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Post Natal C-Section Check 

We are very excited to be offering some new post-natal scar treatment for patients who are less than 2 years post C section and are struggling with pain, irritation, or tightness around their scar. This treatment can help lift and break down any underlying scar tissue that may be affecting the feeling or appearance of the stomach, leaving you feeling more comfortable and confident. 

 

What is a C section?

A caesarean section is a surgical procedure in which a baby is born through a cut made in the mother’s abdominal wall and uterus. You can also opt for an elective C section, and this is something to discuss with your midwife / consultant. In the UK last year (2023), 34% of births were C section deliveries. The incision is usually closed with dissolvable stitches however in some circumferences, staples are used which must be removed. 

 

Types of C-section:

 

Elective Vs Planned

Category 1 - Immediate threat to the life of the woman or fetus

Category 2 - Maternal or fetal compromise that is not immediately life-threatening

Category 3 - No maternal or fetal compromise but needs early delivery

Category 4 - Elective – delivery timed to suit woman or staff

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Most C sections are performed under spinal anaesthesia which can be topped up with an epidural or spinal anaesthetic. Sometimes a general anaesthetic is needed (5-6% of patients) and this is usually due to maternal contraindications to regional anaesthetic, but more commonly if fetal wellbeing is compromised and delivery must happen as soon as possible. 

 

What happens to our tissue during a C section?

During a Caesarean section, several layers of deep tissue are cut through affecting both the nerve function and tissue integrity of the stomach. Post-natally, often women describe a feeling of numbness, itchiness or a tingly sensation around their scar and the tissue surrounding it and this is due the interruption of the localised nerves. Scar tissue is typically tighter and coarser than usual tissue, so if this isn’t broken down or treated, it can leave women with tightness and pain around their scar which can interfere with daily activity, exercise, and intercourse. 

 

Healing times and your recovery:

C section scars usually take 6 weeks to heal, so this is why we don’t see patients before this marker. By this time the tissue has fully closed over, however you have a 2-year window to fully optimise your C section scar, so a very large amount of time to work into the tissue and get the most out of scar treatment. This can be very reassuring for mums! After this time, the tissue can be a bit more stubborn, and it may be slightly challenging to get rid of the scar tissue. 

 

Usually in those first 6 weeks, you are advised to take things easy and slowly, listening to your body and taking advantage of help that is there. You are advised not to drive in this time or lift anything heavier than your baby. You can start walking when you feel you are ready however it is important to pace yourself. It is advised to see a specialist women’s health Physiotherapist before you start structured exercise so they can check your abdominal muscles for any diastasis recti and check the mobility of your scar. This will enable you to return to exercise safely.


 

How long can I wait to have another baby post C section:

The research is mixed here, but generally it is recommended you wait 6-12 months to conceive again. 

 

Returning to exercise post C section:

The NICE recommendation suggests that mothers wait 6-8 weeks before commencing exercise and that they have had a check from a healthcare professional. If you are looking for expert guidance and wanting that personalised approach (which we absolutely recommend), or even if you are just looking for a bit of advice, seeing a Specialist Pelvic Health Physiotherapist can come up with a structured and individualised plan for you to fully optimise your recovery.

 

How can Physiotherapists help with C section recovery: 

It is very important you have a personalised treatment plan formulated by both you and the Physiotherapist that is tailored to your body and your needs. Everyone is different and has a different pregnancy and birth experience. 

 

At your first consultation at RGP, we offer you a: 

  • Full lumbar and pelvic assessment to identify any areas of tightness or weakness that may be affecting your mobility or posture.

  • Diastasis Recti screen.

  • Deep inner core muscle assessment to ensure you can engage your lower abdominals correctly.

  • Scar assessment with appropriate treatment in the form of sensory feedback and scar massage 

  • Discussion around additional scar therapy modalities if required.

  • Pelvic floor assessment offered. 

  • Road map on how to safely return to exercise if these are your wishes. 

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Why is it important to consider your pelvic floor post C section?

C-section mums are still susceptible of developing pelvic floor weakness and dysfunction post-partum, due to the mechanical weight of baby on the pelvic floor muscles across the 9 months that you are pregnant. The pelvic floor fascia stretches and thins to accommodate this and can also weaken if you are not specifically strengthening this muscle group. 

 

In the weeks to months following your C-section you may find that you are feeling a lot better and/or asymptomatic of your bladder or bowel. However, if you are keen to return to exercise, it is advised to get a full pelvic floor screen to identify any areas of weakness, so you can return to exercise safely without the risk of injury or an onset of urinary dysfunction. 

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