As much as most women wish to avoid a c-section, the fact is that lots of births are caesarean births. As an educator in women’s health, and especially pre- and postnatal fitness, I always include c-section recovery as one of the birth preparation topics covered in my pregnancy classes.
A caesarean is a major abdominal surgery. It’s the only abdominal surgery where you’re not given much of an after-care plan, and you get sent away with a baby to care for! It’s therefore imperative that you do everything you can to take your recovery seriously; allowing time to rest, and promoting wound healing.
There are lots of things you can do to make your recovery as comfortable as possible at different stages along the way. So I’ve broken this down into timescales. I hope it helps you should you ever need it.
THE EARLY DAYS
I mean REALLY breathe. If you’ve ever worked with me pre- or postnatally, you’ll know how important the breath is (obviously)! It all starts with the breath. Try to inhale fully, filling your lungs and expanding your ribs. Then exhale completely, noticing the gentle fall in your belly. This is the first step to reconnecting with your core. Don’t underestimate it.
• Gentle movement for circulation
Right away you can start to mobilise your wrists and ankles. Whilst you’re still in hospital, ensure you keep doing this to avoid blood pooling. Any gentle movements you can manage will be beneficial, so try gently rolling your head from side to side, pointing and flexing the toes etc.
• Wound care
Keeping the wound clean and dry is very important. You’ll be given instructions about how to do this but as a general rule, you should avoid soaking in a bath for the first couple of weeks. Instead, you can dab the wound gently, being careful around your stitches. A cool compress can be lovely held against your scar. A few women have told me that they soaked a dressing (or even a maternity pad) in tea tree oil and kept it in the fridge until needed. Love this idea! If anything looks especially angry, or you experience severe pain then speak to your HCP immediately.
• Bridget Jones pants
Yup, make sure you have some lovely high waisted, big stretchy knickers, and perhaps your comfy maternity trousers with a big waistband. The last thing you want is any additional pressure on a tender scar, so clothes that come up high and completely cover the area are best. This will also add an element of support.
You can take arnica in tablet form or as a topical gel (although don’t apply anything directly on the wound while it’s open) to help reduce swelling and bruising.
• Log roll out of bed
So many women are surprised to learn that this is something you should continue to do after baby arrives, and not just a pregnant woman’s manoeuvre. In order to minimise pressure on your scar (and abdominals and pelvic floor), always make sure you roll onto your side when getting in or out of bed i.e. don’t do a sit-up, or roll down on your back. Always go from your back, onto your side, then use your top arm to push you up into a seated position, before swinging your legs round and out of the bed.
• Peppermint tea
Trapped wind is an unexpected and very common symptom experienced post birth, and especially post c-section. Make sure you have some peppermint teabags packed in your birth bag, as this can really help deflate a gassy tummy. Don’t worry – it won’t last for long.
1-8 WEEKS POST BIRTH
We are essentially made up of water, and all of the tissues that need to repair in your body need to be hydrated. Make sure you’re drinking plenty. It’s one of the most crucial parts of your healing.
All the connective tissue that needs to heal is full of collagen, which is made up of amino acids. So protein is an absolute must. Make sure you’re getting a decent dose at every meal: Meat, fish, pulses, eggs, beans, nuts, tofu, chia seeds. There’s plenty to choose from, whatever dietary requirements you have.
• Keep log rolling
See above! Don’t stop this until – at the very least – your scar has fully healed, and the midline of the tummy is feeling firmer.
• Breath work, core connection, PF awareness
It’s never too early to begin work on your pelvic floor. And I’m afraid that a caesarean birth doesn’t mean your pelvic floor is unaffected: You still carried a baby for (roughly) 9 months, your body still experienced all the hormonal changes, and – if you had an emergency section – chances are you endured some degree of labour first too. Start by adding a gentle pelvic floor contraction with your exhale breath. For more detail around progressive pelvic floor work, take a look at this video.
• Tennis ball / prickly ball
In the unlikely event you own a little prickly (physio style) ball, great. Otherwise a tennis ball does the job almost as well… Simply place the ball under the sole of your foot and massage away. The soles of the feet are especially high in mechanoreceptors which, when stimulated, cause a number of things to happen:
1) You literally feel good. The sensation of touch allows the body to relax and release tension.
2) It stimulates gentle action of the pelvic floor.
3) It increases sensitivity in the feet, which improves balance in the long term.
• Belly wrap
A belly wrap offers some much needed support, and an extra layer of cushioning for your tender tummy. It’s not there to shrink your belly, nor will it “switch off” your muscles. If you feel like you need some extra support then please do get some! (And I mean that in both the physical and mental sense). After a c-section, a belt is not normally recommended until around 6 weeks, at the point when the scar is clean, dry and intact. using it in the early days can delay healing and increase the risk of infection.
2+ MONTHS POST BIRTH
• Massage, massage, massage!
Scar massage is an absolutely crucial part of your long-term healing. Scar tissue can form adhesions which, if left untreated, cause stiffness / pain / reduced mobility etc. You can begin with some very gentle massage once your wound has healed, and then build up from there. Check YouTube for videos on how to do this (I like this one) or – better still – go and see a women’s health physiotherapist (WHP) who can work on yours, and teach you how to do this at home. NB: Scar massage is something you should continue doing long term.
• See a Women’s Health Physio
Access to a knowledgeable WHP should be a standard part of postnatal care, but sadly that’s not the case here in the UK. At the very least, ask your GP for a referral on the NHS, but ideally get yourself booked onto a Mummy MOT with a reputable WHP.
Never give up on your scar tissue. Not ever. Keep touching, keep moving. Seek help if you feel any pain or discomfort, even if it’s years (or decades!) down the line.
Finally, a massive thank you to all the women who kindly sent me photos of their scars. It’s great to show real images, of real women, with whom I’ve had the pleasure of working. You are all amazing.