I had planned a water birth, with calming music and chilled lighting.
I did not want a C Section.
Delivery day arrived and it wasn't going to plan. My baby needed to come safely, and so I had to put my own wishes and life aside, go beyond those doors to a bright, white room full of equipment and I was terrified, but I had no choice.
My baby came first.
They made the cuts through several layers of tissue, nerves and moved muscles and organs out of the way to get my baby out safely and put me back together. I spent days hunched over, afraid I would pull my stitches and end up back in surgery. It took a good few weeks to months for me to feel like I could move without fear of hurting myself more, even lifting my baby was hard and sometimes painful. I was up all of the night, trying to get this tiny human to feed and then I'd do it again all day.. And that isn't even touching on how I felt mentally.
Mentally, I was exhausted, upset, and felt like a failure because my body didn't birth how nature describes. All I heard was 'At least he's here safely' and that made me feel worse because, of course I was relieved my baby was here safe, but I then felt guilty for even feeling remotely disappointed about how things went.
My son was born just before Christmas with the whirlwind of parties and family gatherings followed by my husbands 30th birthday with everyone keen to see the new arrival and I felt bad for not feeling up to it. Why? I don't know! I didn't want to upset anyone but yet I was neglecting myself, putting on a brave face and not giving myself enough time to recover. However, a c-section is major abdominal surgery, so for more information about the procedure, returning to exercise and scar massage read on..
What Happens during a C-Section?
Caesarean Section deliveries can be planned or un-planned. During the C-section, the doc makes an incision into your skin, through the fat cells, connective tissue, and into the abdominal cavity. The abdominal muscles are then spread apart and the bladder is moved down and out of the way in order to get to the uterus. There is an incision made into the uterus and the baby is guided out. The placenta is taken out shortly after. The uterus is then stitched up, the bladder put back in place, then connective tissue, the abdominals, and the skin stitched up, to varying degrees. We have a lot of layers of sutures and thus, scar tissue that will form.
Recovery in The Early Weeks After C-Section
In the early days and weeks following your C-section you’re going to be focused on resting and relaxing as much as possible with your new baby. These are the main things you will want to do in the first 6 weeks postpartum:
Ask for help.
You’re going to want to do things yourself, but try to reign yourself in. Allow yourself to receive help and offers from your friends and family – they really want to! Your job as mama is to love, feed, cuddle, and sleep. If possible, even get people to bring your baby to you at feeding time.
Every time you go to lie down or to move from your back to a seated position, you’re going to lie to your side first. This is so we can avoid big crunching and sit-up type movements that put a ton of pressure on the abdominals and scar. An example of this is getting into and out of bed. Get into the habit of lying on your side and then slowly rolling to your back when getting into bed. Getting out of bed, roll to your side, lower the legs off the bed, then use your upper body strength to push yourself up to seated. If you can, get someone to help you with this, as well.
Core restoration can start within the first few days postpartum. You are going to start reprogramming your core to function from your diaphragm down to your pelvic floor muscles, with the Connection Breath.
On your inhale breath, feel your ribcage and your belly gently expand and relax. On your exhale breath, gently exhale to encourage gentle activation through your pelvic floor and deep abdominal muscles. Before you do any exertion, say getting out of bed or picking up the baby, practice your Connection Breath. Start your exhale breath and then begin your movement or lift.
In the first few days, you’ll want to stay off your feet as much as possible. As you begin to heal, slowly increase the amount of walking you’re doing around the house. Monitor your energy levels that day and the next, and if you’re feeling good, you can keep slowly increasing your movement. Start with short outdoor leisurely walking and gradually increase your time. Use this as a time to breathe, relax, and move.
Returning to Exercise
In your return to more traditional strength training (after your six-week clearance and a check-in with the pelvic floor physio) you’ll want to allow your body plenty of time to adapt to the increase in movement and a good deal of recovery time between bouts of exercise. If you have any bleeding or pain (scar, pelvic, back) at all during or after exercise, keep your intensity more mild.
Examples of beneficial core restoration exercises are:
- Pelvic tilts
- Leg slides
Again, the Connection Breath can be integrated into each of these exercises. You’ll want to exhale on the toughest part of the exercise, just before you move. For example, in your squat, inhale as you squat down and then exhale to stand back up.
On the “exercises to avoid list” you’ll find:
- Crunches, sit-ups, leg raises, and front planks
- Running, jumping, step ups
- Heavily weighted exercises
- Anything with direct downward pressure on the pelvic floor
The return to exercise post C-section is very much similar to the return to postnatal exercise after a vaginal birth. Really pay attention to how your body feels during and especially after exercise. Above all, move in ways that make you feel safe, amazing, and energized during and after exercise.
C Section Scar Massage:
It’s very common for women to experience discomfort in their c-section scar, even when the scar is healed and looks normal. Sometimes the scar can be very sensitive and feel uncomfortable if anything touches it. It can also feel like you are unable to use your tummy muscles. Restricted mobility of the scar, called adhesions, can cause these symptoms.
Adhesions usually form after surgery, and are composed of strong strands of collagen which bind together to create blankets or ropes in the areas that have been injured by trauma and infection. The body can't automatically correct scar tissue, which is where manual therapy comes in.
Once scar tissue adhesions form, they may bind together organs, nerves and muscles often making going to the toilet, (digestion/bowel problems and urinary incontinence) not to mention sex, very painful. It's also not uncommon for c-section scar pain to be reproduced in a pulling or trapped sensation when women return to full-range movements as part of their daily lives and exercise programmes. Soft tissue work can also significantly help to restore function in the body, which in turn aids emotional recovery post traumatic delivery.