Holistic C-section Recovery Program
Did you know around 1/3 of women in the US give birth by C-section (that’s a whole other post). Many women are given very little postpartum instructions other than a list of things they cannot do. This can be a challenging time for a new mom that is now concerned about caring for her new baby with a list of restrictions. Many only get a small amount, if any, about treating their scar and problems that scar tissue can cause once their incision is healed. They usually are not told about doing anything to the tissue surrounding the scar either. Scar tissue does not form neatly and can attach to other tissues binding things together that should not be. Scar adhesions can also contribute to other problems like incontinence, urinary frequency, pelvic organ prolapse, and low back pain. Many women report painful scars and other issues associated with their C-section long after the birth of their baby, but it does not have to be this way!
Did you know I will come to your house in the first few days home from the hospital to help you get started on healing from your C-section and teach you ways to:
Postpartum women must have a prescription from their doctor for Occupational Therapy prior to starting program. Please contact me with any questions! www.healthyhivellc.com
It was once thought that if a woman had one cesarean delivery, all of her babies should be born that way. Today, we know that many women can undergo a trial of labor after a cesarean delivery (TOLAC), and 60-80% will successfully achieve a vaginal birth after cesarean (VBAC)
The American Congress of Obstetricians and Gynecologists (ACOG) deems vaginal birth after cesarean (VBAC) safe and an appropriate choice for most women who have had a prior cesarean, including some women who have had 2 previous cesareans according to guidelines published in 2010.
A successful VBAC has fewer complications than an elective repeat cesarean. However, a failed trial of labor after a cesarean (TOLAC) has more complications than an elective repeat cesarean. The most injuries occur when a repeat cesarean becomes necessary after a TOLAC fails.
Let’s discuss some of the benefits, risks, and ways of preparing for a successful VBAC.
There is higher risk of urinary stress incontinence with people who have had both a C-section and a vaginal birth, however, this is something that can be resolved or improved without surgery. This is also something that commonly happens no matter what type of birth you have and even to women who have never given birth. Working to improve the function of your core and pelvic floor prior to and after birth is very beneficial.
Tips for Planning your VBAC
1. Picking your Birth Provider
This is probably the most important aspect that will determine if you have a VBAC or not. Having a trusted and supportive care provider can make all the difference. Whether you choose to birth at a hospital or have an out- of - hospital birth with a midwife, you need to interview your potential provider about their experience and policies regarding VBACs. Talk with people in your community like doulas, childbirth educators, and L&D nurses who can usually give recommendations on VBAC friendly providers.
The International Cesarean Awareness Network (ICAN) is a non-profit organization whose mission is to improve maternal-child health by reducing preventable cesareans through education, supporting cesarean recovery, and advocating for vaginal birth after cesarean (VBAC). ICAN has compiled a directory of U.S. hospitals that do and do not provide medical care for VBAC. Women can access ICAN’s Hospital VBAC Data Base at http://ican-online.org/vbac-ban-info .You can also check their website for cesarean rates.
2. Healing from your Previous Cesarean
Addressing unresolved issues from previous birth(s) is important. Many women report pain in their scar area years after C-section. If your scar seems to be stuck and does not glide like the rest of your skin then it is adhered. Scar adhesions are strands of collagen that form in the body after surgery or trauma. These powerful strands can wrap around structures and can restrict blood flow or reduce the function of internal organs. When you have multiple cesareans you are getting cut multiple times in same area which will cause more adhesions and scar tissue to form.
Do you feel disconnect to your tummy and pelvic floor since your C-section? Your muscles may shut down around a surgical site to allow for healing. This means your abdominals and pelvic floor muscles may go on a vacation after a C-section causing weakness which can lead to incontinence. Your pelvic floor can also tense up due to the pain of a C-section. A pelvic floor can stay tense which results in dysfunction. It is important to be able to let go and fully relax your pelvic floor muscles for a vaginal birth.
What can you do if you have these problems? Work with a women’s health physical or occupational therapist that is knowledgeable in scar management techniques, and core and pelvic floor function.
If you are holding on to negative emotions associated with a previous birth it can be helpful to seek out help from a professional or trusted person. You can also check your area for postpartum support groups. An added benefit of a VBAC is that it may help a mother heal emotionally from her previous cesarean. Non-medicated births and exclusive breastfeeding help to keep hormones working properly and make you less likely to experience postpartum depression. Postpartum support for both moms and dads can be found at www.postpartum.net.
3. Nutrition and Fitness
As with any pregnancy you want to keep yourself as low risk as possible. Being healthy through food and exercise will not only help you in the delivery room, but your will feel better during pregnancy and recover more quickly postpartum
Birth Boot Camp has designed a program specifically for the childbearing year. The Food and fitness program will help you build a great physical foundation for your pregnancy, birth, and baby.
Take a birth class that is right for you. Many people think birth classes are just for first time moms. But if you did not previously have the birth experience you desired a childbirth prep class can be a great way to prepare for your next birth. Make sure your birth class curriculum includes plenty of information on VBAC so that you can make good informed decisions.
