Recovering from C-section Birth
with Katie Kelly, B.Sc., M.Sc., PT

Sometimes it feels like individuals who have experienced C-section birth have been left behind. We talk about recovery from vaginal birth often while C-section is considered almost a luxury – as though the recovery is easy and the repercussions on your body are less than that of a vaginal birth. C-section is considered major abdominal surgery. There are seven layers of muscle and tissue that are affected by the incision. The resulting recovery can be painful leaving your body stiff and can make everyday tasks difficult. I can recall vividly a moment from each of my three C-section recoveries that were extremely uncomfortable. My father-in-law telling a joke after my first baby was born and making me laugh – it really hurt. I recall not having feeling in my legs for almost eight weeks after my second C-section and sweeping the floor after my third baby was born, finding the small amount of twisting very difficult.

There can be even farther-reaching mental health implications of C-sections, particularly for those who are not expecting a belly birth including birth trauma and feelings of failure, feeling as though you have been mistreated, and intense feelings about how your C-section scar looks and affects your body.

Given that there were more than 103,000 C-sections performed in Canada in 2016-2017 – that’s 28.2% of births – his is an important conversation to be having. Nearly one in three births. That’s a lot of women feeling as though their recoveries are an afterthought. It’s time to change the conversation. My guest today is Katie Kelly. Katie is a clinical pelvic floor physiotherapist and owns her own practice in Moncton, New Brunswick. She received both her B.Sc. And her M.Sc. In physiotherapy from Dalhousie University. Clinically, she works with women and men suffering from urinary and fecal incontinence, pelvic organ prolapse, pregnancy and postnatal recovery, postoperative rehabilitation and genito-pelvic pain conditions.

She is often a guest lecturer for the School of Physiotherapy at Dalhousie University with a focused knowledge on pregnancy, pelvic health and exercise with regard to weight loss. She’s an active contributing author to the Canadian Physiotherapy Association’s Women’s Health Division newsletter. Katie has formed a relationship with Mount Allison University’s sexual health laboratory to research chronic pelvic pain and genital pain conditions. In 2019 she and her business partner Eryn Matheson opened Motherhood Link, an online site for pelvic floor and core muscle information around the pregnancy and postpartum period. Here they provide birth preparation and recovery courses as well as deliver lots of free information to help educate the public about the pelvic floor. She is a member of the New Brunswick College of Physiotherapists, the Canadian Physiotherapy Association’s Women’s Health Division, the Canadian Sex Researcher Forum, and the Canadian Obesity Network. Katie joined me a few weeks ago. I will mention she was struggling with a cold, we’ll hear a few coughs throughout the audio. They appear in places I wasn’t able to edit them out. So, I just want to give you a heads up in case your earbuds are extremely sensitive.

April: So, C-section recovery is something that comes up all the time in our shop because I’ve had three Cesareans, we were always trying to figure out what we could develop to help C-section moms because there’s really nothing.

Katie: There’s nothing.

April: And so when I started seeing your your posts about even just the massage, I’m like, nobody ever talks about this. Nobody ever mentioned anything about aftercare with the exception of don’t have a bath or soak, you know, swim in a pool until your staples are removed and the Steri-Strips come off. Yeah. So yeah, good luck to you adios.

Katie: And good luck to you.

April: And I’ve, you know, each incision was very different in how it healed and how it looked and between number one and number two, they actually removed all of the scar tissue because it was so bad to start over again.

Katie: So a lot of them will try to do that now if they see there’s been a lot of scar tissue that’s developed.

April: So I, I really want a, like a download of what, what can women do to prepare for it because a) there are a lot of women who go into birth, not expecting to have a Cesarean section. So there’s that whole mental prep and re-configuring your, you know, your desired outcomes for your birth story. But then there’s also those of us, you know, I knew going in that I was going to have a Cesarean and it wasn’t a scheduled section, but I knew when I went into labor that I would be operated.

Katie: So, I think you make a really good distinction between a planned Cesarean and, and an emergency or an unscheduled Cesarean. And what started happening in clinic, well, this whole, this whole thing started because I had a Cesarean as well. So I had an emergency section for my first and I was already a pelvic floor physiotherapist at the time, so I’m lying here in the hospital bed was like thinking this is going to be a vaginal delivery. I didn’t have the same type of like – there are some women that need to have a vaginal delivery. I didn’t have that sensation. I was like, as long as I don’t, you know, I, I recognized there was no easy way to get a baby out. So it’s kind of like what, I was fine with whatever, but I had some education on a vaginal delivery. I hadn’t had any education on a Cesarean delivery.

