1

By Cassie Dionne, PT

Taylored Training Physiotherapy

2

Your Ultimate C-Section Guide

Table of Contents

About the Author……………………………………………………….3

What is a Caesarean Section……………………………………...4

Is Exhaustion Normal?...................................................4

How Much Can I Lift?.....................................................5

What to do in the First Week Following C-Section….….5

How to Get in and out of Bed…………………………………….6

Important Exercises……………………….…………………………..7

Managing Constipation……………………………………………...9

Incision Care…………………………..………………………………..10

Post-Natal Physiotherapy………….……………………………..10

3

About the Author

Cassie Dionne, PT

BPHE, MScPT, Lead Physiotherapist Pelvic Health & Orthopaedics Taylored Training Physiotherapy Cassie Dionne is the lead physiotherapist at Taylored

Training Physiotherapy in Kingston, Ontario, Canada

where her goal is to change the way physiotherapy is

experienced! Cassie and the amazing team at Taylored

Training Health Centre work together to change the way

women talk about, feel about, and experience pelvic

health.

Together, their goal is to open up the dialogue and talk

about everything that women are oftentimes too

embarrassed to talk about AND to provide you with the

most comprehensive and up-to-date information to help

you feel your best throughout all ages and stages of life!

Follow Cassie and the entire Taylored Training Health

Centre Team to learn more all about health, fitness, and

nutrition!

Facebook:

@Taylored.Training

@Tayloredphysiotherapy

@cassiedionnept

Instagram:

@tayloredtraining

@tayloredtrainingphysio

@cassiedionne_pelvicpt

Twitter:

@ttitraining

@cassiedionnept

“Pelvic floor dysfunctions are so incredibly

common, but no one likes to talk about it. Most

people simply accept that this will be their new

normal, not knowing there is actually SO much

we can do to improve and oftentimes cure any

dysfunction.

This is why my mission as a Pelvic Health

Physiotherapist is to educate and work with

women (and men) so that they can live their best

life. To improve their confidence, quality of life,

and quite simply to help them do the things they

love to do without the worry of pain or leaking.

I want to open up the dialogue and talk about

these important issues that many may be

nervous to talk about, and change lives!”

4

Your Ultimate Post C-Section Guide

We think Moms are amazing, beautiful and strong humans and sadly don’t always get the support and

guidance they need pre-and post-delivery. This e-book is all about learning how to care for yourself

following a Caesarean Section – whether planned or unplanned. It is designed to be an adjunct to your

pelvic health physiotherapy and to help keep you on track and get you feeling your best as soon as

possible!

We want to provide you with the tips, coaching and support you need in order to have a speedy and

successful recovery so you can get back to doing all the things you need and love to do.

What is a Caesarean Section?

Caesarean sections – more commonly referred to as c-sections – can either be planned (giving you time

to prepare for the procedure and recovery) or unplanned.

In Canada, recent stats show that 1 in 4 births are by caesarean section.

A c-section refers to the delivery of a baby with a surgical incision through a woman’s abdomen and

uterus. The exact surgical procedure may differ slightly depending on whether the section was planned,

unplanned, or an emergency, but typically a horizontal incision is made very low on the abdomen. The

surgeon then separates the abdominal muscles, and makes an incision in the uterus in order to deliver

the baby.

Though c-sections are common, it seems to be oftentimes forgotten that they are in fact a major

abdominal surgical procedure. Because of this, there are certain restrictions women need to give

themselves in order to properly recover post-delivery. That said, typically when leaving the hospital new

moms are simply told to “take it easy” and to not lift anything heavier than their baby or drive for six

weeks, with little other advice.

This lack of advice, support and coaching can be frustrating. We want to guide you through what your

recovery should look like and answer your questions!

Post C-Section we find the common issues for women post-surgery include:

Q: I’m exhausted. Is that normal?

A: Yes! Not only did you something incredibly exciting happen but you just had major abdominal

surgery! It is absolutely, entirely normal to feel extra tired. Don’t worry about this. In fact, after your C-

section it is just as important to give yourself some time to rest and relax.

