I had a C-section… so why am I leaking urine?

You had a C-section. Maybe it was planned. Maybe you labored for hours. Maybe you even pushed first.

And now… you’re leaking urine.

Not exactly what you expected, right?

A lot of people assume that a C-section means skipping pelvic floor issues altogether. So when leaking shows up—whether it’s 6 weeks postpartum, 6 months, or even years later—it can feel confusing… and honestly, a little unfair.

Let’s clear something up right away: you didn’t do anything wrong, and your body isn’t broken.

There’s usually more than one reason

Leaking after a C-section is rarely caused by just one thing.

Your body adapted for months during pregnancy. Your posture likely shifted. Your core was stretched and reorganized. And now you’re healing from surgery on top of all of that.

So when I work with someone who’s leaking, we’re often looking at a combination of things like:

• changes in posture (like a forward shift of the pelvis and posterior rib cage)

• lingering tension in muscles like the glutes, hamstrings, or even calves

• how your core, breath, and pelvic floor are (or aren’t) working together

• how well your pelvis actually moves (because if the pelvis isn’t moving well, the pelvic floor can’t respond and act like that supportive “trampoline” it’s meant to be—and that can be influenced by the spine, hips, and even your feet… but that’s a conversation for another day)

• a pelvic floor that might actually be holding too much tension, not too little

And sometimes… one piece that hasn’t been addressed yet can keep everything feeling stuck.

For the sake of this conversation, let’s zoom in on one of the most overlooked pieces:

Your scar

Your C-section scar isn’t just what you see on the surface of your lower abdomen. There’s also an incision made on the uterus—most commonly horizontal along the lower part, though it can vary depending on the situation.

So the scar tissue runs deeper than most people realize—through layers of skin, fascia, and down to the uterus. And right in front of the uterus sits your bladder.

This is why your scar can affect more than you think.

Scar tissue doesn’t just exist at the surface or the uterus—it can form anywhere along that pathway, including the layers in between.

So if that scar becomes restricted, tight, or just isn’t moving well, it can start to affect how everything in that area functions.

Not in a dramatic, something-is-wrong way. More in a “your body is adapting around it” kind of way.

So how does that turn into leaking?

Your body is really good at compensating.

If your scar isn’t moving well, it can affect how your core functions. And when that happens, your body will often start holding tension in other places to create a sense of stability or control.

That might look like gripping your glutes, your upper abdominals (or even your diaphragm), or yes—even your toes.

Over time, this changes how pressure is managed in your body—how it moves, where it goes, and how well your system can respond to it. Especially during things like coughing, sneezing, lifting your baby, or getting back into workouts.

And then your pelvic floor steps in… and tries to compensate for the compensation.

Sometimes that means gripping. Sometimes it means it can’t respond quickly enough.And sometimes… it shows up as leaking.

Not because it’s weak.

Not because you’re doing anything wrong.But because it’s working around something else.

Zooming back out for a second

Scar tissue is just one piece of the puzzle.

But it’s an important one—and often the one that gets missed, or only addressed at the surface level.

Because most advice out there jumps straight to “strengthen your pelvic floor.”

And while that’s not always wrong, it’s also not the full picture.

If your body is dealing with scar restrictions, pressure issues, or coordination challenges, then doing more Kegels is a bit like trying to fix a team problem by only coaching one player.

Helpful? Maybe.The full solution? Usually not.

If you feel like you’ve tried everything…

You probably haven’t missed anything—you just haven’t been shown all the pieces yet.

Leaking after a C-section isn’t something you have to accept as your new normal.

And it’s not something you need to keep guessing your way through.

There’s a reason it’s happening. And when we look at your body as a whole, we can actually find it.

Let’s figure out what your body needs

If this is something you’re dealing with, we can look at:

• how your scar is moving

• how your body is managing pressure

• and what your pelvic floor actually needs (not just what you’ve been told to do)

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→ Book a Pelvic PT Initial Session here