Cesarean Recovery Before I Knew Better

Six years ago I found out I was pregnant with twins. It was a complete shock and we didn't find out until our anatomy ultrasound halfway through the pregnancy. Because I am how I am, I had a full on panic attack in the ultrasound room because I did NOT want twins. I don't know why, I guess I felt like I had just now crawled out of the depths of depression after my son and now I was going to have to do it again, except with two.

Anyway, my pregnancy was very uneventful. Thankfully, both baby girls were healthy and I didn't have any complications. The only slight issue was that Baby B was breech. She never ended up turning and after lots of consideration, my husband and I opted for a Cesarean delivery. I'd had a vaginal delivery with my son two years earlier and while everything went okay, the recovery was  hard for me. I was depressed, had a pretty gnarly tear, and my kid didn't sleep. I was also not a Pelvic Health PT at that time and didn't know a whole lot about recovery back then. I didn't know much about Cesarean birth or recovery at that time.

Picture then night before our twins were born!

I will say that a scheduled Cesearan felt like a vacation after the labor, fatigue, and complete exhaustion from my first delivery. We'd gotten a night of sleep, were able to get up and putt around the house with our son before heading to the hospital around 10am. The surgery went well and for a good many hours that day I was still nice and numb which meant I could focus on nursing the babies instead of the pain.

However, there wasn't much information for me after the delivery. Not a whole lot of education on what I should expect after this major surgery, how to help my body heal, even what was normal pain versus something to worry about. I was sent home with a cheap belly binder and told to schedule my follow up with my OB for 6 weeks. 



It was a lonely time and sometimes filled with fear. I remember feeling a pain in my belly that I became convinced was nerve related and would never go away. I started catastophizing about how I'd have this pain forever and become depressed and suicidal and never be able to care for my kids. I did call the nurse and she felt like it was okay and sure enough, the pain went away, but those days of fear were exhausting because I just didn't know.

First hour at home two days after Cesarean section.

Now, if we all had Pelvic PTs in our lives, things might look a little different. We would have a good bit more knowledge about what to expect, how to heal, and what's normal and what's not. Here's how things would have been better for me had I known then what I know now:

First of all, I would have been working on proper core activation and breathing long before delivery, Cesarean OR vaginal birth. This would have not only helped my core stay happy, but would have allowed my pelvic floor to move through a nice range of motion in preparation for delivery. I would have immediately started working on this breathing in the hospital bed that first day, certainly before the effects of the spinal wore off so that my belly could get a nice, natural movement and let my pelvic floor come along for the ride also. Not only does this help with relaxation and pain relief but it also promotes healing and a reduction in swelling in the belly and labias. Who knew right? I probably would have done some belly binding (like my friend Melissa at The Fayetteville Doulas showed me recently) that would have helped me move around better, promoted healing, reduced pain). A few weeks later I would have started gentle abdominal massage to promote bowel motility (I tried to stay off the pain meds but just being in the hospital taking them can promote constipation). This could have also helped my abdominal muscles function better, therefore helping my abdominal separation become less of an issue AND helping me lift the babies with less pain and risk of injury to my back (which still bothers me six years later). I would have gotten the go ahead from my doctor around 6 weeks once the scar tissue had healed to begin scar tissue massage. This is gentle massage of the Cesarean scar that helps the tissues move well and reduce the risk of things getting super stuck later on. A Cesarean scar that doesn't allow tissues to move well can actually contribute to low back pain, hip flexor pain, urinary urgency/frequency, continued dysfunction from abdominal separation, pain when you are moving or exercising and more! It's defintely something I would have worked on to help get me moving on the right foot. I would have also had a Pelvic PT do an internal exam to check my pelvic floor muscle function. I would probably at that point have started on some Kegels since I wouldn't have had pelvic floor tension and this would have greatly helped my back pain and my leaking over the last few years.

Alas, I didn't have one in my life at the time so it's been a lot of years of dysfunction that have made it a lot harder to deal with now. I hate that women aren't getting the education we deserve, the preparation we desperately need before childbirth and in the postpartum periods. I do think things are getting better. In the past year I've met several amazing doulas in town who share the passion for educating women that I do and they are doing great things. I have met women who have been fortunate enough to have seen a Pelvic PT and are so excited for all the knowledge they had going into their births. I have colleagues in town working their tails off to make women's experiences better and so many on social media who are doing the brave thing and putting this information out there into the universe. However, I think we have a ways to go. We still need to talk about birth more openly, about recovery and our experiences with less embarrassment and shame. There is NOTHING shameful about childbirth - and when I say childbirth let me make it clear that no matter how that baby comes out, it's birth. Cesearean section or vaginal birth is all still birth. There is nothing shameful about recovering from up to 9 months of difficult physical exertion (growing a human being in our body) and then going through a birth. It's no joke and it's not easy and it's okay to have to take a long time to heal and recover.  What's NOT okay is the lack of knowlege moms have going through all of this.

My hubby with our baby girls.
This was one of their favoritate places
to sleep! 

Please, tell your loved ones that there is so much more out there for them. Find a doula and start asking questions, ask your provider for information, or find a Pelvic PT in your area to help get you started. I offer monthly Birth Body classes where we talk about how to prepare your body for labor and delivery and how to start your healing process just hours after you give birth in a safe and healthy way. We talk about how to start using your abdominals and pelvic floor after birth in ways you can work on while you are breastfeeding, rocking, playing with baby. We talk about what's normal and what's not and when to ask for help. I'm not writing this blog to promote this class though, I'm writing it to continue to try and spread awareness for women, specifically mommas this time, that there is SO much we don't know that we really ought to know. Let's continue to demand better for ourselves, get the education we deserve, and become healtier moms for our babies!

Lacy

Fayetteville Pelvic Health & Wellness
Lacy Kells, owner

lacykells@fayettevillepelvichealth.com
910-309-3726


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