Having a C-section can be a daunting prospect. Beyond the support of your healthcare team, recuperation at home can be made easier with these four pillars of Caesarean recovery.
In Canada, the Caesarean birth rate has steadily risen to 34 percent as of 2022, while in the United States, Caesarean births rose to 32 percent in 2023.1,2 As this number continues to increase, it’s important to highlight the realities of recovery after a Caesarean. Why is this information relevant when you’re pregnant? With over a third of births in each country being Caesarean sections, and many of these being unplanned rather than elective, it's crucial to understand what the Caesarean procedure and recuperation entail. This knowledge can help you feel more prepared and empowered to navigate the recovery process, no matter how your birth unfolds.
A COMMON MISCONCEPTION
You likely won’t be fully recovered from a Caesarean at six weeks post-op (and that’s okay!) Full recovery is typically closer to 1–2 years, with the bulk of the recovery happening in the first 6–12 months.
RECURRING SYMPTOMS
Like any other surgery or injury, sometimes symptoms might pop up later in life. Our bodies change as we live our lives; you might take on a new activity, gain or lose weight, or maybe start a new sport. When changes occur in our bodies, that’s when old symptoms may return, such as:
- Tightness around your incision site
- Altered sensation (i.e., numbness or tingling)
- Pain around or at your incision site when:
- Coughing
- Sneezing
- Laughing
- Sudden movements
- Lower back pain
- Hip pain
- Pain during sex
But learning to take care of your abdomen and Caesarean scar early in your recovery will give you the tools to support yourself for the rest of your life.
SCAR REHAB
This can start immediately post-op with rest, gentle movement, core connection, compression, and general massage. Approximately four weeks onwards, you can progress movement, core connection, and massage.
The optimal time for Caesarean recovery is in the first eight weeks; however, just because the first eight weeks are the most optimal doesn’t mean that all the recovery will be done in that timeframe or that it’s too late to start if your recovery is beyond this.
Scarring is a normal and natural part of healing. What we are trying to prevent is excessive scar formation. This can happen if there’s too much tension in the healing area. Decreasing the tension will support healing and can help decrease scar tissue formation.
Inflammation
Inflammation is a source of tension during healing, which is normal, but too much can add extra tension, making it harder for the area to heal. So, inflammation management, in all its forms, is one of the key ways to support the healing process. In the later stages of healing, mobilising the tissues around and along the scar can help decrease tissue tension.
THE FOUR PILLARS
1. Rest
Caesarean sections are major abdominal surgery, and like all other major surgery, rest is paramount for proper healing. Slowing down and resting during the first six weeks will impact the rest of your healing journey. For many, this is much easier said than done, but it's crucial to remember that recovering from surgery and pregnancy, especially while breastfeeding (if chosen), requires an immense amount of energy—much of which comes from rest.
2. Core Connection
Rest doesn’t mean staying in bed for six weeks. It’s important to spend time each day performing some gentle, intentional movement to build core connection. Simple movements include:
- Diaphragmatic breathing
- Pointing and flexing your feet when in bed
- Standing up straight when getting up
- Walking to the washroom
- Walking to refill your water bottle
These are all ways to support early core connection. From there, progression can be made to further engage your core. Not sure how to progress? You can seek the support of a pelvic floor physiotherapist to guide you in reconnecting and building your core as well as your entire body strength after a Caesarean birth.
3. Compression
This is helpful for inflammation management and to support the abdomen. As soon as you are comfortable applying compression, it’s beneficial to do so with either an ab wrap (not a girdle), compression underwear, or compression tights—which can double as management for swelling in the legs post-op. Make sure that the compression isn’t too tight; it should feel snug, like a gentle hug. It’s important to make sure that the healing area can breathe to prevent excess moisture, which could lead to an infection.
Compression is also especially helpful when returning to daily activity as it can add support to your core. It’s especially helpful in the first eight weeks, and as the weeks progress, decrease the frequency of wearing the compression garments. During this time, you should be working on core connection and strength, which in turn decreases the need for compression garments.
4. Self-Massage
Sometimes the surgical area or the surrounding tissue can feel tight, which can lead to discomfort or pain. This is where massaging the area comes into play. General massage to the abdomen can be done as soon as you’re comfortable; however, I typically recommend waiting at least 48 hours after surgery. Early massage to the abdomen can help ease gas pains, help with bowel movements, and decrease inflammation. It also helps support the healing tissues along the incision, even if work isn’t done directly to the scar.
Direct treatment to the scar can start between four and eight weeks post-Caesarean, once the wound is completely healed, there are no open parts to the incision site, and a scab has formed and fallen off. If an infection has occurred, then the date that the infection has healed is week zero and massage to the scar can begin 4–8 weeks after that.
Technique
Start simply, slowly, with lighter pressure, and a shorter duration; increase pressure over time. Massaging around the scar is also incredibly beneficial as there are often adjacent structures that can use the treatment. Apply just enough pressure to meet resistance under your fingertips—like checking an avocado for ripeness, not making guacamole!
Moisturise
Applying some kind of moisturiser, oil, balm, or salve to the scar daily is a good place to start. The product used should be as natural as possible with no chemicals, fragrances, or dyes.
Remember: This is after the incision site has fully healed.
If massaging your scar feels daunting and you’re not comfortable touching your abdomen or your scar, that’s okay. You can start further away from your healing scar or massage through clothing. You can also see a registered massage therapist for treatment if you prefer.
Silicone Strips
Silicone strips are another option for Caesarean recovery. Like massage, this can begin 4–8 weeks after the incision site has fully healed; you’re good to start wearing silicone strips when no scab is present. Start gradually at two to three hours a day and increase the time if comfortable. Silicone strips help create a barrier keeping moisture in, which supports scar healing. It decreases the tension placed upon the scar (especially at the ends) and adds a layer of protection between yourself and the outside world, which is helpful if the area is tender.
Healing after a Caesarean section is a deeply personal journey, and it’s important to remember that everyone’s recovery process is different. While some may bounce back quickly, others may need a more gradual recovery. It's essential not to compare your progress to others. Your body is healing in its own time and in its own way, and that’s perfectly okay. Give yourself grace and reach out for support when you need it.
The tools that you learn early in recovery will support you as you live a long and fulfilling life as a parent.
