Cesarean birth is a vastly different birthing experience from vaginal birth and can benefit from certain preparations. In the first blog of this birth detour series I discussed the importance of preparing the heart and mind for surgical birth despite what your ideal birth plan looks like. Opening the heart and mind to the option can be critical to supporting our postpartum healing experience. When we make peace with the option we can begin to prepare our body for surgery and for post-operative healing.
What is a c-section birth?
The Cesarean procedure is a major abdominal surgery that incises 7 layers of tissue and produces about a 7 inch horizontal scar just above the pubic area. Traditionally the scar will have a soft dressing taped on it for 1-2 days post op.
There should not be a significant amount of bleeding from the abdominal wound that would require substantial dressing changes.
The wound should remain clean, dry, & intact and may have surgical glue/steri-strips or staples depending upon your surgeon. You should receive instruction on how to CARE FOR YOUR WOUND AT DISCHARGE. If not, ASK for guidance on when to remove steri-strips (they rarely fall off on their own), if you have staples- who will be removing and when, and a list of things that would require a return to your provider (bleeding, foul smelling drainage, etc).
Leaving the hospital can be a confusing and chaotic experience as baby care instructions often overshadow your own.
Postpartum Healing: What to Expect
While incisional bleeding isn’t expected after cesarean birth, VAGINAL BLEEDING is. In all births, detachment of the placenta leaves a ~8 inch diameter wound on the uterine wall.
This is the origin of postpartum bleeding. Because of this, postpartum diaper or pad usage is still necessary after c-section. Just as in vaginal birth, increases in postpartum bleeding can indicate overexertion.
Other key postpartum guidance includes SPLINTED COUGHING/LAUGHING and rolling in bed to protect the incision. A firm pillow or folded bath towel can work well as a splint. It is helpful to hold the towel roll or pillow tightly to the incision to support the abdominal tissue.
Coughing/laughing, and even straining to move in bed can create pressure on the fresh incision thus jeopardizing it’s integrity.
The incision does not begin to have any tissue tension or strength until collagen is delivered to the area around 3 weeks. It is important to protect the wound from strain in the early days postpartum.
Collagen is laid deep in the wound bed to strengthen the tissue but it can also cause ADHESIONS. Adhesions are collagenous connections between tissues that would not normally be connected (example: bladder and uterus, muscle and skin/fat).
Adhesions can cause a variety of issues to include back pain, urinary urgency, and painful sex among others.
It is important that pelvic floor physical therapy assessment be considered for BOTH vaginal and cesarean birth as both populations report incidence of pelvic floor dysfunction and musculoskeletal issues postpartum. Just because the baby didn’t pass through the birth canal, does not mean the pelvic floor is not symptomatic.
In addition to PELVIC FLOOR PT for pelvic issues, PT can be vital in assessing scar tissue and performing scar tissue mobilization. Self-scar mobilization can be a vital part of tissue healing, but a professional evaluation of your tissues can be incredibly helpful.
Curious about how to implement scar mobilization for yourself or your clients?
Join us live in our 90 minute C-section scar mobilization webinar or catch the recording/self-paced version on our website.
The 3rd blog in this preparation for C-section focuses on home preparations that will support your healing and facilitate independence in the home environment postoperatively.