Here’s the thing: cesarean births are really common. In most of the United States, about 1 in 3 women who give birth have a c-section each year! There are many reasons for this rising number — but that’s another post. The fact remains that a huge section of the pregnant population will face a c-section, whether from choice or medical intervention, and I think it’s important to educate and prepare you in case you’re one of them! 

There is a shocking lack of information and preparation out there for women who may need a c-section. But there’s a lot you need to know! In fact, I wrote an entire post that outlines my top 5. And after you give birth and head home, there are different recovery steps if you’ve had a c-section, from cesarean scar care to mobility and healing — but most postpartum care information caters to women who delivered vaginally. It drives me crazy, so I’m doing everything I can to make sure you have what you need to thrive during pregnancy, delivery, and postpartum — no matter what. 

Anatomy of a cesarean delivery

Most of us are not super knowledgeable about the details of c-section surgery and recovery— and I think we all should be. Even if you’re not planning on having one, it’s always better to be educated and prepared, because even the best birth plans can turn into surprise situations. Before we talk through anything else, I want to help you understand that this is a major abdominal surgery. I don’t highlight that to scare you — in fact, it’s the opposite!

Going through a major surgery, especially when it’s unexpected, can sometimes be traumatic (and it’s almost always frustrating when your recovery timeline is longer than you imagined). But when you know what the surgery entails and what recovery may look like, you’re much better equipped to face it, heal from it, and even thrive in the early postpartum period. Here’s what happens during a cesarean surgery: 

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A post shared by Skyler Jacobs | Certified Nurse Midwife (@wellandworthyco)

After a c-section, you’ll have a scar — that part seems obvious. But did you know that without proper treatment and care, that scar can cause long-lasting pain and problems? The connective tissue of your abdomen is majorly affected by your c-section. Sometimes, scar tissue can form adhesions, which limits mobility and can cause tightness or pain. The area immediately surrounding your scar will feel numb after delivery, but this can turn into pain, discomfort, or hypersensitivity over time. 

One aspect of c-sections that isn’t often discussed is the possibility of developing what’s known as a “cesarean shelf”. When layers of tissue adhere together during the healing process, the scar can become indented and immobile. Then, the tissue above that scar can “puff” and create a shelf. This is not only painful, but can also create insecurity about the appearance of your stomach. Thankfully, most postpartum women dealing with adhesions can be treated through pelvic floor physical therapy.

While you may not think you need pelvic floor PT since you didn’t deliver vaginally, the reverse is often true. Your pelvic floor still underwent all the pressures and changes that come with pregnancy, and then you had surgery on top of it! You may need to be treated for diastasis, pelvic floor tightness or weakness, or scar adhesions. You can also treat your own scar right at home — and there are endless benefits to doing just that. 

Benefits of caring for your scar

Caring for your c-section scar can decrease numbness and sensitivity, decrease adhesions and the possibility of a shelf, and avoid keloid and hypertrophic scarring. On the flip side, scars that remain adhered and tight can cause pain with sex, difficulty emptying your bladder, and pain in your pelvic region or lower back. 

Have I convinced you that caring for your scar is important? Great! Here’s how to do it. 

How to care for your c-section scar

When it comes to c-section scar care, there are four main tips that I think you’ll find helpful. 

1. Keep it clean. 

Remember, this is a surgical site! Avoid submerging your scar in the bath until it is fully closed up. When you shower, it’s okay to get those steri-strips wet, but avoid scrubbing the area (you probably won’t want to anyway, but just in case!). Allow the steri-strips to fall off as normal. 

2. Desensitize it. 

I wrote an entire post on this, because I think it really makes a difference in your long-term recovery! You can begin indirect contact as soon as one week post-op, but don’t begin direct desensitization until 6 weeks (or longer, if your scar hasn’t yet healed). Here’s your comprehensive how-to desensitization guide. 

3. Mobilize it. 

Scar mobilization is a fantastic tool for preventing adhesions. You can perform mobilization above and below your scar at around 3-4 weeks, but don’t perform any mobilization movements directly on your scar until 6 weeks (or longer, if your scar hasn’t yet healed). At the 12 week mark, you can add cupping into your routine to continue to mobilize the surrounding tissues. 

4. Use silicone strips on it. 

Research has shown that silicone is really effective in treating scars and minimizing their appearance over time. This is even true for hypertrophic and keloid scars! I recommend starting usage after your scar has fully closed. You may only be able to tolerate strips on your scar for a little while at first, and that’s totally fine. Work up to wearing them 24 hours a day, taking them off daily to clean. 

To clean silicone strips, wash them gently with mild soap and water. Let them fully air dry before you reapply to your body! For the best results, you’ll probably need to wear them for anywhere from 2-4 months. 

Need more guidance?

Whether you delivered vaginally or through c-section, you might be confused about what is safe to do during the first six weeks postpartum. If that sounds like you, you’re in luck — I created a course just for that purpose. This 12-week program is designed to help mamas recovering from both vaginal and cesarean deliveries, with specific modules depending on which childbirth method you’re recovering from. 

Inside, you’ll find safe movements to help you get in and out of bed, lift and carry  your baby, breathe and engage your muscles correctly, and gain whole body functionality as you heal. There are also lots of educational videos to help you understand your core and pelvic floor anatomy, identify and address prolapse, diastasis recti, and incontinence, and learn how to massage and desensitize your scar. I also created modules of movement specifically for mamas who had a c-section. Movement Through Early Postpartum was created to support you in every way as you journey through the early postpartum days. I hope it’s a helpful resource for you! 

Purchase Movement Through Early Postpartum here!