3 Categories of Cesarean Section Recovery and Healing from a Women’s Health Physical Therapist

After a c-section, thinking about caring for yourself in the 4th trimester (3 months following the birth of your baby) can be quite overwhelming. We understand, you’re busy, tired, and likely very nervous thinking about recovering parts of your body that are tender and somewhat painful. At Breathe. PTW, we walk with women through every stage of their life with the goal to get them back to living he active lifestyle they deserve.

When you choose Breathe., you’re choosing a team of highly-qualified women to support you physically, mentally, and emotionally through your journey. Ready to get started, but not sure how? Here’s what to consider when starting your path to c-section recovery. 

3 Main Categories To Consider With Your Cesarean (C-Section) Recovery & Healing.

Core Recovery

Ok, so we know the core is very important. The center of our body and abdominals is where we have a foundation of stability to work off of. It helps us get out of bed, stand for longer periods of time, and play with your baby (and other little ones if you have them)!

What exercises are good for early core strength? In the beginning it’s not about feeling like we have the strongest core of all time, but being able to mentally connect to those muscles and turn them on when we need them.

This is one exercise to connect to your abdominal muscles after all they’ve been through: 

Inhale into your belly, Exhale and pull your belly button to your spine. Hold this core engagement as you lift and lower one leg to 90 degrees. Inhale into your belly with both feet on the ground. Repeat on the opposite side. Do this for 10 rounds total. 

Pelvic Floor Recovery

Learn how to relax your pelvic floor!

After a c-section, your body is searching for stability and will get it wherever possible. This can result in the pelvic floor muscles tightening (when we don’t want them to). 

How to relax them? Through belly breathing:

Scar Care

This may have been your first major surgery, and now you have a new scar to show for it. What do you need to do for your scar?

Once your scar is totally healed and fully closed, it’s important to get the scar moving so it isn’t sore and painful when your clothes touch it, or when your little one is standing on your lap and pushes a tiny foot into your scar. 

Check out this blog on scar massage to learn more about how to get your scar moving. If you are having any difficulties or would like professional guidance, your postpartum physical therapist can help with scar mobilization in physical therapy sessions.

Breathe. PTW Supports Women in North Liberty & Des Moines With Healthy C-Section Recovery

We’re so happy to help and want to see every woman live their most energetic, active lives! Our physical therapists are well-versed in the care, attention, and physical needs of postpartum women. If you’ve had a C-section or are planning to have one, and need an expert guide in your recovery, trust Breathe. PTW.

Give us a call at 515-255-3932 to set-up your appointment today!

Breathe. is unique! Private, personalized care that celebrates client victories, big and small. We believe all women deserve to live energetic, vibrant and active lives and it’s our mission to be a partner in achieving that, by specializing in dry needling, DRA, pants peeing, pregnancy/postpartum pain and recovery, pelvic floor dysfunction, headaches, back pain and other orthopedic concerns. 

Appointments available in Des Moines, West Des Moines and Iowa City / Cedar Rapids area. www.breatheptw.com

This post is educational and not medical advice. Please consult your medical provider for information specific to your needs.

Dealing with a C-section Scar Instead of Ignoring It

Whether or not you wanted it, you had a c-section (or more than one) and now you have a scar.  Nobody probably ever told you this, but learning to touch and massage your scar can have some pretty amazing benefits.  Feel queasy about it? We have loads of ways to do it for you, and probably get even better benefits than you can gain on your own. 

1. Your stomach will look flatter

If you have fat or skin hanging over your scar, working on the tissue will loosen your scar to make your stomach look smoother and maybe even flatter.

2. Your stomach may feel stronger

Scar tissue tends to adhere together so the layers of your skin and muscle can’t slide on each other like they’re supposed to.  This can make the muscles feel weaker.

