Hello lovelies!
Here is your Power to the Pelvis Newsletter for February!! This month I want to focus on my mamas who have had c-sections. There is a large lack of awareness and fear surrounding c-sections. I hope to bring some more awareness to this topic as it is very prevalent in my community.
* Tip of the Month:
About 1/3 of babies in the US are born via cesarean section (according to WHO, 2024). This is far greater than any other country in the world. There are pelvic floor OTs and PTs trying to provide education in US hospital systems for recovery after c-section including acute, in-hospital rehab that SHOULD be an automatic referral but often isn't.
Some women have elective c-sections, and even still some of those women think that having a c-section will prevent them from having pelvic floor issues. From what I see clinically this is often not the case.
Here are some of the common issues I see with c-section and recovery.
- Incision site pain and difficulty caring for self and others - one thing I recommend to all of my mamas during labor prep is to prepare for the possibility of a c-section, and this includes post-op care such as incision/scar care and support in those first few weeks postpartum. This might involve using abdominal binders and/or pressure support with mobility
- Scar tissue formation - scars like to adhere to everything. I kind of think of scars being like vines that just grow and wrap around everything in their path. With c-section, that is 7 layers of abdominal tissue and several layers of stitching to close you up... which leads to several layers of scar tissue formation. I like this video as it explores those layers and gives an interesting visual.
- Pain: abdominal pain, pain with sex, painful ovulation, pain with bowel movements, back pain, etc. - along with scar tissue formation, there may be discomfort due to scar tissue positioning and the pull of internal organ tissues, or compensations in the body that can affect muscles and joints leading to pain.
- Lower abdominal weakness - this is common with vaginal and c-section delivery, but especially with c-section as it can sometimes be painful to engage the lower ab muscles after birth. My labor prep and postpartum sessions include lower abdominal engagement exercises to prepare for, and recover from, birth. One of my favorite things to teach is gentle belly breathing while engaging lower abs on the exhale. This can be done in a variety of positions, depending on comfort.
I recommend early rehab to start the process of healing. That includes:
- Laying flat or at least not in a full seated position (as able) to allow the tissues to gently stretch and not scar down in the closed, flexed position
- Teaching clients how to roll out of bed safely without straining the incision or using their abdominal muscles
- Education on alternative feeding positions to reduce strain on the abdominal tissues
- Baby carrying, lifting and baby wearing modifications to reduce abdominal strain and low back pain
- Compression/wrapping off/on for the first few days to week(s) after delivery to support the abdominal structures and provide support to the incision site
- Diaphragmatic breathing to gently engage the core and pelvic floor to reduce swelling and muscle atrophy/loss
* BLOG I'm reading:
I don't 100% agree with everything I read on posts about pelvic floor therapy, but I enjoy reading Sara Reardon's blog - The Vagina Whisperer (what a COOL moniker!!). She's been in the business of pelvic floors for almost a decade. While I don't recommend kegels as often as she does, we can both agree on normalizing conversations about pelvic health... vaginas... vulvas... and we don't shy away from hard questions about pelvic floor dysfunction, pelvic pain and sex.
Did you try any of these tips? I'd love to know what you think. I read every email! And if you have something you are curious about or want more information on, let me know... maybe I'll add it to my next newsletter!
See you next month!
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