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Why C-Section Moms Should Consider Pelvic Floor Therapy Even If You Think You Don't Need It

Just about anyone can tell you that childbirth is a difficult task. It’s rewarding of course, but

undoubtedly difficult. No matter the way the baby is delivered, recovery is tough and requires


It’s becoming a lot more common to see mothers who have delivered via C-section, and so

more of these mothers are seeking support for their specific needs. With the increased number

of C-sections performed, we need to see more opportunities for mothers to learn and find

resources catered to this procedure.

Unfortunately, it’s difficult for many of these mothers to find the information they need so that

they can get this help. Peer support is amazing. We see a lot of blogs and communities trying to

offer this.

At the same time, we don’t see as much support and information catered to mothers who have

C-section deliveries. So, let’s talk about it.

Women with c-section holding a baby

Breaking Down Cesarean Deliveries

You’ve heard of C-sections, and you probably at least know what they are in a broad sense. In a

nutshell, a C-section or cesarean section is when an infant is delivered through surgery.

I won’t get too graphic; an incision is made into the abdomen and uterus so that the baby can be

brought into the world. There are several variations in how a C-section is performed, the

type and position of the incision for example, but that’s not our focus here.

The rate of C-sections has increased from 7% in 1990 to 21% in 2023, so we need to talk more

about a mother’s needs in the postpartum period. Someone delivering with this method doesn’t

have an identical recovery to someone who delivers vaginally.

mature pregnant women in deep thought

Why Go This Route?

Firstly, why would someone want or need to have a C-section? It is a surgical procedure, and it

shouldn’t be taken lightly.

The most appropriate answer to that question is that it’s the mother’s business. The

medical answer to that question is a bit longer. There are a lot of different situations where a C-

section is a safer option and even somewhere it’s the safest way to get that baby out.

If an infant in the womb is abnormally large, in a less-than-optimal position, or has more

than one baby, a C-section can reduce a lot of risks associated with these conditions. In the

case of stalled labor, certain problems with the placenta, and some active infections, a C-

section is necessary, not just ideal.

A C-section is a major procedure that is just as significant as a vaginal delivery. It even comes

with its own set of postpartum care instructions.

What’s Up with Pelvic Rest and Other Restrictions?

When you’ve just had a baby, of course, there’s going to be restrictions on what you can do!

Some of these are shared with both vaginal and cesarean deliveries, and some are procedure

specific. Rest is always important after giving birth. The way you rest is a little different after a C-section.

There are weight-lifting restrictions that can, in some cases, be more severe than in a vaginal

delivery. Some sources describe the restrictions as nothing heavier than your baby.

Another important restriction is pelvic rest. You may have heard this term thrown around without

knowing what it means. It means no penetration. No tampons, no sexual activity

involving the insertion of anything. Many mothers don’t feel up to that kind of activity, but the

specific warning is always helpful.

Post C-section, mothers are instructed to wear a menstrual pad for several days after birth.

This is one of many things that applies to both a C-section and a vaginal delivery, and some

mothers may be left wondering why this is.

The answer to that is pretty easy. There’s blood and tissue that was needed to make a safe

environment for your infant that you don’t need once the baby’s out!

There are more specifics on this restriction, like how much discharge is too much and what to

look out for, but those are questions for your doctor.

Possible Risks After a C-section

C-sections come with most of the same risks as a vaginal delivery. Research hasn’t shown

much evidence to suggest that a cesarean offers any more protection from urinary incontinence,

sexual dysfunction, or experiencing prolapse than if you have a vaginal delivery. The risks of

complications like that and the effects of them are pretty similar between the two

methods of birth.

However, these are possible risks, not guarantees. Every pregnancy and delivery comes with

the chance of complications, not a promise. This article is here to provide information that might

be missed, not to make anyone overly concerned.

Women holding wet pants

What’s Going on with the Bladder?

Some mothers talk about difficulty controlling their bladder after having a baby. Typically, the

the problem being discussed is urinary incontinence, which is the fancy term for peeing when you’re

not trying to.