3. You might have better and easier orgasms! 

The skin of the lower abdomen is continuous with the labia and into the clitoris.  Sometimes if that tissue is tight it can make the clitoris sensitive, and not in a good way!  A sensitive clitoris can hurt instead of feel good. 

We’re so happy to help and want to see every woman live their most energetic, active lives! Give us a call at 515-255-3932 to set-up your appointment today!

Breathe. is a three-clinic holistic physical therapy practice in Des Moines, West Des Moines and Iowa City / Cedar Rapids area specializing in dry needling, dra, pants peeing, women’s health, pregnancy/postpartum pain and recovery and pelvic floor dysfunction. Learn more at www.breatheptw.com

Recover Confidently After Cesarean

4 Ways Physical Therapy Treats C-Section Scar

Have you read that you should work with your c-section scar but can’t get yourself to do it?

There are a lot of reasons we can feel queasy about touching our scar, especially as deeply as we need to to make a difference, so the good news is that we can do it for you.

Here are four ways we can help:

This may be covered by insurance if your scar is causing pain!

1. Ultrasound. 

We can use therapeutic ultrasound (not the kind that looks into your body!) to warm all the scar layers before we manipulate the scar.

2. Cupping.

Using suction cups around the scar helps to pull the layers of your skin and muscles apart so they can glide better.

3.Myofascial Release and Deep Tissue Massage with Scar Massage.

After we use the ultrasound and cupping we use our hands to really get into the scar that may break up the scar tissue. 

4. Trigger Point Dry Needling.

If there are specific areas of your scar that need extra attention, we use trigger point dry needling to release those tight spots.

We’re so happy to help and want to see every woman live their most energetic, active lives! Give us a call at 515-255-3932 to set-up your appointment today!

Breathe. is unique! Private, personalized care that celebrates client victories, big and small. We believe all women deserve to live energetic, vibrant and active lives and it’s our mission to be a partner in achieving that, by specializing in dry needling, DRA, pants peeing, pregnancy/postpartum pain and recovery, pelvic floor dysfunction, headaches, back pain and other orthopedic concerns. 

Appointments available in Des Moines, West Des Moines and Iowa City / Cedar Rapids area. www.breatheptw.com

Pelvic Pain Remedies at Home

As I’m writing this, I am currently almost 5 months postpartum and just feeling like I have the time and confidence to get back into a regular exercise routine. For the last couple months, I have been focusing on re-connecting to my core (diaphragm, deep abdominals, and pelvic floor) through my breath work and applying that functionally into everything I do – this is huge to start straight from the get-go. And of course, my posture to set myself up for success aches/pains and muscle alignment. 

Starting with this foundation is THE most important step in your journey to exercise postpartum. 

If you skip straight to jumping back into your pre-baby workout style, you may easily and quickly find yourself down a road of not feeling strong, stable, or supported physically, or even leaking pee, pain, or heaviness. Re-connecting to your core from immediate postpartum, but lifelong, is the secret to success! 

Here at Breathe, we talk about connecting to your breath and having it be foundational for all exercise and function, but how do you know if you’re doing it right when you’re at home?!

Here are my favorites tips/tricks to ensure success with controlling your deep core at home: 

1. Use Your Finger

• I’m just going to say it. You can do it, even if it sounds weird. When you’re at the office and get a pelvic examination, part of what we feel for is using our finger to see if your pelvic floor muscles can contract and relax. 
• Place 1 finger inside your vagina and gently hook it onto one of the sides, let it rest here. 
• With a contraction (Kegal) you want to feel 1) your vagina closing in around your finger circularly and 2) drawing your finger up towards your stomach like an elevator rising. Try this with an exhale!
• With relaxation/releasing, you want to feel the opposite. 1) pressure softening circularly around your finger so the opening is easy to stretch if you tried and 2) lowering of the muscles downward like your elevator dropping back to the main floor. Everything should feel soft and squishy  now. Try this with an inhale!