We recognize that finding time to rest and relax can be incredibly challenging with a newborn. So, don’t

be shy to ask or accept help from your family, friends and support network.

5

Q: Is it true I can’t lift anything heavier than my child for the next 6-weeks?

A: Unfortunately, this one is mostly true.

Obstetricians and researchers maintain that lifting any more than 10-15 pounds isn’t ideal in the first 6

weeks following a C-section. Heavy lifting and straining can weaken or damage already weakened

muscles and connective tissue and slow your healing time. We know this can be a challenge as typically

you have to carry a newborn AND all of their gear, but it will help you recover faster so please try to stick

to this rule!

In the First Week Following Your C-Section

If you saw a pelvic health physiotherapist pre-birth, do your pelvic floor exercises just like they

instructed you to. Even though you did not have a vaginal delivery, your pelvic floor muscles still

underwent a lot of strain over the past nine months, and also play a pivotal role in how your

core function and your recovery

o Remember some of the cues they may have given you, and recognize that it is normal

for these exercises to feel much harder now than they did prior to the delivery:

▪ Try to stop the flow of urine

▪ Imagine your pelvic floor is like an elevator: first the elevator doors close, then

the elevator raises to the top floor

▪ Imagine picking up a blueberry through a straw with your vagina

If you did not see a pelvic health physiotherapist pre-birth, not to worry – make an appointment

and they can assist you to ensure you are doing proper muscle contractions!

Try to empty your bladder every 2-3 hours even if you don’t feel you need to use the washroom.

The reason for this is that in the first week following your C-section it is normal that the

sensation that you have to pee may not have quite returned just yet post-surgery.

Try to move around and walk as normally as possible and try not to stay in any one static

position for too long. Don’t worry, you cannot do harm to your stitches with this normal

movement.

When standing or walking, try to stand tall

As cliché as this may sound – listen to your body! If you’re feeling exhausted, it is ok to take a

rest and accept help from family and friends. Remember, you just underwent major abdominal

surgery!

Follow our tips below for how to get in and out of bed and what exercises to complete!

6

How to Get in and Out of Bed

Because of your incision, doing

the typical “sit-up” or quick

jump in and out of bed will

likely be very uncomfortable.

That is why we want to show

you the best way to get in and

out of bed to help your

incision heal quicker, and to

avoid discomfort or pain!

To get out of bed:

1. Roll on to your side

and move your legs to

the edge of the bed

2. Drop your legs off of

the bed and use your

upper body to push

yourself up sideways

on to your elbow,

supporting your

incision with the other

hand if needed

To get in to bed:

Do the exact opposite!

1. Sit on the edge of the bed and lie on to your side, supporting your incision if necessary.

2. Swing your legs onto the bed, and then roll yourself on to your back.

Remember: Avoid doing a sit-up or trying to rush getting in and out of bed as this will likely be quite

uncomfortable

7

Exercises:

Some of these exercises may seem simple, but they are important in your recovery and may actually

prove to be a lot harder than you may expect!

1. Deep Breathing – Repeat every hour!!

This exercise is important for a few reasons. First, it is something we teach anyone and everyone

after ANY surgery. The reason being, after surgery it can be difficult to get air into the bottom of

our lungs and we often need to also clear mucous from our lungs as well.

To do this exercise, sit up tall with your feet supported and your body relaxed.

Support your incision with your hands or a small pillow. Then, take a deep breath trying to

ensure that your lower ribcage expands, not your upper chest.

Repeat this for a minimum of 5 breaths

Important: You may get the feeing that you need to cough up some mucous after doing this.

Feel free to do a gentle cough, just support your incision with your hand or a pillow while

coughing.

8

2. Ankle Pumps/Movements

After any surgery, swelling is common and the best

thing to reduce swelling is movement! Throughout the

day try to keep your ankles moving up and down and in

circles. This promotes circulation which will help reduce

any swelling.

3. Leg Slides

In the early stages of recovery, you are limited to

what exercises you can do. This one is a simple

exercise that will engage your core and pelvic floor

to promote recovery.

