C-Section Support

Have you been told you need to have your baby via c-section, and c-section preparation has you feeling overwhelmed? Maybe you had your baby via emergency c-section and you want to know what you can do to kickstart your c-section recovery? ‘C-section support’ is a podcast brought to you by Kristy Urrutia, Occupational Therapist and C-section Mama of 2. Join Kristy every fortnight for short and practical episodes designed to educate and empower women who birth via c-section.

Restrictions after c-section birth 07/01/2024

Restrictions after c-section birth Hello, welcome to episode four of C section support by OT in motherhood podcast. Thanks for being here today. We are going to talk about the potential restrictions that you'll have in place after your C section surgery. There seems to be a lack of knowledge about what these restrictions might be. I do have some friends who have had a similar experience - they had a C section birth and weren't given very clear information from their hospital or their doctor about what these restrictions were, which can be really confusing when you've just given birth. You are tired, you don't have much energy, you've just gone through a surgery that you may or may not have been aware that you were going to have. So it's really important to know what you can and can't do. The reason for this is knowing your restrictions means you can have the best recovery possible. Those restrictions are in place so that your body can heal and to reduce the risk of further injuries. So things like infection, potential hernias, or just the wound not healing properly. I've jumped on Google and I've literally looked at what these restrictions are and the information out there is really confusing. Obviously we don't want to rely on Google for our health information, but there's so many websites that have conflicting information, which doesn't help the confusion and, you know, potentially people feeling anxious about the way that they birthed their baby already. I want to note that restrictions might vary between hospitals, between surgeons, depending on the type of incision you had. So in episode one, I spoke about those - it could be vertical or horizontal. Of course, if you have any other medical issues, so always, always confirm your restrictions with your doctor. To ensure that you have this, things that you can do are ask for written information before you leave the hospital, check with the doctor who sees you before you're discharged and with your nurse as well. If you have a support person with you in the hospital, ask them to write notes during these discussions so that you have everything down. And if you're unsure of anything, then check - check with the doctor before the doctor discharges you. Of course, if you know that you're having a C section in advance, then it's a good idea to educate yourself. Consult a trusted provider, but also confirm these with your doctor prior to giving birth. This gives you an idea of what you can and can't do, which does have implications on, of course, your own health and what you can and can't do, but also, things that might need to be done around the house to manage the normal activities of the house. So it could be looking after other children, it could just be the daily tasks like meal preparation, and shopping, and driving and things like that. So it is always best to consult with your doctor. Some of these restrictions. One of them you might have heard of is we don't want you lifting anything heavier than your baby. I realize this is a little bit varied, because you know, some people bring home a six pound baby, some people bring home a 10 pound baby. But I think the reason they phrase it that way, is that it's easier to understand than saying, for example, don't lift anything more than two kilos or five kilos or 10 kilos. Because I, for example, wouldn't really know what in my household weighs that much. So no lifting heavier than your baby is something that's easy to grasp, I guess, and understand. Now, this can be difficult, especially if you do have another child. But it's really important to try to adhere to this. So, think of other ways that you can do the activities that you need to do without lifting. Okay, so there are different ways. So if you do have a child that could be maybe changing their nappy on a different surface rather than lifting them onto the change table. It could be teaching them how to climb into the car seat themselves. It could be sitting down on the couch to give them a cuddle instead of lifting them up and giving them comfort. Um, there's different ways to do that. Other things that you might be doing during a normal day, lifting for example, like a heavy laundry basket. Ideally get someone else to do the laundry for you, but if you need to do that then, you know, you could be carrying just a smaller load, for example, just a few items. The reason we don't want you lifting heavy loads is because it puts strain on your abdomen and on your wound site. And we really want that wound to heal properly and your muscles as well to heal. The muscles have been pulled apart for the surgery, but also have been stretched during pregnancy itself. You are also at higher risk of having an injury post birth because your joints and everything are more loose. So that's something to take into account too. Also, when you are lifting your baby, there's certain ways that you can lift in a healthier way. In a way that will help you prevent injury, but also help you prevent pain through your back or through your arms. Because a baby, even if they're, you know, 8 pound or whatever, is not really heavy. But if you're doing it many, many times during a day, there is also that risk of injury as well. So we want to do it in a way that's obviously safe for your baby, but safe for you as well. Driving is another one. Now, when I had my children, I was told not to drive for six weeks. There is conflicting information out there, but generally after