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Caesarean Section Recovery and Healing with Nicole Alfred (EP#157)

In this eye-opening conversation, Tahnee chats to C-section recovery coach and expert Nicole Alfred about the reality of C-section trauma, care, recovery, and why we need more support and awareness for women birthing this way.

One in five women worldwide has had the major abdominal surgery commonly known as C-section- the word major is no hyperbole. Seven layers of tissue (both abdomen and uterus) are cut through, to deliver the baby. Traditionally C-sections were only used in emergencies where either the mother's or baby's life/health was at risk. In modern-day society, they have become a regular pre-elected surgery. 

Today on the podcast, Tahnee talks to C-section Recovery Coach, Doula, and specialised Massage Therapist, Nicole Alfred about all things C-section trauma, recovery, and post-surgery care. Working in this field for over 15 years and having experienced C-section herself, Nicole brings much depth of knowledge and awareness to the lack of C-section rehabilitative care available to women within the healthcare system globally. Nicole's work focuses on changing the current narrative about C-sections, not to promote them like they're better or safer than vaginal birth, but rather something to be avoided where possible. Nicole also works passionately to bring awareness to the lack of preparation and follow-up care that would routinely happen with any other major surgery. Through her multi-layered healing programme  Nicole guides women back to a place of connection within their bodies on every level- physical, mental, emotional, and spiritual.   

Tahnee and Nicole discuss the untold realities of what happens during and after C-section, the trauma women carry (physically and emotionally) post-C-section, why women need to be advocates for themselves and the care they receive no matter how they birth, and so much more. Make sure you tune in for this beautiful, eye-opening conversation.


"I tell patients, "This is where you gave birth. In this area that I'm working on, I don't just dig right into scar tissue like I would with a muscle that was tight, I respect it. Post birth body acceptance is really important, but it's also really hard. It is hard because what your body was before you had a baby; was just your body. But now you've had a baby and there are all these changes that have happened. And now you have this permanent line across you that may or may not hurt sometimes. And so, it's a lot to integrate. And unfortunately our medical systems are failing. They're failing women by not having the right information available".


- Nicole Alfred



Tahnee and Nicole discuss:


  • C-section trauma
  • What happens in a C-section?
  • Massage for C-section scarring.
  • Body acceptance post C-section.
  • Bacterial infections post C-section.
  • Urinary incontinence post C-section.
  • Subsequent pregnancies and VBAC.
  • Healing the pelvic floor post C-section.
  • The damaging 'bounce back' ideology.
  • REST - why it's so important post ALL birth.
  • Dyspareunia (painful intercourse) post C-section.
  • The feeling of failure many women experience post C-section.
  • Corsets/belly binding - when and how we should be using them.



Who Nicole Alfred?

CEO of Fully Alive Wellness and creator of the C-section Recovery Method. Nicole Alfred is a trained doula and has been a Registered Massage Therapist in Oakville, Ontario Canada for the past 15 years.
Nicole also co-owns a continuing education program called Perinatal Massage Therapy Education. Nicole helps C-section Mamas who have experienced an emergency cesarean recover from birth and contributes globally to education and healing protocols for C-section recovery.  






Nicole's Instagram

C-section recovery Facebook group 

C-section recovery method website

Nicole's massage- Fully Alive Wellness

Diastasis Recti book- Katy Bowman


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Check Out The Transcript Here:


Tahnee: (00:00)

Hi, everybody. Welcome to the SuperFeast Podcast. I'm so excited today I'm speaking to a C-section recovery coach and a registered massage therapist, Nicole Alfred, all the way from Ontario, Canada. Welcome, Nicole.


Nicole Alfred: (00:13)



Tahnee: (00:14)



Nicole Alfred: (00:14)

Thanks so much for having me.


Tahnee: (00:16)

It's so great to have you here. I'm so excited to have this episode on our podcast because we were chatting a little bit before we jumped on about how much we've spoken about vaginal birth on our podcast, but we really haven't touched on C-section, and you used the statistic one in five women worldwide have had this major surgery. I'd love to welcome you here. And I really wanted to start and open with your story, because I know you've had two C-sections, so I'd love if you could share with our audience how you came to be so passionate about this topic.


