Congratulations on your pregnancy! If you already had a cesarean delivery with a previous birth, are planning for an additional c-section, and are looking for guidance on how to best prepare during your pregnancy, then you’re in the right place!
The general game plan for subsequent c-sections is to:
- Rehab the previous c-section through scar mobilization
- Strengthen to body during pregnancy to minimize any prenatal pain, support you post-operatively and prepare for postpartum demands
- Meet with a pelvic physical therapist
And that’s it! Let’s dive into each one a bit.
Rehab the Previous Incision: Scar Mobilization
Scar tissue acts as a tether and limits how well you can engage your core and abdominal muscles. This can lead to pain, discomfort, pulling sensation through the abdomen, and pelvic floor symptoms during your pregnancy or even postpartum. Common ways to mobilize scar tissue is by using your hands, silicone cups, or through movement.
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Hands
Using your hands to get the tissues moving is a great place to start, especially if this is your first time mobilizing the scar.
To mobilize with your hands:
- Apply lotion over, above and below the scar
- Gently press your fingers into areas that feel more restricted or harder to move, and glide your hands side to side or up and down. Areas to try include directly over the scar, between the belly button and the scar, or even below the scar towards your pubic bone.
Cupping
Mobilizing with myofascial silicone cups helps reach slightly deeper tissues and muscles that might be harder to target with just your hands.
To mobilize with cups:
- Apply lotion over, above and below the scar
- Squeeze the sides of the cup, place it over the skin, and let go to provide suction
- Gently move it up and down or side to side
To learn more, watch this video! Here’s a link to the cups.
Movement
Adding in dynamic stretches also gets the scar moving and is also a great complement to the manual techniques (cupping and hands).
Some exercises to try include deep belly breaths (left), half kneeling open books (middle), and cat cows (right).
Full-Body Strengthening
Even if you’re still working on getting your scar more mobile, it’s never too early (or late) to start strengthening your entire body. The purpose of strengthening is to minimize pain during pregnancy and postpartum, support you post-operatively, and prepare you for postpartum demands while juggling at least two kids.
Areas to focus on include your core, lower body, and upper body.
Core
Start with seated or standing exercises to make sure you can feel the gentle squeeze of muscle activation around your belly, as you draw your belly button in. Progress to hands and knees exercises. Try pressing your hands into your thighs while sitting (left), farmer’s marches (middle), or bear planks (right).
Lower Body
Practice getting on and off the floor through a half-kneel or lunge (left). Practice sitting down and standing up with squats (middle). Practice bending over to pick your newborn or equipment with deadlifts (right). All of these exercises can strengthen your glutes to decrease SIJ pain and mimic tasks you already do in your day-to-day life.
Upper Body
Strengthen your upper back and shoulders, so you feel more confident holding, feeding and carrying your newborn. Try shoulder blade squeezes (left), bent over rows (middle), and overhead presses (right). These exercises can help to minimize midback pain that is common with nursing.
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Work with a Pelvic Physical Therapist
Pelvic PT isn’t just reserved for moms after a vaginal birth. Lots of people benefit from working with a pelvic PT during their pregnancy and after a cesarean birth. During pregnancy, a pelvic PT can assess your previous scar, check your strength and mobility, and come up with the best game plan to keep you active and symptom-free during your pregnancy. After delivery, a pelvic PT can guide you through scar desensitization and mobilization, assess your pelvic floor, assist with finding the best ergonomics for holding, carrying, and lifting your baby, address any pain, and get you back to doing all of the activities you like.
Each pregnancy is a unique journey and the pelvic physical therapists at Pacer Physical Therapy come up with a plan that’s unique to you. To learn more or work with us, book a complimentary discovery call today!