surgery in Australia, it's a six week restriction. It can sometimes be brought forward under the discretion of your doctor. So if you do need to drive before that, it is best to consult your doctor and have written clearance. A few reasons. One of them is that it can affect your insurance, so if you are in an accident prior to that 6 weeks and you didn't have doctor's clearance, you can be liable for covering the cost from the accident. So in the early days after your C section, the reasons we don't want you driving are that you're taking pain medication that can potentially impair your ability to drive. You have that wound site, so to be able to drive safely, you need to be able to do a head check. So turn and see what's behind you without pain. And we also want you to be able to put your foot on the brakes hard, like for example, in an accident without causing pain. So, the risk of that is that the seatbelt, of course, can injure your wound site. But again, check with your doctor about this. I understand, of course, some people have had a C section and their baby is in NICU so they need to be visiting their baby every day and it's difficult to rely on other people to take them to the hospital. Or, you know, especially if you've got other children and you're doing the school run and again you don't have much support, it's important that you're able to get to school. So consult with your doctor and you might be able to drive earlier than the six weeks. One thing to be aware of if you are driving earlier than that is that often when you're driving that also means you're lifting a pram or a car seat in and out of the car. Be aware of your lifting restrictions. So generally the post surgical restrictions after c section are a period of six weeks. So if you are driving before six weeks, we also don't want you to be lifting a heavy pram, which generally are at least five kilos. Um, so maybe you could baby wear your baby instead. Okay. In terms of wound care, we don't want you soaking that wound. So that means no baths and no swimming. The wound of course can get wet, like in a shower, but that's just, you know, with water running over it and making sure that your wound is dry afterwards. Swimming and baths soak that wound, which can increase your risk of infection. Okay, so we really want that wound to be healed properly before doing those activities. Another restriction is no sexual intercourse. This also means no using tampons, basically no inserting anything into the vagina at all. Um, again, the risk of this is infection. You have that external wound, the C section wound, but you also have that wound on your womb from where the placenta was attached. So you basically have two wounds that are healing and we want to optimize that healing, make sure you don't get an infection. Infections, you know, even if you're increasing that risk a small amount, infections are annoying. They're painful. They can further delay your healing. They could mean another hospital admission. There's something that you just really want to avoid at all costs and do everything that you can to avoid that from happening. Okay. Another restriction as well as not lifting heavier than your baby. Uh, we also don't want you bending or reaching or twisting excessively. And the reason for that is that those movements do put strain on that wound. Activities in which you might do those movements are things like laundry; carrying the basket, but of course also reaching up to the washing line. Uh, meal preparation, so reaching up to your top cupboards. Twisting, bending, you're going to be bending a lot when you're looking after a small child. So we want you to be careful of that because, as I said previously, the muscles in your abdomen have also been affected from the C section birth as well as pregnancy, so we want those to heal properly as well. We also don't want extra stress on the wound site. So the wound itself takes six weeks for that initial healing phase to happen. The healing does go on longer than that, but that's when the initial healing happens. And I will talk about this more in another podcast episode. So, we want that wound to close properly and for that scar to be, to be strong, I guess. Those excessive movements; bending, stretching, twisting - can put strain on that site, potentially pull it, potentially open the wound, especially in the early days, so we don't want that happening. Again, that's a potential risk for infection, but also hernia and just poor healing as well. Now, of course, as I mentioned previously, the ideal situation is for someone else to do those activities for you; the laundry, the meal prep, and helping you look after your kids as well as, um, of course there's other activities during a day, but there are things that you can do to still do those activities, but to minimize the strain on your body. So for example. In your kitchen one easy thing you can do is have someone move your commonly used items onto the bench or to a space that's easily reachable for you. All right. Thanks so much for listening today. I really appreciate it. If you can think of any other restriction or it's something I might've missed, or maybe something that your doctor has told you as well, then feel free to reach out. Let me know. Um, you can reach me at OT and motherhood on Instagram. So what I want you to do from this episode is go ahead and confirm with your doctor what your restrictions might be. Start thinking about how you can modify your home to prevent these movements, especially, like I said, the lifting, the bending, the twisting. Um, because there are ways that you can set up your home to avoid those things. And I will talk about this in another episode as well. Um, so look into that, make sure you're aware of what your restrictions are before birth, and that can help you prepare and to have the best recovery possible. Alright, thanks for being here, see you next time. /episode/index/show/a3399478-322a-40ff-862b-75eef1f952da/id/31957897

