Hi.

Welcome. I answer questions you might be too embarrassed to ask. Here's to pelvic health!

6 things to help you recover after a cesarean

6 things to help you recover after a cesarean

Cesarean Section Recovery

1. Preparation

Let me preface this by saying that if you've had an emergency C-section, then obvs it's a bit late to prepare. However, all of these things will still be helpful to start doing now. 

Preparing and practicing the following points can make the first few days and weeks after a caesarian so much easier:

 Image credit: http://herscoliosisjourney.blogspot.com/

Image credit: http://herscoliosisjourney.blogspot.com/

  • Practice getting in and out of bed safely. It will be tempting to try to sit straight up out of bed when there is no baby in your tummy anymore, but that can be painful and damaging to the wound at the base of your tummy. So, practice rolling onto your side first, flopping your legs over the edge of the bed, then using your arm to push yourself into sitting. Avoid using your abdominals. To get into bed, try crawling in on all fours, facing the head of the bed, drop down onto one hip, then slide your lower hand out to lie onto your side, again, avoiding any use of your abdominals.
  • The medications you'll receive in hospital may have a constipating effect. So, to keep things flowing freely, you might like to add some sort of fibre supplement to your diet a few days before the procedure, and keep it up in the weeks after. Try to eat plenty of fibre; oats are good, as are pears, prunes and kiwifruit. Similarly, keep well hydrated to keep your poo soft. 
  • Pack hospital clothes that won't press on the wound line. Usually, the wound is about 10-15cm long, just about your pubic bone. So underwear that sits below or preferably above (think big granny panties) that line are best. Similarly, pants without a tight waistband are be best. 
  • if you have toddlers, remember that you are not to lift anything heavier than your newborn for the first six weeks. Therefore, your toddler will have to get used to not getting picked up by mum. Encourage their independence by getting them to use stools to climb up to chairs/bath. Let them come to you and have cuddles at their level rather than lifting them. Teach them to climb into the carseat, stage by stage, by themselves. 
  • You'll probably be advised not to drive for 6 weeks after birth. Make sure you have someone to drive you, or access to public transport that you can take a pram onto. Occasionally, doctors may give you the all clear to drive prior to the six week mark, however, many insurance companies won't cover you in that time. So check with your insurance before going for a hoon. 
  • Rest and ask for help. Abdominal surgery can really take it out of you (excuse the pun) and sleepless nights with a new born can add to fatigue. You need to heal, so plan strategically and don't try to be superwoman. You may need help around the house - it can be hard to accept help sometimes, but say YES! 

2. Abdominal support

Remember, your abdominal muscles have been stretched for the past 9 months, and after a caesarian, they are still stretched. However, the baby is no longer there to hold the muscles taut anymore. Therefore, it can feel like you have minimal control or support around your abdominals or back. An abdominal support can help give support, and aid recovery. Tubigrip is great and you can get it from your women's health physio. 

I usually recommend tubigrip for the first week or so, as it's easy to go to the toilet in. However, post natal recovery shorts can be really helpful and a little more user friendly too. Check out:

  • 2XU post natal sports leggings or shorts
  • SRC recovery shorts
  • Solidea recovery shorts

They all pretty much do the same thing, and are safe for caesarian. It's just a matter of personal preference on style/cost/colour. 

3. Avoid increasing abdominal pressure

Activities that increase the pressure inside your abdomen may cause the wound to dehisce (open) so avoid the following:

  • sit-ups or crunches for at least 12 weeks
  • sitting up straight out of bed, roll out instead (see above)
  • constipation
  • excessive coughing - if you have to cough, roll up a towel into a sausage shape, press it firmly against the wound and cover it with both hands and forearms. Press firmly whilst you cough. It's important to clear chest secretions after surgery to prevent lung complications, but avoid doing it excessively. 
  • lifting anything heavier than your baby for 6 weeks. That means no shopping bags, washing baskets, toddlers or the suitcase you bought into hospital with you. 

4. Pelvic floor and deep abdominal exercises

Your pelvic floor has been spared the stretch of a vaginal birth BUT, it has still had 9 months of extra weight and hormones making it weaker. Your pelvic floor and tummy muscles work hand in hand. Read here and here to learn how to strengthen your pelvic floor. 

Similarly, your abdominals have been stretched and weakened. You should avoid using your upper tummy muscles, but you can start gently activating your lower, deep abdominals in the first days after a caesar. How do you do that?? Well, sitting in your chair right now, get yourself into a nice tall posture, with your weight evenly on your sit bones. Now place your right hand on your upper tummy, and your left hand just below your belly button. Keep breathing normally and see if you can gently draw your lower tummy in towards your spine, away from your left hand slightly, without moving the upper tummy under your right hand. You may feel your pelvic floor squeeze too. Keep all other muscles relaxed and keep breathing whilst holding that muscle contracted for 10 seconds. Easy? Cool, now do that 10 times in a row, every day, and also remember to activate your pelvic floor and lower tummy each time you lift, cough or change positions. 

5. Exercise

The general rule for exercise is only gently walking for the first 6 weeks after a caesarian. Start with 10 mins a day in the first week, 15 mins a day in the second week, 20 mins a day in the third week etc. so that you're walking around 40 mins a day at the 6 week mark. Exercising with others helps to decrease the risk of post natal depression, so organise pram walking dates with your fellow mumma friends or mother's group. 

After the six week mark, it's time to get your body stronger, particularly your pelvic floor and deep abdominals. Pilates, run by a physiotherapist, is the best for this. Other safe forms of exercise are; walking, swimming, post natal yoga, light weights, cycling. Leave the running or heavy weights until at least 12 weeks post birth. 

6. Wound massage

Once given the all clear of infection at your six week doctor check up, it's a good idea to start some gentle self massage. There are many layers of skin, fascia, muscle and nerves involved in the wound, and they can tether together. In the shower, use two fingers to massage lightly over the wound. It may feel strange, a bit numb, or tingly - that's normal. And you may find that one side is a little more tender/puffed up than the other - that's usually the side that surgical instruments have been used a little more. Again, that's normal. It will take some time, but daily gentle massage in the shower, or with some moisturising cream can help to desensitise and limber the area. 

- the vagina physio

 

Photo credit: Helen Carmina Photography

Third and fourth degree tears during childbirth

Third and fourth degree tears during childbirth

Vulvar varicosities – Say whaaaaaat? I have veins, where???

Vulvar varicosities – Say whaaaaaat? I have veins, where???