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Everything They Don't Tell You About C-Sections

Nyssa's Tara Stadnyk uncovers the many 'unmentionables' of caesarean births. From the operating room to postpartum care, read about c-section deliveries and how we can revolutionize our thoughts and language on this important subject. 

For an in-depth look at the unmentionables of womanhood, sign up for Nyssa's Body of Knowledge. Our upcoming issue on c-sections features interviews with Dr. Gergana Peeva, specialist in Obstetrics, Gynaecology, and Fetal Medicine, and Dr. Celestine Compton, physical therapist and pelvic health specialist.


Language, Empowerment, and Self-Awareness

Maybe it's not the birth you hoped for or planned for. Maybe it is, and you're doing it knowing that a caesarean delivery is your best option. Regardless of the reason, c-sections are essential for the health and wellbeing of both mama and baby. Despite being the most common surgery performed in the U.S, with over a million cesarean deliveries every year, we hear so few stories about them. More often than not, birth stories you see online and in the media show an overjoyed mother with baby in arms, partner by her side, and a ceremonious glow surrounding them following the mother’s vaginal victory. She is miraculous. She is magical. 

But what about mothers who give birth by caesarean? Is her body not just as miraculous, just as intrinsically magical? Why don’t we celebrate c-section births the way we do vaginal births?  

Medical terminology remains full of centuries-old language that degrades women’s bodies and experiences. In the case of caesarean sections, we often hear vaginal birth defined as  “natural”, while c-section birth is somehow “unnatural”. 

It's time to change the way we view and speak about caesarean birth journeys. 

Gee Gee Collins Painting of Mother Holding Sleeping Baby

What Can I Do? 

Support & Share.
New mothers should be supported in their choice or non-choice of having a caesarean birth. Ask your friends or family about their c-section birth. Share your story and your scar. Love that warrior wound, that magical gateway created for life and love to come through. 

Revolutionize & Empower.
We change the landscape of women’s health by rephrasing the way we define women’s experiences. Nyssa’s Loudspeaker features stories of mothers who give birth by c-section, and interviews with medical experts who work with women throughout their caesarean birth journeys.  At Nyssa, we see awareness and education as a collective is equally important as the inner journey, the self-acceptance of our own body’s unique journey. 

Remember c-section mamas… You are a great mother and you did what was best for you and your baby. Now tell it to yourself!


The Quick 411 On C-Section Unmentionables

It’s going to be hard at times… maybe really hard.
C-sections are a unique surgery in that you not only need to care for your own painful post-surgery incision, but also care for your newborn. Prepare in advance for limited mobility in the first few weeks. Who can you call for meal help, baby help, housework help, and someone to hear you out when you need to talk? Find your mama love & support team!

Like any major operation, there are risks.
A cesarean section is generally a very safe procedure, but like any operation, there are risks. Some c-section risks include infection, blood clots, excess bleeding, damage to nearby organs, accidental cuts, and temporary breathing difficulties in your baby. Know that during your operation, a group of 8-10 medical professionals will be present to support you and your baby through a safe birth journey. 

The healing time can be longer than a vaginal birth.
Generally speaking, c-sections take longer to heal from. *Note: This is not the case when we compare c-section births to complications from vaginal births like tearing. Caesarean deliveries typically require around 4 days in the hospital compared to 2 days for a VB, and sometimes a longer postpartum healing period before resuming activities like driving, exercising, having sex, and carrying anything heavier than your baby. 

We bleed after a c-section birth, too.
As the uterus takes 4-6 weeks to contract back to normal size, there will still be bleeding after a c-section surgery. Avoid sex and using tampons during this time. Instead, opt for intimacy that does not involve penetration, and use comfortable cotton pads like Nyssa’s organic cotton postpartum pads.

Love thy “shelf”.
A “shelf” or “pooch” occurs when the looser skin just above the scar hangs over the incision area, creating a “shelf”. This fold can return to normal after time, but some women have it long after birth. We can learn to love it, the way we do our scars, stretch marks, and other signs of being a badass birth warrior.  

Gee Gee Collins Abstract Painting of Woman Naked
There may be numbness. 
Numbness in the incision site is a common side affect, and is caused by the severing of small nerves during the operation. It usually takes a few months for this feeling (or lack of!) to subside. 

Gas is common, annoying, and painful.
In the first week following a cesarean surgery, trapped gas is very common and can be brutal! Try massaging your belly using an extra-gentle, clockwise, circular motion with your hands. Applying heat can also be very soothing. Nyssa’s {postpartum underwear} feature built-in pockets for ice/heat, designed specially for postpartum recovery.