And here I am feeling like I’m a professional in this arena. And one of the things that happened, well I didn’t, I didn’t know how painful and incision was going to be. So I was not prepared for that. I knew it was going to hurt, but I didn’t understand how it was going to hurt so much that it would limit my ability, my ability to pick up my baby. So I didn’t understand that. I remember being in so much pain, which is like the danger of when you know just enough to be dangerous. You know, I was talking to the nurse and I’m like, ‘I think they nicked my bladder!’ And she’s kind of like, ‘There there, dear’, cause it was hurting so much when I urinated. And so one nurse told me that I was kind of crazy, one told me that it was impossible for my bladder to hurt when I peed. And another one was like, ‘Of course your bladder’s hurting because your bladder sitting on a uterus that just had a surgery. So as your bladder deflates, your uterus moves’. And at that point I felt like an idiot because I knew the anatomy. I got stuck the first time they sent me off to walk by myself in the hallway cause I was in so much pain. I was just like stuck there thinking in my physio brain, ‘If I had been a total hip replacement, there’d be a physio behind me with a wheelchair’. And I’m trying to get myself back from the shower and I don’t know what to do. So all of these things started to make me really angry. Like, if I know these things as a physio…I had choked on my hot chocolate and I knew to splint my incision with a pillow, but I’m like, ‘most people don’t know this. So if this is me thinking I’m reasonably well prepared, like what’s the lay person to do’? So that’s when I started to do a little bit of research into it. And then I ended up having a scheduled section for my second and there’s no “Prepare to Push”, I’m using air quotes. There’s no “Prepare to Push” course for section moms. So I had proposed the idea to our National Physio Women’s Health Division newsletter that I sit on the board for, that I help to, I volunteer to write articles for them. I was like, ‘Why don’t we do the topic of C-section’? So that’s when I really started to research it and I started finding so much information that now I’ve developed a course for professionals to take, but it’s still a passion project of mine to go around spreading as much information about how we can prepare our bodies. And then what we can do afterwards. And I think it’s interesting what you, what you said about how so many women go into birth planning a vaginal delivery. I get that a lot in clinic. People will come to me for birth prep. They, and then there’s this dichotomy between, between women who want vaginal deliveries whether they’ll even listen to me if I want to give education on a possible Cesarean. So in clinic, we do have what we call a JIC handout. So Just In Case handout. Take it for a friend, give it to your partner. Like, you don’t have to read it. ‘Cause I don’t want to be the person that’s responsible for getting in their head when what they want is a vaginal delivery. But I also don’t want them to feel after they’ve had Cesarean that they’ve missed out on seeking some education. So yeah…

April: It’s a delicate balance.

Katie: It really is.

April: Yeah. I can definitely see where you’re coming from there.

Katie: And it’s difficult to not, I mean, it’s not my place to say how to plan for your birth, but I do try to encourage people if, if I’m not huge on birth plans, I’m more like educate yourself on everything. But if you want to do a plan, do a plan A and a plan B and a plan C and a plan D…

April: That’s smart.

Katie: Because if you end up in plan D and you never really had any thoughts about it before, then you can’t be as an informed birther as you want to be.

April: That’s a great approach. That would never have occurred to me at all.

Katie: It’s lots of plans for birth.

April: Lots of plans for birth. Yeah. Keep an open mind. What can people do to prepare themselves for a possible Cesarean if they don’t know it’s coming and is there something different that people who do know it’s coming can do?

Katie: So some of the things that we want to counsel about are the different types of C-sections because there’s a lot of fallacy around that. So you can have, as you said a scheduled section or an unscheduled section, or you can have something called a crash section. So the crash sections are the real emergency sections where they’re done within, usually within 10 minutes of the decision being made. Most moms are put under general anesthetic, most moms are put under general anesthetic. So the results are a little bit different. It’s, I find it tends to be a little bit more of a trauma, a traumatic birth from a mental perspective because moms aren’t awake for their delivery. So to just know that those are options. And then there’s another beautiful option called a family centered or a patient centered C-section now, or a gentle C-section where they tried to replicate vaginal birth as much as possible.

