I’ve been working with pregnant women for years now, and I really wish I could stop by every single hospital room and celebrate with them after they deliver their babies. No matter how you deliver your baby, you’re bringing life into the world. That’s an incredible thing — and it’s also a major bodily event. 

As with anything surrounding pregnancy, childbirth, and postpartum care, there seem to be a lot of myths floating around. I really don’t know how some of them started, and I think today’s topic might be the most baffling of all. Maybe you’ve heard it… 

“C-sections are easier on your body because they don’t affect your pelvic floor as much as vaginal deliveries do.” 

Whaaaat? 

Here’s the truth from a pelvic floor physical therapist: your pelvic floor is affected by pregnancy, no matter how you deliver your baby. And while vaginal recovery and C-section recovery differ in a few key ways, they both require time for your body to heal and intentional movements that promote a healthy pelvic floor after pregnancy. 

Whether you’re planning to have a C-section or you end up needing one in the course of labor, it’s important to know what to expect and how to advocate for yourself. In 2022, 32.1% of births in the US were Cesarean. A topic that affects 1 in 3 moms is definitely worth discussing. Let’s get into the mechanics of C-sections, because understanding the process is actually so important in your recovery journey! 

Cesarean delivery 101

My intention is always to educate and never to scare, but know this: a C-section is a major abdominal surgery. I just want you to know what you need to know long before a C-section comes knocking at your door! 

During your Cesarean section, your OB-GYN will deliver your baby by cutting through seven layers of abdominal tissue: 

• Skin 
• Fat
• Fascia 
• Abdominal muscle 
• Peritoneum
• Uterus 
• Amniotic sac

When you read that full list, you begin to understand why I’m calling it a major surgery! Thankfully, with proper recovery steps, you can avoid or reduce common pelvic floor dysfunction that occurs postpartum. 

The canister of your core

You might have heard of your abdominal muscles referred to as your “core” in a workout class. In reality, they’re just one part of your core’s “canister.” Think of it this way: your diaphragm is the lid and your pelvic floor is the bottom, and the muscles in your abdomen and lower back function as the sides. Together, they work like a complex soda can, keeping the perfect pressure inside. This protects your organs — and your baby when you’re pregnant! 

When that pressure is mismanaged, you experience dysfunction. For example, if your core muscles are weak, pressure is directed to your abdominals, which can cause or worsen diastasis. (A quick note: diastasis can’t be prevented during pregnancy, but you can practice a few key things that will help you heal postpartum.) If your pelvic floor muscles are weak, pressure is directed towards the pelvic floor, which can contribute to prolapse or incontinence. 

When you have a C-section, that intra-abdominal pressure system is sliced open. Your core muscles will be affected by Cesarean delivery. This doesn’t spell doom for your pressure system — it just means that healing is required to help it function properly again. 

How pregnancy affects your pelvic floor 

Let’s zoom out from delivery methods for a minute — because whether you deliver vaginally or via cesarean, you are still pregnant for 9-10 months! During that time, your pelvic floor undergoes increased pressure due to the growing weight of your baby and your expanding uterus. 

During pregnancy, you just need a lot more space in your core, which turns up the pressure volume on your “canister”. The abdominal muscles separate to accommodate this growth, which is what causes diastasis during pregnancy. And your pelvic floor works hard to compensate for the added pressure and weight, but sometimes, it struggles to keep up with the rapid evolution of your body. 

This pressure alone can cause lasting pelvic floor dysfunction, no matter which delivery method ends up being right for you. The increased pressure and straining from constipation (another side effect of pregnancy and delivery) can cause hemorrhoids. The added pressure on your pelvic floor can lead to incontinence. So many other pregnancy and postpartum issues are common, but not normal. This is your body telling you something isn’t functioning properly! And that’s exactly why I’m such a huge advocate for postpartum pelvic floor physical therapy. 

Now, let’s zoom back into Cesarean delivery. Remember, not all C-sections are planned, which means many women have pushed or attempted labor prior to their C-section. During labor and pushing, your pelvic floor can stretch up to 3x its resting length! This is incredible and necessary to deliver a baby, but an overstretched muscle has a hard time contracting and performing its regular function. 

So, in summary: myth busted. Yes, your pelvic floor can be affected from your time of labor, even if the result is a C-section — and it can even be affected in planned C-sections when pushing was never attempted. 

How scar tissue affects your pelvic floor

Maybe you already know how pregnancy and labor could affect your pelvic floor, and you were prepared for core weakness postpartum. But if you’ve had a C-section, did you know that scar tissue can also play a role in pelvic floor dysfunction? 

After you’ve had a Cesarean delivery, it’s so important to practice good scar care techniques to prevent improper healing. After any surgery, your scar will be raised. As it lays down over time, it can cause adhesions to other tissues. And since your C-section cuts through multiple layers of tissues, it can cause adhesions between organs and tissues in your abdomen. 

Adhesions can cause pain, incontinence, painful intercourse, difficulty engaging your deep core, and more — it all depends on what organs or tissues are affected by the adhesion. For instance, an adhesion that attaches to the perineum postpartum can cause pelvic floor tension and tightness, which is a common cause of painful intercourse. This is why scar massage is so important after a Cesarean delivery!

Need help healing after a C-section? 

Recovering from a Cesarean delivery can take time — but I put together a list of essentials that will help you through your early postpartum days. You’ll spend a lot of time caring for your baby, but don’t forget to take care of yourself too! 

There’s one thing even more important than your postpartum products, and that’s your postpartum recovery. I’ve found that there are a number of recovery tips and techniques out there for new moms who delivered vaginally, but many of these programs don’t offer Cesarean support. So I created one that covers both! 

Movement Through Early Postpartum was created to help moms recover from labor and delivery efficiently and effectively, reducing pain and dysfunction while restoring the core and pelvic floor over time. Throughout your first 12 weeks, this program will teach you how to optimize the healing process, stay educated on what’s happening in your body, identify and relieve a host of potential postpartum problems, and return to movement safely.  

Inside, you’ll find 40+ educational videos, a 12 week movement plan that corresponds with your delivery method, and so much more. I want to help as many mamas as I can, and I can’t wait to see YOU inside!