, your doctor will usually give you the green light to exercise. For step-by-step postpartum exercises go use this postpartum guide.
A C-section is a surgical procedure, 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 the fascia is cut horizontally, this is a layer of soft, flexible connective tissue that acts as a sheath over these muscles. Then the abdominal rectus muscles are separated from one another and moved to the side. These muscles are very rarely cut, and if they are they are usually put back together.
Exercising after a C-section should be done with caution. As long as your doctor is okay with it, you should be able to perform pelvic floor exercises – See Pelvic Floor Hold ‘Ems and Quick Squeeze ‘Ems. After your doctor releases you to exercises around the 6-8 week postpartum mark, you can start the daily core exercises. They should be done pain free. If this is not the case you need to back off. The bridge and clamshells are really important for C-section mamas…these create stability to take the strain away from the incision area. You had major surgery. Combine that with a newborn’s sleep schedule and it can create stress. Ease into exercise and only if it can be done pain free.
Some women find comfort in wearing a postpartum support band or belly band. I recommend these should be used for comfort. When they are used as part of a strength training program, the body tends to lean on the “support” instead of recruiting muscles to strengthen the core.
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 in all of our core workouts, specifically our postnatal workouts.
Vaginal deliveries with midline episiotomies, especially 4th degree (1st being smallest) can create dysfunction of the pelvic floor, which interrupts core function.
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.
Scarring after a C-Section
Normal tissue in our bodies is aligned in a nice uniform direction. However, when scar tissue forms it is kind of like your toddler played pick up sticks and tossed them all over the floor. The tissue is laid down in haphazard directions. Most C-sections are performed using a horizontal incision or bikini cut over a mom’s lower abdominal. When the scar heals, just like any other scar, it lays down tissue in every different direction. The scar tissue can cause adhesions to the abdominals, pelvic floor and surrounding muscles.
You can work the scar tissue at home – read more about c-section scar mobilization.
How could an incision wide enough to accommodate the debut of a newborn not produce a glaring permanent mark on the abdomen? Well, contrary to what many women believe, a doctor does not cut through the abdominal muscles to reach the baby (the only muscle that is cut is the uterus). He separates the two sets of these muscles and then cuts through the uterine wall. These days, a traverse or horizontal cut (a.k.a. the Bikini Cut C-Section) is popular because the scar is coverable with bikini bottoms, follows the natural curve of the lower stomach, and causes minimal complications, if any. This incision draws much less attention and opportunity for infection than the longitudinal, or vertical, cut.
Do you worry about the “muffin top” 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! 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.
Should I wear a Postpartum Support Band
Unfortunately, no brand of shape wear can tighten a woman’s stomach muscles; you must rely on nature and a postpartum exercise plan. A support band can release the pressure from the back during healing, and using it for this purpose is perfectly acceptable, as long as it doesn’t become a substitute for engaging and strengthening the core muscles through a workout routine.
“The Muffin Top”
Many women are dismayed to discover a “shelf,” or a bulge, that protrudes over their C-section scar. I experienced this phenomenon after my first C-section, and appealed to my Ob/Gyn, Dr. Kent Snowden, for an explanation. He assured me that this “shelf” was probably fatty tissue damage, and that it was so prominent because of swelling. Once the parts of my body, inside and out, had settled back into where they belonged, the scar tissue should remain the only evidence of the surgery. A woman who has sustained multiple C-sections will end up with more scar tissue, but whether she chose stitches, staples, or tape for suturing should not make a difference in the amount of fatty tissue damage or scar surface area.