The C-section Scar and what you maybe didn't know!Oct 27, 2020
In 2019, polls taken on several social media forums for women who have birthed by C-section have identified gaps in their knowledge about wound management in the postpartum period.
92 % of mothers polled were not advised about the need to support their caesarean wounds with a cushion or rolled-up towel during sudden movements.
This important information should be shared by health care professionals for all women after caesarean birth for both hospital and home care wound management.
A poll of 512 mothers of children birthed by C-section was conducted to discover how many had actually received such wound care education. The results of the mothers poll revealed that 92% had not received any education about wound support and the rationale behind it. The poll identified that only 8% of the women had been given education regarding protecting their wounds during any sudden movement after the surgery.
A second poll of 256 practising midwives was conducted. The midwives were asked to indicate whether or not they actively advised women to support their wounds with a cushion or rolled-up towel after surgery or gave specific education prior to their discharge home. The results of the poll showed that 94% of midwives did not routinely educate women about wound support methods and their importance or specific wound care and assessment principles.
The findings of the two polls highlight a lack of education currently offered to women after C-section birth.
The incidence of wound breakdown after C-section is reported in the 2018 Consensus Document to be 1.9%–7.6%. by the World Union of Wound Healing Specialists. Wound breakdown is also known as Wound dehiscence and is characterised is the separation of the edges of the surgical wound. It may be just the surface layer or the whole wound. It may become a serious problem and complications such as delayed healing and infection leading to sepsis can be catastrophic.
The incidence of wound breakdown after a C-section birth is a significant problem and women should have knowledge and understanding to know how to reduce their risks.
One of the three main causes of wound breakdown is mechanical stress on the layers of the wound during sudden movements such as coughing, sneezing or laughing. Mechanical stress is caused by raised intra abdominal pressure occurring during such movements and can cause separation of the stitches .
Education for women including simple explanation of the wound healing process, the environment conducive to healing the nutrition to enhance healing and the warning signs for complications is an important inclusion in discharge planning for mother and baby.
Consistent, sustainable and comprehensive education after C-section birth is vital to a good recovery. An innovative visual tool the Five Guide was developed by UK Nurse & Midwife Janine McKnight-Cowan to improve women's knowledge and understanding of the five-layer healing process.These layers are 1.Skin> 2.Fat> 3,Muscle> 4.Peritoneum > 5.Womb. see Five Guide – Caesarean section
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