A few things to note before we talk about C- section massage.
C-Section is Major Surgery
Having a caesarean section birth is a major surgery, although these days they are becoming more common practice. There are 2 types of caesarean incisions, transverse (bikini line cut) and vertical ,which is usually only during an emergency. The first incision is usually made horizontally just above the pubic line cutting through the skin and subcutaneous layer (fat). The second, through the rectus sheath (thick layer of connective tissue called fascia), which secures the rectus abdominus muscles (most superficial abdomen muscles). The rectus abdominal muscles are separated and pulled, rather than cut.
Another incision is made through the parietal peritoneum (internal layer of connective tissue/fascia), then the loose peritoneum and then finally and carefully the uterus, which is a very thick muscular layer. Once the baby is delivered each one of these layers will be stitched up again, but the muscle and the fascia will usually have to reform their own bond. Scar tissue will continue to develop anywhere from 9 months or up to 2 years.
C-Section Scar Tissue
The scarring throughout these abdominal layers affects the abdominal muscle strength and integrity, which results in weakness and instability. Working with a specialist pelvic physiotherapist pre and post-natal, whether you have had a vaginal birth or C-section birth, can assist with regaining your core strength.
Scar tissue will form where the uterus was cut as well as the surrounding connective tissue. This scarring can weaken the uterus muscle wall and affect the Bladder by stretching the bladder wall which can potentially increase the urge to pass urine. Abdominal massage can assist in releasing the fascia of the abdomen and help reduce the likelihood of adhesions making it safer for future pregnancies.
Often one side of the scar will feel tighter than other. This can create tightness and pulling of the position of the uterus. This can affect the utero sacral ligaments, pulling on the sacrum and restricting movement of the sacro – iliac joint. This may ultimately cause lower back pain and possibly a pelvic rotation.
Studies show Soft Tissue Mobilization Techniques (massage) have great benefits including:
- Encourages healing of the scar, superficially and deep to incision.
- Desensitizes the area.
- Reduces pain
- Reduces adhesions and scar tissue
In the first 6 – 8 weeks after birth you will be getting settled into a new routine and trying to get as much rest as possible. Once you have clearance from your doctor you can consult with a pelvic physio. Together you can make a plan to get back to exercise or moving a bit more. Then it’s time to start to address your scar.
Some women might feel uncomfortable touching their scar or having someone else touch it. This may especially be true if the caesarean was unplanned. Caesarean’s can sometimes be a traumatic experience depending on the circumstances. Treating the C-section scar with massage can help work through difficult emotions, and is therapeutic beyond the physical.
~ Sarah Trew
C-section massage is performed by a qualified remedial therapist. You will also learn how to perform self-massage. If you would like to know more or book in for a treatment, please contact our remedial massage therapist Sarah Trew, or book with her online.