2. Sit on Your Vagina

• This is a phrase we use for posture with every client we see, but I am talking about this phrase in a different way now as well, in this case. 
• Sit on an exercise ball, or a towel roll, or even on your flat hand. Goal is to sit on something that forms to your perineum with gentle pressure. 
• Now practice your deep breathing as mentioned above. With your inhale (relaxation/opening) you want to feel ever so gentle pressure down and opening. With your exhale, you want to feel your perineum lifting up and away from the surface.

3. Grab a mirror

• A mirror is a great tool for feedback at home! 
• One way to use it for pelvic floor is to grab a handheld mirror and literally watch your vagina. With your inhale (relaxation/open) you will see the holes soften, ever so slightly descend, and open. With your exhale (contraction), you will see your butthole pucker in (technical term is “anal wink” haha I love it) and vagina close and pull inward as well
• Another way is to grab a full length mirror and lay it on the floor when you do floor exercise. Watch your lower belly throughout all core work and ensure proper form and control without having to crunch up to see your lower belly.

These are all great tools to help set yourself up for success at home as you get back into living the active life you love! 

Have questions with any of these? Contact us – we can help! 

What Really Causes Constipation and How To Fix It

Constipation is far too common, especially here in the United States. Today it is estimated that 4 million Americans suffer from frequent constipation and it is the most common gastrointestinal (GI) complaint. For women, being pregnant, postpartum and during the luteal phase of your cycle (after ovulation and up to right before period) can all increase the chance you might suffer from constipation due to hormonal changes.  However, like leaking urine, it is common but never considered normal.  

Constipation is Typically Defined As:

• fewer than three bowel movements a week
• stools that are hard, dry, or lumpy
• stools that are difficult or painful to pass
• a feeling that not all stool has passed

There are multiple factors that contribute but here are 3 reasons you may be having difficulty pooping.

Poor toileting mechanics:

• With our modern age, our western toilet seat has become higher and higher.  This has no benefit to our ability to have a good bowel movement because it changes the angle between our colon and our rectum. The higher the toilet, the less the angle and the more difficult it is to open our rectum so a bowel movement can slide out.  When we are able to sit in a position that resembles more of a squat (ie. our knees are slightly above our hips and our feet are elevated) our angle increases which helps a muscle that wraps around our rectum relax; then our rectum can contract and open (It’s kind of like unkinking a garden hose).  To try this at home you can place a stool under your feet when sitting on the toilet.  This is also why the owners of squatty potty have made millions!  Not everyone needs a squatty potty but they can be very helpful.  The main thing to remember is make sure you feel 100% relaxed when you are sitting on the toilet.

Inability to relax the pelvic floor: 

• OK, so now you are sitting on the toilet, you feel relaxed, but something still doesn’t seem right.  Have you tried relaxing your pelvic floor muscles?  Your pelvic floor muscles are at the bottom of your core; they run from your pubic bone and tailbone and between your sit bones and provide support for your rectum, bladder and uterus.  The pelvic floor muscles are the muscles that need to relax before a different muscle (called your external anal sphincter) can push a bowel movement out.  If you cannot relax and lengthen your pelvic floor muscles, having a bowel movement is very difficult.

Nutrition and water intake:

• This might seem like a no brainer but it is so important for creating the best bowel movement we can so it is easier to pass.  Not enough water can cause stools that are hard, lumpy and dry because there is not enough moisture to keep them soft.  Fiber intake is also very important.  Insoluble fiber adds bulk to our bowel movements and can help speed up its time in the digestive track which is especially helpful for constipation.  Soluble fiber is also helpful because it helps our stool hold onto water to contribute to stools that are soft, well formed and easy to pass. Examples of foods high in insoluble fiber include wheat, whole grains, brown rice, broccoli, spinach and zucchini.  Soluble fiber foods include oatmeal, nuts and seeds, apples, berries and psyllium husk. 

