Hello, welcome to episode two of ‘c-section support’ by ‘OT in motherhood’ podcast. Today, we are going to talk about something that I believe is one of the most important first things you should be taught in hospital after a c-section, and that is how to get out of bed. Something really simple can make a real big difference to your recovery. So we'll be covering the technique you can use, best sleeping positions, the importance of rest, and alternative sleeping arrangements.
So first of all, how to get out of bed. Your first time out of bed in hospital is going to be a tough one. You will receive some pain medication that will be timed approximately half an hour before you get out of bed and you will get up for the first time with the nurses, so you'll have some assistance if you need it. It might be uncomfortable, but that's okay and it will get better, I promise. So make sure for the first couple of days at least you are making use of the staff or your support person that's with you in the hospital to hand you your baby, for feeding and things like that. So you're not holding your baby when you're also getting out of bed.
I realize that describing this technique is a little bit tricky. Of course, it is going to be better to see it. So my aim is to make a video and I will have it available on my Instagram at some point in the future that will show you this technique. But for now, I'm just going to talk you through it. We start with you lying on your back. I want you to bend your knees up. This technique is called the log roll technique. So we want you to imagine that you are moving like a log, your body is moving as one. We don't want your upper body moving at different times to your lower body. So once your knees are up, I want you to turn to your side towards the edge of the bed. You can move your hands forward in front of you to help you do this. Once you're lying on your side, you're gonna put your arm or your hand that's on the top and you're gonna put it in front of you on the bed, and you're going to move your feet towards the edge of the bed. Once you do that, you're going to push up from the bed as your legs come off the side of the bed in one movement so that you're sitting up.
Now, when you do this, I want you to breathe in before you do it and then breathe out as you're sitting up. We always want to exhale on exertion, okay? Once you're sitting up, I want you to wiggle your bottom to the edge of the bed and then you can stand up. Always bring your nose over your toes, so your body weight is forward, and use your hands on either side of you and push up from the bed into standing.
The first couple of times you might feel that you need to sit on the edge of the bed for a few seconds. If you're feeling light headed or anything like that, sit there for a little bit until that feeling goes, before you stand up. The reason we teach this technique, and we teach this technique after a lot of different surgeries, is that it reduces the straining on your wound or your abdomen.
You're minimizing the use of your abs, so therefore you're reducing the amount of pain that you'll be in when you sit up. When you're in hospital, I definitely want you to use those bed controls. They're there to help you, so don't be afraid to use them. But before you go home, I really want you to practice this technique so that you know what you're doing. And I guess you can ask the nurses or someone for feedback to make sure that you're doing it right. Because once you're home, you'll be needing to do this many times during the night and during the day when your baby needs a feed. The other little tip I want to recommend is when you're in hospital try and get out of bed on the same side of the bed as you would at home, because that means you're practicing exactly as you would at home. The other little tip, when you are getting out of bed is if you're able to do this one handed, you can brace a pillow or even a rolled up towel against your wound and that can also provide you a little bit of support.
Okay, so the best sleeping position is lying down flat in bed. You can use pillows to make yourself more comfortable. So for myself, I prefer to sleep on my back and I put a pillow under my knees and that again, reduces a little bit of strain on your wound, but also your back. Initially, after my c-section, I found that I actually had a really sore back, which I was surprised at. That pain was strain on my back muscles because my abs weren't really working very well because I'd had the surgery, so my back was compensating. I found that my muscles were getting fatigued. And also if you think about it, your center of gravity has changed as well. You no longer have a baby in your belly. So your center of gravity that you had at the end of pregnancy has suddenly moved back and that can affect your muscles when you're standing and when you're moving and cause back ache. So anyway, a pillow under my knees helped me. On the rare times that I did sleep on my side, and this was probably after a few days, I found that if I put a pillow between my knees . . . So bend my knees a little bit, put a pillow between my knees . . . that again supports your back and reduces that strain on your C section wound.
The other thing you can do if you have swollen feet or legs after your c-section, which again is quite common in the first few days, because of, well, part of it is the fluids you've had during the surgery. You can elevate your legs, which will help reduce that swelling. So, put one or two pillows under your feet. If you are breastfeeding, and you can learn and master the art of breastfeeding lying down, this can be really beneficial because it provides your body with more rest while you are breastfeeding, which ends up being hours and hours, breastfeeding your new baby. Okay. I never got the hang of this, unfortunately. So I would always breastfeed my babies sitting up, supported by pillows, but if you can lie down, it's a good idea. The thing with this is I would definitely use a support person to help you actually move the baby before you get up.
Now, why am I recommending that the best position for you to sleep is lying down? There are multiple reasons for this. Horizontal rest is best after c-section, and ideally as well as sleeping on your back or on your side in bed overnight, it's a great idea also to get periods of horizontal rest during the day. I realize in practicality, this can be a bit difficult when you've got an unpredictable schedule and you're spending lots of time breastfeeding. But if you could structure your day, perhaps to have a rest after lunch for example, which a lot of hospitals do that anyway, have a resting period about one o'clock. So if you could continue that routine when you're home, that can really help.