How to have a gentle c-section 07/01/2024

How to have a gentle c-section Hello. Welcome to episode five of C-section support by OT in motherhood podcast. Today, we're going to talk about how to have a gentle C-section. You might be wondering what is a gentle C-section. So it's not a specific way of doing the surgery, but more of a gentle approach to the birth. It aims to make the experience more like a vaginal birth with the baby going to the mother as soon as possible, and it also promotes early initiation of breastfeeding. The approach involves the family and also provides more choice and control over the experience. It aims to have the C-section more like a personalized birth experience rather than just a surgery experience where it values the emotional side of birth as well. I've realized that a lot of aspects of my own births had a gentle approach. I hadn't actually heard of this term before I had my oldest daughter. Because my birth was a planned C-section I was given the opportunity to fill out a birth plan by the hospital and on that, it had tick boxes and some space to fill in comments, and it had some choices that could easily be incorporated into the birth. And since then, I've also heard of approaches that might be possible depending on your provider and your obstetrician as well. So today I'm going to talk about a few common options and choices that you might be able to incorporate into the birth of your baby. The first one is having your support person with you for as much as possible of the birth experience. So for me, my husband was with me while I had my spinal anesthetic, and then he was apart from me for that brief period where I was taken into the theater. So the hospital where I gave birth, the anesthetic happened in a room off to the side and that's partly because the hospital had one theater that was just for C-sections. So it was a bit of like a revolving door of women going in. So one woman would be getting the anesthetic while another would be in the theater, having their baby. And I actually heard a baby's first cries when I was getting my anesthetic sorted out from in the different room. So yeah, he was apart from me just for that time that I was wheeled into the theater and then moved onto the actual operating table. And everything was set up and then he was brought in and was able to sit right by my head, basically. And then obviously he was there throughout the actual birth. And then while I was moved into recovery, he was with me there as well, until I was taken all the way up to the ward and then stayed with me for several hours after that. I gave birth to both of my babies in a public hospital, so my husband wasn't able to stay overnight, but he stayed for the duration of the visiting hours after I'd had both of my babies. It was really important and valuable for my husband to be there throughout the birth because obviously it's the birth of his kids as well, and it was a great emotional support for me. Um, and he remembers different things than I do - there's some parts I just can't remember and he's able to remember those. So that's really special as well. Another thing that's quite easy to do is to have music playing during your births. Uh, so I think for my daughter, we, uh, I went into labor early. And we hadn't actually sorted out a playlist, and for my son we had but I don't even remember if we handed over the phone to get the playlist played because I have no idea what music was playing during the birth. I think they did ask us and even for my daughter as well, they did ask us what we wanted playing like what radio station or what type of music? Um, I don't remember what I said and I would have no idea what song was playing. I think I was just so focused on my baby that, yeah, I didn't hear any music at all, but that might be something that you really value. Maybe you have some music that you find really relaxing or that you just want to associate with the birth of your baby going forward. Uh, and you can make up a playlist on Spotify, there’s existing playlists you can look into and see if any of those suit you. One aspect of a gentle C-section that I don't think I had and is, uh, obviously up to the surgeon is actually having a slower delivery of the baby. So I've heard that they can deliver the baby’s head first and then slowly let the rest of the body birth out the incision, so it's more closely mimicking a vaginal birth. And the benefit of that is that it can help the fluid be squeezed out from the baby. One thing that does happen in c-sections is that babies can have a little bit more fluid. Which again, I didn't know with my first daughter until it was the first night and she was making funny noises. And then the midwife was saying, yeah, it was because she had extra fluid. So that could be something that, you know, you need to speak to the obstetrician about and see what can be done okay. Another is having the drape dropped. So you have a, a drape or a big sheet put up around the level of your chest so that you can't see the surgery. Um, and this is obviously partly also to create that sterile surgical field as well. They don't want to introduce any germs because you are obviously open on the table, and they don't want to increase that risk of infection. So what happened with my son, we opted to have the drape dropped as he was born. So I wasn't able to see my open incision because of just angles and everything. But just before he was pulled out, there was a staff member on each side of the drape and they dropped it down so that we could see him lifted up. Associated with that, we were able to find out his sex ourselves. We didn't know in advance if we were having a boy or a girl. Um, and with my daughter, they tried to do that. The pediatrician brought her around the drape, but I honestly couldn't even tell if she was a boy or a girl because of where the pediatrician's hands were. So in the end, he actually announced it was a girl. Um, but with my son, yeah, the pediatrician held him up and we could see that he was a boy and were able to, you know, make that discovery for ourselves, which was pretty special. I have also heard of the possibility of having a clear drape. So still maintaining that sterile field, but you can see more of the process. Again, that's going to depend on