by guest blogger, Michelle Herbst, MPT, DPT

Bringing a baby into this world can  be hard work for some Moms.  Pregnancy  may be filled with aches, pains, nausea and moments of joy mixed with concerned  anticipation.  Motherhood is a wonderful time in a woman’s life and the sacrifices are worth the rewards.  Caring for the baby and others is what we Moms do.  As the focus shifts away from the pregnant mom to the newborn, how is Mom doing?  Remember learning the terms episiotomy or C-section?  If you’re an American Mom these words may be a reality.

Most new Moms heal well from episiotomy and C-section incisions but some mothers do not, and may ignore the problems they are having.  Moms that aren’t healing well or haven’t healed well may not feel quite right.  They may ask themselves, “Why does it hurt when I insert a tampon?  Why can’t I unload the dishwasher without pain or stretching in my belly?”  Intercourse likely isn’t on their radar any time soon and these Moms often continue to ignore their concerns and remain silent.

Don’t let this be you!  Remember the scar that remains was once a surgical incision that was made to facilitate the delivery and improve the safety for the Mom and baby. Painful scars can occur after an episiotomy and C-section due to the adhering/ interweaving of the skin and muscle tissue during the healing process. The episiotomy was made by making a surgical cut through the skin, subcutuaneous (fat and connective tissue) and muscle layers.  During a C-section the surgical incision further extends into the abdominal cavity and uterus.  The incision may be closed with absorbable or nonabsorbable thread, staples or clips.

What can be done?  Ideally, pain medication and routine use of ice can help as soon as the surgical procedures are complete.  Staples are typically removed prior to discharge and within five to ten days the stitches will have dissolved.  Once the  stitches are absorbed incision or scar massage can begin.  However, incision mobilization or scar massage can be done weeks, months and even years after the incision was made.

Incision or scar mobilization works by simply moving the skin along and against the grain of the incision.  Incision or scar  mobilization may be done one to two times per day until symptoms have resolved or improved and does not cause in redness or bruising.

Below is an outline of how to complete incision/scar mobilization to make it a more effective and pleasant experience:

  1. You can warm the affected skin using a towel, wash cloth or soaking in a warm tub.  This may help decrease sensitivity by increasing blood flow and promote relaxation and can help you get used to touching the area.
  2. With two fingertips, gently make circles along the incision.  When working on an episiotomy incision it may help to make gentle circles using a wash cloth.  C-section incision may be touched directly.  You may feel some initial discomfort but, if  you do, simply let up on the pressure.  It is normal to feel hesitant.
  3. Lastly, when you can perform the gentle circles without pain, you can begin rolling the incision.  C-section incision can be  rolled by gently lifting the incision away from the abdominal wall and gently rolling the incision between the thumb and  forefinger.  Episiotomy incisions are more difficult to roll due to their smaller size and location.  But, the technique is the same.

References:  Simkin, P. et al.  Pregnancy Childbirth and the Newborn The Complete Guide. 4th ed. New York. Meadowbrook Press; 2001; 291-293, 324.

Published by Tasha

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