Welcome to the SMA® Baby Club podcast, the place where we talk all things baby parenting and those real life questions so many new mums, dads and parents to be find themselves asking. I'm Amy, your host, and today we're diving into a topic that affects a staggering 40% of birthing women in the UK and that's C-section births.
Planned or unexpected, a C-section is a major physical and emotional experience. Yet for something that affects so many of us, there's remarkably little awareness of what to expect. So today we're opening up that conversation from preparation through to recovery, including scar massage, the overhang, and how to care for yourself, body and mind. In those early weeks and beyond.
Joining me are two amazing experts from The 360 mama, scar massage therapist Hannah West and postnatal physiotherapist Emma Bradley.
They're on a mission to help women understand their bodies and recover with confidence after birth. They run online courses, teach scar and core recovery techniques and offer incredible support for postnatal healing. They've also recently had a book published on C-section Recovery, so they bring a wealth of knowledge to today's chat.
Welcome both of you. Thank you so much for joining us.
Oh, thanks for having me.
Yeah. Thank you. And we're really excited to be able to talk about a topic like this. Because we do think it needs to be talked about more.
Yeah, definitely so important. So just starting off with the big picture. I think a lot of people might be surprised by just how common C-section births are now.
Yeah. The recent statistics show that it's over 40%, which is really a big number when you consider it. I think around 16% of those are elective C-sections. So it's a really valuable point to recognise that for a lot of women that have a C-section birth, is not their original plan. And we do know that a lot of kind of emotions and feelings around that can often come into play when we're talking about postpartum recovery,
Yeah, that's a really good point, because women spend ages planning for this idyllic birth scenario, and then suddenly that plan changes on the day and they're not prepared for it.
And it's, you know, ultimately major abdominal surgery as well. And there are certain things we want you to be aware of and take into account that you need to know so that your recovery goes smoothly after that as well. And if it's not something you've thought about previously, it can be hard to implement those things.
Absolutely.
Yeah. I mean, it's wild really, when you think that women have huge major abdominal surgery and then go home to look after a newborn baby.
Exactly.
We really try to encourage people for that reason, to plan for a potential C-section outcome, even if it's not your initial plan and it's not what you hoped for. If you just have a few ideas about how to make that experience feel a little bit more like you're in control and you've thought about what that might mean for your aftercare afterwards.
If it does happen and there's a likelihood that it might, you feel as though you're a lot more able to prepare for that. Yeah.
So let's just circle back and think about the sort of practicalities then.
So if someone is planning for a C-section birth or like you say, just wants to be prepared just in case, then what are the things they can do to make their life easier once baby has arrived?
So on the point that people just aren't ever really prepared for a C-section, it also means that when they get home that then the house isn't in a great place to be ready for a C-section.
So preparing your home as much as you can, preparing your friends and your family is all going to really help. So letting them know that you're not going to be really able to move for a couple of weeks, putting things in place with childcare so that they can help you out with that. Things like cleaning and cooking, you know, you're not going to be able to do those as easily, and you also don't want to feel the pressure that you need to do those things either.
The other thing you can think about is like clothing, for example. So in the hospital itself, you're not going to want to have clothing with a tight waistband.
You're going to want to use like breathable cottons where possible, because it's a lot more comfortable as your scars healing. And a little bit later down the line, you can consider specific products such as like compression garments, but they're not appropriate for everyone. So hold fire.
I think you also need to think about movement at home. You know you're going to be struggling to get up and out of bed. It's going to be helpful if you can tie like, the dressing gown cable of your dressing gown onto the end of your bed. You can use it to like pull yourself up out of bed.
A poop stool is also going to really help with getting you in the right position for things like constipation and gas issues as well.
Yeah. So the gas thing is not something everyone is aware of, is it? But it can sometimes be really uncomfortable.
Yeah. So surgery, medication and just lack of movement post-birth all mean that gas is a really common thing and it can actually be really painful.
Like my stomach, it bloated right up out here after my C-section. And the things that can help with that are little bits of movement. So, you know, moving your legs around in the bed, peppermint tea, all those things are going to really help clear it.