So surgical lights can be dimmed. They’ll play the desired music in the in the operating room. Some places will allow a photographer in now, which is nice. Some places will allow for a clear drape sheet. So yeah, I know not everyone wants to see that, but that means like the sheet that’s normally put up is normally blue or green, put a clear one so you can actually watch the birth that’s happening. Delayed cord clamping that will happen afterwards. Vaginal swabs that can be put over baby’s face so that they can have some of the microbiome that would normally happen as baby’s pushing through the vaginal canal. So they’ll put that in the baby’s nose and in the mouth. So that’s kind of nice. So that there’s the option, these options that are becoming available now. Now they’re not guaranteed at every hospital, but there are certainly things that you can discuss with your birth providers.

April: Are those happening at any of our local hospitals that you know of?

Katie: I work more closely with the Moncton Hospital. And I find they do offer a lot of those things. So they offer, depending on the surgeon, each surgeon has their own set of guidelines, but a lot of them are allowing to have more input from the patient on what they want to have in the, in the birthing room. So the other things that you can do for preparation is we go over a lot of pain management techniques that are not necessarily pharmaceutical. I think with the opioid epidemic, we’re starting seeing more support from the government and more desire, just more patients where they don’t necessarily want to take medications, especially if they’re breastfeeding. So I know that a lot of mothers will be in pain and they won’t take their medications because of concerns what’s going to happen with breast milk if that’s what they want to do. So number one, I always tell them to counsel with their, like to talk to their providers first because they know what they’re doing when they’re prescribing those medications. And what happens with the pain of a surgery is that once it gets out of control, it’s really hard to get back under control. We say you don’t want to be chasing your pain, you want to stay on top of it. With that being said, there’s lots of other things that you can do. So we talk about TENS unit, which if you’ve ever been to physio before, it’s kind of these electrodes that are put on you and they buzz and that’s used quite regularly in labor and delivery for…

April: Kind of contract your muscles.

Katie: Yeah. So they use it for uterine pain in vaginal birth canal. It has applications over the uterus. So we’re seeing women use it now over their C-section scar. So I will have a lot of women that will buy them planning a vaginal delivery. And then I say in case anything happens, please know that you can use it for your Cesarean scar afterwards as well.

April: Wow. That’s useful information.

Katie: Yeah. So they’ll use it for that. We also know that just learning how to move with a C-section scar is something to consider.

April: Sure is.

Katie: And I compare it to other surgeries. So if you’ve had to have an appendix surgery or if you’ve had to have any sort of abdominal organ surgery, this is the only abdominal pelvic surgery that’s performed where they send you home with another human being to take care of. So if this was as I said, this is your appendix or whatever it would be, they’d teach you splinting techniques, they’d tell you not to do any heavy lifting for X number of weeks, but that’s not the case with Cesarean, right? So it’s difficult. So the more you can limit your, your abdominal muscles from working can help to limit pain if you can use your arms to push you up. Some women will tie a scarf to the end of their bed to use the scarf to pull them up into sitting. I’ve heard of some women that will actually rent the hospital bed. So the high low hospital…

April: I slept propped up on pillows for probably the better part of three weeks after each one, I would say.

Katie: So that is stuff that you can figure out on your own. But if you know it straight from the get go, then you can plan to have the extra pillows and everything prepared for you. We also teach splinting, so that’s where you use a rolled, we usually say a rolled towel, but moms have receiving blankets everywhere, so a receiving blanket or a small pillow that you can press up against your incision. Anytime you’d be holding, you’d be wanting to hold your breath to do something for strength. So standing up from a really low chair or if you have to cough or sneeze, that’s a really good one so that you can just some support to your incision. So those sorts of things. And we know that there’s a lot of research for using abdominal binders after birth and that’s not traditionally done in the hospital system. I can’t tell you why because really over the last 10 years or so, there has been quite a bit of evidence to come out to support it. Improving both pain levels and functions. So meaning that women can get up and moving a lot sooner. And I do want to say in case someone’s looking for abdominal binders, it shouldn’t be really rigid. It shouldn’t be full cloth that doesn’t allow you to breathe. It should be really, really light, almost just hugging the low abdomen. So I’ve heard some people laugh and say even tight Lululemon pants is like enough of an abdominal support system, but there’s lots of different companies out there that are making abdominal stuff.

