C-Section recovery – those early days and first few weeks
Whether your C-section birth was elective (or “planned”) and occurred without you having gone into labour or whether your C-section birth was an emergency (or “unplanned”) and occurred after having gone into labour, you will need to take certain precautions following your surgery.
While a Caesarean section is one of the most common surgeries performed worldwide, each woman’s recovery will look very different. The way in which you recover can often be determined by the situation that led you to having a c-section birth. Sometimes we notice that women who had an emergency c-section can often experience higher pain levels in their recovery, which may potentially be due to them being physically exhausted from labouring prior to the surgery and then being rushed into theatre with the emotional distress that her birth didn’t go as planned.
Alternatively, some women may have a calmer experience during the delivery stage, but then return home to having to care for a toddler and as a result of putting more load through their stitches they may end up with an infection at the wound site or delayed healing of the stitches.
While each woman’s experience before and after surgery can look very different, today’s blog is going to take you through a few important points that will apply to most woman as they safely and gradually return to becoming more active and caring for themselves and their baby…. And often a toddler or two and a partner!!
To optimise your scar healing and gently return to exercise in the first 4-6 weeks here are my top tips:
Deep breathing is always a good idea and during a c-section recovery is no different. Ensure your breath is moving right down to the bottom of your lungs and gently moving your tummy as you inhale. Try to keep your shoulders down and relaxed when you are focussing on your deep breaths. Aim for 4-5 deep breaths each time you’re sitting to feed your baby.
Aim to straighten through your torso with sitting and standing postures as soon as is comfortable and avoid spending long periods of time hunched forwards while the scar is healing
If you are finding this one particularly painful – I always suggest starting with lying flat on your back on the floor/bed with no pillow and start to move your arms from down by your side to reaching overhead and back again
Avoid activities that put excessive pressure on the healing layers of your scar. This can include avoiding lifting anything heavier than your newborn baby, applying pressure to your lower abdomen when you are coughing or sneezing (or even laughing!) and rolling onto your side before getting up out of bed. Obviously for some new mums with a limited support network, it is going to be unavoidable to lift toddlers or prams so take care as best you can and don’t be afraid to ask for help
Return to walking – start with a few 5-10 minute walks in the first 1-2 weeks. If you can do this without your baby in a carrier or pushing a pram, that is ideal. As long as you have no soreness around the scar, gradually increase towards 30-45 minutes at a more brisk pace most days of the week by the time you reach the 6-week mark
I always recommend some sort of abdominal support post birth. The options vary in both cost and effectiveness. If you are on a tight budget, then wearing supportive, high-waisted underwear and some tubigrip will be better than nothing. If you are able to treat yourself to a more specific support garment (like SRC Recovery Shorts), then you will get the maximum benefit of having compression in all the right places for a healing Caesarean wound. We can measure and fit your with SRC shorts in clinic.
Lastly, I’m sure you have heard us mention this a few times, maintain good bowel habits! This includes keeping well hydrated, getting enough fibre in your diet, using a footstool when emptying your bowels and always avoiding straining.
Scar Massage
Before I go into a few tips on scar massage, I thought some of you might enjoy this cool playdough video showing that they DON’T actually cut through the muscle layers – they are “moved” to the sides.
https://www.youtube.com/watch?v=utCS5rzNkfU
As you can see, incisions are through multiple layers (skin, fat, fascia, then into the uterus and the amniotic sac around the baby). When the baby has been delivered, the surgeon then repairs each of these internal layers. The layers of sutures may not all be in line with each other, so where you see your external scar may actually be above or below where the internal scars are.
Scar pain can take some time to settle and some scars may be more sensitive than others. You can start gentle massage when the scar is fully healed. Start off gently using a plain unscented moisturiser. Start with small strokes on the tissue above and below the scar line. This should not be painful. If you feel ready, you can start with small circles along the scar line. Aim for 5-10 minutes each day for best results and start to apply deeper pressure in towards the stomach muscles over the coming weeks.
If it is safe to start scar massage, we can show you how to do this at your 6-week Postpartum Assessment.
It is important to remember that every woman’s experience will be different, and we do our best to make each assessment and treatment after a caesarean birth individual to each woman’s needs.
We look forward to helping you recover from your caesarean birth as you return to doing the things you love most.
By Tyneale Lloyd
Physiotherapist – Women’s Pelvic Health
Book an appointment to see Tyneale (our C-section expert) here.