5. Chiropractic Care
Many birth professionals feel that chiropractic care increases VBAC success rates. The Webster Technique has become a familiar term in the pregnancy and birth conversation. More and more families are seeking out chiropractors who are proficient in this technique as a way to support an easier birth. To find a Chiropractor who has completed advanced training in caring for pregnant women go to https://icpa4kids.com/
6. Build your Support Tribe
In addition to finding a supportive birth provider it is helpful to surround yourself with positivity and supportive people. Here are some ways you can do that.
Nikki Goodale, OTR, CLT, BBCI
(2010) Ob Gyns Issue Less Restrictive VBAC Guidelines. Retrieved from https://www.acog.org/
Introducing The Healthy Hive, LLC. Therapy, education, and wellness services catering to women's health . I am Nikki Goodale, wife, mother, occupational therapist, and Birth Boot Camp instructor living in East Texas.
My pregnancy and journey into motherhood has inspired new passions and career paths. Prior to my daughter's birth I worked full time as an OT, I worked the majority of the time in an outpatient clinic doing hand/upper extremity therapy and lymphedema therapy. When my daughter Lilly was born I quit working full time and started doing PRN (as needed) OT work in the acute hospital, outpatient, and home health settings so I could spend more time with her. This also allowed me to have the time to be able to take more courses in areas I was interested in.
As a new mom I began to see the importance of the "tribe". I had always heard the saying " it takes a village to raise a child" and this became very clear to me. New mothers face many challenges. Trying to navigate pregnancy and the postpartum time can be difficult. Many mothers find themselves feeling very isolated and do not know where to turn for information and support. I wanted to help educate and be a resource for women and saw a need for more women's health services in East Texas.
I am a Certified Lymphedema Therapist and for the past several years have enjoyed working with women recovering from breast cancer. I've treated people of all ages with hand and upper extremity conditions and treated many common conditions seen in pregnant women and caregivers such as carpal tunnel and dequervain's tenosynovitis aka " mommy thumb". With my new interests in pregnancy and birth I wanted to expand my knowledge and skills to be able to support more women throughout the lifespan.
I certified as a childbirth instructor through Birth Boot Camp which offers a variety of pregnancy and childbirth classes. After entering the world of motherhood and becoming a Birth Boot Camp instructor I realized how many women were injured during childbirth or developed musculoskeletal problems during the postpartum period due to motherhood movement patterns and changes with their body from pregnancy.
Every day women are having cesareans and having to learn to care for their newborns while recovering from major abdominal surgery. Many women are suffering from painful scars from episiotomies or C-sections years after they give birth. Many are suffering from pelvic muscle dysfunction that can cause them many issues short and long term. In addition there are women who also suffer emotionally and need support and resources.
Recognizing these needs, I have continued my education to expand my skills to offer an integrative service for women here in East Texas. I have done continuing education through the Hermann and Wallace Pelvic Rehabilitation Institute and with multiple leaders in women's health therapy. My training includes modalities such as the use of SEMG biofeedback for pelvic muscle dysfunction.
But, what is occupational therapy? My definition is "helping people succeed at daily activities that are meaningful for them and that occupy their time, whatever that occupation is." For example, a valued occupation of a new mom may be breastfeeding, which takes up much of her day and although it is natural it is a learned skill. OT is all about helping and supporting others to take on the life roles they want. Woman often put their needs and health last while nurturing others. But, to help others we must practice self-care. Like the saying goes "you cannot pour from an empty cup".
The goal of the Healthy Hive is to help the "queen bee" thrive in all of her life roles. The Healthy Hive combines many of my passions, what I have learned from more than 6 years of occupational therapy experience , continuing education, Birth Booth Camp training, and my research of holistic techniques and lifestyle solutions.
Specialized Occupational Therapy
- Lymphedema Program - Complete Decongestive Therapy
- Strength After Breast Cancer: An evidenced based rehab program for breast cancer survivors
- Urinary Incontinence/ Bladder Dysfunction
- Pelvic Floor Muscle Dysfunction
- Pelvic Organ Prolapse
- Pelvic Pain (Dyspareunia,Vaginismus,vulvodynia, interstitial cystitis/painful bladder syndrome)
- Postpartum Recovery Program
Includes c-section and perineal scar management and holistic core restore program that addresses issues such as diastasis recti.
-Upper extremity conditions
(See website for more details on specific diagnoses and treatment interventions)
Birth Boot Camp Classes I offer
-Birth Boot Camp: Training for an Amazing Hospital Birth
-Birth Boot Camp: Training for an Amazing out-of-Hospital Birth
-Food & Fitness: A Program for the Childbearing Year -Comfort Measures: Amazing Coping Strategies for Labor
-Homecoming: Life with a New Recruit
My concern for the wellbeing of the "queen bee " and her family extends to assisting women with referrals to other services such as lactation consultants, physicians, midwives, body workers, and women's health boutiques. I can provide recommendations on toxin-free cosmetics, skin care, baby and household products.
I will be accepting private therapy clients starting January 2018. Offering treatments at an office location in Tyler, Texas as well as home visits in certain situations and locations around East Texas. You can contact me now about scheduling Birth Boot Camp classes.
A new website will be coming soon with more details on services. Feel free to call or message me with any questions!