April: There used to be even, I think they were even just called Belly Bands.

Katie: Yeah. So, yeah, so even belly bands, as long as it’s giving you a little bit of support. But I almost always recommend a belly, some sort of belly support if I know that a mom is going in for a Cesarean and she already has a child at home that she’s still lifting. Because it’s just difficult for moms to follow the surgical, like the postoperative guidelines that were given. And there’s been lots of research to say that a mother’s inability to follow those guidelines will make her feel guilty. Like, ‘The surgeon told me, I can’t do this, this, and this. I can’t listen, I’m already starting off motherhood on the bad foot, the wrong foot’. Right? So if you’re having a baby and you’ve got a one year old, two year old, three year old at home, good luck not lifting that child for six weeks straight. So at this point, I always encourage people to follow their surgeon’s recommendations, but if we know you’re not going to follow them, then let’s plan for that too. So how can we set you up so that you have as much support, so that you won’t cause harm to your incision and you can continue on healing and being a functional parent and mom, and not feel bad about it? It’s also kind of stuff that we’d like to do. And then after delivery, yeah, we want to start bringing a large amount of awareness to the fact that women should be tending to their scars.

So some of the things that we see is chronic scar pain and we see women that have an inability or an inflexibility around that area. So all of a sudden they might feel that they can’t bend backwards as far as they used to or extend their leg as far back. I see a lot of complaints from women that want to do yoga and Pilates and they just feel like since they’ve had one or two C-sections and as you said, you can tend to see more and more scar tissue that will develop that they just can’t get into the same flexibility as before. And then there’s always women that just don’t like the appearance of what a scar does because a scar is firmer tissue than the soft fatty tissue on an abdomen. And fatty tissue on an abdomen is normal, everyone. But all of a sudden there’s rigid band that’s pushing into it and we’ll give this little…

April: Yeah it’s a little pooch.

Katie: Yeah, so there’s no guarantee the scar massage will help that. But I have seen clinically, like I can’t give you research that shows that I can give you research that shows that it helps pain and it can help flexibility. But we’re starting to see if, if women tackle that problem, we can see some improvement in that.

April: I am so excited to hear an update on that because that’s where I came into this conversation when you posted about, you know, the massage and tingling and itching and I am nine years out from my last Cesarean and it is the only, like the last one I’ll ever have. It still tingles. It still itches. It’s like, it’s like a ghost that lives on my abdomen.

Katie: And people won’t ask you about it. It’s kind of like, ‘Well, you’ve got a baby and you’re alive, so you should just be satisfied’.

April: And so I just, I sort of thought, well, you know, if there was something I should’ve been doing, I would’ve gladly done it.

Katie: Right. But, but it’s not talked about.

April: It was not talked about, you know, they send you home and, and I remember having staples that pulled and feeling really uncomfortable and just, yeah. And I often get the question as well with some of the products that I make and sell, if it’s okay to use it as a massage balm? And that one is, that one’s tricky for me because if the wound is still open, you don’t want to introduce any pathway to bacteria.

Katie: Correct. If the wound is still open, typically people aren’t ready yet, not tolerant. So for my, for my patients that are really keen to get started on scar massage, I usually say not before four weeks. Like you’ve got other things to worry about, but rather your energy be going into bonding with baby and getting in nutritious food and trying to sleep and recover. Once – until there’s a scar, you can’t do scar massage. So racing to try to do mobility there isn’t really going to help you. So you’re looking for your scar to have a cap, which is a code word for scab. And for that to heal and to have an actual scar to work on, and even then it’s more likely women who’ve had a traumatic birth – so an unplanned C-section, feeling like you were mistreated during a birth, having to go under general anesthetic. No, not for everyone, but we just, we see this happen more. Um and I’m stealing this…

April: Unplanned outcomes.