It’s nothing to be ashamed of. It’s very common for women to experience after delivery. It also is

not something to be considered normal and should be brought to the attention of your

healthcare provider.

What you might not know, is that someone who delivers via C-section is about just as likely to

experience this as someone who delivers vaginally.

There is a slightly increased risk of what’s called urge incontinence for those who have C-

sections. Urge incontinence is having the sudden urge to pee, and not being able to hold it.

That being said, studies have shown the risk of experiencing urinary incontinence between C-

sections and vaginal deliveries are pretty similar. Some used to think that C-sections

could reduce the severity of these issues, but recent research suggests that’s not the case.

No matter how your baby is delivered, there is a risk of experiencing urinary incontinence.

Taking care of your pelvic floor can be a big help with this, but we’ll get into that later.

What About Intimacy?

Resuming physical intimacy after a C-section can be intimidating. Once you’ve moved out of the

time for recommended pelvic rest and started to feel more physically and mentally up to the

challenge, you may still have problems.

young couple sitting edge of bed

Pain during sex is one of the most commonly reported sexual dysfunctions after having a baby.

Although it is common, it is not normal.

Pain during sex is a sign that the pelvic floor muscles are likely experiencing difficulty with

tension and coordination. That’s something that can be addressed by trained professionals, but

waiting for it to go away may cause other problems.

Sex should never hurt, and there is nothing wrong with getting medical help for that issue.

However, the standard for intimacy after having a child needs to go well beyond not being in

pain. Having a C-section shouldn’t remove or diminish someone’s ability to experience pleasure

during intimacy, but it could call for special attention to recovery.

Scientists have studied women’s sexual satisfaction at length, and researchers have

conclusively learned that uterine and pelvic floor muscles are involved in orgasm. Because C-

sections directly involve these muscles, it makes sense that there could be an effect on your sex

life. Even the natural healing process after a C-section can cause nerve sensitivity as well as

feelings of tight skin and muscles.

The scar tissue that naturally forms during recovery can sometimes be so sensitive that it

causes some discomfort or pain during sex. The procedure itself also has the chance to cause

weakness and instability of the pelvic floor, making it more difficult to enjoy sex.

Don’t panic; it is possible to recover from these complications. You’ll need some help,

but that’s where PivOTal Performance comes in. Pelvic floor therapy can help you with pain

relief, muscle strengthening, emotional support, and more.

It’s still important to note that if you’re experiencing pain during sex following a C-section, you

need to speak to your healthcare provider. Having open conversations about these issues will

only help you get access to the treatment and services you need.

The Pelvic Floor and Pelvic Therapy

How does pelvic floor therapy factor into this? To put it simply, pelvic floor therapy offers so

many benefits that it should be the standard of care in the US! It already is in countries like

France, Australia, and the Netherlands, where postpartum women are automatically referred.

Pelvic floor therapy can help address all of the issues we discussed earlier, and it can provide

other benefits like additional emotional support, education, pain relief, and so much more.

What Does the Pelvic Floor Have to Do With It?

The pelvic floor does a lot for the body. It holds things in place, it helps you empty your bladder

and bowel on demand, it helps with sexual sensation and more.

Having an unhealthy pelvic floor can contribute to existing complications, or even be the cause

of them.

If you have a C-section, that doesn’t mean your pelvic floor hasn’t changed. Just experiencing a

pregnancy can cause changes to your pelvic floor’s function and condition, regardless of how

you deliver.

These changes to the pelvic floor can be a result of differences in hormones, increases in blood

volume, and other things that are altered during pregnancy. Your body has to make some

pretty significant changes to accommodate a growing baby, which is why you need to keep an

eye on unusual changes in any pregnancy.

Half of the pregnant women begin to experience symptoms of pelvic floor disorders before even

giving birth! Your pelvic floor does a lot for you, addressing problems with it as soon as you’re

able to is important.

Knowing that caring for your pelvic floor is important helps, but how do you take care of it? How

do you know when that care is needed?