Nicole Alfred: (00:50)

Oh, definitely. I started my career as a massage therapist young, I was 21 in Ontario, Canada. We go to school for two years to study massage therapy. And I had some experience working with perinatal patients in the hospitals, in high-risk hospitals, and really just saw how simple massage techniques can really benefit someone in postpartum. So I knew I always wanted to work with perinatal healthcare. And when I came out of school, I was young, no kids yet, anything like that. I started attracting a lot of pregnant patients to my practice, so I went and became a doula, a birth doula specifically, and learned about childbirth and how I could support my clients best and all that.


Nicole Alfred: (01:33)

I didn't really give a lot of thought to C-sections because that was just never an option. Fast forward a couple years later, I was 29, I went to give birth... I gave birth at 30 actually, to my son. And again, I didn't prepare at all for C-section. Some talk had come up about it because he was going to be big. He ended up being 10 pounds, nine ounces, which is quite large. But my husband and I are both big people, so we were like, "I can handle this." I had midwives, I had a doula. I really wanted a home birth in the birthing pool, I had that all set up ready to go, but they had just said he was going to be too big.


Nicole Alfred: (02:14)

I slowly came to terms with that and was going to be okay with that, but I was determined to birth him vaginally. So after about 40 hours of labour in the hospital, I tried to push him and he was just too big to fit through my cervix. So we ended up having to do a C-section. It was a necessary one, but it wasn't like emergency, rushing me, it was just, "Hey, he's not coming, but he is fine, he's not distressed. So brush your teeth and let's go in." So it was quite calm. So as much as I didn't want to have C-section because I have a physical job, I was worried about, how am I going to get back to working as a massage therapist?


Nicole Alfred: (02:59)

At the time, I had a really big clinic where I was managing a lot of practitioners, and I just thought, "How am I going to physically do this?" Because I do understand that C-section is surgery, not just childbirth. It is what it is, came to terms with it, said my goodbyes to everyone, "I'll see you when I come out." Go into the C-section. And because I had already tried to push him down, they had to push him back up and because my uterus was so frail at that point after so many hours of labour, it actually ended up rupturing and it became a very life threatening situation.


Nicole Alfred: (03:32)

Everyone got taken out the room, so it was just me and the anesthesiologist on my side of the curtain. I did get to see my son quickly, but then I quickly was just like, "I can't be here, you need to put me under general because I can hear everything you're saying, I know there's a really bad situation happening." And when I came out of that birth and woke up out of my sleep, I just felt lost and just unsure of what had happened to me. Everyone was looking at me like I had three heads because they just knew the severity of what just happened. And every day, you learn a little bit more and more, and you just start to piece together what had happened and feeling trauma.


Nicole Alfred: (04:18)

It was definitely something that was thinking I was feeling, but I wasn't going to sit in it, I wasn't going to let it get in my way, I had stuff to do, I had to move on. My family needed me. So I just brushed it off and said, "Yeah, it was hard." But then just had to navigate my way through recovery. I had no idea what to do because I didn't prepare for a C-section. I talked to my midwives, I talked to my pelvic physiotherapist that I was seeing, talked to my obstetrician, talked to my family doctor, talked to friends who have had C-section, and no one really had a clear step-by-step plan on what to do and how to get back to feeling strong again.


Nicole Alfred: (04:57)

Because I had a physical job, I had to get back there. And so it was really frustrating. It was a lot of trial and error, a lot of just figuring things out for myself. I ended up taking a lot of courses to educate myself on topics. And then just making myself the experiment and then being able to attract other C-section clients to me and being able to try things on them over the last seven years has given me a lot of perspective and insight just on the whole picture of rehab.


Nicole Alfred: (05:32)

I gave birth again to my daughter this time last year in March. And she was a planned caesarean because of the rupture, the previous rupture, they wouldn't allow me to deliver vaginally, otherwise I would've. So I had to have a planned caesarean, and it was the most blissful experience that I could have ever imagined. It was 100 times different than what I had the first time. I did a meditation series that was specifically for C-section that took you almost hypno-birthing where they bring you through all the moments and what to focus on. It was like that, but for C-section, so they'd be like, "Oh, this part of your C-section delivery is this part in a vaginal birth." And they just compare.