Katie: Unplanned outcomes, right? I’m stealing this this scenario from someone, I can’t remember who it is or I would quote them, but this is not my idea. If you compare birthing trauma to other types of trauma, for example, if someone hijacked your plane and you still landed safely and got off the plane and all was well no one would say to you, ‘Well, you landed safely. So what are you complaining about? Versus in a birth, if someone, if something happens and your birth plan and your birth vision gets hijacked, people will say to you, ‘Well, you’ve got a healthy baby and you’re okay. So stop whining’. But that’s not how our mental health…

April: Well, the focus immediately shifts away from mother. You’ve done your job, your vessel hood is now complete.

Katie: Get on being a mom.

April: Yeah. Get on it.

Katie: But in any event, what we see happen in these in these higher traumatic births that I will have a hard time even touching their scar. And I’ve made this mistake in my career now too many times to not check ’cause I have someone they will, I will…I’m learning that I can’t predict it and that’s where I’ve made the mistake. So, they’ll come in and they’ll be joking and they’ll be, it won’t be what in my, in my stereotypical brain, thinks as like a postpartum PTSD, postpartum they won’t appear like that. And then I will lift up their shirt and get ready to do scar massage and I put my hands on their scar and I just see something in their face and they guard and I go, ‘Oh no’. And I take my hand off and I go, ‘Have you been able to look at your scar in the mirror’? And they just burst into tears. So it sounds like a silly question to ask for people who don’t have a trauma associated with their scar. But now I’ve taken to asking the questions, ‘Have you been able to look at your scar in the mirror? Have you touched your own scar? Can you touch your own scar? And does your scar represent negative emotions for you’? And if I get those, if I get people who have that, they know the answer straight away, they just slip, will start crying or they’ll say, ‘Yeah, that’s me’. So then we have to do a little bit of work before we can even start touching the scar. So, so then we might have to work off the scar. Like, ‘Can you even touch your abdomen right now’? I start a lot of scar massage over clothing. Or, we start with a lot of mirror therapy. They just start by looking at their scar in the mirror and that’s how we treat some of the scar pain scenarios that we see. But if it’s not talked about, they feel crazy.

April: That hurts my heart to hear you say that.

Katie: I know. And so this is something that I started, then I had to start researching this because I didn’t realize it was even a thing until I started doing more and more scar work.

April: Yeah. I had never really thought of it like that. But yeah, I’m not, I’m not surprised now that I’ve heard it articulated, but I don’t think I would’ve made that connection either.

Katie: Well and me neither, so there you go! So now, I mean this is what we’re trying to promote like this is there is as much healing that needs to go into Cesarean delivery as there does into a vaginal delivery. And I’m really big on not calling vaginal deliveries ‘natural births’. Because I don’t know what a natural birth is to be honest with you. Like is it a vaginal birth? Is it a medication free birth? Is it a birth that’s in home? So I really, it’s not my job to judge what kind of birth someone had or what kind of birth someone wants. It’s my job to help them prepare and to rehabilitate from that. So I could be the first person that makes them feel bad about their Cesarean. So it’s a vaginal birth or vaginal delivery or it’s a Cesarean birth or a belly birth is what I call them.

April: Is there like a component of trauma informed care around that or is it?

Katie: I think there needs to be, yeah, I don’t know that there’s a set of parameters. I think more and more we’re seeing more awareness for birth trauma because you can have PTSD from a vaginal delivery as well. There are some women that don’t want to have vaginal deliveries and they’re forced to have vaginal deliveries. So it goes both ways. It’s just when I, when I set my sights on working more and more with Cesarean mamas, I started to notice this phenomenon that hadn’t really been talked about in any of my education previously. And I’ve been working as a pelvic floor physiotherapist for 10 years. So for it to not have come up at all in the, you know, the almost a decade that I’ve been, that I’ve been studying. It made me realize that someone needs to be studying this. So it’s nice because we do have research groups around the world that are starting to put effort into trying to figure out what’s going on with Cesarean moms, because it’s about 30% of the population in the developed world now.

April: And the stats keep climbing.

Katie: Exactly. Yeah.

April: Is there a difference in how the pelvic floor itself is affected through a vaginal birth versus Cesarean birth or is it more related to how the baby was positioned prior to delivery?

Katie: That is a very good question, actually. I don’t get asked that all the time. Because I find the myth out there is that a Cesarean preserves pelvic floor, right? So when you boil down the research, it’s actually very interesting. Now if you read research at all, there’s problems with research and all research studies.

