Post-Cesarean Healing: A Holistic Approach
Healing from birth is multidimensional. The body is recovering from pregnancy and labor, there's a massive hormonal shift, we're making milk and feeding a baby, our sleep is even more screwed up than before, and we have a whole new person in our lives (exciting and wonderful and magical, yes! But also challenging).
Healing from surgery complicates the picture further. Not only is the body recovering from pregnancy, and possibly a long labor, but there's also an incision through the tissues of the abdomen to contend with. There's likely an emotional dimension to work through, trauma even.
My approach to healing from a cesarean is also multidimensional, considering someone's immediate condition as well as their long-term wellness (because any approach to the postpartum should take into account someone's lifelong physical, emotional, psychological, sexual, intercommunal and other aspects of wellness). So, I offer you a snapshot of my postpartum care for folks recovering from a c-section.
Once in recovery, the parent usually needs a whole lot of rest, unless it was a planned cesarean (in which case she's not wiped to from labor). Lately I've been to a few very long labors that ended in surgery, and once the babies had their first meals, those mamas needed a serious nap. Unfortunately, hospitals are not the most restful places with all the beeping and blood pressure cuffs and people coming in and out, so it might not be until someone gets home that they get in some real rest.
Aside from what I would regularly do when someone has just had a baby, I dose a bottle of water with a few pellets of homeopathic Staphysagria 30C and shake it well, with instructions to sip on it over the next 24 hours. Alternatively, they can take a dose under the tongue as soon as they're able, and another dose 12 hours later (a dose before going into the OR is great too). Staphysagria is the remedy to promote healing of cutting incisions, and it's always in my birth bag for an unexpected cesarean (and it doesn't interact with medications used in surgery).
We start tackling symptoms related to surgery as well as nutrition on the next day.
Both mama and baby have been hit with a load of antibiotics, which means that her gut is wiped of the helpful bacteria that are essential to our digestion. Couple that with medications from surgery and opiate pain-relief postpartum and you've got a recipe for painful bloating, constipation, and just generally poor digestion.
Ideally, I'd want them to start taking a high-quality, refrigerated probiotic as soon as possible (this will also help prevent yeast overgrowth that manifests as the breastfeeding challenge known as "thrush"). It's possible to cut down on bloating by drinking teas of "carminative" herbs, those herbs and spices that reduce gassiness and promote digestion. It just so happens that this category of herbs tends to be most useful for breastfeeding! I love to see my clients drinking teas made with fennel, anise, coriander, cumin, ajwain, and black cumin, and using them in their foods (no matter how their babies were born!).
The best foods are those that are warm and easy to break down, so soups and stews. Think bone broth, meat stews that have been cooked for hours, and soft veggie soups. The "C-Recovery Vegetable Stew" is a great one, from The First Forty Days by Heng Ou (I consider this book an absolute essential and it should be on everyone's registry!). All traditional medicinal systems, including Traditional Chinese Medicine (TCM) and Ayurveda, emphasize warming foods after birth, because the gates to our bodies are opened, risking "cold." This might sound strange, but these are just different ways of understanding processes that happen in the body. Cold foods exacerbate this weakening of the body, and include food and drink that is literally cold, but also foods that cool us (raw foods, dairy, frozen and reheated foods, etc).
A simple tea that comes from TCM is made from goji berries and red dates. These tasty treats are highly nutritive and recommended for any kind of recovery, whether childbirth, surgery, or illness. Rinse eight red dates and a half cup of goji berries, then simmer in eight cups of water for an hour (check in beforehand with an experienced herbalist or naturopath if you're on blood thinners or medications for diabetes). I encourage people to have these ingredients on hand (see the links above) for postpartum recovery, and again, no matter how they baby comes out. One of the reasons why this tea is so helpful is because it's blood building.
Our bodies make almost a gallon of blood in pregnancy, a function of which is to provide a buffer against blood loss. But, in a cesarean birth, we tend to lose more blood than average, which means that our bodies have to build it back up. If someone was already borderline anemic, this blood loss could feel huge. We need adequate blood to make milk (this is one of the reasons why there can be a delay in milk coming in after a cesarean). When our iron is low, we also just generally feel like crap, and you don't need to feel worse when you're already recovering from surgery.
Protein and iron provide the building blocks of blood, and vitamin C is not only necessary for wound healing, but helps our bodies absorb more plant-based iron. So again, nourishing and easily digestible foods are a must. I also recommend that people take a plant-based iron supplement. My preferred supplement is Floradix, a liquid herbal supplement that is easily assimilated by the body. Liquid chlorophyll derived from iron-rich nettles or alfalfa is also a good option.
It goes without saying that anyone who has a baby needs support. But, if you're not able to get up and change a diaper or to hold a baby comfortably (because of pressure on the incision), then you need extra support. Calling in a postpartum doula, scheduling savvy friends to come by to help out, and having family around can really help. Enlist community to bring nourishing foods. When you're ready, find supportive spaces for processing your experience, such as International Cesarean Awareness Network meetings.
The Other Kind of Support
Your core muscles provide support for your whole body. Cutting through those muscles can challenge our body's ability to provide structural support as we move, stand, and sit. I recommend that anyone who has had a cesarean work with a soft tissue therapist.
Ryan Bailey in the Seacoast, New Hampshire area is phenomenal. Check her out at Expecting Pelvic Health.
Karlene Joy Salguero at Women's Journey Physical Therapy in Cambridge, Massachusetts specializes in postpartum recovery.
Your internal organs also support one another. Scar tissue adhesions may form, disrupting the placement and mobility of internal organs, resulting in abdominal pain, pain with intercourse, incontinence and bowel issues, and other problems, sometimes years after surgery! Soft tissue therapy and acupuncture are helpful, as are castor oil packs (starting around four months postpartum).
You can also manually work on your scar once it is completely healed to reduce adhesions, which can also improve the look of the "belly shelf" at the scar site. I can't recommend Jenny Burrell's work any more strongly; definitely watch this video on scar massage and acupressure for bloating.