Forest Trees

C-section recovery and scar healing

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C-section surgery

During your C-section surgery many layers of your tissue and organs will have been displaced or cut to allow for the safe access to and passage for your baby. It’s important and helpful to know what has happened during your surgery so that you can be mindful of the healing process that your body needs to go through.  This will help you to prioritise rest and recovery as well as put in place some strategies that will help you rebuild a strong core and prevent any potential issues from developing.

During your C-section the following steps will have been carried out:
 

  • A horizontal incision is made at your bikini line (vertical incision for emergencies).  

  • Cuts are made through the layers of your skin, fat and fascia.  

  • Your rectus abdominis muscles are separated and moved to either side.

  • Your bladder is moved down and out of the way.  

  • Your uterus is cut and your baby is delivered.  

  • Your placenta is removed and your uterus is stitched up.  

  • Your bladder is put back into position.  

  • Your muscles & fat are also put back into position.

  • Your fascia & skin are sutured with stitches, staples or tape to close the wound.  

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C-section symptoms

You are likely to experience lots of symptoms following a C-section that are directly related to the surgery and healing process. These symptoms are all part of the normal healing process and will usually take 6 weeks to subside, but every woman is different.

 

You may find that most of the immediate symptoms of discomfort, such as pain welling and soreness will have subsided by the time that you have your 6-8 week postnatal check. However, many symptoms will last longer as the formation of scar tissue can take up to 2 years and will have longer lasting effects.

 

If you have any concerns make sure that you raise them with your medical practitioner.

Below are some of the mid to long-term symptoms that you may experience.

 

  • Numbness & loss of sensation to your abdominal tissues.

  • Inability to connect with and control your core muscles properly. 

  • Bulging flesh above your scar.  

  • A keloid scar (raised lumpy scar).  

  • Abdominal/scar discomfort and/or pain.  

  • Soft tissue adhesions.  

  • Postural changes (rounded shoulders).

  • Musculoskeletal aches and pains (especially in your back, shoulders, and neck).  

  • Pelvic floor issues and pain in your clitoris, labia or during sex.  

  • Urinary incontinence, faecal incontinence and flatus incontinence.  

  • A change in your bowel habits (increased frequency of bowel movements or constipation).  

  • Digestive issues (due to antibiotics).  

There are lots of practical and lifestyle strategies that you can use to help rehabilitate your body following a C-section.  By taking care to nurture yourself as you heal you will give yourself the best chance of reducing long-term symptoms and issues and rebuilding a strong core.

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C-section & core recovery solutions:

  • Gets lots of sleep and rest to help the healing process.

  • Don’t over exert yourself during the first 3 months post-surgery.

  • Hydrate well and eat nutrient dense food to support the healing of your tissues.

  • Support your scar so that it can heal as quickly and safely as possible.

  • Gently massage your scar after it has completely healed (check with your GP).

  • Correct your posture and alignment, so that your body can be balanced as it heals.

  • Engage in a safe C-section/postnatal recovery exercise programme (after 12 weeks) if cleared by your GP.

C-section & wound recovery

https://www.nhs.uk/conditions/caesarean-section/recovery/

 

It’s vital that you take care of your surface wound and all of the layers of tissue underneath to ensure that you heal safely and effectively. Your midwife should advise you on how to look after your wound. You'll usually be advised to:

  • Gently clean and dry the wound every day.

  • Wear loose, comfortable clothes and cotton underwear.

  • Take a painkiller if the wound is sore - for most women, it's better to take paracetamol or ibuprofen (but not aspirin) while you're breastfeeding.

  • Watch out for signs of infection.

 

Non-dissolvable stitches or staples will usually be taken out by your midwife after 5 to 7 days. The wound in your tummy will eventually form a scar. This will usually be a horizontal scar about 10 to 20cm long, just below your bikini line. In rare cases, you may have a vertical scar just below your bellybutton.  The scar will probably be red and obvious at first, but should fade with time and will often be hidden by your pubic hair. On darker skin, the scar tissue may fade to leave a brown or white mark.

 

Controlling pain and bleeding

Most women experience some discomfort for the first few days after a caesarean, and for some women the pain can last several weeks.

You should be given regular painkillers to take at home for as long as you need them, such as paracetamol or ibuprofen. Aspirin and the stronger painkiller codeine present in co-codamol is not usually recommended if you're breastfeeding.  Your doctor will be able to advise you on the most suitable painkiller for you to take.