We also talk a little bit on our channel about, what to put in your hospital bag, and that might be a little bit different if you've had a C-section as well. But things like slip on shoes so you're not bending over to pull shoes on and tie laces.
A pillow from home can be such a great tool, either just to brace yourself gently if you were to cough or sneeze, but also for the journey home just to kind of protect your tummy a little bit. And they're often the things that people get a little bit caught out on. For example, if it's just not something they've even thought of.
And the other thing is that you may just spend a little bit more time in hospital if you've had a, C-section. And so making sure you've got enough stuff that actually allows you to stay entertained and, that, you know, sort of climbing the walls while you're there,
you absolutely don't forget your long cables so that you can reach your phone from behind, you know, not having to turn around as well.
Yeah, it's definitely a bit of a difference, isn't there, in sort of what you're preparing for a C-section birth v's a vaginal birth.
So definitely, I guess one for people to be mindful of when they're packing their hospital bags and preparing.
And I think it's also really important that we highlight that we need to normalise that.
Asking for help is fine. It's like we don't have to go it alone. Like, definitely recruit your support network. Ask your family and friends for help. It's not like indulgent. It's actually just what you need for recovery.
Absolutely. Like you really need space to heal properly. You do not need to feel guilty about this. Your body needs that time and everybody will benefit. Your family will be happier. It's definitely worth doing.
so talking then about this like early recovery, you're back home. It's exciting, is part terrifying its absolute chaos. You've got a newborn.
What should that sort of early recovery period look like?
I think an important point to mention, because it does surprise people often, is that it's still really normal to bleed post C-section.
So, there is sometimes a bit of a myth around the fact that if you've not had a vaginal delivery, that you might not expect to bleed in the same way, but anything up to the sort of first six weeks after birth, it's really normal for you still to be bleeding, and that at first can be really heavy.
And that in itself might limit what you can do and what you feel comfortable doing.
We talk a little bit as well about knowing how the impact of nutrition and hydration can really change, how your body heals and recover. So just trying to have an awareness of ultimately what you put into your body is what your body can use in order to heal.
And so paying a little bit of attention to that is really important. And hydration is so key. And even more so if you're breastfeeding and you're more dehydrated for that reason.
Yeah, it's that like intentional rest, isn't it? It's like connecting in with your body, some gentle movements in bed that breath work. Breath work is a wonderful tool to reconnect with your abdominal muscles, to calm down your nervous system.
It's a great way just to get blood flow around your body, isn't it? So it's not about doing nothing, it's just about intentional rest.
And we do find that that sometimes is a bit controversial when we talk about it, because people find it really hard. But like what you said about asking for help can feel hard.
Actually taking the time to rest sometimes can feel hard too, but we're not talking about no movement at all. We are kind of encouraging you gently to start to move a little bit more around the house and gradually build it up, but just not taking your baby out for a walk around the park on day three, like it's just not necessary.
Not lifting the shopping. Yeah,
I think that's a really nice way to sort of reframe it.
So it's not about doing absolutely nothing, is just about so being aware of the things that you are doing and how that's going to impact your recovery.
So what about early scar care.
So with scar care obviously you're going to have a dressing on it when you come home. And it can be a little bit daunting taking that off. But when that dressing comes off, we need to think about keeping that wound dry and clean. And that means using just the water from the showerhead to clean it.
You're just going to run it over the area. You don't need to rub anything into it, no products whatsoever. And then once it's clean out of that shower, you want to make sure it's really dry before any clothes are going on. So that means using a dry towel just to pat it dry. When it's fully dry, then you can get dressed.
But for people who maybe have a big overhang,
The area is likely to be a little bit more moist in there. You're getting sweaty. So you can just use a sterile gauze in the area. And that'll just wick away that moisture and keep it nice and dry.
Amazing. Thanks. Top tips. And so moving on to talk about exercise postnatally.
