Updated: Apr 5
By Alyssa Brunt, MScPT, BScKIN (HON)
When we first learned where babies came from our first thought was likely something along the lines of “I have to push WHAT out of WHERE?!”. Knowing that one day we may have to push a baby out of our vagina was a bit intimidating but ladies, rest assured our body was made to do this. However, not all of us want to or are able to have a vaginal delivery. Sometimes women have a personal preference to deliver by Cesarean section or require the procedure when things don’t go as planned during labour.
A C-section is a procedure in which a baby is delivered by making an incision or cutting through the abdominal wall and uterus. The incision can be either vertical, running from the navel to the pubic bone or horizontal across the pubic hairline, which is more common as it heals faster and increases the likelihood of having a vaginal delivery in the future.
Now I’ve mentioned the benefits of pelvic floor physiotherapy both during and after pregnancy before, but I’ve found that there is a common misconception that C-section deliveries require less treatment postpartum as compared to a vaginal delivery. It is often thought that because a baby wasn’t pushed out vaginally there is less trauma to the pelvic floor muscles and surrounding soft tissue structures. I mean yes, you don’t have to worry about tearing or an episiotomy but truthfully moms, C-section deliveries require the same and if not more treatment postpartum than vaginal deliveries.
No matter what way you deliver your baby into this world, pregnancy in itself creates a lot of strain on the pelvic floor muscles and surrounding soft tissue structures. These muscles already support the pelvic organs and have an increased demand when there is a growing fetus within the uterus for 9 long months. This means that C-section or not, pelvic floor dysfunction including pelvic organ prolapse and urinary and/or fecal incontinence can occur.
Additionally, most C-sections aren’t always planned. Although some women do opt for a C-section early on, most are an emergency procedure due to complications during labour. This could be anything from fetal distress, slow moving labour, breech positioning, placental complications and more. This means that women who have emergency C-sections still undergo a lengthy labour, especially pushing, before the doctor deems it as medically necessary. The muscles and nerves within the pelvis can still be stressed and impacted during that delivery phase.
Most importantly C-sections require a lot of post-partum treatment because of the nature of the procedure. Cutting through the abdominal wall further weakens the muscles and can result in diastasis recti or mummy tummy. Additionally, this is a surgical procedure which means post-surgical rehab including breathing techniques and positioning need to be demonstrated to reduce the risk of pneumonia. Proper positioning needs to be taught to reduce any pain on the incision that can occur with the duties of motherhood like breast feeding. Physiotherapy can also help to reduce any scar tissue build up under the incision site by mobilizing the scar and making sure it doesn’t adhere to the underlying tissue. When a scar is left untreated and becomes stuck to the skin, it can contribute to painful intercourse down the road (which nobody wants!).
Whether you had a vaginal delivery or a C-section, pelvic floor physiotherapy is important for getting you back to feeling like your best self after the birth of your baby. With manual therapy techniques, gentle core and pelvic floor exercises designed specifically for you, your pelvic floor physiotherapist can help to reduce any pain/discomfort and increase your strength. Please come and see me for a consultation or appointment today, no matter how many weeks or months postpartum you are and we can get you well on your way to recovery!
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