Returning to your normal activities

Try to stay mobile and do gentle activities, such as going for a daily walk, while you're recovering to reduce the risk of blood clots. Be careful not to overexert yourself.

You should be able to hold and carry your baby once you get home. But you may not be able to do some activities straight away, such as:

  • Driving.

  • Exercising.

  • Carrying anything heavier than your baby.

  • Having sex.

 

Only start to do these things again when you feel able to do so and do not find them uncomfortable. This may not be for 6 weeks or so.

Ask your midwife for advice if you're unsure when it's safe to start returning to your normal activities. You can also ask a GP at your 6-week postnatal check.

Risks to future pregnancies

https://www.nhs.uk/conditions/caesarean-section/risks/
 

Women who have a caesarean usually have no problems with future pregnancies. Most women who have had a caesarean section can safely have a vaginal delivery for their next baby, known as vaginal birth after caesarean (VBAC).

But sometimes another caesarean may be necessary. Although uncommon, having a caesarean can increase the risk of certain problems in future pregnancies, including:

  • the scar in your womb opening up

  • the placenta being abnormally attached to the wall of the womb, leading to difficulties delivering the placenta

  • stillbirth

 

Speak to your doctor or midwife if you have any concerns. For more information, the Royal College of Obstetricians and Gynaecologists has a leaflet on birth after previous caesarean (PDF, 494kb).

C-Section healing your mind

 

Following your C-section you will undergo a physical journey to heal your body and you may also undergo a mental and emotional healing journey to heal your mind.

 

Your C-section surgery may have been elective and planned or it may have been an unexpected medical emergency that you had to accept.  The way in which your C-section was approached, administered and how you felt about it, may affect your recovery.

 

It’s important to check in with yourself so that you can identify any unresolved feelings, thoughts or concerns and deal with them. This will help you to support your mental health and enable you to process what has happened from a mental and emotional perspective.

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Some of the thoughts and feelings that you experience may be related to:

  • How you were consulted, included and empowered during the decision making process.

  • Whether you felt seen, heard and considered as an active participant.

  • How you were treated, before, during and after the C-section.

  • Whether you experienced labour prior to the C-section.

  • Whether you were able to follow any of your birth plan.

  • Whether you or your baby had any complications.

  • Whether you had skin-to-skin bonding time with you baby after birth.

  • Whether you were separated from your baby after birth.

  • Whether you had the chance to try breastfeeding within 3 hrs after birth.

  • Whether you have a practical, emotional and professional support network.

 

If you would like further support with your thoughts and feelings relating to your C-section then you can seek support from the following people/places/services.

 

  • Family friends and your support network

  • Midwife, health visitor or GP

  • NHS Birth after thoughts service

  • Local or online postnatal support groups or forums

  • Counsellor or psychotherapist

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Red flags - when to seek help

 

It is vital that you take care of yourself and focus some of your attention on your recovery so that you can spot any warning signs and seek medical attention when required.  Familiarise yourself with the list below and make sure that you tell your midwife, health visitor or GP immediately if you experience any of these symptoms, as they could indicate a problem that requires further investigation or immediate treatment.

  • A wound that becomes more painful, red, or swollen.

  • Foul-smelling discharge or fluid from your wound.

  • A wound that reopens.

  • Headaches or blurred vision.

  • Chills, clammy skin or fever.

  • Increased/rapid heartbeat.

  • Feeling dizzy, faint or weak.

  • Feeling Nausea.

  • Pain, swelling or redness in the calf muscle of one leg.

  • Ongoing low mood, sadness or depression.

  • Unresolved feelings about the C-section, birth or aftercare that are causing you distress or concern.

How you can support your partner

You can support your partner by ensuring that they are well nourished, well rested, have the supplies and emotional support that they need and are watchful of their health. Below are some ways that you can be supportive:

 

  • Ask your partner how you can help and support them.

  • Listen to them with non-judgment and validate their feelings.

  • Understand that it will take time for them to recover physically, mentally and emotionally.

  • Encourage them to seek emotional and mental support from a professional if they have unresolved feelings about their surgery, birth, or recovery journey.

  • Create opportunities for them to rest and sleep.

  • Do the heavy lifting for them and the household chores.

  • Pass them baby if it is awkward for them to lift or carry baby in and out of position.

  • Prepare nutrient dense foods to help the healing process.

  • Ensure that they are well hydrated.

  • Once their scar is healed, help them find and book a session with a scar tissue trained massage therapist.

  • Keep an eye out for any red flags listed above and encourage them to seek help when needed.

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