I know that some of our baby club members have felt that pressure to get back to normal. After the six week, check at the GP. So they give you the all clear and suddenly you're like, amazing. I'm going to go back to, like, doing exactly what I was before. Let's go for A5K run.
Can you advise?
Yeah. The six week exercise myth is, definitely a bit of misinformation. To clarify, that six week check is a medical sign off, that there are no immediate concerns with you, your wound, or baby often as well. It's not really an indication of whether your body is ready to start exercising again. But what we also want to encourage is the concept of reframing what exercise really means in postpartum.
And it's certainly not a return to your pre-pregnancy form for quite a lot longer. I think if you can start to consider exercise as a way of helping your body to recover, then really we can introduce some things like early gentle movement and breath work much sooner than six weeks, so there are things that you can be doing much earlier on.
But actually if we're talking about high impact exercise, running as the example you gave you, the absolute minimum in terms of the current guidelines is to wait 12 weeks.
Amazing. It's all about kind of rebuilding from the inside out.
Definitely. And a real gradual progression to introduce strengthening work, which is required for everyone that has been through pregnancy and then birth.
And then if you've got particular goals, we'd also encourage that you do specific preparation work that runs up towards the sport or the exercise that you're aiming to do eventually.
And is there anything we should do to support our sort of pelvic floor? Is that an issue with C-section births?
Yeah, absolutely. Your pelvic floor goes through a huge amount of strain in pregnancy itself.
So actually, regardless of the type of birth that you've had, it will need time to recover. I think we should also be considering that for a lot of women that end up with a C-section, they may have laboured for many hours before that happens. And so they've gone through, you know, double the impact on the pelvic floor. So, yeah, let's definitely kind of take ourselves away from this idea that a C-section means that your pelvic floor is protected, because actually, it's still going to need plenty of rehab.
and then what about intimacy? Because this is a topic that obviously lots of people shy away from discussing, but something that a lot of mums would say made them feel a bit anxious. Have you got any advice on that after surgery?
So it's obviously totally normal to feel really anxious around doing this after having a C-section.
There's going to be or it's likely there's going to be some tension in the area. It might feel a bit sensitive. So the idea of doing it might also not feel very exciting. And obviously your partner might be a little bit worried about intimacy with you as well. But there's you know, there's lots of different positions you can use that can avoid the area.
So there's no rubbing on it to make it possible.
Yeah. Generally the guidelines tend to suggest waiting six weeks post-birth just because there is some infection risk. If you've gone through labour previously, for example, but also just in terms of you feeling comfortable and confident and ready to do that, it's unlikely to be something that you want to be doing when you're fatigued, when your hormones are all over the place.
Hormones also have this real impact on you physically, so it can mean that you're a little bit drier down below, for example, that can have an impact on how comfortable sex feels, but also recognising that painful sex is something that we come across quite often with our own clients. And that can be related to pelvic floor issues. Tension in the pelvic floor, which is often associated with anxiety, may be trauma, or negative feelings about your birth experience.
But also linked to the scar itself. As Hannah said, that tension that the scar can create. So if you do experience any of those problems, we would really advocate that you do go and see a professional to support you, because I think it's something that people live with way too often, either because they don't want to discuss it, or the assumption that it's just a normal reality of of your body post-birth.
And it's really not. And there's so many things we can do to help and resolve the problem completely.
I think that's why having these conversations is just so important, because people are like, okay, this isn't normal. I can get help with this. I don't have to be sort of suffering alone in silence.
I think that's why it's really important to keep the conversation open with your partner as well.
You know, explain how you're feeling. You know, you maybe want to start with a little bit of self-massage. And, you know, before you build up to, to full intimacy, massage the scar, touch the scar and talk about, you know, what's going to be comfortable for you and what's going to work.
So I'd like to go into more detail about scar care because this is a topic that comes up so much. And obviously it's a huge part of someone's birth story.
But also they can struggle with, you know, how it feels, how it looks. Is that normal?
Yes. I think it's really important to remember we are not trying to get rid of that scar off your body.
It's, it's a really special place where your baby came from. What we don't want is women struggling with pain and issues associated with that scar. And also, if you're not happy with the way your body looks, its totally fine to say, I want to do something about this.
