Massage & Bodywork

September/October 2010

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MASSAGE FOR CESAREAN SECTION CLIENTS turmoil, and that turmoil may be present whether or not the woman links it to her surgical experience. Long after visible scars are healed, she may still feel emotionally overwhelmed by details and obligations. She may distance herself from other people, from herself, or from her experience. She may not be aware of, or allow herself to feel, her emotions, instead storing them in her body. As she remains busy dealing with her ongoing life and caring for her new baby, this client may never make time for the emotional healing she may not even be aware she needs. Until she finds a place where she can feel safe enough to release both the stored emotions and the muscle contractions with which her body is protecting itself, she may continue to physically and emotionally guard the areas where pain has lodged itself. A non-judgmental bodyworker offers a safe place for her to experience positive touch, to develop awareness of her charged areas, and to reconnect with her body and emotions. MORE THAN JUST A RUB It's clear that, just as surgery involves more than the physical body, massage is more than just rubbing oil onto someone's skin. Touching connects to the brain's emotional centers. Massage therapy can be empowering, reaching not just the body but also affecting the client's self-image. As she gradually becomes aware of feelings stored in her body, maybe in the form of ticklishness, TMJ or jaw pain, lower back achiness, a rigid neck, or tight shoulders, the client can begin to use this awareness in her healing process. Once she acknowledges her feelings, she can take the energy she's been using to block them, and use it instead to guide their release. Like her new baby, a post C-section mother needs to be cradled. Her surgeon and other caregivers usually don't have the training or the time Adhesions Adhesion formation can be the result of many surgical issues: • A delay in moving around or walking after surgery. • A surgeon too aggressively trying to reduce blood loss during surgery, resulting in tissues being under-supplied with blood (ischemia). • An inflammatory response to surgery. • Excessive or rough handling of organs. • Existing conditions, such as poor nutrition, prior surgeries, and endometriosis. • Inadequate post-operative fluid and electrolyte balance. • Infection. • Poor surgical technique. to work with her the way you, a bodyworker, can. Although it is not your job, nor within your scope of practice to provide psychological counseling, you can support her and give her safe space for when she wants to cry or express emotion, and help her feel at home again in her post-surgery body. Releasing deeply ingrained emotional patterns and extreme negative self-images may require the help of a psychological counselor, to which you can refer. For a woman who wants to attempt a subsequent vaginal birth, this release can be a vital part of recovery. In some cases, psychological counseling from a postpartum specialist may be appropriate. From my experience, labors following a previous C-section can slow or stop at the point where the Cesarean was performed, as old thoughts and emotional patterns surface. The more deeply hidden the issues are, the more difficult they may be to resolve. If a woman hasn't dealt with them before her next labor, she'll likely have to deal with them again in the middle of it. From adhesions causing chronic pain and infertility to repressed emotions and self-image issues, the deeper scars that can follow a C-section need to be healed. Complete healing is possible if this client allows herself to seek and accept appropriate care. I encourage you to work with her and support her in her search for it. is an operating room nurse and an RN first assistant at surgery. Since 1989, Cook has been a Texas-registered massage therapist, specializing and certified in prenatal/ postpartum massage therapy, and is also a certified infant massage instructor. She developed a "Supporting Birth Through Massage" class to teach birth partners massage and bodywork techniques for use during labor, which she teaches privately and to labor and delivery nurses, midwives, and doulas. For more information, visit her website at NoTES 1. Women's Surgery Group, "Adhesions." Available at adhesions/overview.asp (accessed July 2010). 2. N.F. Ray et al., "Abdominal Adhesiolysis: Inpatient Care and Expenditures in the United States in 1994," Journal of the American College of Surgeons 186, no. 1 (1998): 1–9. connect with your colleagues on 71 Melody Cook, RNFA, BS, LMT, CNOR,

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