This post on Pelvish goes over the signs of a weak pelvic floor and other relevant information on

this topic. That knocks out one question; let’s get into what can be done to help pelvic floor


Pelvic Floor Therapy and Why Every Mother Needs It

What’s the first thing you think of when the topic of strengthening your pelvic floor comes up?

It’s probably that time someone talked about doing kegels as part of their postpartum recovery.

Unfortunately, Kegels are nowhere near as helpful as many people think. There’s a

pretty high chance of worsening your condition by using this exercise.

Thankfully, pelvic floor therapy has a lot to offer. The occupational therapist you work with can

guide you through exercises and activities in a facility, of course, as well as things that can be

done at home.

exercise training

Occupational therapists know exactly how to conduct a thorough assessment of your individual

needs and challenges. This is what helps your OT create a treatment plan customized for

you. For women who are post-C-section, there are a lot of benefits specifically to help you

recover from your delivery, and the plan made specifically for your needs will address that!

Occupational therapists can help teach you a wide variety of pain management techniques,

letting you achieve relief in a way that is less invasive and possibly using less medication-based

management. For example, if you experience pain from the scar tissue at your incision site, your

OT can provide specialized massage techniques that can reduce tightness and

improve mobility.

Pelvic floor therapy will address issues of weakness and help you strengthen your pelvic floor, a

benefit that isn’t exactly a surprise. You may not know that occupational therapists guiding you

with these kinds of programs can also provide advice and instruction on how to use better

posture and employ lifestyle changes that will reduce muscle strain and improve pelvic health.

Pelvic floor therapy also allows you the opportunity to get emotional support that may not be

easy to come by. Your care team will always acknowledge and support the emotional aspects of

your recovery. Psychological health goes hand in hand with physical health, and pelvic floor

therapy allows your occupational therapists at PivOTal Performance a great way to help you

with both.

Occupational therapists are often a part of multidisciplinary teams, working with physical

therapists, physicians, as well as midwives. This teamwork helps to ensure that your whole

body and mind are being looked after and treated. The entire process is a collaboration between

you and your team that is designed to help you take control of your care.

The team you work with wants to see you thrive, and there is so much to offer you that it’s

difficult to fully explain in one article. Recovery is already difficult. Pelvic floor therapy is an

important step to recovery that too many people miss out on.

It can be intimidating to seek out even a consultation for this kind of thing, but it’s perfectly

alright to do so. This post on Pelvish goes over what happens during a pelvic floor exam, so you

can have an idea of what goes into starting this process. You have everything to gain by taking

that first step and quality care with trained professionals to help you the rest of the way.

Calling All Moms

Postpartum recovery is never easy, no matter how you had your baby, and pelvic floor therapy

is an incredible resource that can help you with all of the possible complications we discussed,

and more.

Many women jump from the work of having a baby right to the work of being a mom, which

doesn’t leave a lot of room for recovery. It’s understandable to do this! It also will

benefit any mom to seek out and receive pelvic floor therapy.

There is so much that can be offered with pelvic floor therapy. The treatment is completely

customized to your individual needs; it’s an excellent resource for someone who is in recovery

from a C-section.

With pelvic floor therapy, common concerns can be addressed, in many cases, before they can

become serious problems, leaving you the ability to recover and enjoy being a mom!

Pelvic floor therapy has so much to offer! Muscle strengthening, pain management, helping

common postpartum complications, emotional support, and the list of benefits goes on. Since it isn’t

already a standard of care in the US, many women aren’t receiving the benefits of this

treatment. They simply don’t know about it!

Now that you do know about it, join PivOTal Performance in spreading the word and demanding

better care for new moms!

On social media use the hashtags #PelvicFloorTherapy #PostpartumRecovery and

#StandardOfCare to help spread the word about the benefits of pelvic floor therapy and reach

more women who deserve to get the support they need. To see those hashtags being put to

use, check out the PivOTal Performance Instagram!

Pelvic floor therapy is a team effort, and so is trying to make a difference in the care of women.

Let’s work together to get it done!

Group of women all hands in

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