Leaking after a C-section: Why it happens and what you can do
"I had a C-section, so my pelvic floor is fine" is one of the most common assumptions in postnatal recovery - and it isn't accurate. Bladder leaks after a C-section are more common than most women expect, and rarely talked about.
It's an understandable guess: no vaginal birth, so no pelvic floor impact. But the pelvic floor isn't only affected by how a baby is delivered. It's affected by pregnancy itself.
Why pregnancy affects your pelvic floor
For nine months, the pelvic floor supports the weight of your growing baby, placenta uterus, and additional fluid. That sustained load happens whether you go on to have a vaginal birth or a C-section. By the time you give birth, your pelvic floor has already been working harder than usual for months.
How surgery and core changes add to the picture
A C-section is also abdominal surgery, and it changes how your deep core muscles engage afterwards. Because the deep core and pelvic floor work as a connected system, changes in one often show up as changes in the other - even without a vaginal birth involved.
How common this actually is
Leaking when you cough, sneeze, laugh, or exercise; a feeling of heaviness; or a core that doesn't feel properly "switched on" are all common after a C-section. Common doesn't mean permanent, and it certainly doesn't mean it has to be accepted as just part of having a baby.
Why kegels aren’t the solution
Pelvic floor exercises can help, but only when they're the right exercises, done correctly, as part of a wider picture that includes how your deep core, breathing, and posture all work together. Generic advice to "do your kegels" without an assessment often misses what's actually going on.
When to seek help
If you're managing any of this quietly, you don't have to. It's common, it's treatable, and asking about it is exactly what an assessment is for.