Embracing Your Journey: C-Section Scar Recovery Insights from Blair Mauri and PRESS

April is International Cesarean Awareness Month, a time to recognize and support mothers who have undergone cesarean births. At PRESS Modern Massage, we believe in the power of holistic care, especially when it comes to supporting women through the transformative journey of motherhood.

That's why we're excited to announce our collaboration with Blair Mauri, a licensed Occupational Therapist specializing in Pelvic Floor therapy for the pre and postnatal community, to bring you valuable insights and support for postnatal wellness.

Blair Mauri provides customized, in-home pelvic health services for her clients throughout Brooklyn and Manhattan. Blair has a passion for women’s health, supporting the transition to parenthood, and empowering her clients to feel in charge of their own wellness and recovery. 

It is a common misconception that women who have had cesarean births can’t benefit from pelvic floor therapy, but I am here to demystify this! Physiological changes that occur during pregnancy can lead to a number of symptoms regardless of how you birthed your little one. You may have had some trauma to the perineal area and pelvic floor if you experienced labor and/or pushing prior to an emergency cesarean. While recovering from birth, it is not uncommon that we slip into a variety of movement patterns (hello glute clenchers!) that can lead to long term pelvic floor and full body symptoms. And finally, it is SO important to care properly for your cesarean scar in order to maintain abdominal mobility and sensation (more to come on this soon!).

Here are some pelvic health symptoms you may experience that would warrant evaluation and treatment by a Pelvic Floor Therapist:

• Urinary or fecal incontinence
• Urinary urgency
• Chronic constipation or hemorrhoids 
• Diastasis Recti AKA ab separation
• Painful sexual activity
• Pelvic organ prolapse (heaviness or pressure in the pelvic area)
• Prevention of any of the above

Now, for my cesarean mamas out there, the rest of this post is just for you! While quite common, cesarean birth still requires a major operation where your doctor cuts through seven (yes, seven!) layers of tissue before your baby can be born. Did you know that there is no “standard procedure” for how a cesarean is performed? This, along with a number of other factors (genetics, lifestyle, speed of procedure, whether or not you experienced labor, postpartum care etc.) leads to a lot of variation in the healing of this incision. 

When working with a Pelvic Floor Therapist, the goals for scar recovery will be improved mobility and sensation. 

• Mobility: Mobility is achieved by way of decreasing scar tissue, or adhesions that naturally occur as your scar heals. Scar tissue is hard and sticky! So it can cause restrictions within and between each of those 7 layers as well as in neighboring areas of your scar (e.g. your bladder). Spinal twists and back bends may feel uncomfortable or limited after a cesarean birth. 
• Sensation: Nerves are cut during a cesarean birth, leading to a variety of changes in sensation as you recover. You may feel generalized hypersensitivity, tingly, burning, tenderness, itching, or you may feel an absence of sensation on and around your scar. Important to note that if you are experiencing signs of an infection (severe redness or swelling, puss, fevers) to reach out to your medical provider immediately. 

You can begin waking up those nerves, reducing hypersensitivity, and promoting normal sensation at your incision site at one week postpartum. Begin by taking the softest material you have (I usually suggest a silk robe or makeup brush) and gently rubbing it from side to side above and below the incision site for 1-2 minutes. This may feel tender and sensitive. Repeat daily until the skin is no longer sensitive to this material. Continue with subsequently “harsher” materials throughout these first few months postpartum. An example of a progression may look like: silk robe, soft t-shirt, ribbed t-shirt, a clean finger, cotton ball/Q-tip, itchy sweater, soft hair brush, vibrator. It is normal to take up to 6 months to regain sensation at the scar site. 

Around 6 weeks postpartum, as long as your incision is fully closed, you can begin some scar massage to reduce and prevent scar tissue build up. Begin by acquainting yourself with your scar. To toleration, press along the length of it both superficially and deep to feel for areas of thicker, harder, resistive scar tissue. These will be the areas you want to focus on. 

• Using a little bit of lotion (I use MotherLove!), slowly rub along the length of your scar, pausing on areas of scar tissue or resistance. Move in both left and right directions.
• Using both hands, pull in opposite directions at each area of resistance side to side, up and down, and in oblique (or diagonal) directions. 
• Remember to gently breathe “into” the scar at each pause.
• Throughout this, you should be feeling a stretch, not pain.
• Perform both superficially and deep.
• For best results, massage for 3-5 minutes a day, 3-5 times a week

Other tools I love to promote circulation, sensation, and decrease scar tissue at a cesarean scar site are:

• Silicone sheets
• Castor oil packs
• Cupping (gentle suction over scar tissue areas for 10 minutes, 3x a week)
• Acupuncture 

Using the above strategies will help at any stage of recovery, whether you are a few weeks postpartum or a few (or more!) years. 

The postpartum period is a time of immense change, both physically and emotionally. At PRESS we understand the unique needs of new mothers and are dedicated to providing them with the care and support they deserve. Our postnatal massage services are specifically designed to help mothers recover from childbirth, alleviate discomfort, and promote relaxation and healing.

During postnatal massage sessions at PRESS Modern Massage, our skilled therapists work with mothers to address their specific concerns and needs. Whether it's relieving tension in the back and shoulders from breastfeeding or promoting healing and relaxation in the pelvic area, our massages are tailored to nurture and support new mothers on their journey to wellness.

We understand that every mother's experience is unique, which is why we take a personalized approach to postnatal care. Our collaboration with Blair Mauri allows us to offer a comprehensive range of services that address the physical and emotional aspects of postpartum recovery.

If you feel like you want a little more support in learning these techniques, Blair offers one-hour cesarean scar education visits to her clients so that you feel confident carrying out these strategies on your own. For this, or a more comprehensive Pelvic Floor evaluation, reach out to her through her website. Mention “Press” and receive $25 off of your first session!