The Postpartum Core & C-Sections

One of the first questions many of my postpartum yoga students have is how to navigate recovery from a c-section and returning to their yoga practice. C-sections, whether elective or not, also can have an impact on core function postpartum. Luckily, it is no longer common practice for abdominal muscles to be cut during C-sections, but there is still healing that must take place. What is most common now is that once the top layers of skin, tissue, and fascia are cut, the abdominal muscles are separated along the linea alba to give access to the uterus. The muscles are held open during the period of the surgery, but, while this sounds intense, because the separation is brief, the connective tissue, while traumatized, re-heals rather well. And because the abdominal muscles are not cut, there is less dysfunction in the core postpartum because the length of the muscle bellies remains intact and strength can be more easily rebuilt. 

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ONCE YOU’RE HOME POST SURGERY
Focus on keeping the incisions clean and free of infection. Less complication in healing initially will generally mean less complication in the long term. Avoid engaging the core as much as possible until the incision has healed and follow recommendations from your care provider. Getting out of and into bed by rolling to the side and coming up or lying down, the same way you did during pregnancy, can be a big help in healing the core.
 
ONCE CLEARED FOR PHYSICAL ACTIVITY
Once you’ve been cleared for physical activity, usually after about 8 weeks, as long as there are no complications, you can begin to return to your yoga practice. As with all the exercises to heal the core, it is best to start with small simple movements and build up from there. It is much safer to add things to your practice to make it more challenging rather than pushing too hard and causing damage to the core or pelvic floor. In general, you may find that outside of gentle core work you will want to avoid deep twists that compress the belly and lying on the belly for poses like Cobra or Sphinx pose (a bolster or folded blanket under thighs can make this more comfortable).
 
ONCE THE INCISION IS COMPLETELY HEALED
During a C-section, skin, fascia, tissue layers, and the uterus are cut. As a result, there are several layers of incisions and subsequent lines of scar tissue that heal in the abdomen. In these layers, it can be possible for scar tissue to fuse to tissue layers, causing discomfort and possibly limiting comfortable motion.  Once the incision is healed, consider working with a physical therapist or abdominal massage therapist to help address adhesions and other discomfort. Care providers usually will prescribe self-massage of the scar tissue to help healing.