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Apr 29th, 2020
Apr 29th, 2020 / Nicki Chick
By Camilla Lawrence April 2020 – C-Section Awareness Month
With the current situation meaning many women are experiencing reduced time in hospital after their delivery and minimal postnatal face-to-face appointments once they are home, our lead Women’s Health Physio has put together her top 10 physical recovery tips following this type of delivery.
You’ve just had major abdominal surgery – keep taking any pain relief that you have been advised/prescribed regularly by your Doctor or midwife for as long as you need it – this might be weeks. It is better that you aren’t in pain and are able to move and breath well than you suffer and end up restricting your movement. It’s worth also taking Arnica tablets if you bruise easily.
Keep the area over and around your scar clean and dry to minimise infection. You can shower but try to avoid using any soaps or harsh products in the area of your scar for the first few weeks. Your stitches should dissolve by themselves. Wear loose comfortable clothes and knickers with a high waist band that comes up above the scar area to reduce the pressure in that area. If you are breast-feeding and your scar is very tender, try positioning your baby in a rugby-ball hold to reduce pressure on your stomach or use a good nursing pillow under the baby to protect your abdomen. If you need to cough/sneeze/laugh, holding a small pillow or towel firmly over your scar can support the wound and make these actions more comfortable.
During a pregnancy, the organs in your abdomen and your growing uterus push upwards, limiting the space for your diaphragm to move. So by the end of a pregnancy most women breathe more from the upper chest and neck region. Postnatally you want to aim to get back to breathing slowly and deeply down to the bottom of your lungs again (diaphragmatic/belly breathing). This is a much more efficient way of breathing and has been shown to reduce your blood pressure, aid relaxation and help to regain your deep core muscle function again. For more information on how to do this please see our online video or book an appointment with one of our Women’s Health physios.
It’s vital to get sufficient rest especially in the first few weeks after your delivery to recover and heal. If you are up feeding during the night try to get regular rests or naps during the day when your baby sleeps. Accept any help that you are offered. It is also important to keep mobile each day to reduce the risk of developing a blood clot. Start with just pottering around your home to begin, and then gradually build up your distances outdoors as you feel able. When getting in and out of bed, move through side lying and use your arms to lower you down or push you up to avoid straining your abdomen and scar region.
Try to be aware of your posture; standing and sitting well can reduce the risks of developing future aches and pains – particularly with repetitive tasks like feeding, changing and carrying your baby. Make sure you are sitting comfortably with support for your back when you are feeding, and try to change your baby’s nappies on a surface that allows you to stand straight and not hunch over. When standing or walking, avoid being bent forwards (even if it feels tight and sore in your scar region) – take your time to gently stretch and stand up tall before you start moving forwards. This will be better for your back and ensure your scar doesn’t heal in a shortened position.
Try to avoid getting constipated or straining to open your bowels – this puts extra pressure and strain on your C-section scar and pelvic floor. Aim for regular meals with a good balanced diet including plenty of fruit and vegetables and fibre to keep your stools soft (and to optimize your healing). Ensure you are also getting enough fluid, especially if you are breastfeeding – aim to drink a glass of water with every feed to avoid getting dehydrated. When you go to open your bowels, try to rest your feet up on a small stool or step and lean forwards with a straight back. Let your abdomen relax and keep breathing to avoid straining. Trapped wind can be common after a C-section and extremely painful – regular movement and peppermint tea can help.
Avoid lifting anything heavier than your baby for the first 6 weeks whilst your scar is healing. If you have other small children, encourage them to climb up to you, when you are sitting down, rather than bending to pick them up. Accept all the help you can from others and really try to minimise other activities that cause any strain (housework, carrying or pushing heavy objects etc.).
Before returning to driving, check with your insurance company that you are covered (usually from around 4-6 weeks following a C-section). And ensure that you are able to: wear a seatbelt comfortably; turn around to look over your shoulder; and perform an emergency stop without pain.
C-section massage can help minimise thickened scar tissue formation and surrounding inflammation, and ensure a smoother flatter, pain-free and supple scar, as well as helping you connect with your abdominal muscles again. Please see our online video on how to do this or book an appointment with one of our Women’s Health Physio’s to learn how and when to massage your scar safely effectively.
For the first six weeks following a C-section, you should focus on gradually building up your walking, getting your pelvic floor muscles working well again (yes, this is just as important after a C-section! – try to aim to do a set of pelvic floor exercises every feed), and resting
and bonding with your baby! At 6-weeks after your delivery try and book a Postnatal Body Check or Mummy MOT Appointment with a Women’s Health physio – they will give you a full assessment of your posture, spine, abdominal muscle and scar recovery and pelvic floor function and advise you on a safe graded return to exercise plan. General recommendations are to start with low impact exercise that focuses on rebuilding your core and global body strength and control for at least 6-8 weeks before gradually resuming impact exercise (jumping, running etc.) – everyone’s recovery is different though for some it may take far longer than this.