You and your midwife have agreed on your birth plan. Your bag is packed with everything you may need to welcome your new baby into the world in a calm, loving environment. You and your partner have diligently been practising the hypno-birthing techniques. You are even looking forward to labour, in the knowledge that you have done everything possible to prepare for it. You do realise that things don’t always go exactly to plan, but that birthing pool has your name on it and you are determined to get it right.
So how come you are now lying in a hospital bed with tubes coming out of everywhere, unable to get to your crying baby who is just out of reach in the cot next to you?
Having a Caesarean Section is a big deal, even if it was elective and you were able to prepare yourself for what was going to happen. But when you need it because labour isn’t going to plan and you are rushed in as an emergency, it can be very hard to recover physically and emotionally.
There are some things that you can do for yourself afterwards that will help you to recover quicker and make it easier to care for your new baby.
Our natural reaction to pain is to tense and hold our breath, bracing against it. But following an operation this causes muscles to tense up that don’t need to, particularly around the site of the incision, leading to increased levels of pain and anxiety.
By thinking about breathing out during movement, it gives you more control over your body and allows the muscles that don’t need to be working to stay more relaxed. But you don’t have to take deep breaths, just slow and controlled.
Diaphragmatic breathing or belly breathing is good to help you to relax and to take enough air into your lungs each breath. After an operation, especially if you had a general anaesthetic, the tendency is to take shallower breaths using mostly the tops of your lungs. Taking a couple of slow deep breaths so that your belly gently rises as you breathe in will help your lungs to expand fully.
- Stand up straight
The Caesarean Section operation results in a lot of scar tissue deep into the abdomen, especially if it was an emergency. The neat little scar on the surface doesn’t reflect the amount of internal trauma. Scar tissue and then potentially adhesions form wherever the tissue has been disturbed.
If you stay bent over (as you may feel like doing), the scar tissue will start to form in a shortened state. So even once the pain has settled and you do feel like straightening up, the scar will already be too tight and you are much more likely to have problems in the short and long terms.
When you first get up from a chair or bed, you will probably feel that you can’t stand up straight. This is when it is really important to tuck your bottom in, look up, bring your shoulders back and allow your back to gently straighten. Remember to keep breathing at the same time. Once you are up, it will be easier to move around and to stay more upright.
- Keep moving
Gentle movement can really help your body to heal in the right way. Scar tissue needs to be able to respond to the movements that it will be doing, so by moving properly from the beginning, it will be laid down in the right way for you.
Movement also helps your circulation which is essential for the healing process and to help reduce any swelling in your legs, hands and abdomen. You will need to take it easy to start with, so moving little and often is the best way to stop your body from stiffening up.
Getting back to more strenuous exercise takes longer and the time scale is very dependent on your fitness levels and how you are recovering. Your doctor will be able to advise you on when and how to return to exercise after a Caesarean.
- Drink plenty of water
Your body is approximately 60% water and all your cells need you to be well hydrated to be able to function properly. The European Food Safety Authority recommends that each day, women should drink about 1.6 litres and men should drink about 2.0 litres of fluid.
If you are dehydrated your blood flow is reduced and your body’s healing mechanisms will be compromised. This is especially important if you are breastfeeding. Not drinking just because you don’t have enough time or you are worried about your pelvic floor control is not a good idea.
So try to have a drink handy to be able to sip throughout the day. It doesn’t have to be water – any liquid counts, but be aware of other ingredients that might be hidden in other drinks, such as caffeine and sugar.
Stress has been shown to slow wound healing and it tenses your muscles, which will contract the wound. This might seem like an impossibility with a new baby, but relaxation will benefit both of you as it is very easy to just keep going and push yourself the whole time.
It is good to get into the habit of spending time just breathing slowly and using all your senses to take in your surroundings. That can be while you are resting, feeding or even when you are playing with your baby. There are several excellent websites and apps available to teach you and talk you through mindfulness practices, which really benefit you physically and emotionally.
- Think about how you are holding your baby
People tend to hold babies in the same arm and sit toddlers on the same hip every time they are carrying them. When this is coupled with the bent over posture that is normal as you look down when you are feeding a baby – either breast or bottle, you can imagine the strain that it puts on your whole spine and the Caesarean scar.
Try to alternate the sides that you are holding and carrying, staying aware of how you are lifting the baby or toddler up from the floor, chair or cot.
If you are sitting to feed, pillows are the best way to support your arm while you support the baby. Sit well back into a comfortable chair with good lumbar positioning and place the pillows under your arm and across your lap to lay the baby on. Remembering to breathe and softening your neck and shoulders will also help.
- Get some treatment
Scars can remain tender both on the surface of the skin and in the tissues below for many years after they were formed. This is because of the nerve endings that become trapped and irritated by the restrictions in the fibres. They can also lead to chronic inflammation.
So if you are having ongoing problems with your scar, it is worth seeking help sooner rather than later to help prevent problems in the future.
Very gentle hands-on treatment such as Myofascial Release can work with your body to release the restrictions from old and new scars.
About the author: Nikki Robinson
Nikki is one of the top Myofascial Release Physiotherapists in Europe and is passionate about providing outstanding treatment in her field of expertise. She qualified as a Physiotherapist from the Queen Elizabeth School of Physiotherapy, Birmingham in 1993 and then worked in the NHS and in Australia.
Following that she trained in Myofascial Release in the UK and in America with John Barnes, the American Physiotherapist who developed the technique. In 2006 she founded Holisticare, one of the few specialist Myofascial Release practices in Europe, opening a purpose built treatment centre in 2010, and expanding in 2017. Today the practice has over 2000 patients, who travel from all over the UK and Europe to be treated by Nikki and her team.
Nikki’s book Pain-Free Horse Riding will be published in the UK on 30th Nov 2018 and in the US in April 2019. This is a practical guide for all horse riders on how to treat and prevent pain.
A member of the Chartered Society of Physiotherapy and registered with the Health and Care Professions Council, Nikki is also a member of the Fascia Research Society, ensuring she has access to the latest fascia research and journals from round the world to keep her knowledge and skills up to date.
Nikki’s article was originally published in the Me & My Baby magazine, which was curated by Sue Kennedy a professional portrait photographer based in Harlow, Essex who specialises in baby and child portraiture. You can get your own free copy of the magazine here.
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