Which OMT is recommended after cesarean section?

• A. Both reduce ileus by rib raising and paraspinal inhibition and prevent atelectasis and pneumonia with a thoracic pump
• B. Rib raising and paraspinal inhibition to reduce ileus
• C. Thoracic pump alone to prevent pneumonia
• D. No OMT after cesarean section

Answer: (C)

The main idea is to reduce postoperative lung complications after cesarean by using a technique that improves breathing and airway clearance without stressing the abdominal incision. The thoracic pump does this best: it involves gentle, rhythmic compressions over the chest to transiently increase intrathoracic pressure, which helps mobilize secretions, enhances ventilation, and supports diaphragmatic movement. These effects reduce atelectasis and the risk of pneumonia in the early recovery period, and it can be performed without directly manipulating the abdomen, making it safer right after cesarean delivery.

Rib raising and paraspinal inhibition, while they can influence autonomic tone and gut function, involve more chest and back manipulation that can be uncomfortable or impractical with a recent abdominal incision, and their direct impact on preventing pneumonia is not as strong as the thoracic pump in this context. Thoracic pump alone provides the most targeted and tolerable protection against postoperative pulmonary complications after cesarean.