Topics in Women’s Health: Considerations After a Cesarean Section

The cesarean section (c-section) rate in the United States continues to rise.  Statistics for 2010, show that one in three women gives birth by c-section. With numbers that high, it’s necessary for physical therapists to understand the complications of this surgery.

Infections and Cesarean Sections

The first consideration is the rate of  infection at the incision site. It’s also important to consider inflammation in the womb (or metritis). Infection occurs in approximately 5-8% of women. The occurrence of post-cesarean metritis is 10-20%. Physical therapists can screen for infection and inflammation. Screening includes inspection of the skin and tissue around the incision. It also consists of taking the patient’s temperature, and feeling for pain in the area.

Affects of Scarring

It’s also important to consider the scar/incision after c-section. Large amounts of scar tissue can affect how the abdominals function. If there is too much scar tissue, these muscles may not work properly. Proper function is important after childbirth  because these muscles are necessary for childcare tasks.

Appropriate Exercises

What can mothers lift after a c-section? Mothers are not advised to lift anything heavier than her baby. This recommendation stays in place for up to six weeks after a c-section.

Physical therapists can help! They can provide training on how to lift properly and how to apply an abdominal brace (if needed). This is beneficial to prevent over straining. It’s also helpful to teach mothers how to perform core exercises. Specific exercises help to protect ab muscles and the spine.

Allow six weeks for the incision to heal.  Seeing a physical therapist may be beneficial if pain, discomfort, tightness, or swelling is still present after six weeks. A visit to the physical therapist may also be useful if scar tightness persists.

What Will Physical Therapy Include

Physical therapy after a c-section consists of a full non-invasive examination. This includes an assessment of incision site and lower extremity function. It also includes assessing posture, and overall strength. The physical therapist will perform a more specific evaluation of the incision site if there is pain in that area. This will determine if there is too much scar tissue as well as if there is decreased scar mobility.

Therapeutic massage techniques can improve these problems. Massage is specific to the scars. Other tools such as the therapeutic ultrasound can also be used. Other impairments can also be addressed in the appointment. After the initial assessment, a home exercise program is developed. These programs are based on patient’s needs.