what's available at your hospital. Um, so that's something that you can talk about with your provider. Immediate skin to skin is something that's really valuable and that can happen quite often in a vaginal birth, but can be more of a barrier during a C-section birth. Obviously skin-to-skin has great benefits for the baby's wellbeing, but also the mother as well. Now I didn't have immediate skin to skin. Basically for my son and my daughter though, both were held up so I could see them. Then they were taken off to the side, just checked over and you know, vitals taken and any sort of essential measurements taken. And then my husband went over and cut the cord, which again is something that can be really special. They will ask, uh, generally if your support person does want to cut the cord. So they will cut the cord and then the baby will be brought over to the mother. So it's generally a couple of minutes. Generally not more than five minutes. Of course, this depends on if the baby needs any extra assistance. But they will be brought over to you and you’ll be able to have skin to skin. Now something to be aware of ahead of time, if you do want to have skin to skin, is they might prepare you beforehand by making sure that your gown is on . . . So I think I put my gown on back to front for my daughter, so it could be easily opened like at my chest. And the leads that are placed on you to monitor your vitals during the surgery can be placed potentially on your back or just on areas that it's not going to get in the way of, you know, when the baby is placed on your chest. So that happened with my daughter. I had skin to skin straightaway. With, like the location of the drape, there’s really not much space between basically your head and where the drape is. So my daughter was placed quite high on my chest, pretty much under my chin, really. So I couldn't really see her because I couldn't move my head. Um, and I think they placed her there just because, you know, to maximize the skin to skin with me to keep her warm. And they put the blanket over the top of her because operating theaters are quite cold. With my son, he was actually wrapped up and I'm not sure why, because we did request immediate skin to skin, you know, as soon as possible. And I do actually regret not sort of realizing and asking at the time, you know, can he please be unwrapped and placed on my chest? So because he was wrapped up, he was more placed like in my arms so I was able to see him more clearly. Both times my baby stayed with me as I was wheeled into recovery, and then throughout the time in recovery, and then wheeled onto the ward. I was also helped and encouraged to breastfeed in recovery, which I was able to do successfully for both babies. I've heard of this being promoted in theater but I think in some ways it would be a little bit more difficult. And like I said, partly the logistics of how high the drape is placed, that there's not much space to actually place the baby. Uh, whereas in recovery, of course, you've had the drape removed, there’s more space that the baby can be positioned on your chest. And you've got the midwives there that they've got a little bit more time and space to help you initiate that breastfeeding as well. Something else that's really valuable is getting photos taken. I don't have photos of my baby's birth, like during the actual birth process. It was very clear instructions to my husband, that he had to stay seated at my head until he was told otherwise. So obviously with him cutting the cord, he was able to go over to the little bassinet and cut the cord and then come back to me. But otherwise he was told - you’re not to stand up and you're not to move. I think they've had probably too many instances of support people fainting. I know that one midwife said that that's definitely happened before. So it might not be possible to get photos of the actual birth. It might depend on the staff. So you might be able to ask a midwife there, or you might be able to have an additional support person, whether that's a doula potentially, or an additional family member. Or something that you might be able to have is a student. I didn't have a student for my eldest, but I did have a student throughout my pregnancy for my son. Unfortunately, she was unwell on the day of my birth. So she wasn't actually there. But if you do have a student, you can hand them your phone and tell them that, as much as possible, they’re responsible for taking photos. I do have photos though, that were taken in theater. And that was when my babies were born and they were in my arms. And then the staff member took our first family photos, which are really special. So on that note, it might be a good idea if you are having music as well to have two phones. So have your support person have big pockets and have both your phone and their phone in their pocket - one for music and one for photos as well. All right. So that's just an introduction of some fairly common ways that you can have a gentle C-section and some choices that might be available to you. There are some other things that I've heard of that are probably a little bit more rare and a bit more niche. And again, not all hospitals would be open to those - I think I’ll talk about them in another episode, so stay tuned. For now, if you haven't had your baby yet, then it can be a good idea to talk to your partner or your support person about what options you might want to pursue during your birth experience. Write a list, take it to your next appointment with your provider to discuss what might be possible. As I've mentioned earlier, each hospital and obstetrician will have their own guidelines. So it's good to know what is possible, and also have that opportunity ahead of time to advocate for your preferences. And obviously the earlier that these things are discussed, then the more time you've got to advocate for what you want. And for the hospital or the obstetrician to make those considerations for you. Thanks for listening today. Feel free to contact me at ‘OT in motherhood’ on Instagram, if you have any comments or suggestions for upcoming episodes. Don't forget to subscribe below, check out the show notes and I will see you next time. Bye. /episode/index/show/a3399478-322a-40ff-862b-75eef1f952da/id/31957872

