C-section Recovery

A cesarean section is a surgical procedure in which the baby is delivered from the uterus through an incision made in the abdominal wall and the uterine wall.

The period after a cesarean section can be uncomfortable precisely because the abdominal muscles are involved in many of our everyday activities — often without us even noticing it.

When you stand up from a chair, push something, lift a child, cough, laugh, or sneeze, your abdominal muscles are always working. Since surgery has affected these muscles and the surrounding tissues, these ordinary movements may be painful or uncomfortable after a cesarean section.

The postoperative period after a cesarean section

Usually, you are allowed to get out of bed and to drink and eat six hours after the surgery. If the mother is able to go to the toilet independently, the urinary catheter is removed, if present. 

he next day, the dressing is removed from the wound and you are allowed to take a shower. The wound area can also be washed with warm water and soap — this supports healing. 

Pain management is administered regularly, and there is no need to endure pain.

Most often, after a C-section, patients are discharged home on the third postoperative day. If the mother’s or child’s condition requires it, the hospital stay may be longer.  

The surgical wound stitches are usually removed on the fifth day — either during a home visit by a midwife, a visit to a women’s clinic, or at a family doctor’s office.

Scar Mobilization — to prevent the scar from pulling or restricting movement

Scar mobilization helps the C-section scar become soft and mobile, so that it moves with the surrounding tissues — not against them.

Once the wound has healed and the scab is gone, the body begins to build new tissue. This may initially feel hard, tense, or tender, sometimes even numb.   

Once the wound has healed and is dry, it is recommended to start using a silicone patch/gel. 

Studies show that 3 months of regular scar care greatly aids recovery and reduces the risk of the scar not healing optimally (hypertrophic/keloid).

If the scar has been inflamed in the early healing stage, it may heal unevenly and form adhesions, which affect tissue mobility, digestion, or even pelvic organ function. 

Therefore, it is very important to ensure that the scar does not become inflamed.

Signs that a C-section wound is not healing well

Incidence in approximately 3–15% of cases (most wounds do not become inflamed before the 4th–7th postpartum day).

Signs of infection may include:

• discharge from the wound (pus or fluid),
• hardening of the skin in the scar area,
• persistent redness, swelling, and warmth around the wound,
• fever.

If the scar heals well, it is important to start massaging the abdomen. An experienced physiotherapist uses various soft tissue therapy techniques for this and teaches you how to massage your abdomen and later the scar yourself at home.  

The stages of scar care are as follows:

• 6 weeks after surgery – reducing skin hypersensitivity and gentle massage.

• 12 weeks after surgery – direct scar stretching and restoring movement.

Some women notice that the C-section scar seems to “indent,” creating a small pouch above the scar — colloquially known as a “muffin top.” This can often be due to deeper fascial adhesion.  

Proper mobilization and tissue release can significantly improve the scar’s appearance and sensation. 

Even years-old scars can be made more mobile — the body responds to touch even long after surgery.

Lymphatic Therapy — an option if you cannot massage your abdomen yourself

During a C-section, the continuity of the skin and lymphatic vessels is interrupted. 

In the case of a horizontal incision, these are cut across the entire lower abdomen, which can lead to fluid accumulation and swelling. This is the body’s way of protecting itself, but it can slow down healing.

Manual lymphatic therapy — gentle, rhythmic movements support fluid movement and help the body eliminate waste products that the circulatory system alone cannot remove. This relieves swelling, reduces inflammation, and accelerates tissue recovery.

If no complications occur, lymphatic therapy can be started quite early — the therapist assesses the wound’s condition, supports it with tape if necessary, and also helps the scar heal better. 

Studies have shown that manual lymphatic therapy can significantly accelerate tissue healing and reduce the formation of adhesions after abdominal surgeries.

If you are looking for a lymphatic therapist in Tallinn who works with postpartum women, I recommend massage therapist-lymphatic therapist Anu Lumiste (bodytone.ee).

Muscle Restoration — restoring connection from within

Experience shows that the abdomen often does not retract on its own after a C-section and requires conscious rehabilitation.

Common concerns experienced by women who have given birth via C-section:

• the abdomen remains distended even several months after childbirth

• a feeling as if the abdominal muscles “have disappeared”

• pain or tenderness in the abdominal muscles and/or scar area during physical exertion

• painful intercourse after C-section, which is a very common complaint

Appropriate physical support also helps to support abdominal muscle recovery. In the first few months after childbirth, I recommend wearing a support belt, which supports the abdominal area and contributes to the restoration of body awareness.

From July 1st, women can purchase bandages after abdominal surgery with a 90% discount, for 7 euros (with a prescription from a family doctor or specialist). Mamaco bandages are available at Teresa’s Aid Center.

Rehabilitation helps to make the core work in a coordinated manner again. Without supportive recovery, the scar may remain pulling, numb, painful, or cause restricted movement. 

If the function of the abdominal and deep core muscles is impaired (e.g., weakened, tense, or not activating correctly), it can cause overload to the lower back, hips, and pelvic floor. 

Recommendations for C-section Recovery

If you notice that the pain does not subside, the scar is hard, or the area is numb, it is advisable to consult a physiotherapist. If you wish to receive postpartum C-section rehabilitation, you are welcome to an appointment with a women’s physiotherapist in Tallinn or Tartu.  

The initial consultation helps to assess how your body has healed and creates a personalized recovery journey for you — step by step, at your own pace.