Belly birth and your pelvic floor


Did you know that over 30% of women deliver their baby via caesarean or (a belly birth)? And yet, these new moms who have just undergone MAJOR abdominal surgery are given little to no information on proper recovery. The misconception that a C-section birth is easier than vaginal birth is one that we need to move away from. Both are challenging in their own right and should be given adequate recovery time.


Some common symptoms post C-Section

· Scar pain and sensitivity

· Reduced mobility and flexibility especially in your hips and low back

· Difficulty bending forward and lifting

· Low back pain from weakened core muscles

· Myofascial trigger points in the abdomen that may refer pain to the urethra and clitoris

· Urinary frequency, urgency and incontinence


You might be asking: But how can my pelvic floor possibly be affected when the baby didn’t pass through there?


Ah, but this is comes back to what we’ve been saying all along: Everything is connected!


Even though not directly affected during delivery, your pelvic floor was still very much involved in getting your baby into the world, so treat it kindly. Don’t forget that you carried your little bundle for nine long months, which caused constant downward pressure on that very important group of muscles—the pelvic floor. And the muscles of your abdominal wall—which are cut during a C-section, have been overstretched and strained for those 40 weeks.


There are many cases where pelvic floor muscles do not heal properly or the scar from the incision can affect the nerve supply to the pelvic floor leaving you with side effects such as pain with urination, frequent peeing, and pain with intercourse. This is where pelvic floor therapy comes into play.


Therapy can help new mothers reduce or even eliminate urinary incontinence, low back pain, and C-section scarring. Physiotherapists can provide scar massage to mobilize the scar tissue and assist in laying own of organized collagen tissue. By simply massaging your scar for 2-3 minutes a day can make a dramatic difference.


How can massage help my scar?

Good question. But scar massage (also known as scar tissue mobilization) is different than the typical massage you may be familiar with. Scar massage is all about reorganizing the collagen fibers in a similar pattern as the normal tissue, so the scar moves and stretches more like the skin surrounding it. The massage will also reduce adhesions in underlying connective tissues and myofascial layers. Adhesions are parts of the scar tissue that have attached to other structures close by, which if left untreated, can lead to reduced blood flow, nerve irritation, and pain.


This is where pelvic floor physical therapists can help! A pelvic floor PT will assess your C-section scar and begin treating the area with scar massage. This entails the physical therapist using their hands to manipulate/mobilize the scar and surrounding tissues in all different directions using special skin rolling techniques as well as pressing and rubbing motions


This may be a bit uncomfortable and sensitive at first, so it is important to communicate how you are feeling with your physical therapist. You might find it more comfortable to apply a warm compress to the area prior to the massage--soften the skin and increase its elasticity. If appropriate, the physical therapist can teach you how to perform the scar massage on your own as part of your home treatment plan.









Sources:

· Cesarean birth (C-section) frequently asked questions: labor, delivery, and postpartum care. The American College of Obstetricians and Gynecologists, 2015.

· Shin, TM and Bordeaux, JS. The role of massage in scar management: a literature review. Dermatol Surg, 2012. 38: 414–423.

· https://athletixrehab.com/did-you-have-a-c-section-a-pelvic-floor-specialist-can-help-you/

· https://wavephysio.ca/2017/07/11/one-c-section-moms/

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© 2020 by Lauren Sutherland Physical Therapist Health Prof Corp