Nicole Alfred: (06:23)

So they make you feel you're giving birth and not just having surgery, because that's what C-sections can feel like, very cold, like you're just having a surgery, and really, you're having a baby, it's birth. It's birth through a major abdominal surgery. So that was really, really amazing. I had to go to psychotherapy because there was things that were coming up in the last seven years that made me feel like, "I don't think I'm over my birth yet." I thought I was. I'm a very strong minded, strong emotionally person. I just was like, "Let's just move forward, let's just go."


Nicole Alfred: (06:57)

But you go for an oral surgery and they're putting their freezing in, and all of a sudden you're having a panic attack because it's a medical procedure. And a lot of times with C-section and birth in general, I find for people, they've never been medicalized before because they're young and they're healthy and they've never been in hospitals before, they never been had to be a patient in the hospital, let alone go through a major surgery like that. It can be quite traumatising in that just itself, the whole situation of having to go through that. And it's not what a lot of people picture the way they would want to give birth either. So there's a lot of trauma in there.


Nicole Alfred: (07:37)

I feel like a lot of people don't come to terms with it, they don't realise that they have trauma. All these times, they're looking at their body thinking, "Oh, I don't this about my body. I don't like that." Really, there's a root cause for all that. And the root cause, a lot of times is feeling like they failed. And I definitely felt like I failed. I felt like I failed at birth, I felt like I was failing at breastfeeding at the beginning because it just wasn't coming. I had lost a lot of blood during my C-section, so the milk was just not coming in. And so it was really, really hard.


Nicole Alfred: (08:09)

And there's just not a lot of information out there, there's not a lot of support past closing your incision. Most doctors around the world, you were mentioning like I said, one in five are having a C-section around the world, and most doctors around the world are not giving anything for advice other than close your incision, make sure there's no infection, don't drive if you're on narcotics, don't lift anything heavier than your baby, which mine was almost 11 pounds. How did that make sense?


Tahnee: (08:39)

Quite heavy.


Nicole Alfred: (08:42)

Like, "Okay, don't lift anything heavier than a six-pound baby." What about a 10 or 11-pound baby?" So that rule didn't make sense to me. From the beginning, it didn't make sense. I think just after that, it's just birth control and then that's it, you barely even get your incision looked at, you barely get touched after, they don't do vaginal exams. And I just think a lot of birthing people around the world, it's just you feel like you've just been push to the side and just left fend for yourself. And so having to navigate that after major surgery is really frustrating because as a health practitioner, I understand when people go for orthopaedic surgeries like a knee surgery, what they're doing is they're preparing the patient for that, they're doing the surgery.


Nicole Alfred: (09:35)

Then they're putting them on this six to eight-week rehab programme where they're going through all the exercises, how to get strong, how to gain their function again, not just how to make sure they don't get an infection and ruin the surgery that they had done. It's more than that, it's a way to learn how to integrate back into life again, into living. And the problem with C-section is there's none of that, and so people are just either ignoring their symptoms or they're just taking it day by day, but then Googling everything. And then this person says this and that person says that. And it's like, "Wait, no, I just need to strengthen my core." So then they go and find this workout video on Pinterest or YouTube and it's all this mixed information.


Nicole Alfred: (10:21)

And a lot of that information is just ab rehab, it's not like, "Oh, ab rehab for someone who has a major scar across their abdomen, that's going to be restricting their core if they don't work on that." You know what I mean? It's just very general information out there. There's nothing specific for C-section recovery. And so that's why from day one, I was like, "I went through this for a reason. I did not want this birth, this is absolutely opposite of what I wanted. And I went through this because there's a purpose, there's a purpose for my life that I had to go through this because I know that I'm here on this earth to help people. And this is a really big thing to help people with. It's emotional and there's a lot of trauma and I don't take it lightly that people ask me for help or come to me to work on their scars because it's such a vulnerable area."