We, at Breathe., can help you with all things related to bowel movements, whether it’s constipation or the other side of things, fecal leakage, we can help!  We’d love to hear your poop story…..I promise!

References

https://www.niddk.nih.gov/health-information/digestive-diseases/constipation/definition-facts (for constipation facts and definition)

Pain with Sex: What To Do About It

When sex is NOT comfortable… Is it possible for that to change?

The answer is yes!!!

Some people experience pain with sex for the first time after having a baby. This can be pain on the outside of the body with initial entry of something into the vagina, or deeper pain throughout sex. Sometimes it feels like lower belly pain during or afterwards, or pain with orgasm. 

Contrary to popular belief, pain with sex after having a baby is common but not normal (like leaking). If you’re having pain, this isn’t something you have to bear through until it eventually goes away. There is a lot that can be done in PT and at home to get you on an express route to pain free intimacy.

Multiple things can be contributing to this pain, like scar tissue from tearing during childbirth, angry and tight pelvic floor muscles, or vaginal dryness with nursing/pumping.

Sometimes people have always experienced pain with sex – there was never a time where it was painfree. 

In both situations, it’s possible to have not just pain free, but enjoyable intimacy. 

At Breathe., we look at you as a whole person, learning your unique story and what your goals are. We teach you how to do scar tissue massage, relax your muscles, and provide you with a toolbox of stretches for areas that can be contributing to your pain (like your glutes). 

If you are experiencing pain with sex I want you to know:

1. You are not crazy or imagining things.

2. This is something we work with all the time – you are not alone!

3. There is a light at the end of the tunnel – you don’t have to deal with this forever!

When you’re ready, reach out to us to schedule a session in person or via telehealth. We look forward to helping you be your most vibrant self!

Your Birth is Yours, Here’s Why You Shouldn’t Compare It

I remember getting to the point in my pregnancy where I was texting my friends saying:

“I feel like I need to unfollow all the pregnancy, birth, and postpartum Instagram accounts. I can’t see any more negative messages, like “how to avoid a stuck baby.”

Social Media is great! Until it’s not. While people have good intentions with sharing their pregnancy and birth stories, it can definitely become triggering to those who have yet to go through the process.

We always recommend talking about positive birth experiences during your pregnancy. It’s always ok to kindly stop someone from sharing their own personal experience, especially if it includes undesirable birth complications. Going into your own experience of labor and delivery with a positive headspace is more important than politely listening to someone creating unnecessary fear of the unknown.

There is so much of this messaging out there…

The thing is, you can do everything “right” leading up to your delivery, and still have outcomes that you weren’t anticipating. There is so much that is beyond a woman’s control during labor and delivery…and those babies have a mind of their own!

No one…absolutely no one has the same birth experience. There should never be any shame around how your baby came into this world:

• Vaginal vs. C-Section
• Epidural vs. Drug-Free
• Grade 4 Tearing vs. Minimal Tearing
• Delivering in Lithotomy Position vs. Squat/Hands-and-Knees
• Homebirth vs. Clinical/Hospital Setting
• Natural Labor vs. Medically Necessary Induction

Of course, we are ALL about having an active and vibrant pregnancy, and an empowered and informed birth experience. There is so much that you can learn about and do to stay comfortable during your pregnancy and have choices during your birth experience. “You don’t know what you don’t know!” Our best advice is to create and discuss with your partner/doula your birth preferences to decide what is important to you, knowing that we need to have an open mind because things could change situationally.

Doing all of this preparation for the birth you want is a good thing! But there’s something about this “how to” message to pregnant moms that is subtly shaming if things don’t go as planned. Your caring for a newborn, which means you do NOT need to feel the weight of “what if I had done this differently.” You also NEVER should feel shame from others with the outcome of an unplanned c-section. Of course it is okay to have feelings about your experience, but the point is, YOU get to feel how you want to feel about it, and you aren’t wrong for feeling one way or the other – no matter what someone is sharing online.

