csection

What to know about healing from a C-section

I've never had a csection, so I can't speak to the healing process through a personal stand point. But I have worked with some amazing moms who had 1 or multiple csections with incredible results!

I'm going to share some of my insights from what I've learned over the years when working with these moms.

Start early

You can start reconnecting to your body in the hospital. When you aren't napping or taking care of baby doing some simple body movement is totally safe.

The focus of these movements are to keep you from becoming super stiff from laying in bed.

Movements like raising your arms over your head with an inhale.

Sliding your heels along the bed with an exhale.

Practicing the following sequence using an exhale every time you move, pausing between each segment.

  • Rolling from back to side
  • Sitting up from your side
  • Standing up
  • The reversing

These are movements you will be doing anyway, so why not become more mindful with some extra practice.

Starting to become mindful and reconnecting to your body while in the hospital sets the stage for your whole healing process!

Wear the right panties

Even though an incision from a csection is low, it can still be under direct pressure from clothes, especially underwear.

The solution?

The C-panty.

A high waist, gel lined panty designed specifically for csection recovery.

These are amazing and can be purchased at a ton of different locations. I just linked directly to the main website so you can check them out for yourself (no affiliation).

Go check them out, enough said.

Be gentle

You [just] had major abdominal surgery.

Be gentle on yourself. Don't feel like you have to do it all immediately or ever.

As for help. Get your family and friends to help you out. Or work with a postpartum doula!

Realize that your body will not be able to respond to your commands the way it used to.

You'll be sore and tired and may not want to do much other than sleep and care for you baby.

And that's OK.

Give yourself time

It takes time to heal from a surgery.

It takes time to heal from a pregnancy.

It takes time to reconnect to your new body.

It takes time!

Give yourself the space to have time. To slow down and heal. To allow your body to get nourishment and the time it needs to go through a proper healing process.

Then give yourself time to not have a pregnant body anymore. Your body just went through a the fastest physical change it ever will. It took 9 months (give or take) to grow your baby. Within that time frame your body had to morph into the mama powerhouse that it is. Then in minutes it is no longer pregnant.

Your body needs time to resume a non pregnant form again, which doesn't happen over night, especially after a csection.

It'll take at least 1 year (more if your breastfeeding) to regain some sense of normalcy in your body.

Give yourself that.

Learn how to open up

An incision from a csection has come a long way. No longer is it a large vertical cut but a few inch horizontal cut that is barely visible sometimes once healed.

The thing about csections [and really any abdominal surgery] is that your body will respond in a similar way no matter the size.

Your body will want to protect that area while it heals.

To do this your body will do the only thing it knows how to do to protect itself.

Create armor.

To do this it contracts muscles to guard against pain and it turns inward [into a flexed position] to reduce stretch on the sore tissue.

This is ok, to some extent, but not ideal for optimal healing.

What happens if we let the body take over is the muscles that are guarding become tight and shortened and the hunched position becomes habit causing an imbalance in posture, stability and pain.

This is compounded by breastfeeding in a hunched position.

What can help?

Learning how to open up the front of your body!

Allowing your body to safely go into extension to get your body to find a balanced state again.

You can still have pelvic floor problems

A common misconception about csection births are you are immune to pelvic floor problems because you didn't birth vaginally.

While there is a reduced risk of incontinence, you can still have pelvic floor problems like peeing your pants, painful sex, and prolapse.

This is because your pelvic floor was just holding up the extra weight of baby for 9 months and which weakened and stretched it out.

Your pelvic floor works with your abdominal muscles, mainly the transverse abdominus, to coordinate against forces placed on the body that may cause urine leakage and stability issues.

Your abdomen was stretched and weakened from pregnancy plus you have the added incision scarring to heal from.

So regardless of birth, pelvic floor problems can happen.

Find yourself an amazing pelvic floor PT

It's not easy caring for yourself and your baby after a csection.

Getting all the help you can get is not a fail. It's a win!

You just said F - this  to "you just had a baby so deal with it."  You just said "I'm not going to settle for half rate care that doesn't give me all the information necessary to fully heal from pregnancy and birth."

You're committing to your own self care because you know how much it'll help your entire family in the long run.

And a pelvic floor PT is the person who will help you create your self care path.

They'll become your partner in figuring out exactly what YOU need for healing.

They will make sure you can reconnect to your body, you can open up and find proper posture, will ease tight, painful tissue, will give you exercises that are appropriate for your stage of healing, and teach you all you need to know about using your new mom body to avoid future injury.

