Top 5 tips for preparing for a c-section. By Octavia Hamilton, Founder and Physio

There are many reasons you might choose to have a c-section and providing you are well informed then the choice is yours. We are not here to advise you one way or the other, more to help you prepare for your elective section and feel empowered and ready.

My first birth was a vaginal birth but for my second I chose an elective section. A's birth was uncomplicated, but I had done no preparation and it was long. Second time round I wanted to be more in control. Thankfully the NICE guidelines now suggest a woman has a choice and this should be considered. I felt very grateful for the opportunity to choose what type of birth I wanted.

If you have been told that you need a section and it was not your first choice of birth option it can feel overwhelming but there is an opportunity to prepare. Even if you choose a c-section after a challenging first vaginal birth it is still uncharted territory. It is worth saying that whichever birth you are aiming for it is worth covering some information on c-sections, so you are ready whatever comes up. Don't fear, you are not alone and we are here to help.

It should be remembered that an abdominal birth (as they are beautifully named now) is major surgery and you will benefit from both preparation and rehabilitation. Having done both I can say that 'there is no easy way to get a baby out' and recovery from both, though different, required preparation, focus and commitment. But it is very possible to go and return to the things you love doing quickly.

With that in mind I have created this blog to support you through things to keep in mind and some resources to support you. This is a personal account of things I found useful and from a physiotherapist’s perspective. You should always seek advice from your midwife and obstetric team and if you wish to learn more, find a birth preparation course to support your preparation.

Also check out Elective C-section 101 focusing on the content that we have here on XENA.

TOP 5 TIPS FOR PREPARING FOR A C-SECTION

1 : Educate yourself

If you are choosing to have an elective caesarean, then you should do your homework. It is important you understand the risks, benefits, and the process so you are making a completely informed choice.

You will have to have a conversation with your midwife and depending on the trust they may discuss around your choices. Knowing the guidelines and your rights is helpful.

Here are some resources you might find useful Caesarean birth: Your questions answered

It is also important to understand you still have a say in this medicalised birth. Did you know you can still have a birth plan if you choose an elective caesarean? You can pick your music, have the screen up or down, delay cord clamping, encourage a gentle birth and ensure skin to skin contact is made quickly.

Understanding the process of what happens in a c-section is probably a good idea. It is a very medicalised situation so if you are not used to the operating theatre it could be overwhelming.

It is worth understanding the full breakdown of the day so when you are there, having your spinal block put in with 16 other healthcare professionals, you are calm and prepared.

Esteemed physio’s Hannah Poulton and Clare Bourne have put together this fab 1 hour video webinar to help you prepare.

Here is a great visual of how they get the baby out and what they cut through. Don’t worry, there is no gore, just an explanation of the different layers of tissue cut and in what order using different coloured material (very clever). This just helps you respect the process and hopefully then understand the benefits of scar work and rehab even more.

Hearing other people’s stories can also be helpful. Make sure you listen to positive stories though. Not to hide anything from you (you can get all the information you need by researching properly) but no one needs to hear negative stories when preparing for an event. You are still going to need that oxytocin!

You could listen to Emma’s story. She was told she had to have a section due to placenta previa and felt extremely anxious about this. Hear how she prepared, found her peace with the process and went on to have a very positive experience in our two part interview.

Placenta Praevia with Emma

The unplanned elective caesarean with Emma

2: Prepare

Birth preparation is just as important for a c-section as it is for a vaginal birth. It will be a very different experience in that firstly you will know when it is going to happen.

This can be hugely helpful, especially if you have other children as you can plan for childcare. You can also ensure your house is well organised, that you have everything to help you support those early days when movement can be sore and you want everything close to hand. My best purchase before c-section was the water hydrant bottle. When you literally can't move due to the spinal block, having water on hand thanks to the long straw that attaches to your pillow is a game changer. It is so great for further down the line too when feeding the baby.

Food preparation is so important. You won't feel up for whipping together a gourmet meal for a while. So having everything organised and easily accessible will be so helpful. Listen to this podcast with nutritionist Becca Meadows who, whilst juggling her 2 year old, gives some fab tips for food prep and recovery with nutrition and check out The Food Doula for top tips and her postpartum bundles and broth.

