C-section question

[Comma2]

I am terrified of getting a cs, and think it boils down to two friends telling me back then that your stomach muscles will never be the same, and that there are 'scar tissue issues'. Didn't ask any further, but has become engrained in brain and freaks me out, so I think I need to know what exaclt that means. Can anybody tell me? It would really help me get a better grip on myself when I go in there....I already have had an episiotomy and can barely deal with the disfiguration coming along with that...

My stomach muscles are fine after 2 cs's and a hysterectomy. Got a bit of a podgy tummy, but it's just fat to be worked off, the muscles underneath are still in good condition. I was doing crunches at the gym earlier .

When your friend talks about scar tissue issues I wonder if she means abdominal adhesions. AFAIK it is where the internal muscle / tissues heal together. For example when I had my hysterectomy the consultant said my cervix was stuck to my bladder (from my previous cs's) and they had to unpick it. Very common to get some adhesions after a cs, but I haven't heard of many problems with them. Despite my cervix & bladder being stuck I hadn't had problems with sex or peeing.

IMO CS's really aren't that bad, swot up on them and have contingency plans and lots of help if you have one.

Hi,

Sorry to hear you are feeling like this. I have also heard about "scar tissue issues" internally which scares me too But i recovered really well from my c section and am having another in december. My stomach muscles seem ok..my scar although it is kind of keloid has gone much lighter in colour now and you can hardly notice it is there.

Im sure you will be fine if you have to have a section, it is major surgery so you just have to follow the advice, rest as much as you can and dont do too much too soon which may hinder your recovery.

It is easy to sit and worry yourself to death over the things that could go wrong (i do it daily ) but just focus on your beautiful baby thats what i am trying to do!

Good luck

I had an emergency CS last time round. As with meglet have heard that there can be issues from adhesions but externally my scar really isn't a problem - now that I'm pregnant again there's a bit of overhang but when I'm at my normal weight it's pretty unobtrusive. Not the most beautiful thing in the world but a small price to pay for my DD having been got out safely and quickly when needed.

My stomach muscles are fine as far as I know - apart from perhaps needing a bit of strengthening but that's nothing to do with the CS!

HTH

Hi there. I think every experience is different. I was absolutely petrified of having a section and never even read the bits on sections in my pregnancy and birth books as I just thought 'Nope, wont happen to me, not interested'. I did end up having an emergency section with my first child, and although it was a very surreal and strange experience, it wasnt painful. M=In all honesty, my stomach isn't the same as it was pre-birth - I have the classic 'c-section overhang' and I can feel lumpy scar tissue if I press on my lower abdomen - but I think coming to terms with the changes in your body is part and parcel of all pregnancies and births and isnt exclsuive to woem w ho have had c-sections. I'm sure you felt the same after your episiotomy. It all feels a bit strange!

My second section - an elective - was wonderful, totally serene and pain-free and just lovely, and I recovered really well. My stomach is no worse than it was after the first.

Don't worry yourself with 'what ifs'.

I've had 2 c-sections and know what they mean about scar tissue issues.
Its been over 7 years since 2nd c-section and I still get pain on one side. Its not too painful that it stops me doing anything, more of a sharp poking pain right at the end of the scar.

I had a scan to check what it was and it is just scar tissue causing it. The only option was to have an operation to remove some scar tissue, but that would cause more scar tissue so really not worth it.

But honestly, it does not stop me doing anything. Also, I am a big baby when it comes to pain, so I reckon if I can put up with it, anyone can

Me too!@kid - if I can have two sections, honestly, anyone can. I was the world's biggest baby.

oh yes, I have a bit of podgy overhang where the scar is. But I got rid of it after I had ds a couple of years ago and lost the weight, so it's not permanent. It's back now as I've had a cs and hysterectomy in just over a year, but again I think once the podgy-ness has gone the overhang will too and I will just have a line where the scar is.

Comma 2 - I have not had a c section but like you was terrified of the thought while pregnant with ds's - in fact I totally freaked when I was told 4 days after ds2 was due that he was breech and I had to go in for a section immediatly (a scan revealed he wasn't thankfully!). I don't think it's abnormal to be so scared for some women so don;t think you are the only one

I was a bit concerned about what you wrote - '....I already have had an episiotomy and can barely deal with the disfiguration coming along with that'. I have had an episiotomy and am in no way disfigured - in fact cant even see where I had it now. If you have problems from scar tissue or something else regarding your episitomy you should go and talk to your GP and possibly get help? I know sometimes (although rare) problems so occur and women have to be re cut and stiched (awful I know but it can sort any problems out brought n my the original episiotomy not being stitched properly etc).

