Ask the FBMs: Recovering From a C-Section

c-section recovery

Recovering from a C-section takes a few special considerations, but you can still get back into shape! Credit: Mat Honan

Of the questions we get asked, losing weight and getting those abs back postpartum are big ones. Today’s Ask the FBMs takes the abs question a little farther, focusing specifically on C-sections. Reader Octavia wanted to know the best way to lose baby weight and get in shape after the surgery. Because we’re no experts on the C-section, we decided to hand the reins over to Lindsay Brin, pre/post-natal fitness expert who has recovered and gotten back into shape after three C-sections herself. Read on for Lindsay’s thoughts and tips on recovering, scars and an 8-minute video about working the core!

Recovering From a C-Section

Common C-section Questions: How do I get rid of the “shelf” above my C-section scar? Does a C-section cut through your abdominal muscles? Do C-section patients have a harder recovery than vaginal births in reference to physical activity? Or just a longer road to recovery? And is a bikini cut C-section really unnoticeable? 

A C-section is a surgical procedure so there will always be some scarring, but unlike what most women think, your doctor will not be cutting through muscle with the exception of the uterus. When a C-section is performed, two sets of abdominal muscles are separated from one another but are NOT cut. A transverse (horizontal) cut—the so-called Bikini Cut C-Section—actually causes fewer complications. Since it is below your bikini line, it will be far less noticeable than a longitudinal (vertical) incision.

If you had a C-section, some exercises could bother your incision site, so back off until you are ready and only do exercises you are completely comfortable doing. If you feel some discomfort, try saying “hut” while doing the work. And/or support your abdominal area with a pillow for more comfort. Otherwise you should be able to exercise around six weeks when your doctor releases you. You will just need to start out a little slower than if you had a vaginal delivery. And you may feel numbness for a few months after your procedure. Why? Your nerves were cut and will take a bit to recover.

C-Sections vs. Vaginal Births

A C-section is like having a cast on your arm. It will take longer to recover, but the good news is you can have the same end result as a vaginal delivery. As you read above, a bikini cut C-section does not cut through your muscles. The fascia is one of the five layers cut as your doctor goes in to get the baby. Fascia covers the muscles and acts as a sheathe to keep our waists compact. Of course, if your muscles are not toned underneath, there is a lot more compacting for the fascia to do! After birth, your fascia will be back to 90 percent of its original strength within six weeks; the other 10 percent will come back within a year. You cannot strengthen or tighten your fascia without surgery, so preventive measures are necessary—staying within the recommended weight gain is a must! These are listed in the Institute of Medicine2009 Guidelines:

  • Underweight (BMI < 18.5) gain 28 to 40 pounds
  • Normal Weight (BMI 18.5-24.9) gain 25 to 35 pounds
  • Overweight (BMI 25.0-29.9) gain 15 to 25 pounds
  • Obese (BMI > 30) gain 11 to 20 pounds

You will have to train your pelvic floor (PF) and transverse abdominis (TA), both muscles of the core, to create a flat stomach again. You can find these exercises below in the video. Vaginal deliveries with midline episiotomies, especially 4th degree (1st being smallest) can create dysfunction of the pelvic floor, which also interrupts core function. Several of the tools and instruments that doctors use to assist you in giving birth—vacuums and forceps, for example—can cause PF dysfunction. Whether you have a vaginal delivery or a C-section, the pelvic floor and the TA act as a sling to your baby, which is why you need to train these specific muscles to get back the integrity and strength of your core before returning to traditional abdominal exercises.

Do you worry about the shelf that protrudes over your C-section scar? The good news is you can and will get rid of it if you make your muscles do some work! Dr. Kent Snowden, OB/GYN, specifies that the shelf is most likely fatty tissue damage. And after all the swelling goes down and you are back to normal (maybe 6 months down the line), all you should be left with is scar tissue. Now if you have multiple C-sections, this scar tissue will obviously be larger than a single C-section.

Should you request stitches instead of staples or tape? Most of the time the end result is the same.

Can’t see the video? Click here for an 8-minute core workout video!

A huge thanks to Lindsay for sharing the C-section wisdom! C-section mamas, feel free to share your experiences with recovery below. How were those first workouts back? —Erin


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