Recovery after Cesarean Birth
- Katie Bayer
- 8 hours ago
- 3 min read
As pelvic floor physical therapists, we often meet new mothers who feel uncertain, frustrated, or even surprised by their physical recovery after a cesarean section (C-section). There’s a common misconception that because the baby didn’t pass through the birth canal, the pelvic floor must be untouched—and that recovery will be easier than after a vaginal birth.
The truth is, while the recovery process differs, it still involves significant healing—both at the abdominal wall and in the pelvic floor. If you’ve had a C-section, your body has undergone major abdominal surgery. That alone demands respect, care, and guided rehabilitation. Let's talk about what recovery really looks like, and how pelvic floor therapy fits into the picture.
What Happens to the Body During a Cesarean?
A cesarean birth involves an incision through multiple layers of tissue: skin, fat, fascia, abdominal muscles (which are separated, not cut), and finally the uterus. While the uterus heals remarkably well, the trauma to surrounding tissues can lead to pain, numbness, tightness, and altered core function.
Even though your pelvic floor didn’t deliver the baby, it still supported the weight of pregnancy for nine months—and that matters. It’s common for C-section patients to experience:
Pelvic floor tension or dysfunction
Bladder leakage (especially when sneezing, laughing, or exercising)
Difficulty reconnecting to their core muscles
Scar sensitivity or adhesions
Poor posture or back pain
The First 6 Weeks: Rest and Gentle Awareness
In the early postpartum weeks, rest is your primary job. Your body needs time to heal from surgery, replenish energy lost during pregnancy, and adjust to life with a newborn.
From a rehab perspective, here’s what I recommend:
Breathwork: Gentle diaphragmatic breathing can help with pain management, circulation, and re-engaging your core and pelvic floor muscles.
Scar care: Once your incision is fully closed (usually around 6 weeks), gentle scar massage can help reduce adhesions and improve mobility.
Pelvic floor awareness: You can start with gentle pelvic floor contractions (Kegels) if cleared by your provider—but focus on coordination and relaxation, not just strength.
Beyond 6 Weeks: Gradual Rebuilding
Once you’ve been cleared for activity (often around 6-8 weeks postpartum), that’s when targeted rehabilitation should begin. This is where pelvic floor physical therapy can make a big difference.
We focus on:
Re-establishing core control: The deep core includes the diaphragm, pelvic floor, transverse abdominis, and multifidus. After a C-section, these muscles can become disconnected or weakened.
Addressing scar mobility: Adhesions can restrict movement and contribute to lower back or pelvic pain. Scar mobilization techniques improve tissue glide and prevent long-term dysfunction.
Pelvic floor retraining: You may have tension rather than weakness, especially if your body was bracing against pain during recovery. A PT can assess whether you need strengthening, lengthening, or coordination work.
Functional movement: We gradually reintroduce lifting, carrying, squatting, and eventually higher-impact movements like running, if that’s part of your goals.
Signs You Might Benefit from Pelvic Floor Physical Therapy
Not everyone gets referred to PT after a C-section, but many would benefit. Here are some signs you might want to schedule an evaluation:
Persistent back, pelvic, or hip pain
Urinary leaking or urgency
Pain with sex
Difficulty engaging your core
A lingering "pooch" or bulge at the incision
Numbness or hypersensitivity around the scar
Feeling like your body just hasn’t "come back online" since birth
Healing Takes Time—and Support
As physical therapists, our goal is to help you feel strong, confident, and at home in your body again. C-section recovery doesn’t need to be rushed—but it shouldn’t be neglected either.
If you’re feeling unsure about your healing process, reach out to us!
We’re trained to guide you through recovery safely, thoughtfully, and with compassion.
Because you didn’t just have a baby—you had major surgery. You deserve care that recognizes both.