Beware of belly laughs, sneezes, and coughs.
These intense abdominal sensations can be very painful after having a c-section. When you feel the urge coming on, brace your incision area with your hand, a towel, or pillow. After a few more weeks of healing, you’ll be able to experience these sensations with ease (and relief!) again.

Long Term Side Effects Can Occur.
Some women can experience long-term side effects due to scar tissue buildup which can stick to muscles or organs. Symptoms can present as hip or lower back pain, painful periods, restricted movements, or pulling sensations for months and even years after the surgery. Seek advice from a medical professional or a specialist in c-section massage if you are experiencing long-term pain or discomfort.

Every scar is unique.
While some scars are symmetrical and centrally located, other scars can be uneven. It all depends on where your baby was sitting at the time of the operation. A c-section scar fades and usually looks much better after a couple weeks, but it takes about 3 months to fully heal. 

Gee Gee Collins Painting of Nude Woman


Emergency C-Sections: Why They Happen And What To Expect

Emergency caesarean operations can be lifesaving procedures for both mama and baby. While it may not be the birth you had expected, these procedures are necessary, and in no way does it diminish the unique beauty of your birth experience. 

The most common reasons for an emergency c-section procedure are:

Very long labour.
Prolonged labour is the most common reason for emergency c-sections. About 8% of pregnant women who are about to give birth have a prolonged labor. This happens when the labour doesn’t actually start or when labour stalls. 

Baby’s position.
If your baby is breech (feet first) or stretched out sideways (transverse), a vaginal delivery may not be possible or too risky. Your doctor or midwife can sometimes turn your baby by applying gentle pressure to the tummy, but this doesn’t always work. 

Exhaustion.
Sometimes mothers become too exhausted to continue pushing, which can put the mother or baby at risk. At this point, the doctor may attempt a vacuum-assisted delivery, but if that is not possible or unsuccessful, a c-section will be needed.  

Health condition.
Pre-existing health conditions like genital herpes or HIV would be a reason for c-section delivery, as well as any conditions developed during labour such as high blood pressure (pre-eclampsia) or brain/heart health issues. 

Tangled umbilical cord.
If the umbilical cord becomes compressed, tangled, or in rare cases, prolapsed, a c-section will be necessary. 

Placental problems.
Part or all of the placenta can move away from the lining of the womb. This is referred to as placental abruption, and can result in your baby not getting enough nutrients and oxygen inside the womb.

Womb tear or uterine rupture.
In very rare cases, mothers can experience womb tear/rupture or uterine rupture during labour. 

Gee Gee Collins Painting of Mother and Child

Elected C-Sections: Reasons Women Choose Caesareans and Why They Can Be The Safer Option

When deciding on whether or not an elected c-section is the right option for you, your midwife or doctor will explain the benefits and risks for you and your baby compared to a vaginal birth. Many pregnant people are recommended caesarean deliveries if they have health conditions that could be exacerbated by a vaginal birth. But women are opting for c-section deliveries more and more, for a number of reasons.

Vaginal delivery can be more dangerous for pregnant people who have physical and/or mental health conditions, or previous experiences like birth trauma, pregnancy complications, miscarriage and stillbirth, vaginal trauma, and other personal experiences that impact perinatal health. 

A search of international health databases was performed for all relevant articles published between 2006 and 2016. The research showed that women opted for CDMR (Cesarean Delivery on Maternal Request) due to emotional experiences, personal experiences, and social norms. The review outlines:

"A woman's decision was often shaped by various influences including family, friends, and the media. In addition, previous experience of childbirth and interactions with health care professionals contributed to a strong preference for CDMR (cesarean delivery on maternal request). CDMR provided women with a sense of control over the birth and diminished feelings of fear.”
-O'Donvan. National Library of Medicine, 2018.

Gee Gee Collins Painting of Nude Woman

What Can I Do?

Whether your c-section is elected or emergency, here are a few tips to take with you through the procedure:

Remain calm and try to be patient as the medical team organizes for the operation.
The goal is that no more than 30 minutes pass between the decision to perform an emergency C-section and delivery, but it can take up to 75 minutes. C-section surgeries require 8-10 medical professionals present: the surgeon and assistant, 1-2 nurses, 1-2 anaesthetists, an operating department assistant, 1-2 midwives, and sometimes a doctor to check the baby. It may feel overwhelming seeing so many people in the room, but remember that they are there for the safety of you and your baby. 

