Dr. Caroline Campbell PT, DPT, PRPC
April is C-Section Awareness Month! A Cesarean section (or C-section) is a surgical procedure in which a baby is removed from the parent’s uterus through incisions in the abdomen. A C-section is performed when a vaginal delivery is not feasible, due to maternal and/or fetal health. According to the CDC, C-sections account for 32.1% of all births in the U.S.
What happens during a C-section? First, there is the anesthesia- usually an epidural or, in extreme cases, general anesthesia. Next, the obstetrician (OB) will make a cut through the skin, fat, abdominal tissue, and uterus to remove the baby through the incisions. Finally, the placenta is removed, the umbilical cord is cut, and the parent gets stitches in their incision sites. A delivery via C-section may require a longer hospital stay (2-4 days). The recovery process may take longer than that of a vaginal delivery, and most providers recommend avoiding lifting and strenuous activity for several weeks.
You may now be wondering what pelvic floor physical therapy can do for you after a C-section-- after all there wasn’t trauma to your pelvic floor during delivery. While that is true, the pelvic floor went through a lot of changes to accommodate your growing baby. Pelvic floor muscles were placed under stress by the weight of your baby, weakening these muscles, which could have caused incontinence during pregnancy and postpartum. Pelvic floor physical therapists can do an internal exam to assess the tightness of these muscles, and can treat this tightness, lessening the incidence of incontinence and other pelvic floor dysfunction. The fascia that was cut through in your abdomen is continuous with the fascia connecting to the pelvic floor, so the C-section can indirectly cause pelvic floor dysfunction. We can also do scar tissue mobilization to your C-section scar, preventing tightness in the abdomen and surrounding fascia and muscles. Speaking of muscles, they underwent a lot during the C-section! They were cut through and may be weaker than before because of this. A pelvic floor physical therapist can assess for core weakness and diastasis recti (separation of the abdominal muscles), which are both common after having a baby, and especially after a C-section. Even though C-sections cause less direct trauma to the pelvic floor during delivery, you still went through a lot, and pelvic floor physical therapy can help you get back to your best self!
Resources:
https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/cesarean-section
https://my.clevelandclinic.org/health/treatments/7246-cesarean-birth-c-section