How to have a gentle c-section 07/01/2024

The support person's role before your c-section 06/06/2024

The support person's role before your c-section Hello, and welcome to episode three of ‘C section support’ by ‘OT in Motherhood’ podcast. So great to have you back again. Today, we are going to talk about the role of the support person before your C-section birth. So who is the support person? Basically, your support person can be anyone you want it to be. It could be your partner, it could be your mum, a friend, whoever you want really. And it's someone who's with you during the birth and with you at home as well during your recovery. Having someone you trust as your support person can make a huge difference to the experience of your birth and your recovery, and also how you're feeling leading up to the birth as well. Your support person can help provide you with comfort and reassurance. They can help you learn about birth leading up to the time, and they can advocate for you. They can help you recover by giving you information and supporting you practically at home and just overall, really add to your birth experience. It may be possible to have a professional as a support person during your birth, but that's something that you'll need to discuss with your hospital in advance if possible. So for example, this could be a doula. A doula might be able to attend your birth during a C-section, it could be a birth photographer, or it could even be an additional support person. The reason this needs to be discussed in advance is that the operating theater is already quite a busy place. There's quite a few health professionals in there already, and they all have their specific roles that they play. They want to minimize the additional people in there because space is at a premium. Have those discussions with your obstetrician or midwife in advance, and you might have to get written approval. If you happen to have a student midwife, normally they are able to attend the birth without prior approval as they are counted as a staff member during your birth. All right. So before your birth, there's a number of things that your support person can do. They can attend appointments with you at the hospital so this means obviously being there in person, but also helping you prep for the appointments. Thinking of questions you might want to know the answers to. Helping you emotionally as well with those appointments, especially if you're feeling anxious, and helping you to remember the information. Maybe they could even be your scribe during the appointment to help you remember the information. Another major thing that support person can do is educate themselves. This could be attending formal birth classes with you or birth preparation classes, whether that's in person or maybe they're online. They could also do their own preparation, however they like. It could be reading a book, reading articles, listening to this podcast. This is not just around the birth itself, but around your recovery. If you are planning to breastfeed, I really recommend that they also educate themselves on breastfeeding so that they can help you get breastfeeding off to a great start. There is a lot of information out there, which I guess can be hard to navigate, but it's important to do the best that you can to feel informed before birth because afterwards, you’re generally sleep deprived, you've got a whole new normal to get used to. So you have less time and energy to educate yourselves after your beautiful baby has arrived. Another thing is, working with you on your postpartum plan. You might've heard this term before, postpartum planning, and basically it's coming up with a plan for after your baby has arrived. It's not just looking at what items you need, you know, do you need a cot? Do you need nappies? Do you need all that sort of thing? It's more about what support you need. So this could include what professionals you might access, what information sources you trust, it could be, how are you managing childcare if you have other children, and how are you going to manage meals? All the things that need to be done around the house, who is doing what, are they aware of your post surgery restrictions in movement and activities and how can you collaborate on them supporting you during that time of recovery. So you can come up with that together. You can write it down if that helps, there are a few resources around. There's also articles and things you can access about how to actually make a postpartum plan. And there are also some professionals who offer that as a service. Related to this is also your birth plan. And yes, even though you're having a c-section birth, and it is surgery, you can definitely have a birth plan. There are certain things that you have choice over and control over, and hospitals will generally do all they can to support you in having choice and preference during your birth. Obviously within the limits of what needs to happen on the day and the policies and procedures of the hospital. So, that's something to be aware of before time as well, what your options are. And then collaborate with your support person to think about things that are really important to both of you. And are you both aware of what those are so that on the day your support person can advocate for you, to ensure that those things happen. Hospital bag, that is something that is talked about a lot, what needs to be packed in your hospital bag. There are so many different opinions, but it's important that your support person has some things with them as well, especially if they will be with you in hospital after the birth, whether they are staying overnight with you or maybe they're going home again. With my two beautiful kids that were born, I gave birth in a public hospital, which meant that my husband was only able to visit during the normal visiting hours. Both of my births were during the day, so that was fine. But obviously if you have a C-section during