C-Section Prehab and Post-Op Rehab
Despite being the most commonly performed surgery in Canada with increasing rates every year, many women are unfamiliar with what happens during a c-section, how to prepare for it and how to recover optimally. Read on to learn more about what you can do before and after your procedure!
A cesarean section (or c-section) is a surgical procedure by which a baby is delivered through an incision made in the mother’s abdomen.
Whether or not a c-section is performed depends on several factors such as: baby’s position, number of babies, mom’s medical history, and the length of your pregnancy. Cesarean sections are inpatient procedures so you can expect to be in the hospital for 2-3 days after surgery. This surgery is performed by an obstetrician.
During a c-section, an incision will be made either vertically or horizontally across your abdomen. The abdominal muscles are separated (not cut!), the bladder is moved out of the way, and the uterus is opened with another incision. Your baby is then delivered, followed by the placenta.
Note that c-sections do not “spare the pelvis”. Your pelvic floor is still subject to the natural demands that accompany pregnancy due to pregnancy-related anatomical/physiological changes and decreased activity of adjacent core muscles (see 5 Common Pelvic Health Symptoms in Pregnancy). Because of this, it is possible to experience pelvic health symptoms post c-section including: urinary urgency, leakage, constipation or pain with intercourse.
See the link below for a demonstration of what this looks like:
Prehab is therapy done prior to your surgery. Prehab is done to proactively prevent (or minimize) injury and optimize your recovery.
For an elective c-section, it is best to see a pelvic physiotherapist 2-6 weeks before surgery.
Knowing what to expect during and after your procedure, as well as optimizing your fitness before you meet baby, will help you in your recovery. During this appointment, you can expect:
· A thorough history, including: how your pregnancy has been progressing, previous births and your birth plan
· Education about the c-section procedure and how to prepare for it
· Post-op strategies, equipment, wound care, and appropriate early exercise
· Physical assessment of your core and pelvic floor
· Exercises to prepare your body for delivery and recovery
Remember: the more prepared you are, the quicker and easier your recovery will be!
Post-op, new moms are often sent home with one simple instruction: “don’t lift anything heavier than your baby for 6 weeks.” What does this mean day to day? Pelvic physiotherapy can be an excellent resource to answer this question! Your first postnatal appointment can be using telehealth or in-person:
Telehealth is the distribution of health-related services using electronic technologies. At Mississauga Pelvic Health, we use video chat to communicate with new mommas.
During the first 1-4 weeks postpartum, telehealth is a great tool for client-practitioner contact, care, advice, reminders, and monitoring from the comfort of your own home.
In general, your pelvic physiotherapist will want to see you for your first in-person postnatal visit at 6 weeks postpartum.
At Mississauga Pelvic Health, each of our clients has a unique health history and set of goals. Treatment will be specific to each individual. After your evaluation, treatment options may include:
· Education regarding your symptoms, assessment findings, and treatment plan
· Bladder and bowel retraining
· Constipation management and toileting strategies
· Addressing sexual health concerns
· Manual therapy of the myofascial system
· Pelvic floor muscle downregulation and relaxation or muscle strength and retraining
· Motor control training and strengthening of the deep core musculature
· Motor control training and strengthening of the abdominal wall, hips and thorax
· Cesarean scar desensitization, mobilization and management
· Supportive product recommendations, such as abdominal binders or scar sheets
· Postural education and retraining
· Baby feeding positions for scar protection
· Diastasis recti abdominis or pelvic organ prolapse management strategies
· Strategies for a healthy return to physical activity
If you have any questions regarding Pelvic Health Physiotherapy and c-sections, contact us to book a free 15 minute phone consultation with one of our Pelvic Health Physiotherapists.