Thank you for the replies. I am not afraid of the pain, just of the bodily changes for the worse. Sounds like it will be just one of those things you have to deal with, but I am glad to hear that the stomach muscles at least seem to be fairly normal after. I had no idea what my friends meant when they said they'd never be the same again, so probably imagined a bit too bad things there.

@ Cupcake: I am not sure what's going on down there, I never looked after a quick glimpse in the beginning. It feels strange, when I touch accidentally. My doctor claims it's normal. I just have some psycho-thing about it, but it bothers me, as I can't use tampons etc, just can't touch down there (and I had none of these issues before. At all. So feel a bit bad about it all and not sure I could deal with something much more severe like a csection). I am just a huge baby myself I wished I could just deal with it gracefully.

Comma I had a CS and honestly could forget I ever had it. For the first few months afterwards, I did have a bit of an overhang just above the scar - it is like your tummy has been "tucked in" a bit where the scar is - but the effect went away gradually and anyway it really was not all that bad and bothered me less than the general post-bump wobbliness and wrinkly skin (which has also mostly gone since then!).

I haven't noticed any difference to stomach muscles other than what you would expect from being pregnant anyway - I think that has much more effect than the method of birth!

As for the scar, apart from being obviously sore in the first few days I had no bother with it and even after a relatively short time it was becoming much less noticeable already. By a year afterwards, even if I told you I had one you would have to hunt for it and would probably get it wrong (I have a sort of natural "fold" on my belly which looks more like you would expect the scar to look than the actual scar does). There is a surprisingly short, very very faint pale line on my skin, and it is right down in my bikini area so it is covered up anyway! So for me at least, it has really not been disfiguring at all.

Do you have a particular reason to think you might need a CS?

When they do a cs they do not cut the stomach muscles but they do move them. Afterwards they try to put things back where they came from but obviously this is not exact. So a post cs tum can be a bit different to before and it seems to be the case for some of us that it takes more time to get back to normal. Or if you are lazy like me and don't exercise much it doesn't!

A cs scar can have an overhang of skin. Mine certainly did to start with and I hated it but 3 years on it was pretty much gone. It is caused by the scar being tighter than surrounding skin. To improve the look of your scar too you can massage it gently from very soon after the op. I imagine that if you could bear it this would also help to break down scar tissue from your episiotomy.

As for scar tissue, it is normal to have internal adhesions after surgery. These often cause no problems whatsoever, but it is impossible to tell what will happen as some women are more prone to adhesions than others. I did have some problems conceiving again which seems to have been due to my cs, but even that has worked out in the end.

There are some pictures of scars on caesarean.org.uk if you want to see what healed scars look like - they really are not too bad. And if you get an overhang that doesn't shift in time, a plastic surgeon can fix it.

Anyway, I can promise you that if you were to need an emcs thoughts of scars will really be the furthest thing from your mind. You would be ok.

Comma - After I had episiotomy with ds1 I healed very quickly and was lucky to have no problems BUT I found using tampons very uncomfortable and stopped using them. I was aware that something was a bit different down there.

I had ds2 23 months later and bizarrely giving birth a second time seemd to sort that problems out! I had no episiotomy but I did have a nasty tear that took much longer to heal.

I think certain changes are ineitable but I don't think you should suffer. COuld you make an appoimtment to see aanother doctor? One who specialises in womens health perhaps, and may be more understanding when listening to your concerns over your episiotomy issues?

Comma, your friends that said their stomach muscles weren't the same - was this their first pregnancies? I had a vaginal birth with my DD, I didn't gain much weight but had a bit of a tummy after having her. I then put on about a stone and then a further stone when I was pregnant with DS, I was 2 stone heavier after his birth and my stomach stretched a lot more with him, my bump was huge and got stretch marks on my stomach, the skin looks over stretched too (now it is back to pre pregnancy weight so 2 stone lighter). My DS was a section and it wasn't my muscles that felt/looked different it was my stomach skin/fat. When I lost the weight it was clear my skin had been soooo stretched and lost elasticity but had that been my first birth I might've thought it was all down to the section whereas I know it was down to weight gain and my huge bump!

Regarding the actual CS though, I didn't find recover that bad and would put it on par with recovery from the episiotomy I had with my DD - the pain was just in a different place.

Now am scheduled for section for breech baby and still just terrifed of it. I will cry all the way through. I know it's not that bad, but after eye surgery, lots of dentist mess-up and the crap with the epi I just can't deal with any more cutting about on my body....

Comma you need a big hug.

It's so hard to deal with issues that you build up re. hospitals - like my issue about not going back to labour ward!

The difference with this surgery is that you get a lovely prize halfway through, and that helps you to ignore the rest of the procedure and much of the aftermath. It's a really weird experience being awake for it (if you really have issues could you request a general anaesthetic?) but it is literally minutes until this little puffy creature is pulled out, dried and given to you for a cuddle.