And is it okay to massage your scar from the start?
Yes and no. So directly touching over the scar is not advisable. We want to keep that wound nice and clean. But there's loads of things we can do around the scar to encourage that healing. So we can use gentle stroking massage techniques towards the scar to encourage the healing and the blood flow.
And we can absolutely use breath work. So when we breathe into that lower abdomen, we are allowing all those layers of the scar to slide and glide over each other and improve the movement in that area.
you are massaging your scar from the inside out by using that breath work technique
And so once that scar has healed over, what are the kind of next steps around scar massage?
So what we advise with scar massage is to use it without an oil. So we find that when you don't use an oil, you're able to get much better grip on that scar and get much better movement between the layers of the tissue. Because you got to remember that with the surgery, it's not just that top scar that we're treating.
We're trying to address the layers below as well that are likely to become stuck together. And if we're able to get better grip on the tissue, we can create better movement in all those layers of the scar. And you'll likely get a better result with the scar massage. That doesn't mean don't use an oil on your scar, but we advise that you use that afterwards to really hydrate it.
And when it comes to an oil, you want to be looking for something that is natural. Things that have aloe vera in, vitamin E or rosehip oil are all really advised and a great product to use. You just want to make sure it isn't perfumed. That's the only thing.
So just to recap, we shouldn't when we're massaging this scar, it should be dry, but an oil can be applied
after the process is complete.
Should be applied. Yes. Okay. And then are there any sort of particular techniques. Appreciate that this is being listened to. And people aren't necessarily watching this, but are there any simple techniques that you could describe, for how to sort of actually touch the skin?
So an issue that a lot of our clients come to us with or follow us online is that they can't actually touch their scar.
So sometimes scar massage is just about how do I even start touching my scar? And the best thing you can do is to start working on desensitising the area. So really the best thing you can do for that is to do a really light brushing technique. So either you can just very gently rub your hand over the surface of the skin, or you can use like a zigzag motion with your finger and just brush it over the area.
This honestly, it's almost like you're tickling the surface of the skin. You're not rubbing at the skin. And because the nerve endings are in the more superficial layer of the of the skin, that's going to really stimulate them to regenerate into the area. So it doesn't matter whether you're struggling with hypersensitivity or numbness, it's the same technique. It will both of them will help stimulate those nerves to regenerate in the area and deal with either that hypersensitivity or numbness issue.
we also hear a lot about the overhang.
Anyone listening that's not sure what that is. Can you explain what it is and whether there's anything we can do to treat that.
So essentially an overhang is where we have a tight pulled in scar that is often stuck down to the below layers of the tissue, which can often be accompanied by lumpy scar tissue in the tissue above the scar, which is also caused by the surgery.
And what this creates is a tight bit of tissue that creates, that causes a bit above it to basically hang over the top of the scar.
So kind of like a shelf,
a bit like a shelf. Yeah.
And it's also important to note it's not about size.
It's to do with the way in which your anatomy changes. So it can affect women of all sizes.
So is there anything we can do about an overhang?
Yes. And scar massage is a wonderful tool to help with an overhang. So with scar massage, we, when we're treating the scar that we can see quite often that scar is stuck down and pulled in.
And scar massage is a great tool for releasing that scar off, softening it and stopping it from being. When it's less attached to the body, we get less of the tissue hanging over the top. Scar massage is also great for treating the area around it, so we're never concentrating on just the scar we can see. And when we massage around the scar, we can address any lumpy scar tissue that may be above the scar.
And this is a really common because, you know, the surgery that happens isn't just at the scar. You can see quite often. They will open you up and then create more surgery in the up above the scar that you can see. So we need to treat all the tissue around the scar. And we can also address any swelling that might be hanging around after the surgery.
And all of these things are contributing to your overhang.
Are there any other things as well that affect an overhang?
There are numerous things that can be affecting an overhang. And if we're just using massage, we're unlikely to get the results that we want. So we need to think about things like posture, ab separation, swelling. These are all going to be contributing to that overhang.