April: Of course.

Katie: Generally what we see is that Cesarean seems to be preservative or help prevent pelvic organ prolapses, which is when the organs start to descend too low into the vaginal canal and can cause sensations of vaginal heaviness or you can actually start to see the organs come out. So we have enough research to suggest that. So in Cesarean Sections it does help to prevent that, but a lot of women don’t realize that you can still have urinary incontinence. It’s just a pregnancy alone can put weight on the pelvic floor. And then there’s different types of vaginal deliveries. So what we usually see is a nonsurgical or a non-instrumental vaginal delivery, which means you had a vaginal delivery and you didn’t need an episiotomy. You didn’t need to be cut or you didn’t need to use forceps or suction. If you have a vaginal delivery like that, that seems to be the most ideal way for mother’s pelvic floor. Like that seems to be a less trauma to the public floor and we don’t have the surgery to deal with. And then we have instrumental or assisted vaginal deliveries where there are incisions that are made and larger instruments that have to be used. That seems to be the highest trauma to the pelvic floor. So when you start to get a large degree tear, so third degree tear, fourth degree tear, that starts to affect the anal sphincter that we know, those moms tend to be at risk of having a number of different pelvic floor conditions and C-sections seem to fall in between the two. So C-sections, there’s a little bit like they tend to have bladder problems. It tends to be different than someone who pushes out a baby. So women who push out a baby tend to have more leaks that happen with cough, sneeze jumping jacks, and women who have Cesarean deliveries tend to have more bladder urgency. So feeling like they have to pee all the time. They will have potentially different types of pain with intercourse, but both, both types of delivery will have pain with intercourse. Obviously, if there’s, if there’s a tear then there’s pain or potentially around a tear, but that doesn’t, because you’ve had a C-section doesn’t mean you won’t have that. So when you’ve had a C-section, you have had a surgery to your uterus. So it’s just there’s been an incision at the other end of everything. Right. Um and what I, the other thing that we’re, we, we are starting to see in the research and what I see clinically too is that women who have severe degree tears do have more anal rectal problems. So having a more constipation or more leakage that, that seems to be mitigated by a C-section. But as I said before, C-section scars haven’t, like, they’re not studied as well as vaginal birth issues. So we’re just starting to document now about chronic scar pain. So we know that with any surgery there’s a risk of having chronic scar pain that doesn’t really seem to be addressed at all. And then the limitations to movement and then the subsequent more and more scar tissue that we’ll see that will develop after having numerous sections.

April: Does that happen? If you do have, you know, an appendectomy or any other kind of abdominal surgery, can that, is that something that is inherent to having a scar or is it specific to…

Katie: Scar pain? Yes, it’s inherent to having any surgery there’s a risk of having chronic scar pain with any surgery. It’s not talked about very much. And I think what happens with C-sections once, once your appendix is out it’s out, you’re not having a repeat appendectomy, right? C-sections, we can see them happen over and over again. And there’s something different about the birthing process. Like there’s just something different I find about, because I treat a lot of abdominal scars. So I treat abdominal scars. I see a lot of gastrointestinal patients as well. I’m not limited to just C-sections, but there’s something about C-section scar that there’s a lot of emotion tied to those. And again, as I said, you don’t get to go home and have the same recovery that you would with other, even other gynecological surgery. Someone who has a hysterectomy and abdominal hysterectomy will have the same scar, like it’s the same type of incision, but they get to have a different recovery associated with it. So that’s the stuff that needs more study.

April: So, there’s also a lot of cultural shift. It needs to change. With how we support women…

Katie: Fourth trimester.

April: The fourth trimester, that’s a very good way of putting it. Yeah.

Katie: Yeah. We don’t always, I kind of make the joke when I, when I’m trying to encourage them and to get a belly brace. Like we don’t go home to a tribe of women anymore that roast us and take care of us for the fourth trimester. Like, you know, some women don’t even realize they can’t drive for X number of weeks after having a C-section. So it’s like you put your 10 pound baby in a 10 pound car seat and you have to lift that car seat and go to Costco, right? Where if your appendix was out, you probably wouldn’t be expected to do that.

April: That’s right. That’s right. Yeah.

Katie: So it’s a different mentality.

April: So tell me about these, the gel packs that you can apply to your, I keep touching my abdomen.

