So what tissue was cut in order to perform the C-section? On your skin, you’re probably looking at a horizontal or (less often) vertical, low belly incision. From there, your physician had to cut through several layers of tissue to get to (and eventually through) your uterus. The incision you see on your skin may or may not match the incision through the tissue below. You may have a horizontal incision through your skin but vertical incisions below, so it’s important to ask your physician what type of incision you had and how that affects her restrictions on exercise after the delivery.
Most of the time, your doctor is able to make a low belly horizontal incision through the skin and similar low belly horizontal incisions through the layers of tissue, avoiding cutting through any of the muscle tissue. Instead of cutting through muscle tissue, the physician will make the incision through fascia, which connects your abdominal tissue layers together and to bone.1 Fascia doesn’t contract, but since it is connected to muscle tissue, contracting muscle tissue will pull on the fascia and incision. That’s why it’s so important to avoid abdominal muscle work until your physician clears you to do so.
Vertical incisions through the layers of tissue often require the most stringent restrictions. Because of the direction your abdominal muscles pull, vertical incisions are at higher risk for being affected by tension in your abdominal muscles. If your doctor is putting additional restrictions on your return to exercise, it could be because of the location or type of incision for your C-section— don’t assume she’s just being old fashioned.
The medical staff caring for you in the hospital should cover wound care for your incision before you’re discharged. Be sure you understand exactly how to care for your wound and what to watch for when looking for signs of infection. If you have any questions or you’re unsure after you leave the hospital, call your hospital right away. If you suspect you may have an infection, don’t hesitate to go to the emergency room. Infections after a surgery are serious and can be life-threatening. Your physician, the emergency room staff, anyone at that hospital, and your family (including your baby) would much rather you go in for a false alarm than stay put with a true infection. When in doubt, get it checked out!
Be sure to check with your physician or midwife about scar tissue massage at your 6-week checkup. As all of those layers of tissue heal, you can sometimes develop adhesions, which can be uncomfortable, and scar tissue massage can break up those adhesions. Scar tissue massage may also help the appearance of the scar. Be absolutely sure to have your physician or midwife instruct you in scar tissue massage. Each situation is different, and your own medical care provider needs to instruct you about how and when to do scar massage. Don’t simply search YouTube or Pinterest for guidance. You want to be 100% sure your tissue is healed before you begin the process, and you want to know exactly how to do the scar tissue massage based upon your own situation.