How ALL Allied Health, Pharmacists and GP’s can help support C-Section Recovery

“This is a Q & A with Esme that was published by Mother & Baby in their pharmacy addition. It helps show the important role that all allied health, pharmacists and GP’s play in supporting post c-section recovery. ”

Q: Why is exercise so beneficial when recovering from a C-section (including physical, mental, emotional, social benefits) and how can mums safely start to move following a C-section delivery? What guidance do you offer around balancing rest and movement?

Results from this study suggest that first-time mothers should be encouraged to start walking and bodyweight exercises at low intensity within the first six weeks after giving birth. Women at risk of pelvic floor dysfunction or injuries should be advised accordingly and may benefit from a slower, guided return to exercise with an exercise physiologist. Contributing factors may include delayed second-stage labour or forceps and vacuum deliveries.

The latest guidelines highlight just how important it is to support new mums to return to movement as early as possible — a higher step count (>6000 steps) in the first 4 weeks was associated with a significant decrease in PND diagnoses.
BUT it can be really challenging to navigate new motherhood and return to exercise, so having a support in an Accredited Exercise Physiologist can be key. 

Horizontal rest remains important for tissue healing in both vaginal and early C-section recovery. We now advise:

• Weeks 0–2: Low-intensity rest and gentle mobility

• Weeks 2–4: Progress to walking and bodyweight movements

• Weeks 6–8: Begin returning to weights and structured exercise

See:

• BJSM 2025;59:515–26 — Jaramillo Garcia A, Ali MU, Forte M, et al. 2025 Canadian guideline for physical activity, sedentary behaviour and sleep throughout the first year postpartum.

 Q: What are the contraindications to returning to exercise following C-section? How can mums ensure they return to exercise safely? When is pain considered a red flag and an indication that new mums should stop exercising and seek professional advice?

Red flags include pain at the C-section site or other pelvic floor symptoms. Women should start slowly, aiming for sustainable, low- to moderate-intensity activity during the first 6–12 weeks postpartum.

Pain is a sign to check in with a healthcare professional — particularly if pain increases with exercise. This is considered a contraindication to continued activity.
 

Q: What are the most common post-operative challenges as far as mobility, movement, and exercise when recovering from a C-section, and what are some ways these challenges can be addressed and managed?

Post-operative challenges after a C-section commonly include abdominal discomfort, reduced core strength, limited trunk mobility, scar sensitivity, and general fatigue. These can make everyday movements — such as standing up, lifting the baby, or walking — more difficult in the early weeks.

To manage these challenges, we recommend:
Gentle mobility exercises within the first 1–2 weeks to restore range of motion, particularly in the hips and lower back.
Postural awareness and breathing strategies, which help reconnect the core and pelvic floor without increasing intra-abdominal pressure.
Scar desensitisation techniques after the wound has healed, to improve comfort and reduce adhesions.
Gradual progression of activity, starting with supported walking and bodyweight movements, and then slowly increasing to more structured strength work as tolerated.

Support from an exercise physiologist or women’s health physiotherapist can be really helpful in tailoring recovery for each individual - it’s often not a one size fits all! 

Q: Wound healing and core recovery are key concerns after surgery — how do you advise women to safely rebuild strength, and are there tools or supports (e.g. abdominal binders, compression garments) you recommend that pharmacies could offer?

We don’t recommend abdominal binders due to their potential to increase intra-abdominal pressure, which may place undue stress on a recovering pelvic floor and endopelvic fascia.

Compression garments, particularly those with a supportive gusset, can be very helpful in the first few days and weeks postpartum.

Q: Constipation, poor sleep, and reduced mobility often compound recovery — what role does movement play in relieving these issues, and what practical tools or resources could pharmacies provide to assist?

Movement plays a key role — motion is lotion for the bowels. As little as 10 minutes of movement can make a noticeable difference.

If a new mum is taking Movicol, it can be an opportunity to broaden the conversation. Constipation-like symptoms may also be related to conditions such as rectocele or posterior wall prolapse.

Q: Can you elaborate on the role of exercise in supporting the mental and emotional health of new mums following a C-section? In your experience, how open are women to discussing their mental and emotional wellbeing after a C-section, and how can exercise professionals — and pharmacists — support a holistic approach to recovery?

The early postnatal period is a time of emotional change for most women. Some may experience distress or symptoms of depression, especially if they feel overwhelmed or unable to cope. Early intervention through support or specific care can help women adjust and may prevent more serious mental health issues.

COPE training is a fantastic resource for all health professionals. Derived from the National Perinatal Mental Health Guideline, COPE offers a series of fact sheets and tools for health professionals on perinatal anxiety, depression, postpartum psychosis, schizophrenia, and birth trauma.

These fact sheets are free and provide excellent guidance. The best thing professionals can do is ask the questions. The next best thing is to know where to refer if a mother discloses she is struggling.

Q: What behavioural red flags might indicate a new mother is struggling physically or emotionally post-surgery, and when should pharmacy teams consider encouraging her to seek further support from allied health professionals?

COPE offers helpful guidance through relationship factors that may be observed or reported:

• Is the mother thoughtful about her baby?

• Can she describe the baby’s daily routine?

• Did she experience past pregnancy loss or high levels of concern?

• Is she able to reflect on her baby’s needs and express empathy?

• Does she engage in enjoyable activities with the baby (play, talking)?

• Did she experience birth trauma?

• Does she express delight in her baby?

• Does the baby make her feel uncomfortable, unhappy, or enraged?

• Did she take responsibility for infant care in the first week?

• Is she excessively worried about the baby?

• Can she cope with the baby’s distress?

• Does she have access to emotional, social, or practical support?

• Does she respond appropriately to the baby’s cues?

• How much time does she spend away from the baby?

• Are her responses consistent and protective?

• How does she refer to the baby?

• Does she show or share photos of the baby?

We love to support all women in recovery in the 4th trimester, and support postpartum.