Katie: So silicone treatment for scars has been used for oh, like decades now. And I don’t know why we don’t talk about it in the gynecology world. I think it’s talked about more in plastic surgery because their goal is to make nice looking scars. So I have some friends that are plastic surgeons and they talk about it quite a bit. And the other thing about a C-section scar is that traditionally they’re supposed to be done below the bikini line, so almost into the pubic hairline. So it’s like their mentality is a no one’s going to see that scar anyways. Who cares? But that’s not necessarily true. Like some women wear clothes or like, you know, swimsuits, fashions. I’ve now been alive long enough to have the ultra-low jeans and the high waist jeans. So if it’s high wasted right now, I know ultra-low will come back again. But lingerie or just, you know, whatever.

April: There are bathing suits that ride low.

Katie: Exactly. and with that also is, as you’ve mentioned, the itchiness. So, we call those hypertrophic scars, scars that the tissue is just still kind of always in a constant state of healing that’s happening. So, we tend to see the scar will stay a little bit pinker or redder. It won’t fade to a white color as quickly and it will feel itchy and you can have pain around it. So if that’s the case, we know silicone scar treatments are a low risk way to get some benefit. I used them after my C-section scar. So you can get them in a gel – like a cream – or you can get them in a tape or a –  almost looks like a paper that you cut. They stick on, they kind of feel like, you know, those gel ornaments that you stick on your window? They kind of feel like that. So I find in the Plastic world they recommend like in the, sorry, like the surgical Plastic Surgery world, they recommend the cream more because they’re working on like face scars and you don’t want to see a bandage on your face. But for moms, the, to me the tape works way better because it’s narrow, so you have to make one or two cuts. And I’m lazy, so that’s what I like to do. And pants just rub that area. So I find the, the cream just rubs off. So I usually recommend going and getting the silicone scar tape and you can find it in some pharmacies. I usually recommend people ordering off of Amazon. It’s hard to find the tape usually can find a little stickers, but then because C-section scars are, you know, about 15 centimeters long, you end up having to stick three or four stickers on. It’s a waste. Just go on Amazon and buy the silicone scar tape.

April: Okay. That’s great advice.

Katie: So my business partner, Eryn Matheson, who is also a pelvic floor physiotherapist her and I were just really tired of having people come from like long drives from rural areas to come see us, people who are doing birth preparation classes with no mention of pelvic floor or no mention of how to prepare for a C-section. And we were just been giving these talks over and over again, so we finally just recorded it and put it online. So, we do offer it through our company Motherhood Link. So, you can find us at or on Facebook or on Instagram under that name as well. So if you are looking for the birth prep class, it’s about four hours of information and there’s two streams. So you can kind of go the vaginal route or you can go the Cesarean route or you can look at both of them and you’ve access it to it forever, which is what we love because women just want to watch the vaginal and then after baby, then they might end up watching the Cesarean if it ends up being a C-section. But you have access to it forever. So we love that, but there’s also just loads and loads and loads of free information. So we’re posting videos. We write blogs all the time. If people have questions, we do our very best to answer questions that people might have. But if you do want to purchase the course, the promo code is pregnancyprep. All one word, all lowercase letters for 30% off. So we’d like to offer that to you guys.

April: Thank you Katie.

Katie: No, my pleasure.

A huge thank you to Katie for joining me today. I know I’ve said this at the end of other episodes, but I really feel that these conversations are going a long way to beginning a cultural shift in how we support women through their fourth trimester. I hope you feel empowered with new information. Please go to for show notes, links, and more information regarding Eryn and Katie’s course at Motherhood Link. You can find Ripple Effect on iTunes, Google play, Stitcher, and Spotify. If you’re enjoying Ripple Effect, I would love it and appreciate it so, so much. If you could leave a review on iTunes and share our episodes on social media so we can reach more people. I’m your host, April MacKinnon. Join us again for future episodes. It’s always such a pleasure being with you today.

The Ripple Effect Podcast

About the Podcast

April MacKinnon dives into how reframing our self-limiting beliefs and behaviours and bravely chasing our dreams, ripple out to change the world, one action at a time. And how, sometimes, it is the small moments in life that lead to a complete pivot in perspective, only to be found in hindsight. More about April »

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