Congrats on your pregnancy mama! Having a baby is one of the most joyful yet frustrating experiences of your life and I cannot wait for you to meet your little one.

Whether you are a first time mom or veteran, it is super important to prepare for both a vaginal and cesarean delivery. In 2020, 31.8% of pregnant women in the U.S. had cesarean deliveries, and that number continues to grow. While I could go into a whole blog post about why this rate is rising, it is important to acknowledge it and BETTER PREPARE women for this type of delivery.

A cesarean delivery is a major abdominal surgery where your OBGYN will cut through several layers of tissue: skin (outermost), fat, fascia (tissue that directly encases the abdominal musculature), abdominal muscle (not typically cut but split apart along the grain of the muscle), peritoneum, uterus (move bladder out of the way), and the amniotic sac.

Because a c-section is a substantial abdominal surgery, recovery is different in several ways from a vaginal delivery, but unfortunately these differences are not discussed as often as they should.

Additionally, many first time moms are not fully prepared for a c-section simply because they did not know they would need one until labor began.

So I am here, writing this post, to better prepare you for a c-section even if you are not expecting to have one.

1. You May Feel Gas Pain in your Shoulder

After a c-section it is common to experience increased gassiness and this can be from a multitude of things, but most often it is due to the decreased activity of your bowels following the surgery. When this happens, it can leave you feeling constipated, bloated and gassy. The gas can actually push on the diaphragm and the phrenic nerve which can cause pain in the shoulder region.

This is why your nurses will encourage you to walk right away after surgery to get the bowels moving again and help decrease your discomfort.

2. You Might Still Feel A Tugging Sensation During The Procedure

Though the anesthesiology team will be present to make sure your cesarean does not hurt, it is common for many women to still feel “tugging” or “pressure” during the procedure which is simply the doctor removing your baby.

3. You Might Feel Nauseous or Shakey

This is a completely normal reaction to the anesthetic medication administered, however you should always feel free to speak up and let your anesthesiologist know what you are experiencing so that they can appropriately manage your symptoms.

4. Your Scar Needs Love

With each layer that is cut through during a c-section there is the formation of scar tissue. Scar tissue is important to heal the site of the incisions, however it can build up in an excessive or non-cohesive manner causing each layer to adhere to the next. This can cause pain and discomfort in and around the scar days to years later without appropriate massage based on tissue healing timeline.

Additionally, when your OBGYN cuts through those layers of tissue, they also cut through superficial, peripheral nerves which can take up to six months or more for the nerves to heal. This can cause numbness, pain or increased sensitivity, which is why it is so important to work with a pelvic floor physical therapist soon after your delivery to assist with scar healing.

Check out the video below for 3 techniques on how to perform c-section scar massage.

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A post shared by Dr. Mae Hughes, pelvic floorPT (@dr.maehughes)

5. You WILL Need Pelvic Floor Physical Therapy

Pelvic floor physical therapy can help with a multitude of things following a cesarean delivery including scar de-sensitization, scar massage, abdominal massage, body mechanics for daily activities such as bending over or sitting up from the toilet, core strengthening, pain with intercourse and full body healing.

Many women assume that because they are delivering via cesarean that they will not need pelvic floor physical therapy, but this is false. The pelvic floor and surrounding core/back/hip musculature still undergoes major physical changes during both pregnancy, labor and delivery, and the postpartum period.

I STRONGLY urge you (whether vaginal or cesarean) delivery to schedule an appointment with a pelvic floor physical therapist within the first 6 weeks of delivery to help you recover and navigate the fourth trimester.

There are several ways to locate a pelvic floor physical therapist. The first is to ask your OBGYN or Midwife because they will typically have a list of providers they use. You can also use directories such as pelvicrehab.com or pelvicguru.com in addition to asking other women who have children!

My goal is to help you feel empowered and prepared for whatever type of delivery you may have! Make sure to check out my Instagram for more pelvic floor, pregnancy and postpartum information!