Know that you will be conscious, pain-free, and holding your baby as soon as it is safe to do so.
Because you will receive an epidural or spinal anaesthetic, the procedure is pain-free, with perhaps some slight pulling sensations. You also won’t see the operation, as a screen will be set up in front of you. Usually mothers choose to be awake for the surgery. Partners can also be in the room for support. The start of the operation to delivery of the baby typically takes only 3-6 minutes. While the operation is being completed, the mother and partner can usually hold the baby. Doctors try to establish skin-to-skin contact for baby and mother as possible.

Ask questions about your postpartum healing plan.
C-section healing looks very different than vaginal birth healing. As the time for c-section recovery in the hospital is generally a little longer than vaginal births, you will have time to ask the doctors and nurses about your postpartum healing process. Take care of yourself, mama. You are AMAZING. 


Healing After C-Section Delivery 

A cesarean delivery is a major surgery. Like any other surgery, your body needs time to heal afterward. This can be especially challenging now that you are a new mama with a baby to care for! New mothers should expect to stay in the hospital 2-4 days after a cesarean delivery, and plan for 6-8 weeks to fully heal. Women who experience c-section births will still have vaginal bleeding postpartum until the uterus contracts back to normal size. You can expect to bleed for 4-6 weeks.

Gee Gee Collins Abstract Painting of Woman Naked

What Can I Do? 

Rest & Restore.
Most of us have heard the advice, “sleep when your baby sleeps.” This is SO true. Take naps whenever possible. Wounds heal best when the body can rest.

Ask for support from your partner, friends, and family when you feel the need to rest. Many new parents arrange with loved ones to help with meals, housework, grocery shopping, dog walks, or with your baby. Try to ease the load whenever and wherever possible.

And to support your body through the healing process, drink plenty of water and eat a wide variety of nutritious foods.

Exercise, Slowly But Surely.
During the weeks following a c-section surgery, doctors recommend avoiding strenuous activity like cycling, jogging, weightlifting, aerobic exercise, and lifting anything heavier than your baby. Introduce gentle, restorative exercise soon after the surgery. Start by walking a little bit each day, and gradually increase the distances as you heal. Walking boosts blood flow and helps prevent pneumonia, constipation, and blood clots.

Avoid Tampons & Sex... For A While.
Do not have sex or use tampons until you have reached the 6 week mark when the cervix closes completely. Enjoy other forms of intimacy with your partner like cuddling and gentle massage.

Take Care Of Your Mental Health.
Talk about your emotions with friends, your partner, family members, your doctor, or a counsellor. Nyssa’s Loudspeaker also has many great support references for navigating postpartum emotions. If you experience feelings of ongoing anxiety, depression, or thoughts of hurting yourself or your baby, notify your doctor immediately. 

Gee Gee Collins Painting of Nude Woman

Relieve Your Pain & Care For Your Wound.
Ask your doctor what pain medications you can take. Doctors most often recommend taking paracetamol or ibuprofen (but not aspirin) while you're breastfeeding. 

Expect to feel numbness and soreness at the incision site in the early days after your surgery. Non-dissolvable stitches or staples will usually be taken out by your midwife or doctor after 5 to 7 days. It is normal for your scar to be slightly raised, puffy, and darker than your normal skin tone.

Gently clean and pat-dry the incision site every day. Opt for showers instead of baths until the wound has fully healed. Wear comfortable, loose-fitting clothing and cotton underwear.

Support the incision site when coughing, sneezing, or laughing. Do this by bracing your abdomen with your hands or a pillow.

Watch out for signs of infection like redness, lots of swelling, or discharge of pus/foul-smelling fluid. See a doctor immediately if you notice any of these signs.

Set yourself up with Nyssa’s FourthWear Postpartum Recovery Underwear that features discrete, built-in pockets in the abdomen and between the legs for ice/heat application. The use of cool or warming therapy helps reduce pain, inflammation, and scar tissue buildup following c-section surgery.

 

Paintings by Gee Gee Collins.


Read More About C-Section Births
A Mother’s Joys & Scars
An Obstetrician’s Perspective on Cesarean Birth

Heal Below-The-Belt After A Caesarean Section

Nyssa's Postpartum Recovery UnderWear

FourthWear Postpartum Recovery Underwear diagrammed to show potential placement of ice/heat packs

Supersoft, belly hugging underwear with our patented pocket design to securely hold ice or heat therapy between the legs and over the lower abdomen where postpartum recovering bodies need it most.
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