The first few days are really tough re. your scar. I found it virtually impossible to sit up from lying without help for a while and rolling over in bed is painful for a good while too. However, I had an emcs which I hear is more difficult to recover quickly from.

re. stomach muscles, your stomach muscles can separate naturally in pg (diastasis recti) and as MrsHappy said they do part them for the surgery. However, this is not a permanent arrangement and you can encourage them back together with appropriate exercise once you have recovered. A physio will take you through things on the ward, and some people swear by Tupler's book on how to get rid of your mummy tummy, but I haven't read it.

Adhesions - I think I had one or two to the LHS of my scar, and they were only a problem when I began pilates. I went to the doctor and he said the best thing to do is to exercise more and tear them apart! I thought they might be a problem in this pg but they haven't been, and they became less of a problem the more toned I became.

I'll be honest and say that I found the recovery hard, but I think that was more to do with having had bad SPD that didn't resolve itself, and having been induced and having laboured before the CS. I also think I was a bit anaemic and DD was a nightmare to feed. Much as I want to avoid a repeat CS, I would be happy to have another one if I was given a concrete reason like a breech baby. I'm almost curious to see what the difference is between an emcs and an elective!

hobnob thanks! I feel much better about it today, especially the part where it is elective and not em. It didn't help to fight with DH about when my annoying MIL comes, but well. Nothing I can do about it now, he just asked her to come and I'll deal with it all. It's only a couple of weeks, and then hopefully I can have my two lovely kids for myself.

Comma , I had a emcs 14 months ago and it really wasn't as bad as i thought. In fact i would go as far as to say it was a great experience. The anesthetist (sp?) and his nurse were by my head the whole time, telling me everything that was going on and being very calming. The atmosphere in the room was so chilled out, they even had the radio on. The time from the op begining to your baby being born is so fast you might not even be aware they have actually got going! And after the baby is out you won't care anyway!
I was told that sometimes a planned section can take a bit longer just because they have time on their side to do things cautiously.

Perhaps you could ask to meet the person carrying out the c - section beforehand? Do talk your concerns through with your midwife.

But honestly, i didnt ever want to think or talk about the possibility of a c section beforehand, but i am so pleased i had one, firstly it saved my little girl and secondly it really was a suprisingly laid back and very positive experience.

Good luck

stickybean that's good to hear! I know that my doctor will do the section, and I hope he's good at it. I think I'll jsut stop thinking about this. Sounds like every which way, including vb, you can get lucky or not, so probably no need to obsess or think I have to control this....

Comma2,
My personal experience of a cs was that I recovered quickly, had no probs wit bf-ing and was physically fine again pretty quickly.

The issue with the scar tissue boils down to you having a what they call a 'scarred womb' which makes you more prone to having a rupture if you have another vbac.

Other than that you'll find that the skin will be a bit looser around the tummy area and you'll lose some feeling on the skin around there.

On another note COmma, if you have a cs, make sure you get on your feet as soon as you are able and walk around-even if you still feel weak. Get your husband to strip off and get in the hosptial shower with you (you'll need him there to hold you in case you faint). As soon as you get moving and wash yourself the less chance that you'll have infection complications.

Fingers crossed you get a VB tho xx

The day after my section I felt and looked totally butchered, but just a few months later you could barely see it and now its a very fine white line that you honestly would have to search for. The surgeon did a beautiful job and I've no regrets.

I was scared too and never wanted a section (it was an EMCS), but I've just opted for another so it couldn't have been all bad.

I wish you lots of luck, you'll be fine. x

Thanks Nesta. I will be on the table on Wednesday (baby has flipped a couple times, so date changed). It's good to hear somebody came through fairly unscathed.

9 years later I wouldn't know I'd had a caesarian- but I can still feel the effects of the episiotomy/tear I had 13 years ago. In comparison with my vaginal birth, the after-effects of the caesarian never troubled me at all. I was enjoying myself on holiday a few months later with never a thought for the scar.

Have never, ever regretted having two elective sections (family history big babies and problems). Was a bit nervous before each of them - it's an odd concept someone cutting into you whilst you are awake, but it's fine honestly.

Worst time is about 48 hrs after when they downgrade you from the super-strength painkillers jeeust as the baby really starts to 'wake up' and want serious feeding - cue crab like movements to slide off bed - for me at least - but honestly we are talking 'a bit sore' not any agony - and friends who had natural births tell me that they were 'a bit *** sore down under' so no complaining!

First section did leave me with a bit of an obvious 'ridge' - external stitching which was removed later (doesn't hurt). Second one done by some gold-plated ob-gyny abroad (was working there) and a fantastic internal (dissolved) stitching job that doesn't show at all.

Ps - good luck for tomorrow!!