Have you ever heard that birthing by C-section is the easy way out? That kinda makes me cringe a little. A major surgery is not an “easy” feat at all! When it comes to birthing babies, at least in my humble opinion, there is no easy way.
Did you know that thirty-one percent of all births in the United States are C-sections, and it’s the most common surgery performed in the US?
No matter the mode, birth comes with extreme changes within your body that you need to heal from.
What is a C-Section?
A Cesarean section, or C-section, is the surgical birth of a baby.
During a C-section, an OB will cut through 5 layers of tissue to open the abdomen and then the uterus to birth a baby. Usually, the mom is awake and given a spinal injection to cause numbness from the waist down so she can be awake and ready to hold her baby once he or she is born.
After delivery, stitches, and staples will close the mother’s incision, and then she will be taken to the recovery room to start bonding with her baby.
When is a C-section performed?
C-sections are typically performed when a doctor is concerned about the safety of a mom or a baby and can be planned or unplanned. A few reasons a C-section may be chosen are:
The baby is showing signs of distress
The baby is breech
An emergency situation that endangers mom and/or baby
Previous C-section delivery
An emergency C-section is usually performed in life-threatening situations. In this instance, mom may be given general anesthesia to speed up the process to ensure everyone’s safety.
A C-section is major surgery!
While the concept of a C-section seems pretty simple, this is a major abdominal surgery for a woman to undergo! The risk for infection, bleeding, and blood clots are increased with C-section delivery and for these reasons can make recovery difficult and painful.
With each C-section, your chances of having the next birth be vaginal birth decrease. The surgical scar on the uterus weakens the uterus (think of the uterus as a big muscle), making it more prone to rupture during regular labor contractions. (see below for more about VBAC - vaginal birth after cesarean!).
A C-section doesn’t save your pelvic floor!
Despite some misconceptions, a C-section does not prevent injury or weakness to your pelvic floor.
For nine months, you grew a tiny human who took up space in your abdomen and rib cage and was supported by your pelvic floor muscles, stretching and putting pressure on them. Just the complexity of pregnancy causes weakness to the pelvic floor muscle system. This is enough to cause pelvic floor symptoms and problems in women before or after birth.
Studies have shown that the mode of delivery does not impact postpartum incontinence. Instead, the most significant predictor of postpartum incontinence was having incontinence during pregnancy.
Another study collected data from 15,000 women related to urinary incontinence. This research showed that by the time a woman reaches 50 years of age, the rate of urinary incontinence is the same for both vaginal delivery and C-section births.
The best way to combat urinary incontinence in pregnancy and postpartum is to work with a pelvic floor physical therapist to strengthen the muscles and connect to your inner core piston.
Recovery from C-section
As mentioned previously, birth by Cesarean is not the “easy way out”! After this major abdominal surgery, the mother is limited in her mobility and sometimes experiences a lot of pain - all while she has to take care of a newborn!
Lifting and perhaps even stair climbing restrictions are given post-surgery. You may find bed mobility, getting dressed/showered, taking care of your newborn, and just standing up difficult after C-section due to pain and core weakness. Having a support system in place to help you when you return home will be a welcome necessity.
Get the freezer stocked with easy to prep foods.
Get friends and family scheduled to hold the baby so you can actually take a nap during the day.
Make sure you’re taking time every day for self-care and movement.
So what can you do to start to help yourself heal?
Piston breathing can be done as soon as you’re feeling up to it after birth. This will help coordinate the diaphragm, pelvic floor, and abdominal contractions. These are all essential in daily movements and functions, such as peeing and pooping. Start getting these systems primed for action with some gentle piston breathing.
Gentle walking to your tolerance. Using an abdominal binder, which is usually provided by the hospital, helps support your midsection and enables you to move around more easily. It will also reduce the stress on your incision and allow healing to take place. Make sure that you aren’t cinching it too tight, or you may inadvertently cause pressure imbalances in your core.
For the first few weeks, you won’t be allowed to lift anything heavier than your baby. But you can take advantage of this movement by completing piston breathing when you lift your baby by exhaling as you lift. Exhaling when transitioning from sitting to standing is another great functional way to incorporate piston breathing and ensuring your core is engaged when doing the lifting.
Around 2 weeks postpartum, you can do gentle scar massage and mobilization for desensitization. Around 4-6 weeks postpartum, once your incision is fully healed and you’re cleared by your doctor, you’ll also want to start gently massaging your scar. This will help to reduce any adhesions, pain, itchiness, or discomfort associated with your incision site. While no special lotions or oils are needed, coconut oil infused with lavender can help decrease any pain and promote healing. For information on how to perform scar massage, check out my in-depth video.
It’s also beneficial to consult a pregnancy and postpartum physical therapist to help return to movement and exercise! A trained and knowledgeable PT will guide you on which exercises are safe and personalize an exercise plan. This can start as early as two weeks postpartum!
VBAC and reducing your risk for further C-sections.
Vaginal births after C-sections or VBAC have over a 70% success rate! The greatest predictor of VBAC success is having had a prior successful vaginal delivery before the C-section.
Vaginal deliveries have a lower complication rate and a shorter recovery time. If you’ve had a C-section and are interested in a VBAC, it’s best to discuss the options with your provider. Some healthcare providers may not be advocates of VBACs, as there is a greater risk of uterine rupture due to scar tissue on your uterus. If your healthcare provider isn’t supportive of a VBAC, I recommend finding another provider who is more open to your healthcare decisions.
What’s the best way to prevent a C-section and prepare for a VBAC?
Seeking the expertise of a pelvic PT! Pelvic PTs are trained to
Reduce any adhesions or tightness in and around your scar and abdominals that can impede the function of the abdominal muscles (remember the abdominal muscles are interconnected with the pelvic floor!).
Assess your pelvic floor and address any weakness or tightness within your pelvic floor muscles to allow the baby to come out easier.
Teach you to connect to your diaphragm and pelvic floor to adopt efficient pushing techniques and positions for allowing your baby to descend and move through your pelvis.
Relaxation and mindfulness techniques to allow your body to open and birth your baby easily.
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