Cesarean section: care during and after healing

Often, because this procedure is so common, its importance is downplayed; however, the truth is that A cesarean section is major surgery which requires special and specific care to ensure the best possible recovery.

The Internal tissue healing takes about 9 months to complete. approximately, and it will always be necessary to take care of the cesarean scar.

Many women end up seeing their childbirth turned into a Caesarean section.

A cesarean section is a procedure required in specific cases which avoids the suffering of mother and baby, however, has become a very common practice in Spain, exceeding the 25% of births attended in the public health system; the World Health Organization (WHO) recommends not exceeding 15%. These are numbers that give us pause for thought.

A mark on your lower abdomen reminds you for life that you had the courage to face a major surgical procedure to bring your baby into the world.

It sounds beautiful. For many women, it's a scar of honor, but the truth is, for other women, it can generate rejection, and they may even be unable to look at their stomach in the mirror.

This makes it difficult to treat correctly the scar of the cesarean section, something that toThis would help minimize both its physical appearance and possible adhesions to internal organs, tightness, and discomfort. that it may cause.

A cesarean section is not a choice, it's a necessity. It's shocking to see social media posts that downplay this procedure and even talk about scheduling cesareans on demand.

Experiencing a cesarean section involves a great physical and psychological impact.

You had prepared yourself to give birth and care for your child, and now you find yourself in bed, with an IV in your arm and unable to move.

You might just be thinking about getting up as soon as possible and dedicating yourself fully to your little one. It's all too easy to put your own care on the back burner, and to gradually invest less and less time and attention in it.

We would like to accompany you in this difficult process and help you in any way we can.

Let's look together at what happens during this procedure, how the cesarean scar forms, ways to care for it to avoid future complications, and some warning signs that should prompt you to see your doctor or pelvic floor physiotherapist for a check-up.

The cesarean scar is just a small mark, if you compare it to everything that happens to the tissues during the procedure.

A cesarean section is an obstetric procedure to remove the baby, and it consists of a double incision, in the abdomen and in the uterus.

It is usual to be awake during the procedure, in which you will have epidural or intradural anesthesia, so you will not feel any pain and you will be awake at all times while the cesarean section is performed.

In a cesarean section 7 layers are cut to reach the baby:

• The skin.

• Subcutaneous tissues.

• The rectus muscles are separated, to reach the abdominal cavity, through the parietal peritoneum.

• An incision is made in the uterus. And the procedure continues through its layers:

  • Perimetrium.

  • Myometrium.

  • Endometrium.

• The amniotic sac, if it remains intact.

That is, seven very different layers that must be traversed and later closed, each using a specific technique, until the skin is reached. For this reason, a cesarean section is considered major surgery.

In the last layer, the skin layer, is where you will see the stitches or staples that shape the cesarean scar, but you have to be aware that underneath, there is a lot of healing tissue.

In addition, you should keep in mind that if your abdomen has been affected during pregnancy with diastasis recti, your recovery may be slower and more difficult because a cesarean section involves an incision through it.

As you can see, a cesarean section is a eithervery complex operation and laborious.

Don't rush it to heal as soon as possible.

The treatment for a cesarean section is slow and requires effort and patience, but you will see that giving it the proper attention is worth it.

Years ago, it was common to see women with very noticeable, vertical scars. Thanks to advances in medicine, nowadays, the trend is to perform the procedure at the bikini line to avoid discomfort and make it more aesthetically pleasing.

Depending on the way the incision is made In the lower abdomen, we can find two types of cesarean scar.

• Transverse or horizontal cesarean section scar: As we mentioned earlier, this type of cesarean section is the most common today. The bikini incision offers many advantages, both aesthetically—as it is less noticeable and easily concealed by clothing—and medically. This type of incision damages fewer muscle fibers, produces less bleeding, and creates a much stronger cesarean scar, which is important in case of future pregnancies.
• Vertical cesarean scar: This refers to the type of cesarean section that was performed before the new technique explained in the previous section. This procedure allows the doctor quick access to deliver the baby, which is why it can still be used in emergency cesarean sections, in cases of significant complications, or in cases of placenta previa. The vertical cesarean section fragments more muscle fibers and can cause more bleeding, which is why the transverse cesarean section is preferable. Furthermore, the incision is larger, extending from below the navel to the pubic bone.

