*The forth and final guest blog I have is from Emma James Physio all in light of #cesareanawarnessmonth*
About the writer
Emma James, owner and clinical director at Emma James Physio based in Hemel Hempstead breaks C-section taboo and gives tips on C-section scar rehab.
As a new mum, it’s enough of a challenge to cope with a newborn and the trauma of giving birth. When you add a C-section into the equation - especially if this was an emergency intervention - it can be a whole other story.
A C-section is a surgical procedure used to deliver a baby through incisions in the abdomen and uterus, they can be planned ahead of time or can be a surgical intervention as a result of complications with labour.
Remember, whether your baby is delivered vaginally or via a C-section, neither is the easy option! We must remember that every delivery is individual and we should not compare ourselves to others. For some women, the experience is a wonderful calm and non-traumatic event, for others it is a life or death situation and can have a long-lasting emotional and physical impact on them.
Most importantly, a C-section is abdominal surgery and although superficially the scar may look small, seven layers that are cut through to get to the fetus. They are skin, fat, rectus sheath (the medical term for the coating outside the abs), the rectus (abs, which are split along the grain somewhat more than cut), the parietal peritoneum (the first layer surrounding the organs), the loose peritoneum and then the uterus, which is a very thick muscular layer. We must note it is the internal impact that can sometimes create long term issues.
‘Ensure that you get adequate rest and recovery so that the immediate effects of a surgical incision and anesthetic are minimised.’
The most important thing you can do as a new mother having undergone a C-section is to look after your health. This will help the scar and abdominal wall to recover so that they can effectively stabilise the back and protect your pelvic ring moving forward. Ensure that you get adequate rest and recovery so that the immediate effects of a surgical incision and anaesthetic are minimised. Hydration, good nutrition, and uncompromised blood supply are required to ensure optimal scar healing occurs and to minimise the impact of adhesion's later using silicone gels and massaging the scar is an effective way to accelerate wound healing and ensure the scar is mobile and pliable.
Ensuring that you are mobile and moving around is also imperative to assist with circulation and swelling, however the caveat to this is to ensure that you do not overdo it. Adhere to the 80/20 rule and ensure that you are mobile at least 20% of the time in the first few weeks.
Once the initial shock of giving birth and having major abdominal surgery has passed and you have been discharged home, you must identify and focus on activating your pelvic floor. Gentle contractions around the pelvic floor and gently contracting the abdominals before changing positions can help to alleviate the fear of moving and accelerate the recovery process. It is often particularly useful to brace your abdominals slightly with a pillow or a cushion to give you support when moving, also gentle pressure upon the scar helps with desensitising it and normalising the soft tissues.
‘I would encourage women to look at the scar in the mirror and touch it as soon as they can, often allowing your partner to massage bio-oil or apply the silicone gels can also work to help with bonding and intimacy rebalance.’
Many women and patients I see in the clinic and on online consultations struggle with looking at the scar and how it makes them feel about their bodies. I would encourage women to look at the scar in the mirror and touch it as soon as they can, often allowing your partner to massage bio-oil or apply the silicone gels can also work to help with bonding and intimacy rebalance. I don’t mean sexual intimacy, it is often a time that husbands and fathers feel very isolated and displaced from their wives and partners and are often frightened to touch you. Allowing your partner to be an integral part of the healing process can improve sexual intimacy later.
My recommendation is to ensure that even if you think that everything is back to normal post-surgery that you visit a women’s health specialist physiotherapist so that they can check and ensure your scar is mobile, validate that you can contract and strengthen your pelvic floor correctly and guide you back to exercise in the correct time frame for you individually to ensure that you do not sustain a post-delivery injury later down the line.
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If you wanted to have a read of some real mum cesarean birth stories. Click here