Pelvic Floor Recovery After a C-Section: Why It Still Matters

Introduction: Beyond the Incision

When you think about recovery after a C-section, your mind probably goes straight to your scar and abdominal muscles. But what about your pelvic floor? Even if you didn’t deliver vaginally, your pelvic floor endured significant strain during pregnancy and possibly during labor. Weakness or tension in these muscles is a common yet often overlooked part of the postpartum journey.

In my earlier post, Your Guide to Post-C-Section Recovery, I highlighted pelvic floor dysfunction as one of the key challenges many moms face after surgery. Today, let’s unpack why this happens and how you can restore strength and balance to these vital muscles.

Understanding Pelvic Floor Dysfunction After a C-Section

The pelvic floor is a group of muscles and connective tissues that supports your bladder, uterus, and bowels. It plays a crucial role in stability, continence, and sexual function. While C-sections bypass vaginal delivery, pregnancy and labor still take a toll:

1. Pressure During Pregnancy: Your growing baby places increasing pressure on the pelvic floor, potentially weakening these muscles over time.

2. Labor Before Surgery: If you labored before your C-section, your pelvic floor may have experienced stress from pushing or contractions.

3. Postural Changes: Pregnancy often alters posture and movement patterns, which can further strain the pelvic floor.

Common Signs of Pelvic Floor Dysfunction

After a C-section, pelvic floor dysfunction might not be obvious, but it can show up in several ways:

• Incontinence: Leaking urine when coughing, sneezing, or laughing.  

• Pelvic Pain: Discomfort during intercourse or when sitting for extended periods.

• Pressure or Heaviness: A sensation of “dragging” in the pelvic area, sometimes linked to prolapse.

• Difficulty Engaging Core Muscles: Weakness in your pelvic floor can make core recovery more challenging

Why Addressing Pelvic Floor Health Matters in the Long Run

Another thing that can happen with c-sections is scar tissue that can effect pelvic floor function.  Scar tissue can adhere to the bladder or surrounding structures which may lead to persistent incontinence even after you feel like the healing is done.  Another chronic issue that I see in the clinic is that people with past c-sections never fully recover and strengthen their deep core muscles again which results in low back pain and increased work for the pelvic floor.  Having a strong deep core allows you to be more functional in your daily life and prevents against potential injury.  Pelvic floor recovery should be a standard service for c-section recovery.  

How to Restore Pelvic Floor Function

Recovery starts with understanding your body and taking gentle, intentional steps to rebuild strength and flexibility.

• Reconnect Through Breathing
  Diaphragmatic breathing isn’t just for your core—it also helps engage your pelvic floor.

• Sit or lie in a comfortable position.

• Inhale deeply, allowing your belly and ribs to expand.

• As you exhale, feel the air go from your pelvic space through your abdomen into your lungs and out your mouth.  

• This simple exercise creates a strong foundation for further recovery.
  
  

• Care for Your Core through Daily Life

  • Log roll out of bed:  Protect your core by bending your knees, rolling to your side then lifting up your body with your arms.  

  • BLT: Avoid bending, lifting and twisting for 6 weeks.  This will allow your tissue to heal

  • Stand and Lay flat:  Notice how much time you are spending with your core crunched in a sitting position.  Try to allow some time with your belly flat so that it can heal well.  

• Introduce Gentle Exercises
  Avoid high-impact activities or heavy lifting early in your recovery. Instead, try:

• Hands and Knees Breathing: In quadruped, with your back flat, simply inhale allowing your belly to fill with air and exhale pull your lower core into your spine. You should feel a small lower abdominal contraction. 

• Bridge Pose: Lying on your back, lift your hips slowly while engaging your core and pelvic floor.

• A therapist can help ensure you’re doing these exercises correctly and without strain.
  

• Address Tension, Not Just Weakness

  For many, the issue isn’t a weak pelvic floor but a tight or overactive one. In these cases, relaxation techniques, such as pelvic floor stretches or myofascial release, are key.

• Seek Expert Guidance
  A pelvic floor therapist can assess your specific needs, helping you regain control and strength while avoiding common pitfalls. 
  
  

My Personal Perspective

From seeing many post c-section individuals I would highly recommend coming around week 6 to start your recovery.  Many people are told that if their scar looks good then they are good to go but that is not true.  I have had many people come 2-5 years after their c-section and they are having pain or incontinence or GI issues because they have never recovered from their c-section in the correct way.  Their doctor just said they were good because the scar looked good but no one has every looked at their function.  C-sections are full abdominal surgeries and we should expect to follow up with therapy just like you would if you would have a knee replacement.  We could prevent so many other issues if we just would be cared for the first time.  

Call to Action: Begin Your Recovery Today

Your pelvic floor is the foundation of your strength, balance, and well-being. Whether you’re dealing with tension, weakness, or both, recovery is within reach. Let me help you take the next step:

• Schedule a Free Consultation to discuss your pelvic floor health.

• Explore Our Postpartum Services for personalized care that fits your journey.

Looking Ahead

In upcoming blog posts, we’ll continue to explore postpartum healing topics, including scar tissue massage and emotional recovery after a C-section. For a comprehensive look at the healing process, don’t forget to check out Your Guide to Post-C-Section Recovery.

Healing your pelvic floor isn’t just about addressing a single symptom—it’s about feeling strong, confident, and supported in your new role as a mom. Together, we can help you recover fully and thrive.

Ready to get started? Contact us today to begin your healing journey.