In addition to these two types of cesarean scar, we can also find the T-shaped cesarean scar, which is much less common.

In this case, a vertical and a horizontal incision are made, forming a T to facilitate the exit of large babies, poorly positioned babies, or premature births in which there are complications.

As you can imagine, the scar is much more visible and difficult to treat. Therefore, it's a practice used only in exceptional cases.

Let's look at the stages of healing so you can better understand how your body works and know where it is at any given time.

The healing process after a cesarean section is slow., Be patient and give it time.

Think about it: you've faced a major operation, and even though life may seem like a whirlwind right now, it's positive and necessary to stop and dedicate time to yourself.

• Inflammatory phase: It begins in the first few hours after the cesarean section and lasts for a few days. At this point, vasoconstriction occurs, and white blood cells arrive in the area to protect you from possible infection. Your scar will be swollen and red or pink. At the hospital, they will treat it, and they may apply a dressing that falls off on its own just before removing the staples. In that case, you will only need to avoid bumping the area. If they don't apply that dressing, the midwife will show you how to care for the wound.

• Proliferative phase: Ten days have passed since your C-section, and the staples have been removed. Your scar is now exposed. You'll feel the proliferative phase begin in the next three to four weeks, when the C-section scar starts to heal internally.During this time, collagen concentrates in the incision to strengthen it and bind the tissues together. New blood vessels also form, supplying nutrients and oxygen to the area. Your scar will appear narrower and change color as it shrinks. This is a good time to schedule a pelvic floor physiotherapy appointment.

• Remodeling phase: This final stage begins three weeks after the cesarean section and lasts between six months and a year. During the remodeling phase, collagen continues to improve the strength and flexibility of the area. Your scar will gradually lose volume, becoming flatter, and its color will lighten over time.

As you can see, your body is working at 100% all year long to make you feel better and better. It was able to adapt to your baby and now it will be able to heal after the C-section.

Ask for help when you need it because, although we know you can handle everything, the reality is that Mom also deserves to be taken care of!

We would like to share some tips on how you can care for your cesarean wound to promote a quick and trouble-free recovery.

• Clean the incision daily. Infections pose a threat to the healing process after a cesarean section, so it's important to keep the area clean. If you haven't been given a special dressing for your wound, you need to... Wash the wound with water and neutral soap. Or, when you shower, let the soapy water run over the area, don't touch the scar too much, and pat it dry with a clean towel.

• Wear loose or baggy clothing that won't rub against the wound. Choose natural fabrics like cotton so that your skin can breathe.

• Keep an eye on the wound. You need to be alert to any signs that things aren't right. Don't worry, we'll give you some tips later on about what to look out for.

• Don't exert yourself physically. After having your baby, don't rush back to exercising or doing anything strenuous that could reopen the incision. Remember that seven different tissues were opened and need time to heal. A pelvic floor physiotherapist can advise you on the best time to resume physical activity and will also recommend some things you can already do.

• Avoid smoking. Nicotine reduces blood flow, lowers oxygen levels, and reduces the nutrients that reach skin cells, which can lead to slower and more prominent scarring.

• If it hurts, take the medication. Even if you are in the middle of establishing breastfeeding and think you can't take anything, your doctor will prescribe safe medications so you don't have to suffer pain.And you can always check them on the platform of e-lactation.

• See a pelvic floor physiotherapist. Pelvic floor physiotherapists are the specialists who can assess not only the condition of your pelvic floor, but also whether the scar tissue is creating adhesions between the different layers, which could cause future discomfort. They evaluate the condition of your abdomen, and best of all, they can provide you with specific therapy to treat your scar and teach you how to care for it at home and exercises to help you recover physically faster.

• Go to your medical appointments with the midwife and the gynecologist. Don't forget to attend your follow-up appointments so that healthcare professionals can monitor how your cesarean scar is healing.

We never tire of repeating it: a cesarean section is major surgery and, although you have to take care of your baby, don't forget that you need care too.

Rest as much as possible, delegate, and ask for help..

Heed that old saying: "sleep when the baby sleeps," because tissues regenerate more and better during sleep.

If the house is dirty, the laundry is uncollected, and the dishes are unwashed… Let someone else do it for you!

Nutrition is key to wound healing, so it's very important that you eat and eat well.

Take lots of fruits and vegetables, foods rich in protein, vitamins and fiber.