It's not just a "do your Kegels" kind of care. It's a whole body, whole life kind of care that will revolutionize how you live, new body and all.

So if you had a csection years ago or have one scheduled in a few months. Find where you are in your healing journey and start there.

If you're ready to commit to self care check this out to learn more!

 

What You Were Not Told About Birth: Part 4

As we all know birth does not always happen vaginally.  Many babies are born through mom's belly.

Moms who have a cesarean have many of the similar factors to consider as moms who birth vaginally.  These factors are centered around all moms were pregnant before birthing and the pregnancy itself alters our body.

However, moms who birth through cesarean have the added factor of an abdominal surgery.

Let's consider the two paths moms may on before a cesarean.

The first path is mom is laboring and pushing, but for what ever reason baby is not progressing or another medical complication occurs and for the best interest of mom and baby a cesarean is performed.

The second path is mom is scheduled for a cesarean and does not labor and push.

Each of these paths have it's own implications on the mom's body.

In the first path, the pelvis is primed for a vaginal birth, the tissues and muscles of the pelvis are stretching and widening, the uterus is contracting.  Mom may have been laboring naturally, induced or with pain medication. She may have tried multiple positions to help baby out and may have pushed for hours. For some baby is in an asymmetrical position or breech which puts strain on moms tissues where we don't want the extra strain. Baby may have been pushing into and stuck on the pubic bone.

Whatever the scenario, when mom has labored and pushed before a cesarean her pelvis has gone through a partial vaginal birth.  This means that she is at risk of long term pelvic floor dysfunction, similar but not as high of a risk to those who delivered vaginally.

A reminder of these problems are incontinence, pelvic pain, and prolapse, which Part 3 goes over in more depth.

In the second path, moms body has started prepping for a vaginal birth, but typically a cesarean is scheduled at least a week or 2 before the due date.  This is to reduce the chances of mom going into labor.

For these moms, they have the least risk of pelvic floor dysfunction.  This is a no judgement zone and I believe cesareans are absolutely needed when medically necessary, but don't let the reduced risk of pelvic floor dysfunction lull you into a false sense of security.

Cesareans are a major abdominal surgery.

Without getting into the medical component of a cesarean, which you can read more about the that in my blog post Vaginal vs Cesarean, I'm going to cover how an abdominal surgery alters the body.

Unlike cesareans of the past, the abdominal muscles should no longer be cut, however they spread and separated from the connective tissue.  So after 9 months of being stretched out they are further stretched and traumatized, regardless of how gentle the OBs are.

Especially during an emergency cesarean, OBs want to get baby out fast, so moms tissues may be bruised and have extra micro trauma that has to heal.

If you think of any other major surgery, most of us don't assume the person will bounce right back from it.  Usually there is a recovery time and rehab, sometimes A LOT of it.

When your abdominal muscles are retracted and organs are shifted some more to remove baby, the fascia and connective tissue that is interwoven through the abdomen down into the pelvic floor is involved. This means that even though baby was not born vaginally, there is still a risk of pelvic floor dysfunction, because of the interplay of tissue.

What are the major implications though of the incision?

A cesarean incision is a scar. A scar is an interruption in the normal tissue fiber, which is weaker and sometimes unpredictable.  The scar for a cesarean is multi-layered and can vary from mom to mom based on the OBs technique and how mom heals.

Some moms heal beautifully without complication and others may have extra scar tissue, infection or added complications that prolong the healing process.

In turn, a scar may visually looked healed but tactically be numb, bumpy, tight or painful.

There are two major implications that result from the scar.

  1. Pelvic weakness, mainly the abdomen.
  2. Pain, mainly abdominal or pelvic.

Let's take a look at each these more closely.

When any muscle is traumatized by injury or insult, such as a surgery it is weakened at a micro level.  Plus nerves are also involved causing numbness and reduced sensation in the abdomen. Combine this with weakened and stretched out abdominal muscle from pregnancy, moms with a cesarean are at a higher risk of longer lasting abdominal weakness and a harder time tuning into the Abs.

This is perpetuated by the fact that most OBs don't want mom to perform any form of exercise for 8 weeks to make sure the incision is healed, which is fair enough. However, with the guidance and expertise of a maternal pelvic health specialist there are safe exercises that can help with healing.

Abdominal weakness can lead to

  • back pain
  • constipation
  • prolapse
  • poor posture

But as I stated before the fascia that is woven through the abdomen reaches into the pelvic floor, which can result in some pelvic floor dysfunction as well and as we all know (now, from reading the series) it's not all about Kegels for pelvic floor dysfunction. So we want functional Abs too!

