C-Section Recovery: The How & Why of Scar Massage
Currently, the rate of caesarean section births is at its highest. At least one in four women in the UK is giving birth via c-section and yet information on how we recover from this surgery and the discussion around it, seems limited.
It was headline news that the ABC network banned a Frida advert during the Oscars that depicted the reality of postpartum recovery. Normalising the postpartum experience is evidently a challenge. More open discussion about women’s bodies, especially after childbirth, is important and we want to bring c-section scar massage into the conversation.
I chatted to Priya Tew, award-winning dietitian, TV presenter, and Eating Disorders Specialist on the importance of caesarean scar massage.
I’ll admit that when I first heard the term ‘caesarean scar massage’ my face and my own c-section scar winced a bit (or maybe it always looks like that?). I’d never heard about it and immediately, prejudicially recoiled at the idea. Initially, like many other women I spoke to, I had assumed it was mainly about helping the appearance of the scar. I was wrong.
What I was also completely unaware of, despite having needed a c-section myself, was why there might be an important underlying need for this massage.
What’s the need?
A Caesarean Section is a major operation during which your body undergoes a trauma. Priya explained to me that as it starts to heal, the collagen fibres are laid down to begin this process and to start creating bonds. “As they’re laid down you can get the formation of adhesions, which initially have a positive role as they help everything to stick together. However, they can bind a bit too much and cause a pulling, trapped, or ‘stuck’ sensation where they may have stuck too firmly or adhered to a nearby organ or tissue.”
This can lead to a range of problems including loss of sensation, restricted movement, difficulty activating the pelvic floor, and lower back pain.
Massage and benefits
Many people are aware of the benefit of soft tissue massage, especially on scarred tissue but we don’t often think about treating c-section scars in the same way. There are many reasons for this: our postpartum bodies feel fragile, the procedure itself may have been traumatic, it feels too intimate, we don’t have the time, or we just simply don’t know much about it.
Pelvic floors get discussed and we might have some awareness of diastasis recti or abdominal separation and back pain, but our scars can be overlooked. Yet they can be a contributing factor in all of these issues.
The whole system, Priya says, is like a jigsaw puzzle. “If you’re struggling to activate your pelvic floor from an adhesion and pulling in your scar, then you’re not going to be able to draw enough breath into the whole of your cylinder (diaphragm, tummy, pelvic floor area). It’s not going to expand as well and if you don’t have that full expansion, then you can’t use your pelvic floor or tummy muscles as well.
During a massage I’ll work on the rib cage, under the diaphragm, on the tummy and below it on the pubic mound region and then I’ll work on the scar itself. I’ll also look at the neck because if you’re rounded forward that will have an impact on how your abdominals are functioning. It’s looking at the whole picture about what’s going on in the body.”
How soon should I start massaging?
General guidelines suggest that your scar should take around 6-8 weeks to heal but it’s important to remember that our bodies and our surgical experiences are all different. According to Priya, “you don’t want to be massaging on the scar itself in those initial weeks but you can do a little, very gentle work above and below the scar to help mobilise the area. It may also help to relieve constipation and water retention.”
Am I too late?
In short, no, probably not. Although the benefits are likely to be greater the earlier you start to massage your scar, there’s still something to be gained from having a massage years down the line. Priya has clients who find time for self-care once their child starts school, or who are only now, many years post-surgery, learning about how their scar might be related to their back pain or pelvic floor concerns.
Very often we’re led to believe that because the changes our bodies go through during pregnancy and birth are normal, we should just put up with them. But as Priya says, “if we teach women what to do then it could change their quality of life.”
Do I need to be massaged by a professional?
It is possible to massage your own scar; in fact, you may feel more comfortable doing that in those early months. However, many of us don’t actually know how it should feel and may find it helpful to have some guidance. Priya thinks that, ideally, we should all be checked over by a women’s health physio after having a child, but it’s especially important to have yourself checked by a medical professional if you have any concerns about how your scar is healing.
But I don’t like the idea of my scar being touched!
Then you are not alone. Priya says it’s not uncommon for women to feel disconnected from their tummies. “If we don’t like to touch our tummy then we don’t know how it should feel. It should be soft and pliable rather than there being stuck areas.”
If you don’t like the idea of touching your scar then Priya suggests using a little ball and massaging through a t-shirt or light clothing. “You can roll the ball around instead of using your fingers. I teach a few techniques using the ball to mobilise above and below the scar, so you don’t even have to touch it. I want women to feel empowered so that they can go on treating themselves.”
How do I find out more information?
Priya also recommends having a look at the Burrell Education website for information about c-section scar massage. The website hosts a list of certified scar therapists so you can find one that’s local to you.
If you enjoyed this, check out our Kids column for more from Eleanor, here.
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