One of the most common questions I am asked or see posted on babywearing forums and Facebook groups is: “Can I use a sling I have had a caesarean?” and the answer is quite simple. It is probably yes. Despite what woman may have planned or hoped for 1 in 4 babies born in England are delivered via Caesarean Section (CS). The 2013-14 NHS Maternity Statistics for England show that of 646,904 deliveries, 166,081 of these (or 26.2%) were caesarean section, with 13% conducted via emergency section. Therefore there are many mums who potentially want to use a sling to carry their baby who are no scared that they can’t now do so.
Firstly, I am not a medical practitioner, I am a babywearing consultant and sling librarian who has worked with many mums who have had caesareans and helped them to find ways to carry their babies comfortably and most importantly safely. If you are in any doubt you must always consult your Midwife or GP. What I will consider are the ways in which we can look at carrying after a caesarean.
The recovery rate after a CS is generally longer (NHS Choices) and the fact it is major surgery can make mums apprehensive about using a carrier. The key with carrying after a caesarean is to carry “high and tight” to avoid the scar. Incidentally, the high and tight rule applies to mums who have had a vaginal delivery too. Simply having a vaginal delivery does not mean you are ok to carry. For example it is thought that 5 in 10 women who have had children have some degree of prolapse but that only 1 or 2 women in every 10 seek medical advice due to the sensitive nature of the condition (www.patient.info). Other post-partum complications such as haemorrhage and tearing can leave women who have had a vaginal delivery feeling weak. Therefore there is no blanket rule to state having a vaginal delivery means you can use a sling or having a caesarean means you cannot. The amount of time post partum where a woman feels comfortable and capable of carrying will vary from mother to mother, there is no ‘set’ time. Listen to your own body.
Women who have had a caesarean delivery will typically spend 3-4 days in hospital although this can be as little as 24 hours. Women who have had a caesarean section should resume activities such as driving a vehicle, carrying heavy items, formal exercise and sexual intercourse once they have fully recovered (including pain). This means that many women will not be ready to strenuous activity until after 6-8 weeks. This does not mean that women should be confined to the house and using a sling or carrier allows them to undertake gentle exercise such as walking. Gentle exercise should be encourage to avoid clots (NHS Choices) forming. This will also help woman to start building up muscles again. Using the sling can stop mothers from bending unnecessarily. Keeping baby close can stop you from having to keep picking them up from their Moses basket or crib.
Time and care should be used when placing baby in the sling to ensure the mother engages her pelvic floor and core muscles. 30% of postnatal women will have some form of stress incontinence after birth. The ability for mothers who have had a caesarean to use is a sling is particularly important as they are unable to carry anything heavier than their baby. This therefore means they should not lift car seats or or even push heavy travel systems and prams. The NICE guidelines recommend early skin to skin contact for mothers who have caesarean deliveries (2004). Skin to skin contact has also been shown to help emotional attachment between mother and child, as well as being beneficial in promoting breast milk production both which can be hindered by caesarean deliveries, typically as because their can be a delay in offering breast. Using a sling allows them to get out and start to socialise and help with mental wellbeing and help reduce risk of post natal depression. This ability to socialise is encouraged by NICE and postnatal care should encourage mothers to have a social network of support. (NICE Pathways)
Using a sling or carrier can play a crucial role in allowing a mother to regain her strength and posture after the birth. The key is to listen to your body and to build up the amount of carrying you do. Your body will develop muscle strength and get used to carrying your baby. Do not assume you will be able to carry for hours straight away. Your postnatal body will need time to adjust and remember you will still have increased levels of Relaxin in your system, especially if you are breastfeeding. Even if you do not feel capable of using the sling it could be used to help the emotional bond between baby and other caregivers
There is no right or wrong sling to use after a caesarean section. In all cases care should be used and it is beneficial to select those which do not sit lower on the mothers’ abdominal muscles and can place pressure on their stomach and scar. Typically these are those with structured waistbands although ideally these should be worn on the wearers waist above hips and far away from scar. I have fitted all manner of slings to mothers after a caesareans. These have included ring slings, wraps (woven or stretchy) and even buckle carriers. We are simply wanting to keep the sling away from the scar tissue and stitches.
If you want to carry and are unsure of the most comfortable way to do so it is worth having a consultation with a babywearing consultant as they will have the time , knowledge and experience to help you find carries which are comfortable. Remember there is no date by which you must have started carrying. You should only begin using a sling when you feel comfortable, do not rush your body. If you want your baby to get used to being carried in a sling ask your partner, grandparent or even a friend to carry them for you.
References and links
http://www.nhs.uk/conditions/caesarean-section/pages/recovery.aspx
Click to access pi-pelvic-organ-prolapse.pdf
http://www.nice.org.uk/guidance/CG132/chapter/1-Guidance#care-of-the-baby-born-by-cs
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