the middle of the night, then your support person can stay with you for a little while after the birth before going home. Obviously if your support person is staying overnight, then they will need an overnight bag, you know, toiletries, clothes, all that sort of thing. Phone charger is a very important thing to have. For the birth itself, there's some items that I recommend. And while you will have a hospital bag packed and probably in the car a few weeks in advance, it's a great idea for your support person to have a little bag packed in advance as well. So a few things, when your support person comes into the theater with you for the birth, they will be given scrubs. So a top and pants, that they need to put over their normal clothes and generally a hat as well. Something that can be useful if your partner does have long hair is to have a hair tie available so that they can tie their hair back easily. Another thing is to make sure that they've got enclosed shoes, they need to be worn in theater. If it's the height of summer, you know, I gave birth to my first daughter in summer in Western Australia, where I think the day before I gave birth was about 40 degrees Celsius or something. So, you know, closed in shoes aren't worn very often. So make sure that you have those in the car so that they can be worn in the hospital. The other things to have with them on the days, obviously a phone, or, or separate camera. But generally phone is a good idea, as you can take photos on there. You can also have music that you might be able to play during the birth, if that's your preference. So make sure that, I guess it's a great idea for your support person to have pockets in whatever they're wearing so that they can have their phone or maybe your phone in their pocket as well. Another thing that was recommended by a midwife before I gave birth was to bring a beanie with you, a baby beanie. Hospital will often provide a beanie and put one on your baby, but if you bring your own, the advantage of that is that you could have worn it down your top for a few nights before birth so that that beanie has your smell already on it. So your baby has that smell on it associated with you. And this can be especially important if your baby does need to be separated from you for whatever reason. If they need to go to NICU or they need to be checked out, then they've got that little item of you. Something else that was suggested is a hankie, which I know is a bit old fashioned and I don't know if everyone really uses these these days, but having a hankie or a cloth flannel, whatever it is, with some perfume or favorite scented oils on it, that can be brought close to you during the surgery. There is occasionally a bit of a smell in theater that you might be sensitive to, or you might not be familiar with. I didn't actually notice this during my births, but my husband did. If you do notice it and you're finding it a bit unpleasant, then that can be something that's brought close to you so that you can smell it. And smell is a really powerful association with memories as well, so that could be a really amazing link that you can link in with your birth for future. Alright, so far we've talked about the role of the support person, attending appointments with you, educating themselves, whether personally or through a formal class, collaborating on your postpartum plan, helping you with your hospital bag, and prepping their own hospital bag. And then the last few things, helping practically on the day. So remembering what time you need to be at the hospital, what you need to bring, what is the process or preparation before you come into the hospital. So sometimes you might be given a wash that you need to use in the shower before you come into surgery. So, remembering all those things that can support you with that, as I'm sure you will be feeling a little bit overwhelmed and have lots to think about on the day. Arranging childcare for other children if needed, be responsible for that. And the last thing is helping prepare you emotionally and mentally for giving birth. Obviously, this is more so if you're aware in advance that you will be having a c-section birth and maybe, you know, you have some negative feelings about it. You’re anxious or overwhelmed, your support person can be really vital in helping you on the day, deal with those emotions, keep you calm. So in advance, it can be amazing if you talk about some strategies. So maybe during the surgery, your support person can talk about some favorite memories that you have together. They can maybe ask you questions about, what is our baby going to be like? Can we, you know, imagine what our life is going to be like? They can tell you how amazing you are, help you with breathing techniques or relaxation techniques. So have a chat beforehand about what this could involve, and have them on board and ready to go with calming you down on the day if needed. Okay. So we've talked about a few things that your support person can do to help you in the lead up to your birth. And in another episode, we'll talk about what they can do in hospital during the birth and at home during your recovery as well. But for today, I just wanted to talk about some initial things that they can do. Your homework for today, chat to your support person, whoever they may be. Chat to them about their role, their expectations and knowledge about what will happen on the day. Collaborate together, make a plan so that you can both have an amazing experience because it is a shared experience and even if it's, you know, maybe not the way you had planned or hoped to give birth, having a c-section, it can be a really beautiful experience and can be really personal. And you can have your choices respected. So talk about what that might look like. Thanks for listening today. Don't forget to subscribe below, check out the show notes and I will see you next time. Bye. /episode/index/show/a3399478-322a-40ff-862b-75eef1f952da/id/31630502

