Care after a C-Section
A caesarean section is major abdominal surgery, indicated when vaginal birth is not possible or where it is deemed a lower risk option to both the baby and the mother.
The most common form of C-section is an LSCS, a lower segmental caesarean section. This involves a horizontal incision through the abdominal wall, cutting through skin, fat and connective tissue. The abdominal muscles are then moved out of the way to be able to make an incision into the uterus to deliver the baby. Once the baby and placenta are delivered, both the uterus and abdominal wall are repaired with dissolvable stitches.
in the early days post C-section, care must be taken with certain movements and any heavy lifting. There is little evidence to support any specific weight restriction on lifting. It is therefore considered safe to lift the equivalent of the baby’s weight. Holding baby and other objects closer you your body, rather then with outstretched arms, is much easier and places less stress through the incisions.
In the first few weeks it is OK to push the baby in a pram, but try to avoid lifting the pram in and out of car. Carrying the baby is also fine, but try to avoid carrying the baby in the car capsule. It may be helpful to teach older siblings to climb onto a step to get in and out of bed. It is perfectly safe for your toddler to sit on your lap for a cuddle.
There is, unfortunately, very little evidence to confirm when it is safe to drive following C-section. It is best to check with your doctor and your insurance company if they have specific time frames. However, some simple tests to assess your readiness can include walking up and down a flight of stairs, sitting and rotating to look over your shoulder without pain and testing with a friend or family member in a quiet street to practice a quick stop.
After any incision in the body, scar tissue is formed. Rather then laying down in nice straight alignment, the collagen in scar tissue can be messy and can form adhesions or get “stuck” to surrounding tissue. This can mean that skin and tissue mobility in the abdominal area is stiff and can hinder muscle recruitment, cause pain and restriction and even look a bit raised and red.
Scar massage is a great technique to reduce this scar tissue build up, reduce pain and promote mobility of the skin and abdominal wall.
The general rule is to commence gentle stretching of both the skin and the scar around the 6 week mark. However, it is highly recommended that you gain your medical professional clearance before you commence these techniques.
There are two main techniques for massaging C-section scars:
1: stretching the skin around the scar
2: massaging directly on the scar
1. Place pads of 1 or 2 fingers a few centimetres from the scar
2. Stretch the skin by moving the fingers up and down along the length of the entire scar
3. Repeat step 2 by stretching the skin side to side and clockwise/ anti-clockwise.
4. Repeat each movement about 5-6 times
Direct Scar Massage
1. Again, get the pads of 1 or 2 fingers and place them directly over the scar
2. Stretch the scar by pulling your fingers1-2 cm upwards and holding 5-10 seconds.
3. Repeat over the entire length of the scar, stretching in all directions (up and down, side to side, and rotations).
If you feel any areas of reduced mobility or tightness you can spend more time working on these. It is normal to experience a gentle stretch when doing these techniques but it should not be painful.
This is a general snapshot of the first stage of C-section scar massage. There are of course alternative techniques but it may be best to consult your women’s health physio if you feel you need some further advice on mobilising your scar or continue to have pain.