There is so much more but this is where speaking to a hypnobirthing and birth preparation practitioner like Susanna or Val will help you navigate what your options are. Yup, you can still do hypnobirthing even if you are having a c-section. Especially if you are feeling anxious about the surgery, then learning some techniques to help you ground yourself will be so beneficial. There are so many birth preparation courses that are dedicated specifically to c-sections and I would highly recommend doing one. The honest midwife is one example.

You could have a doula too to advocate for you. Doulas are non-medically trained support, there to help ensure your wishes are fulfilled and you feel supported. Though an elective section will be calm, planned and often straightforward it is sometimes nice to have someone there to advocate for you in a new and unusual situation. Check out how a doula might help you here with my interview with Jess Franz, XENA's resident birth doula.

3: Keep strong

Just because you won’t need to go through labour doesn’t mean you have got out easy! Your body needs to be fit and strong still to support the process of carrying a baby and then recovering from birth. Did you know exercise improves your health, the baby’s health and speeds recovery post birth.

We have over 200 exercise videos you choose from and here are just some of our favs.

Dynamic and static stretching in pregnancy

Move and revive (great for pregnancy and early postpartum, a good one to practice before your birth)

Ground YourselfHayley's lovely yoga session, calming the nervous system.

Pregnancy Aerobic Strength for those wanting something a little more up beat do this great class by fitness instructor Lauren .

You could also look at the personalised pregnancy program if you want further guidance using our one week free trial to get going.

4: Communicate

Good communication with all those around you is so important so everyone understands that you are going to need rest and support in the first two weeks. Probably more so than if you had a vaginal birth. A great book and guide for the fourth trimester is the first 40 days (the can be found in our shop) which not only has lovely recipes but explains the need for proper rest after birth.

Ensuring your partner or friends and family are on hand to help, especially in those first two weeks which can be when you will need to rest the most. If you listen to the interview with Emma linked above, you hear how her husband was doing 10,000 steps a day at the beginning and she was under a hundred. So, don’t underestimate how little you will be doing week one. Bed to sofa, and back again!

Communication with your little one is important too. I found discussing with my two year old the fact I wouldn't be able to pick her up also really helped. For a month before my birth, I got her to start practicing getting into and out of the car, the bath, bed, and the stairs without my help. Luckily my daughter even at the age of two was very independent and keen to prove her capabilities and I know this isn’t always so easy for more clingy babies! But it certainly helped when G arrived as she was well rehearsed.

5: Start rehab before the birth:

Practice your rehab before you’ve given birth. In your later stages of pregnancy, you are probably fairly used to getting into and out of bed using the roll and push with your hands. This will be THE only way you can get up in the early days after a c-section so nail it beforehand. It you are well versed at how to get in and out of bed in a supported way that doesn’t strain on your abdominals that will help.

Learning how to breathe well is the first stage of rehab. Reconnecting with your breath will help kick your core back into working mode. Your muscles will be stretched, diaphragm tight and posture all out of kilter let alone the impact of the surgery on your tummy muscles.

Lying on your back (if comfortable) or in 4-point kneeling is such a lovely way to realign and start working them again. An abdominal breath will also be the first form of scar work you can do, helping massage there from the inside out and helps with back pain. SO if you only do one thing, practice this.

Sometimes the area where the section was performed can be numb, sensitive, and therefore hard to active the muscles around the area. Knowing how to activate these muscles before birth can really help the rehab process as the muscle memory kicks in.

There is a lot of advice about not exercising before 3 months. But, there is so much you can do though whilst waiting to return to normal activity. Pelvic floor, gentle lower abdominal engagement and a nice stretching program will all be fine. You need to build up movement and activation to get back to ' normal' activities so don't think you can't start before.

If you follow this gentle programme, you can move forwards faster. Remember we are all individuals. Listen to your body and if something doesn’t feel right then seek face-to-face professional support.

Don’t lift they say! Such an annoying statement to make. We are mothers how are you supposed to care for your child and not lift. All I have to say is car seats and that whole advice is out of the window! Let alone the shopping, other children etc.

The sooner your start some gentle rehab the easier everything will get!.