Moms, you had a huge job of growing another human, bringing them into this world, and now are nurturing them as they grow (how amazing are we?!). You did something really freaking hard and deserve credit for that! But, if a part of your birth plan did not work out, it is not your fault. There is nothing you should have done differently during your birth experience, and YOU get to decide how you feel about the outcome.

Sometimes the loudest voices on social media are not the voice of the majority. Know that there is a whole community here to support you – no matter what you choose with your pregnancy, birth, or postpartum!

If you are currently pregnant, here are some ways that you can support yourself during pregnancy instead of using social media platforms:

1. Perinatal and Postpartum Mental Health Therapy: at Breathe., we have many resources to guide you in the right direction – simply ask your PT if you need a recommendation! I personally saw a Mental Health therapist while I was in my 2nd and 3rd trimester to talk through anxious feelings leading up to my labor/delivery. This also helps to establish care ahead of time, so that you have support more readily available if you experience any signs of Postpartum Depression/Anxiety.

2. Perinatal Physical Therapy Care: Seeing a Pelvic Floor Physical Therapist during pregnancy can have many benefits. Your Physical Therapist can assess your pelvic floor muscles and surrounding muscles in the back/pelvis to ensure less pain during pregnancy and prepare your body for labor/delivery (and even postpartum).

3. Prenatal Yoga/Support Groups: Joining a group that comes together in a positive space can be super uplifting; even better if you can get the benefit from movement! There are many groups in the community that offer these services. We can help recommend the groups that may be right for you!

4. Hiring a Doula: A doula can be a HUGE part in your pregnancy, labor/delivery, and postpartum journey. They have a plethora of information that can help you feel comfortable and confident going into the birth of your baby. Having a doula on your team to answer any questions can be very beneficial, and we highly recommend this for anyone considering it – surprise, surprise: we have recommendations for those too. 🙂

To recap – the outcome of our birth story is not always in our control. Whatever the outcome, you have support around you. Find your people, build your team, and remember that your body was made to birth your baby, no matter how they come into this world.

What You Really Need to Make Recovery Easier After a C-Section, from a women’s health physical therapist

Did you have an unplanned c-section with your first babe? Are you considering attempting to have a VBAC with baby number two? While a VBAC certainly isn’t for everyone and there isn’t a one-size fits all check-list, it can be a great option for the right mama. Let’s take a look at the criteria that might set you up for the most success on your VBAC journey vs. conditions that might hinder the process according to Mayo Clinic.

Criteria that would indicate a VBAC is an appropriate option include, but are not limited to:

• Low risk pregnancy
• Pregnant with one baby (not twins)
• At least 2 years between deliveries
• Low-transverse incision from prior c-section
• Medical team with increased knowledge/experience on VBAC deliveries

Criteria that would indicate a VBAC is not an appropriate option include, but are not limited to:

• Preeclampsia
• Previous delivery within 18 months
• Gestation longer than 40 weeks
• Breech positioning of baby
• Pregnant with twins
• Medial team with limited knowledge/experience on VBAC deliveries

If you’ve chatted with your healthcare provider and determined a VBAC is the right choice for you, cheers sister! We hope you’ll invite us along for the ride!

Here’s how a pelvic physical therapist help you prepare for a VBAC:

• Assess the pelvic floor muscles to make sure they are in an optimal position and state for birthing
• Assess prior c-section scar for adhesions that may be contributing to poor pelvic function
• Practice proper “push breathing” to reduce strain on pelvic floor during labor and delivery

We’d love to help you prepare your body for any way you choose to birth. The best way to prepare is to gather all your resources. Let us be a resource for you! 

Birthing your baby (or babies!) via cesarean is a lot of work and you will need to recover slowly, even if some time has passed. If you have more questions, please check out this book, written exclusively for c-section mamas.

We look forward to all the ways we can support you!