Nicole Alfred: (11:16)

I tell patients, "This is where you gave birth. This area that I'm working on, I don't just dig right into scar tissue like I would with a muscle that was tight, I respect it." And with that whole birth acceptance and body acceptance, it's really important and it's hard. It is hard because what your body was before you had a baby, it was just your body. But now you've had a baby and there's all these changes that have happened. And now you have this permanent line across you that may or may not hurt sometimes. And so, it's a lot. And our medical systems are failing, they're failing people by not having the right information out there.


Nicole Alfred: (12:05)

Doctors are never going to say, "Go massage your scar and do all these things." It's not part of their toolkit. But to say, "Hey, there actually is research that supports that mobilisation of tissue, of a scar tissue, it doesn't matter where it is on your body, can help create more mobility in that scar, and so that you can move better and therefore less pain. Hey, that might help for your C-section. Or do you even know how to move your body properly after you've given birth and had C-section? Can you do proper range of motion in your pelvis and squatting and stuff like that? Are you trying to lift your baby from your back muscles or your arms? That's going to injure you."


Nicole Alfred: (12:46)

So again, they don't have to give prescriptive things, but just to put the idea out there or have a booklet or a hand out or an email that goes to people saying, "Hey, this is out there, you are not alone. This can help you. Do your own research, but this is a thing." That's why I created the C-section recovery method programme to be able to help people learn to accept their births and their postpartum body and start to feel strong and confident in their body again so they can start enjoying life and start feeling normal again, because a lot of people don't and it can take sometimes months or years to get back there.


Nicole Alfred: (13:31)

Sorry, that was rant.


Tahnee: (13:36)

No. I'm like, "I could just stop saying anything and you could talk for an hour because there's so much there for me that frustrates me." Well, I have a friend who had knee surgery, like you're saying, last year. She was in physio for months afterward, and it was all part of the treatment. I have a friend who just had a caesarean, nothing. She's on her own looking for, "How do I recover from this thing?"


Nicole Alfred: (14:07)

Well, and it's not just the surgery, it's that now you also have to take care of a human being or human beings, two of them, and learn how to do that.


Tahnee: (14:19)

Yeah. And I think already postpartum care is becoming more and more of a thing in our consciousness that we need to tend mothers and support them through this time. But then there's this added layer of like you're saying, it's this deep abdominal surgery. I heard you say seven layers of tissue, I've studied a little bit of fascial anatomy... I'm a body nerd in another life. I'm a yoga teacher, and I've done massage training and scar tissue work. I've seen some, just in my own body, I have a small scar here on my left arm, and I've had someone work on that and it's changed how my right glute fires? And so this relationship between these fascial connections really interesting to me.


Tahnee: (15:04)

And you think about the pelvis and you think about what an important part of the body it is. You think about the pelvic floor and all of these... because you're not just cutting through the abs, you're actually affecting the health of the pelvic floor in this surgery, which is something that I didn't really realise until I found your work. I think about vaginal birth, yes, you need to tend the pelvic floor, but I'd never even considered that C-section, you need to attend the pelvic floor. I know there's a lot there, but could you speak a little bit to the kind of severity of what's going on from that perspective of a master show of what's happening in a person's body?


Nicole Alfred: (15:42)

Yeah. That's a great point because that's actually one of the biggest myths that I hear and that I think it's just out there, is that if you didn't push a baby out of your vagina, then your pelvic floor should be fine, you saved your pelvic floor, you saved your vagina, which is completely untrue. I see clients who have had previous vaginal delivery and then a C-section, so they not only now have C-section scar, they also have like prolapse from their previous vaginal birth. I've seen people who have only had a C-section have had trauma and yet emotional connection that trauma does affect the pelvic floor.


Nicole Alfred: (16:21)

There's tonnes of information out there, if you Google it, on how your emotional wellbeing affects your pelvic health. Your jaw is connected to your pelvic floor. So I'll find a lot of people with jaw tension, which again is stress, you'll find with a lot of pelvic floor hypertenicity. And so you have to also think when someone's pregnant, they're carrying a baby inside or babies inside of their pelvis, on their pelvic floor, in their abdominal wall, with all those changes happening to grow and accommodate for that uterus that is doubling in size, more than doubling in size, actually.