To perform this exercise, lie on your back with

your knees bent.

Gently perform a pelvic floor muscle

contraction to engage your pelvic floor.

Then, slowly straighten your leg on the

bed/floor, maintaining the contraction the whole

time.

Bend your leg again and repeat 10 x/leg making

sure to not strain at any point during the exercise

9

4. Clamshells

This is a favourite exercise of Moms that I

work with to help engage some of the

stabilizing muscles of the core and hips

To do this exercise lie on your side

with your bottom leg straight and

your top hip bent to 90 degrees

with your knee supported on a

pillow.

Engage your glute muscles – the

muscles where your jeans pocket

would be – and lift your knee off of

the pillow, making sure to not

allow your hips to roll backwards

Hold for a count of three seconds

and then slowly lower

Repeat 10x / side

Managing Constipation

MANY women experience constipation following a C-section. This is normally uncomfortable on its own,

but can be even worse with a fresh C-section incision that you are trying to heal!

Here are some tips in dealing with constipation:

Drink plenty of fluids. Aim for at least 1-2 litres of water a day

If you get the urge to have a bowel movement, go

right away!! That urge will go away if you ignore

it and it can make passing your stool much harder

Don’t rush your time in the bathroom and don’t

strain to empty your bowels

Movement helps stimulate digestion, so after a

meal getting up and walking around helps

Try a Squatty Potty! A Squatty Potty is a fantastic

tool that simply changes the angle of your

rectum, making it much easier for stool to pass

when going to the washroom. Most new moms

(or really, anyone!) that we have suggested a

Squatty Potty have very quickly fallen in love and

still use it even months or years following the birth of their children!

10

Incision Care

Once your incision has healed it is important to do some regular care to your scar to help desensitize the

tissue, break up some scar tissue, relieve itching, stretch the scar, and simply move around excessive

fluid build up.

This usually takes the form of self-massage and should not begin until the incision is healed, usually

around 4-6 weeks. Your physiotherapist will demonstrate exactly how to do this once your incision is

healed!

The Importance of Post-Natal Physiotherapy

Speaking of Physiotherapy, you should know that seeing a Pelvic Health Physiotherapist is such an

important aspect of your recovery from delivery!

Your physiotherapist will assess a number of things including: your ability to contract your pelvic floor

muscles, as well as their strength, endurance, and coordination; whether or not you have a post-partum

prolapse; the presence of a diastasis rectus abdominus (ie an abdominal separation); as well as your

alignment, posture, general mobility and strength, and how well your C-section scar is healing.

They will also help guide and coach you back to doing all of your activities of daily living and regular

exercise (and yes, this includes sex of course!) not to mention help guide you through what is normal

during your recovery.

Q: I had a C-section, not a vaginal delivery, so why are my pelvic floor muscles so important?

A: Even though you did not have a vaginal birth, there is still an enormous strain on your pelvic floor

muscles following any delivery. Over the last nine months you had a constant downward pressure of the

baby which oftentimes in and of itself can lead to stretched and weakened pelvic floor muscles and

connective tissues. In addition, the expanding uterus can put pressure on the other surrounding organs,

possibly leading to dysfunction.

Your alignment will also change throughout the course of your pregnancy and following your delivery,

which can affect how the pelvic floor muscles are resting, potentially leaving them lengthened or

shortened.

Q: When should I book an Assessment with Pelvic Health

Physiotherapist?

A: Typically, you would see a pelvic health physiotherapist at the

6-weeks post-partum mark, however, if you have difficulties

passing urine, getting to the toilet on time or emptying your

bladder book your appointment early so your pelvic health

physiotherapist can discuss with you some strategies to help!

11

Thank-You for taking the time to read through our E-Book

all about recovering from a c-section.

If you have any questions, please feel free to reach out!

- Cassie and the Taylored Training Team

Taylored Training Physiotherapy ∙ 574 Princess Street, Kingston, ON ∙

tayloredtraining.ca ∙ physio@tayloredtraining.ca ∙ 613.507.2673