Do I need Pelvic Floor Therapy after a Cesarean birth?

One common question we get in the pelvic health world is do I need pelvic floor therapy after a Cesarean birth. The answer is a resounding YES!!

No matter how you birthed your pregnant body went through many changes that can impact the pelvic floor, back, pelvis, ribs, neck and core. The other reason is women who have a C-section birth undergo a major abdominal surgery that involves cutting through skin, fascia, muscle and the uterus. For optimum recovery seeing a pelvic floor therapist is important.

The pelvic floor muscles play a vital role in our core. They work with our abdominal muscles, our back muscles and our diaphragm to make up our core and support our body.
As stated above, the fact of being pregnant affects our core strength. Then the core is further disrupted due to the surgery of a C-section. Pelvic health therapists can help assess not only how well the abdominal  muscles work but also how the pelvic floor muscles work in assisting the abdominal muscles to provide the body support.

Sometimes due to the surgery certain sections of our abdominal muscle have a hard time turning on. This can cause the body to grip at the rib cage or push pressure down creating more of a pooch in the lower belly and pelvic pressure. An ab separation or a diastasis recti which most women have late in pregnancy and early postpartum can affect your core healing as well. Pelvic floor therapists help screen for muscle activation and separation and teach you to reconnect with your core safely through things like breath work, posture and exercise.

It is common to see tight pelvic floor muscles after any birth, including a C-section birth. This doesn’t seem fair since the baby wasn’t born vaginally but it is common. Your changes of pelvic floor tightness increase especially if you labored for a while prior to a C-section. Tightness of the pelvic floor can limit things like returning to pain free intimacy. A pelvic floor therapist can assess your pelvic floor and help the muscle return to a normal function.

It is important to get your scar moving! The scar is a good thing, it helps create healing from the incision. The scar typically is small but it goes deep like roots in a tree. If we don’t get it moving well the scar roots can limit the mobility of deeper tissues like our bladder, bowels and uterus. Getting the scar moving can also help the appearance of the scar, limiting the “mommy shelf”.  Good scar mobility can also help with the feeling of “yuck” that some people can feel when touching or looking at the scar. A pelvic floor therapist can teach you how to get your scar moving safely and appropriately to avoid issues that can occur down the line from restrictions.

Activities of daily life can be hard after a C-section birth, especially initially after. Remember how you could pop up out of bed before pregnancy? Or reach down to get something off the ground easily? Or maybe even put your shoes on without thinking about it? Well now after a C-section birth daily mobility can be difficult and sometimes painful. A pelvic floor physical therapist can help teach you how to move, roll and transition safely with minimal pain.

Do you know that you are scheduled for a C-section birth?

See a pelvic health therapist prior to birth to help with things like what you can buy and prep prior to birth, what you can ask the care team to focus on during the surgery and what your options are, how to help with the first poop, icing timelines and how to protect your healing incision with things like moving in bed and coughing/sneezing.

Want better healing, a beautifully moving scar, return to activity safely, pain free intimacy and limit the chances of bowel/bladder issues later down the road? Call our clinic to schedule your evaluation with one of our providers (before if you know ahead of time and) after your C-section birth to help!

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Blog written by Dr. Jesse Rapp