Tahnee: (17:01)

I was going to say, "I feel already"-


Nicole Alfred: (17:07)

More like more than doubling in size. Do you know what I mean?


Tahnee: (17:07)

It's getting very big.


Nicole Alfred: (17:07)

Yeah. Your body has to grow to change to accommodate that. And it's all natural, it's all about how it's supposed to go, but then what we're finding, what the research is showing is that postpartum, what we're doing in those first eight weeks to rehab the body, to reconnect to the abdominal wall. Gone are the days where it's like, "Oh, your three finger separation of your ab muscles that's called diastasis recti." It sometimes to know where you're at finger widthwise because it gives you a starting point, but what's actually important is that you know how to turn on your abdominal wall, you know how to connect that to your pelvic health, to your pelvic floor. And that's really important.


Nicole Alfred: (17:50)

And the thing with the C-section is that it will inhibit that connection because your tissues are supposed to be moving. Your tissues usually glide and slide against each other, and when you have scar tissue in there, and scar tissue, when it lays down is not very linear in the way that the fibres lay down, it's all kind tangled up like a woven basket. And so that just makes the area already less mobile. And so when you're talking about reengaging into your core and all this stuff, you can't really fully do that until you work the scar tissue.


Nicole Alfred: (18:23)

So you're going to have inhibitions there. So there's the structural issues with having a C-section scar across your abdomen for your core function, and then you also have the emotional stuff. Really, really pelvic floor conditions are dyspareunia, I always say that wrong, which is painful intercourse. So that's actually something, again, I didn't push a baby out of my vagina, I should be fine to go back and have sex at eight weeks. But then they go, "Okay, first time's uncomfortable, that's normal." But then the second, the third, the fourth, the fifth time, it's just too sore, they can't even have anything inserted, sometimes even a tampon.


Nicole Alfred: (19:05)

And that's because you're literally tense in that area. You've gone through so much with birthing your baby and have this trauma that you've stored inside, your pelvic floor is not letting go. Another one too that's common is leaking pee, that's urinary incontinence. A lot of times it's the stressing incontinence more than anything, so like you're sneezing and you're peeing. That happened to me at 18 months postpartum when I was working out with a trainer because I didn't address my scar tissue, I didn't address my core function past those first couple of months when I was seeing my pelvic floor physio.


Nicole Alfred: (19:47)

And so I wasn't doing my core exercises and integrating them with movements to get me started first before I started even lifting weights. There's so much that we need to consider when we're rehabbing our cores after a C-section, because again, it's not just about closing your abdominal muscles, the gap there and knowing how to pick up your pelvic floor. There's the functional movement side, there's the scar tissue that we need to address, which is huge and can take time. But I feel a lot of people have this bounce back ideology and that they're supposed to bounce back after.


Nicole Alfred: (20:24)

And it's like, "Okay, if you want to even have that idea, which is stupid, you can maybe say that after vaginal delivery, but I still don't believe it, but after a C-section, no, because you need to work on your scar tissue and that takes time." You need to take time for it to close, and then once it's closed, you can't just start digging into the tissue. It's sensitive, it's sore, it's tender. So it can take months. But people just want to get back to CrossFit and running and lifting crazy weights and they just want to look skinny again or something.


Nicole Alfred: (21:00)

And the focus shouldn't be on how fat or thin you are, it should be, can you function? Can you lift your babies? Can you get up out of bed every day without pain? Can you be intimate with your partner? What do you think when you look in the mirror with your clothes off? How do you feel about your birth? All of these things are so important that people just don't consider and right away go to the aesthetics, "Oh, I don't my belly overhang, my belly shelf." That's a really big one. But what's underneath that? How does that belly shelf make you feel? If it's starting to make you feel your worth is not as much, that's an issue. We've got to talk about that. Because who cares? Only you care, no one else is judging you. And if they are, then they're jerks and you shouldn't be associating with them.


