Scars...and Healing as it Relates to C-Sections
Most recently, I posted on healing and the process of scarring. I want to relate that to a common place surgery: C-sections. I understand that this topic can be sensitive for some as they’ve envisioned a certain delivery experience but situations did not allow, if you can, hang with me. These stats are often scary and I don’t mean to be negative - just share real literature and knowledge so you can have more power and understanding with your recovery postpartum or the years afterwards! For some women, this is not a big deal while others will be affected a little more indefinitely.
Let’s Dive in:
According to a study done by the CDC 31.9% of all deliveries in 2018 were via Cesarian Section - thats about 1:3 births! There are various reasons for a C-section and the most common are for the safety for health of the mom and baby due to various diagnoses like:
placenta previa,
infections/STDs,
co-morbidities like diabetes or high blood pressure
baby size or maternal size
baby positioning
labor complications - baby is in distress
What I find is that most don’t realize that a C-section is a true abdominal surgery with potential for common issues seen with other abdominal surgeries.
A C-section is a true surgery…
C-section scarring is known to create scarring between the uterus, omentum and bladder which creates constipation, GI symptoms, and abdominal pain
There is some good news relating to a C-section, however. Statistically speaking, those who’ve had a C-section demonstrate lower incidences of urinary incontinence and prolapse. Yay!!
But:
I can say, though, that because you’ve had a C-section does not mean that the pelvic floor will always function appropriately even though you did not deliver vaginally. I have seen where the trauma to the pelvic floor due to the labor leading up to the C-section has led to issues. I have also seen where the scars from the C-section can cause urinary frequency issues as well as incontinence.
Stop with all the negative! So what do we do??
First be aware of the pros and cons of any decision you have for the body. Your provider, Midwife, and doula all can prepare you for thinking about all the things. And just because you think about it does not mean it will happen! It is better to prepare and know all the angles of a decision than be surprised and frustrated because you didn't have time to explore all the options.
And, sometimes you don’t get to choose what happens. This can be even harder when we are the type that like to be in control. I would suggest to see someone to help your work through the processing and this can definitely be a grieving process for someone who had envisioned her birth to be a different way. This truly can be a hurdle in healing physically. I recommend ReadyNest Counseling if you are in the Nashville area.
Second be bold and humble to ask for help. Most of us who are in the women’s health world have been there ourselves and can help guide you to who you really need to get in touch with or how to help.
Third, breathe. Diaphragmatic breathing or 360 breathing can help move the belly contents, the gut, and newly healing scar. Breathing also helps to massage the Vagus nerve known to help stimulate digestion, relaxation and help to turn on our “off” switch. Think about breathing down into the lower ribs on the back, into the spine, and belly. I recommend starting with just 5 minutes a day. Breathing can also make the scar remodel in the directions we want them to - out and in, up and down and side to side.
Fourth, massage the scar (click here for a free PDF)! THE MOST important for every mom after a C-section.
When the scab is gone, start gently with rubbing across it and with sliding your finger over. You can also massage around the scar if the scar is too tender. Just start with 2-3 minutes a couple times a day. A women’s health physical therapist can walk you through this if you are not comfortable just yet.
Apply more pressure as the tissue tolerates it. You can even try to pull the skin away from the belly and sliding the skin in different directions. Remember, your belly moves in a lot of directions so the skin has to move with it!
When we talk about scar mobilization, we want to make the scar as close to the same texture as the surrounding tissue. Scars main goal is to close a space in tissue. Our main goal is to help that scar be as similar to the tissue it is replacing and movement as well as mobilization are the best things for it.
Finally, Diet and Nutrition are super important with healing and our bodies ability to replace muscle, tendon, fascia and heal more completely. Watch out for another blog on nutrition, supplements, vitamins, and best habits with my favorite Registered Dietician Grace Dwyer of www.gracegoodwindwyer.com.
Resources:
https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002494
https://www.marchofdimes.org/pregnancy/c-section-medical-reasons.aspx