On the other hand the scar can cause pain. When a scar is formed the body arbitrarily adds connective tissue to the area.  Then over time the body comes back and straightens it up to match the force vectors in the tissue.

Some bodies aren't as efficient at this process or are overly efficient, meaning they don't straighten it up very well leaving nodules or bumps or extra scar tissue is created and may adhere to surrounding organs or tissues.

This disorganization or adhesions can result in pain receptors saying something is wrong, thus abdominal or pelvic pain.

For many moms this is most noticeable with activity, bowel movements, a full bladder, sex, and menses (once they start).

Long term implications if not addressed as be increased severity of symptoms, "sudden" start of symptoms that may seem out of the blue but stemming from the cesarean or complications in later births.

So as you can see there are risks for all forms of birth and we as women need to research, ask questions and feel in control of the decisions we make regarding birth.

Knowing that you are not alone, there are people who can support you through your birth and your healing after birth. There are treatments for these complications and ways to help reduce these risks. All it takes is reaching out.

We'd love to hear your birth experience. Comment below.

Vaginal Birth versus Cesarean

To continue the What They Don't Tell You Series we need to talk about the differences between birth methods so we can understand what happens to our bodies during each.

Most of us know the two ways babies are birthed: vaginal and cesarean.

You may be thinking, "well of course I know the difference" and if you've experienced both then you have a leg up on the rest of us.

However, most of us don't really know the physical differences each has on our body.

Let me help clear that up.

A vaginal delivery is just that, the baby is birthed through a small hole in the pelvic floor, aka the vagina.

A cesarean delivery, the baby is birthed through an incision made in the abdomen and uterus.

Now, let's look a little closer at each.

VAGINAL DELIVERY

A vaginal delivery may be natural with no medical intervention or have medical intervention.

A natural delivery means the woman's body went into labor on it's own, chose or was unable to use medication for pain relief, and did not need any equipment or intervention to remove the baby from the vagina.

Medical interventions during a vaginal delivery may include: induction (which may include membrane sweeping if not consented), pain relief medication, IV, fetal monitoring, forceps, episiotomy, and vacuum.

Without getting extremely technical what our bodies need to be able to do for a vaginal delivery is the following:

  • Open and expand the upper pelvic rim and SI joints
  • Use the power of the uterine contracts to help the baby descend into the vaginal canal
  • Open and expand the lower pelvic rim and coccyx
  • Relax the pelvic floor

This process may be affected by the position of baby, pregnancy complications (preeclampsia, placenta position, etc), pain management, medical interventions, distractions or actions that may slow moms progress.

This is where I can get super detailed about what happens to the body, especially to the pelvic floor, but that is for future posts.

Ultimately, our body will either be able to pass the baby through the vagina or the decision will be made that a cesarean is required.

CESAREAN

There are two ways a cesarean is the birth method... an emergency after pushing is not successful or the life of baby or mom is at risk and a scheduled cesarean.

Before an emergency cesarean the mom's body goes through the same processes as a vaginal delivery and may even have other medical interventions performed prior to the cesarean.  She may even push for hours, which can  affect the pelvic floor almost as much as a vaginal delivery.

For those who have a scheduled cesarean, the mom knows exactly when she will be birthing the baby.  A cesarean is scheduled for many reasons, a few of these are pregnancy complications like placenta privea, baby's position, being "over due" and for some a previous cesarean.

This is what happens to the body during a cesarean:

  • A catheter is placed so you can pee
  • The mom is given a spinal block or epidural to numb the lower half of the body. In some emergency situations general anesthesia is given.
  • Horizontal incisions are made just above the pubic bone - cutting through skin, fat, and fascia.
    • The muscles are not actually cut, however the the fascia that connects them are and then separated to pull the muscles apart.
  • The uterus is then cut and the baby is eased out
  • The uterus is massaged to help the placenta release
  • The incisions are stitched or stapled back up layer by layer
  • Then you are in recovery - where you catheter is eventually removed

 

So what really happens to the body during a cesarean beyond the steps of getting the baby out. Again, this is the topic of another post.... so stay tuned.

To recap...a vaginal delivery requires a full stretch of the pelvic floor to birth the baby & a cesarean is major abdominal surgery.

Regardless of the birth method your body just went through intense changes during pregnancy which affect the structure of the pelvis, spine and soft tissues in the abdomen and pelvis...not to mention other joints like our feet and shoulders. Which means your body has already undergone changes that have nothing to do with birth method and can affect long term health and fitness.

To be continued...