Don't forget to drink plenty of water, especially if you are breastfeeding, because, on the one hand, your tissues need to be hydrated and, on the other hand, you need it for your body to function properly.

Massages on the cesarean scar are recommended throughout life.

They will help you ensure that this mark is just that, a reminder of the arrival into the world of the most beautiful thing in your life, and not a constant nuisance.

We recommend, however, that if possible, you consult a pelvic floor physiotherapist, who can teach you how to perform these exercises in a practical way. They can also recommend tools that may make them easier, such as glass suction cups.

In addition, physiotherapists can help you with electrostimulation. This therapy is complementary and speeds up the healing process after a cesarean section.

Massage of the cesarean scar stimulates blood circulation Applying water to the area increases oxygenation and cell growth. This will cause it to heal faster and gradually decrease in size, becoming less visible. Furthermore, it is also important to prevent adhesions and minimize the formation of rigid tissue that causes tightness.

You can begin scar massage once the stitches are removed and you have received approval from the healthcare professional monitoring your recovery. It's usually possible to start... around 3 weeks after delivery.

• Phase 1: The skin. You might find it uncomfortable to touch the scar for the first few days, so you can start by gently touching the area above and below it. Gradually, you'll see how you can touch the scar itself. Place your fingers above and below the scar and Stretch the skin by moving your fingers up and down Apply pressure along the entire incision. Make small circles. As the skin loosens, you'll be able to gently pinch it to stretch it. Feeling some discomfort is normal, but you shouldn't experience any pain.

• Phase 2: Superficial muscles. Press harder with your fingers on your abdomen to feel how that layer moves. If one side is more mobile than the other, don't worry, it's normal; it will gradually regain its mobility. Place your fingers over the scar and make the same movements as you would with your skin., But apply a little more pressure and use a zigzag motion. There may be adhesions and tension. If you notice them, focus more on that area to soften it. You'll feel the tissue gradually relax. You might experience some discomfort; this is normal due to the sensitivity of the area after the procedure.

• Phase 3: Deep musculature. In this final phase, you'll work at a deeper level to move the underlying tissues. Sit down and bring your fingers towards your abdomen. They need to apply more intense pressure to the area The area surrounding the scar, above the incision and near the pubic bone, should be massaged. The movements should be from side to side and up and down. If you notice one side is tighter, massage in the direction that is more difficult to move. Stay there gently until you feel the tissues release. Massaging the deep muscles is important to prevent lower back pain or urinary incontinence.

Feeling pain or tightness in the area during the first few weeks is normal, but there are symptoms you should be aware of and consult your doctor as soon as possible.

Warning signs after a cesarean section include:

• High fever above 38º C.

• Intense pain in the area.

• Redness or swelling.

• Suppurate pus through the incision.

• Bleed through the scar.

• Vaginal bleeding intense.

• Foul-smelling secretion through the vagina.

• Difficulty breathing.

• Chest pain.

• Fatigue severe.

If you experience any of these symptoms, go to the emergency room immediately to receive the necessary treatment.

Everyone is different, so it's best to create a massage routine that feels comfortable and stick with it until you feel your tissues moving freely in all directions. Ideally, you should do this daily for about 5 minutes; you can even take advantage of your shower time and apply our [product/treatment]. Nourishing body oil while you massage the area.

Yes, it's normal for the wound to itch during the healing process. Be careful if you scratch, as it's important to keep the wound clean to prevent infection. Try wearing loose clothing to avoid irritating the area. Consult your doctor if the itching becomes too intense. Thinking about other things or looking at your adorable baby can be good alternatives in this situation.

After a cesarean section, some women experience a loss of sensation around the incision. This can be temporary or permanent. In this case, the massages described in the previous sections can help you gradually regain sensation and release tension in the area. If you still feel nothing, consult your doctor or a pelvic floor physiotherapist.

Remember that, unlike a vaginal birth, Cesarean delivery involves a longer recovery and requires special care.

Banish those discourses, which minimize the process you are going through.

You may have doubts about trying for another pregnancy. The good news is that it is possible to have a vaginal birth after a cesarean section.

Treat your cesarean scar with care by following these tips and those offered by healthcare professionals to minimize any potential discomfort it may cause you, both physically and mentally.

The healing time is long, but in the end it will be a memory of your little one's arrival into the world!