This Caesarean section Awareness Month, Lesley Gilchrist, registered midwife and co-founder of My Expert Midwife talks to My Baba about how women can plan and prioritise their recovery after a C-section.

Choosing to have or being recommended to have a C-section can be a much more challenging path to take when deciding how your baby will be born. The day you have your C-section you will not only be giving birth to your baby, but also having major abdominal surgery, so there is a lot to consider when making the choice to give birth this way. Once your baby has been born via C-section there is both the short-term and long-term recovery time to consider, so it is essential to have plenty of information to draw from to help optimise your recovery. There can often be a focus on your physical recovery, and whilst this is clearly important, women can sometimes feel that their emotional needs are side-lined, especially if their C-section was unplanned and happened during their labour.

Physical recovery after your C-section

C-section birth is major surgery and recovery time should be planned in but is very individual from one woman to another. However, remember that whether you’ve had a planned or emergency C-section, it is likely to take longer to heal and recover from than a vaginal birth. During the first few weeks, extra care when moving around and lifting things is advised as your movement will be more restricted. Arranging help in advance from family, friends or hiring a postnatal doula can provide much needed help especially if your recovery takes longer than you anticipated.

Short-term tips for recovery from a C-section

  1. Take it easy, your body needs time to mend, avoid lifting heavy objects as this can cause back and abdominal problems in the future.
  2. Your body needs fresh, nutrient rich food to recover and plenty of soluble fibre (fruits, vegetables and wholegrains) to help with bowel movements.
  3. A curved nursing cushion can provide you with support and help prevent soreness when you are resting, holding or feeding your baby.
  4. Take regular pain relief prescribed or recommended by your doctor or midwife to keep on top of your discomfort.
  5. If you are worried about increasing pain, redness, weeping, oozing or an odour from your wound area contact your midwife or maternity assessment centre for advice.

Long-term term scar recovery from a C-section

Scar massage can help influence the development of scar tissue from as early as the first few weeks to up to two years after having a C-section. As scar tissue tends to develop slowly, a regular routine of self-massage can help to improve the appearance and mobility of both external and internal scar tissue after your C-section.

Most women are not aware that they can improve their long-term recovery through regular scar massage. It is not talked about by many healthcare professionals in the immediate days after a C-section, but the benefits of scar massage can impact upon not only the external appearance of scar tissue but also improve comfort long term by helping to reduce the development of adhesions.

The benefits of scar massage

During the healing process C-section scars can vary from being quite prominent to almost invisible. Using a scar massaging technique can help improve most scars. As scar tissue forms slowly regularly massaging it can encourage it to form flatter and have a less raised appearance.

Scar tissue also develops internally and may adhere to other tissues creating adhesions. These are bands of scar tissue that can tighten and constrain internal tissues. It is most common on the colon, ovaries or between the bladder and uterus and can cause pelvic and back pain during long-term recovery.

When to start C-section scar massage

This is a guide to the frequency of massaging, but everyone is different, so develop a routine that feels comfortable for you. Once you have had your six-week post birth check or when your scar is considered well healed you can gently start the scar massage.

  • Begin with 5 minutes daily until your tissues are freely moving in all directions. This may take a few weeks or longer- everyone is different.
  • Then reduce to a weekly massage, focusing on any stiff or tight areas and working with them.
  • You can then simply massage the area every so often- maybe monthly. The week after your period finishing is a good time as you won’t have any additional tenderness or irritation.
  • Massaging monthly to 6 weekly up until the 2 year mark from the birth can still provide benefits.
  • If you find the tissues getting tight again, slip back into a more regular weekly pattern of massaging.

Emotional recovery after your C-section

Around half of all caesarean sections are not planned. When how we expected to give birth changes from having a vaginal birth to a C-section, often with little time to process this change, the effect on our emotions can be dramatic. It is totally ok to feel this way and by recognising them you are helping to process your birth experience, which can also help you to heal emotionally, should you need to.

Common feelings after an unplanned C-section include:

  • A lack of control. Unplanned C-sections are most likely to happen during labour- a time when you feel at your most vulnerable. You may feel as though things happened really fast and this can in turn lead to feelings that you lacked control during your birth.
  • Feeling guilty. You have a healthy baby, right? So, what’s the problem? Remember it’s ok to feel upset and to grieve for the experience you wanted. Of course, you are grateful for having a healthy baby and being alive, but this does not cancel out your right to feel disappointed about your birth experience.
  • Feeling angry. Feelings of anger and resentment can come when you process the events leading up to your unplanned C-section. Could you have done things differently or could your care have been better?

It may take some time to process your feelings and that is ok. Talking with people you trust can help and they may be close by around you, or you may need to look further afield for professional help or towards online communities of likeminded people who have had similar experiences.

If you feel as though you have unresolved issues surrounding your unplanned C-section you can contact your hospital and arrange to talk through these events with a doctor or midwife. They will help explain the sequence of events and if things could have been improved.

When is it time to seek help from a medical professional?

If you continue to feel low in mood, without any improvement, you can seek help from a qualified professional such as a trained counsellor or psychotherapist to help you develop techniques for managing how you feel about events. Your GP will be able to signpost you towards the resources available in your local area.

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