What You Really Need to Make Recovery Easier After a C-Section, from a women’s health physical therapist

You can find a million lists on the internet about what you pack in your hospital bag after you have a baby.  C-section recovery is not talked about nearly enough.  You may be reading this in preparation for a planned c-section, or you may be reading this after an emergency c-section, feeling completely unprepared and unsure about what to do. 

Here are three things that we recommend to get to ease recovery after a c-section:

1. Belly Band

Your tummy will likely feel like a bowl of jelly, and that can make you even more apprehensive with movement. A belly band can make you feel more “put together” so you can get up and get moving (which is the #1 tip to an easier recovery).  You can search online and find one.  We recommend the simple, one velcro strap (verses elaborate strapping).  You can put it on while laying down (rolling to each side to get it under and around you) or standing up.  Wear it when you’ll be up and around, but take it off when resting.  Typically use it for about 2 weeks postpartum.  Some hospitals will have one for you, if you ask for it.

2. Bed Rail

Here are pictures of a homemade bed rail.  Again, you can search the internet to
find one or make one yourself.  This will help you get in/out of bed and minimize the strain on your abdomen.  Learn the “log roll” here. This is the best way to move while you use a railing.

3. Magnesium citrate (or Natural Calm)

Constipation can be one of the most uncomfortable parts of recovery.  It isn’t great on your pelvic floor and won’t make your stomach feel good.  A lot of the synthetic medications you are given don’t work as well as good old magnesium.  Read the instructions – take in the middle of a meal for best results.  Natural Calm comes in a powder to mix with water, or a gummy chewable.  Ask your physician if you have any other medical conditions that may limit your ability to safely take magnesium

We recommend physical therapy as early as 2-weeks postpartum.

Are you cozy at home but still want the virtual experience of a pelvic floor PT? Telehealth for new moms has been wonderful. We can watch you move, coach you in exercises, find the right stretches for after feeding your baby, and talk through all the things.

Birthing your baby (or babies!) via cesarean is a lot of work and you will need to recover slowly. If you have more questions, please check out this book, written exclusively for c-section mamas.

We look forward to all the ways we can support you!

Breathe. is a two-clinic holistic physical therapy practice in West Des Moines and Iowa City / Cedar Rapids area specializing in dry needling, DRA, pants peeing, women’s health, pregnancy/postpartum pain and recovery and pelvic floor dysfunction. Learn more at www.breatheptw.com

Why Pelvic Floor Physical Therapy is Important, No Matter How You Birth

“I had a C-Section – does my pelvic floor still need attention?”

Maybe you’re planning to have a c-section, or already had one. But was your pelvic floor impacted?

The answer is yes! Pelvic floor PT is an important part of any postpartum recovery. The weight/pressure of the baby throughout pregnancy puts an extra demand on your pelvic floor muscles, and changes in core strength also can lead to pelvic floor muscles being either too tense or uncoordinated/weak. 

Not everyone needs a pelvic exam, but if you’re feeling like your muscles aren’t quite working right or you’re having leaking, constipation, or pain with sex postpartum – we can help with that! 

During pregnancy, we teach you how to relax your pelvic floor muscles and how to avoid putting extra pressure on the pelvic floor muscles. Postpartum, we mindfully incorporate kegels with core strengthening exercises to help you feel strong and get back to all of the things you love without pain/difficulty.

When is The Right Time to Come In?

Anytime! We start as early as 2 weeks postpartum, helping decrease pain and get your strength back so you can care for your baby with ease; But many women find their way to pelvic floor PT months, a year, or years after their last birth. It’s never too late! 

Are you cozy at home but still want the virtual experience of a pelvic floor PT? Telehealth for new moms has been wonderful. We can watch you move, coach you in exercises, find the right stretches for after feeding your baby, and talk through all the things.

Preparing for a C-Section, but not yet delivered? We can help you prepare fearlessly with our Planned C-Section Guide eBook.

We look forward to all the ways we can support you!