Often we'll need to treat with some physical rehabilitation as well. Exercise can be a really helpful tool in helping women to reengage with their core. For example, we quite often see women using different parts of their core.
So if you're a lot more active in the upper part of your tummy, and you lose the ability to really engage with the lower part of your tummy, we see this kind of mismatch of engagement, and that changes by causing a bit more of maybe a bulge down below. And also, as Hannah said, your posture is a huge factor here and we spend a lot of time in early motherhood holding, feeding, carrying babies, which encourages a little bit more of a flexed posture.
And because of that, there's a little bit more sort of bulging of the abdominal area. So we want to combine all of these things and recognise that actually, as a whole, we want to address everything
And if there's someone listening who's like maybe a year or two years postpartum and thinking, I've left it way too late to, like, do anything about this, is that the case, or is there still stuff they can do?
Absolutely. The tissues in your body are always regenerating, and we're hoping through massage that we're helping them regenerate in the way that we want them to. We've seen women in our clinic, you know, as old as like 14 years after having a C-section or a surgery.
And we still helped not change only the way the scar is feeling. So change the pain and the sensitivity and the tightness, but even changed the way the scar looks that many years later. So no, it's never too late to start massaging a scar and feel better in your body.
I think that's really reassuring. I expect for lots of women,
So we've covered so much, but before we wrap up, there's something else I wanted to touch on that might be overlooked. And that's the kind of emotional impact of having a C-section. I think a lot of people maybe come out of an especially in emergency C-section.
Having found the experience quite traumatic. Is there anything you can add around that?
Yeah, definitely. I think for both of us as therapists, we really recognise the crossover between physical symptoms and emotional symptoms. And as a result, we often work alongside counsellors or birth trauma therapists. Or we might encourage our clients to go and do a birth stories with their birth team just so that they can have a better understanding of why decisions were made and what the process was.
It's unfortunately still true that there's quite a lot of negative narrative around C-sections, and that can really impact how people feel about the experience. And often still feel like it's a failure because it wasn't their own initial plan or what they'd hoped or imagined for. And, you know, the more that they have those kind of ongoing negative sensations, then, it can be difficult to interact with their scar and really accept it.
birth is just really unpredictable.
And when it ends up in surgery, it can be really overwhelming. But I think it's important to remember that those feelings that you have around that are really, really normal and everyone can experience those. So remember, just keep talking to your friends, talk to your partner, talk to health care professionals. You know, they can be really familiar with the feelings that you're having.
is there anything else people can do at home themselves to kind of help them come to terms with their experience?
of course, the talking, the journaling, gentle mindfulness, they can all help integrate the experience. You know, healing is physical and emotional. So both matter equally.
Yeah. And also, let's recognise that it can affect people on a huge spectrum.
So for some people, something like that at home is enough. And for others they really do need professional support. So I know that there are people out there that are trained to support you through this, and if it feels like it's overwhelming or if it's affecting you every day, then seek the support.
I think that's great advice because we don't want people to be suffering at home alone. There are people out there who can help, so definitely reach out for that support.
this has been such an amazing conversation, and I know that it's really going to help our baby club members feel supported and informed.
If they're facing a C-section,
just want to say a massive thank you for joining me. Thank you. Hannah. Thank you. Emma. Your wisdom and knowledge. It's just been amazing to share. Thank you.
Well, thanks for having us.
Thank you.
If you'd like to find out more, visit the c section hub on the SMA® Baby Club website. We've got articles, checklists, and plenty of expert led guidance. And as a special thank you, The 360 Mama are giving some baby club members an exclusive offer on their C-section Recovery Online course.
It's packed with practical demonstrations, recovery exercises, and self-care guidance.
Thank you again. And thank you, our listeners, for joining us. We'll see you again very soon.
We hope you enjoyed this episode of the SMA® Baby Club podcast. Make sure to rate it and subscribe so you never miss an episode. And don't forget to join the SMA® Baby Club if you're not already a member. See you next time!