How to get out of bed after C-Section 05/30/2024

How to get out of bed after C-Section 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. /episode/index/show/a3399478-322a-40ff-862b-75eef1f952da/id/31524462

Introduction to C-Section Birth 05/30/2024

Introduction to C-Section Birth Hello and welcome to episode one of ‘c-section support’ by ‘OT in motherhood’ podcast. Thanks so much for being here. I have to say I am quite excited to get started. This is something I've been thinking about and planning for quite a while and I've finally made it happen. By the time you're listening to this it will be 2024, so happy new year and I hope you have had an awesome start to the year. Alright, today, for this first episode, I wanted to give an overview of what a c-section is, and talk about some of the attitudes in society and the emotions that you might experience around c-section birth. If you are listening and you've given birth via c-section, first of all, I want to say a huge congratulations. That is amazing. You have done an amazing job bringing your baby into the world. I want to say that you absolutely birthed your baby. There seems to be an attitude that c-section birth is not real birth, but you grew your baby, you carried them, you went through major surgery to get them here safely, you literally sacrificed your body to bring them here - that is awesome. You are not a failure. Okay? There seems to be this attitude in society that c-sections are the easy way out, and I have to say that I think those people that think that haven't had a c-section themselves, or maybe if they have, they're feeling some negative emotions around it still. It is definitely not the easy way out. It is hard. I have been through it twice. And each time you can have a different experience. I have to say that both of my births and recoveries were not the same. There were quite a few differences, and I knew in advance that I was going to give birth via c-section as well. The way you give birth does not define your worth as a mother or your motherhood journey. It's merely the start of being a mum. It's how your baby came into the world. I totally understand that it can be disappointing to have a c-section birth, especially if it was unplanned and an emergency and you were not expecting it. To be honest, when I found out I was going to have a c-section for my first baby and that I would need a c-section for each consecutive pregnancy, I cried. I left the office of the OB and held it together. I was with my husband and I got outside and I burst into tears. And with me, I had time on my side. I found out when I was 15 weeks pregnant, so I had time to process that, to get my head around what that might look like, to put in supports in place, and to just understand the process. And I understand that some of you listening may not have had that chance. So one of the major parts of me bringing this podcast is to educate people and to prepare them so that you can have a more positive experience. I do want to say it's okay to grieve the birth that you wanted. You might have a grief experience and that is okay. Your feelings are valid. I see you, I hear you. Your feelings, your emotions are valid. It is okay to be upset that you did not experience the birth that you wanted to have. Two conflicting emotions can coexist. It doesn't mean that you don't love your baby. You can absolutely love your baby and be sad that you didn't experience a vaginal birth. You can be happy your baby is safe and wish your birth went differently. You can be excited about your new role as a mother and wish that it didn't start that way. If you are feeling this way, I really urge you to talk to someone. That could be a friend or it could be a professional. Sometimes it can be easier to talk to someone that you don't know because they will not be offering up suggestions and trying to fix things for you. They will have an impartial ear, I guess. So, people that you could talk to could be your GP, it could be your midwife, it could be your child health nurse. Some hospitals may offer a birth debrief. You could pursue that option. There are also private providers who offer birth debriefs as well. I'm also going to add some resources in the show notes of some organizations that you can reach out and talk to if you are feeling down, about your experience. I wanted to go into some of the practicalities of what a C section is. I won't go into too much detail, as I will cover some of this in future episodes, but just an introduction. So, it is a major surgery. Generally it is done through spinal or epidural anaesthetic, which means you are awake and the lower part of your body is numb. You won't feel the surgery happening. And the benefits of being awake are that you get to meet your baby straight away. But there are some situations where you may need a general anesthetic, which is where you are put to sleep. And that will often happen in a more emergency situation. So, during the surgery, the obstetrician will cut through seven different layers in your abdomen. It is usually done through a transverse or lower segment incision, which is done just at your bikini line, underneath where your underwear would go. That's the most common and it's where it's a horizontal incision or cut in your