Since having my second unplanned cesarean, I’ve been dedicated to both my personal recovery process and “preaching the good word” to potential clients of mine as an Edmonton doula. As someone who has had cesareans, supported women in the OR while having cesareans and supported women through VBAC’s (Vaginal Birth After Cesarean), I’d like to think that I am quite knowledgeable of the difference you can expect in recovery as opposed to vaginal births. However, one thing that was never taught or talked to me about until my second child was scar tissue and the importance of work being done on your healed incision. Something so simple, yet oh so important and a powerful tool in healing your body post-op! Let’s dive into this whole realm, shall we?
So let’s start with a crash course on scar tissue – what it is, what it can cause and how to treat it. All of our body’s connective tissue is made up of a certain fiber called collagen. When any injury or incision is made into our skin, muscles, ligaments, etc, new collagen fibres replace the tissue that has been damaged to create scar tissue. The problem with these fibres is that they are not as smart and organized as our original tissue and often form in a very mismatched way, which can hinder the function of the structure where the scar has formed. There are many problems that can arise from this – movement in the area where the scar is can be stiff, nerves and sensory feedback to the area where the scar exists can be damaged, and it causes a disruption in well-functioning fascia. Ok now before I lose you (because this was all a lot of info for my average, Edmonton doula brain when I first heard it too!), basically this all means that a scar, especially one located viscerally (deep, abdominal cavity) can literally effect ALL areas of our bodily function. This is because fascia is like a giant spider web that moves smoothly with our muscles, so when part of this web is cut and grows back incorrectly, the whole web moves different. Fascinating, I know!
So how can we get back to a place where our body is functioning again as it should? This is where scar tissue massage comes in. This unique type of massage can be done on any healed scar, but cesarean scars are extremely important as they are located in a particular part of our body where function is extremely important and because a cesarean incision goes deep into our visceral layers. When a scar forms adhesions (these wacky new collagen fibres I was talking about earlier), the adhesions tend to pull on different organs and sometimes cause them to move out of their designated position. Scar tissue massage works to “break up” these adhesions to help our organs to move back into place and function as they should. This massage also allows the skin, fascial and even muscular layers of the scar to move with more flexibility, therefore allowing our whole body to function optimally.
Now who does work on scar tissue massage? Well first of all, YOU! You can start the scar mobilization process on your own – this video is a good place to start. In regards to hiring a pro, looking for an RMT (Registered Massage Therapist) who is experienced in scar tissue work. Personally, I’ve had my scar worked on by my physiotherapist (read here about why I think you need postpartum physio) and my chiropractor as well, and both did incredible work for me. You’ll likely have to get multiple treatments done before you notice a positive change, but stick with it! Whoever you decide on, allow them to help you navigate your number and frequency of appointments. Do know that some mild pain and discomfort are normal in this process as your systems get back into place… it will be worth it in the long run.
If you’ve had a cesarean I encourage you to read my story – especially if you are going to be attempting a VBAC or you are disappointed with the outcome of your birth. As a birth doula in Edmonton I understand the complexity of healing from a cesarean, and have both had my own emotional healing to do as well as aided in the emotional healing of others. Cesarean scar massage is a very important factor in your physical healing postpartum and the better you can heal physically, the stronger of a mom you can be to your little one(s) and the more smoothly you can move on and learn from the experience of a caesarean birth.