So the reason that lying down helps is because it helps your abdominal muscles and your pelvic floor recover. Your pelvic floor has been put under strain during pregnancy. Yes, you did not give birth vaginally, but you had however many kilos of baby and placenta and fluid and everything sitting on your pelvic floor for your pregnancy. So your pelvic floor has been stretched and needs time to recover. By lying down, you can reduce that weight on your pelvic floor and help it recover quicker. Similar to your c-section wound, you are reducing gravity, so you are reducing the amount of weight that's on that wound and you can help it heal. The other thing it can do, as I mentioned before, is help reduce swelling, especially if your swelling is in your legs, because it gives you an opportunity to elevate those legs and keep them above the height of your heart.
One more thing is that it keeps your wound in neutral. I guess the risk if you're spending a lot of time sitting up after your c-section, so if you're sleeping sitting up, you're resting sitting up, you know, watching tv, maybe while you feed your baby - that wound is not getting a chance to lie flat, and straighten out, which of course it needs to be when we walk around and when we move. So we want it to be as flat as possible for a long period of time during the day so that it can heal properly and not feel tight and then stretched or pull in future.
Other sleeping positions or ways of getting out of bed that I've seen, I've seen a few different techniques recommended on Facebook groups and social media. I just want to go through some of those and just give, um, a bit more insight into benefits and reasons that maybe they're not the best options. One of the frequent things that I see recommended is to sleep in a recliner. Yes, they're comfortable. Um, I don't have one of those in my house. So that's the thing. You might not have one available to you. And again, like I mentioned, you're likely sleeping in not a complete horizontal position. Some of them do pretty much lie flat. Um, then you have the issue of getting out. If it's an electric recliner, that's amazing. If it's one of those recliners where the footrest comes up and you need to push it in manually with your feet - that's almost like doing a crunch, and you're going to find that really difficult after a C section. It's going to be painful and put strain on your abdomen. So have a look at that before you use it, I guess. We don't want you getting stuck in the chair. That would not be good.
The other thing I see is recommending people to sleep propped up in bed. So either with a wedge pillow or just a bunch of normal pillows behind your back. Again, similar thing sitting up - it isn't the best. It can be more comfortable of course, it can be easier to get out of bed because a lot of people don't know about the log roll technique. So if you're thinking about how you normally get out of bed, which would just be to sort of sit upright, then If you're already propped up, then of course you're not putting as much strain on your abdomen. I guess one of the major risks as well with sleeping upright is the potential that you will fall asleep while holding your baby, which of course isn't safe. It's always better to safely co sleep - so sleep lying down in a safe way with your baby, then risk falling asleep in a sitting up position, whether that's in bed or on the couch or in an armchair. I'll go into a little bit more about that safety soon.
The other thing I saw, which I actually thought was a really kind of ingenious idea was to tie a sheet or the cord of a dressing gown to the edge of the bed. So if the bed has a rail or something, tie it on there and use it like a rope to pull on to sit up. Um, good idea in theory, and it probably does help. But if you're lying down flat, you will still be using your ab muscles. When you're pulling up, you'll be bracing and tensing those. It would help if you're already in a sitting up position, it would help you pull yourself up that last little bit. But again, we really want you to be lying flat, ideally.
One last option is to have someone help you with sitting up. I guess the risk of that is that your support person could actually hurt themselves by pulling you up. Especially if we think about how many times you might need to get out of bed. You know, during the first few days and weeks, when you're attending to your baby, they could potentially hurt themselves, so best not to do that if possible. In saying all this, of course, you need to sleep and sleep is vital to recovery. So if you are lying down and you've tried this log roll technique and you're really struggling, then you just need to sleep however is best for you. And as soon as you can, go back to lying down in bed for sleep. I obviously don't recommend that you lie down and you're just really struggling and therefore you're not getting up as frequently as you need to.
After the birth of my first baby, this was me overnight. My daughter was waking really frequently in hospital and getting out of bed was just not comfortable, even with the bed controls. So I spent probably way too much time, or more time than I should have sitting up out of bed because I was just waiting for her to wake again. So we don't want you to do that. For my second baby, I had better technique and I learned from that and knew the benefits of rest and prioritized that more.
I also just want to touch on co-sleeping. As I mentioned before, lying down with your baby in a safe way is always better than risking falling asleep when you're sitting up. I will put a link in the show notes that goes over some strategies and things you need to be mindful of when you co-sleep.
Now you might not want to co-sleep and I know this was definitely me. I was really not keen on it for several different reasons, but the fact is that the majority of parents, whether they intend to or not, do end up co-sleeping at some stage when their baby is small. I'd much rather you know how to do it safely and have already set up your environment in advance for it to be safe, than for you to be desperate in the middle of the night when you haven't slept, you're so sleep deprived, you’re just desperate for sleep that you just do it without planning and potentially in an unsafe way. Plan your sleep environments in advance, ideally before birth, if you can. Know where you're going to sleep during the night. Are you going to sleep in that same place for naps during the day? Is your bed set up in a safe manner that you can co-sleep? If it happens, even if you plan not to, it may happen. Preparation is key, okay. In another episode I will go more into planning in general, but for now, I just wanted to cover that.
I have some homework for you. First I want you to try this log roll technique. It's a great thing to actually do if you're still pregnant, as it also works really well if you've got a big belly. And then obviously you can keep doing that, after your birth and into your recovery as well. And the second thing, as I mentioned, check out the link in the show notes about safe co-sleeping, familiarize yourself with that. And make sure that your sleep environment meets those criteria and be aware of the things that you need to do with your baby as well, to optimize their safety.
Thanks so much for listening today. Have an amazing fortnight and I'll chat to you next time. Bye.