skin and through all the layers through to your womb as well. There is another type, which is called a classical incision where it might be a horizontal or vertical cut on your abdomen and then a vertical cut through your uterus. And that's most often used in an emergency situation and the different incisions have different implications for healing and for future births. So if you're not sure what type of incision you have, that's something that you can talk to your doctor about and what the implications are of that. C-sections can be elective, which means they are planned in advance. It still may be recommended by the medical team or it might be completely your choice and that is where at some point during the pregnancy, the decision is made that it is best to have a c-section and it will be planned in advance so that you will have a date set, you'll sign consent forms and you will know when you are coming in for surgery. The other type is an emergency and this is unplanned where the decision is made due to issues with the baby's or the mother's health that may not have been apparent earlier on in the pregnancy. So it is possible that you could have an elective c-section planned and then it become an emergency. You might have been attempting a vaginal birth, or a VBAC, which is a vaginal birth after cesarean, and then it become an emergency c-section. So, furthermore, there are actually different categories of the surgery, and this is something that I didn't know before I had surgery. It is something that I saw on my discharge letter, so I didn't know what category I had until after I had given birth. The categories are; category one where there's immediate threat to mother or baby. This is your true emergency where the baby needs to be born as soon as possible. There's category two where there's problems affecting the health of the mother or the baby, but it's not immediately life threatening. This is the type of c-section that I actually had for my first child. I had a C section scheduled, it was an elective. It was recommended strongly by my medical team. So I had a date set and then I went into labor beforehand, which means that it became a category two and I bumped someone off the list on the elective list on the day and they fit me in to have my baby on that day. Category three is where the baby needs to be born early, but there's no immediate risk to the mother or the baby. And then category four is scheduled for a time that suits the mother and the medical team. So my son, my second child was actually born via category four c-section. So I had a date set in, I went in as a complete elective admission, and he was born later that day. And what happened, he was born about, I think, five hours after I went into hospital because on that day there had been about three other emergency c-sections. So, women that needed to have their babies more urgently. Which means that my surgery and the other women on the elective list were delayed. So that's the way that the medical team determines the urgency of c-sections and helps them prioritize which births need to happen on which day. And it is possible that if you are scheduled for a category 4 c-section, that if there are a lot of emergencies on the day that you're scheduled, it can happen that your c-section is bumped for the next day. Not ideal in some ways, but it's possible. So just be aware of that. The other thing I didn't actually cover was the reasons for c-section birth. There are a lot of different reasons. I also am not going to cover, why the c section rate is so high in Australia. Currently about over 30 percent of babies are born via c-section. And as I said, there's many reasons. It could be that the baby is breech, meaning they're not head down, so they're sideways or their feet are down. It could be that it's a multiple birth. There could be a medical condition or issue with either the baby or the mother. It could be due to a vaginal birth failing to progress (which is a terrible term), but basically the baby could be in distress and needs to be born more urgently. Thanks for listening today, and I just want to reinforce that if you are feeling down about either having a c-section birth, as in, it is planned, you will be having one in the future, or perhaps you have already had one, and you have some negative emotions around that, I really, really urge you to reach out and talk to someone. I just want to reiterate that you are awesome. You grew your baby. You brought them into the world safely. You are honestly superwoman and congratulations. In another future episode, I will go more into what you can expect on the day during your C section and the recovery. But for now, I just wanted to give a little introduction to what you can expect. Thanks for listening. Don't forget to subscribe below, check out the resources that I've linked in the show notes, and I will see you later. /episode/index/show/a3399478-322a-40ff-862b-75eef1f952da/id/31524077

Restrictions after c-section birth 05/29/2024

The support person's role before your C-Section 05/13/2024

How to get out of bed after C-Section 04/21/2024

Introduction to C-Section Birth 04/01/2024

Welcome to C-Section Support 03/18/2024

C-Section Support

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