Tahnee: (21:53)



Nicole Alfred: (21:58)



Tahnee: (21:58)

I find that really interesting because what I hear you're pointing to really is, I know men have this too, but women it's quite front of mind for us, is this idea of our body reflects our insides and we what we present is how we have seen in the world. It's a tricky one. I've had a journey with eating disorders and things myself, so I really come at it from my own place. I've only the experience of a vaginal birth, but that's something, it's different. I remember the first time I made love with my partner afterward, I was in tears, and he was just like... This is probably too much information, but anyway, he was down between my legs telling me how much he loved me and how much he thought I was amazing for what I'd just been through.


Tahnee: (22:47)

But it was still very confronting for me that I'm like, "Am I different? Is it bad?" It's just this funny thing you have to go through, I think. I can only imagine the caesarean, especially if it's unplanned, adds another layer to that because then you've got a scar, you've potentially got other things going on. I don't actually really know what a belly shelf is. Is this that there's overhang above the scar?


Nicole Alfred: (23:13)

Mm-hmm (affirmative). It can happen with multiple pregnancies that your skin just stretches out, because some people do carry quite large, like I carried my son-


Tahnee: (23:22)

I do too.


Nicole Alfred: (23:23)

I was like I was having [crosstalk 00:23:23]. I've had people come into my clinic and I'm like, "How many weeks are you again?" And they're just, "Oh, I'm 38." I'm like, "Wow, you do not show outwards, you're internal."


Tahnee: (23:38)

I've a friend like that.


Nicole Alfred: (23:38)

Your organs are probably squished, but your skin is not stretching.


Tahnee: (23:42)

My friend went to a party the night she gave birth and nobody could tell she was pregnant. And I was like, "All right." Anyway.


Nicole Alfred: (23:50)

Some people just carry so differently. Everyone's body I find just reacts differently to pregnancy and to birth. Generally, I would say most people will tell you that they definitely feel their actual hip bones have widened. Obviously, you carried a baby in your pelvis, that makes sense. And I think after that it's, the skin stretches, sometimes it's just that we're carrying extra weight in that area. With a C-section the skin where the scar has been laid down, it can be quite tight fastly there, really restrictive. And so that can definitely add another layer of... just make it accentuate more, that overhang. I have seen people who haven't had C-section have an overhang, especially if they've had three or four kids.


Nicole Alfred: (24:45)

The biggest way to fix that is to go for surgery to fix it, but I tend to not focus on the aesthetics as much. I know it's important to my clients, but I focus on what's going under on underneath that. Is it a postural issue? Like are you just standing really slouchy because now it's making a look bigger? Do you have that core connection? How is your ab separation? Because if your abdominal wall is not strong, that can make it look more bigger, more rounded. Scar tissue, what's going on with that? So there's a lot of layers that we look at with underneath the skin.


Nicole Alfred: (25:25)

And there's the whole part of acceptance that, instead of just being like, "I hate this, I hate this, I hate this," when I look in the mirror, okay, I don't love it, but I accept it. This is my body and this is my body that gave me babies. We honour our body so much when we're pregnant, we're just like, "Oh, I feel like a goddess." I love being pregnant.


Tahnee: (25:50)

Me too. I was just telling that to someone.


Nicole Alfred: (25:54)

Yeah. I love it. I want to be pregnant again. Bring it on. You honour it, you eat the best foods, and you do the best therapies, and you go for your massages regularly, you do your yoga regularly. You take such good care for that baby and for your body as it's growing that baby. And then after, we treat our bodies the same way that the medical system is treating it, it doesn't matter. It's not important. Who's creating a plan for recovery no matter how you give birth? Do you know people that talk about like, "Yeah, this is my plan for my recovery to help me get back to feeling good again."


Nicole Alfred: (26:32)

No, it's like, "This is my nursery and these are the clothes I bought for the baby. And this is my stroller that I bought." And so much is focused on the aesthetics and not the function, not, how are you going to integrate this life with this new baby? How are you going to still be able to do the things that you enjoy with this baby? How are you going to be able to heal your body? Who are you going to have help you heal your body? Who's bringing food? What therapists or what practitioners or programmes are you going to be doing to help you create a plan to get back to feeling strong and confident in your body so that you can do all the things that you enjoy again?


Nicole Alfred: (27:18)

It's rare, you don't hear a lot of it. And that's something I talk about all the time. Because I'm a planner.


Tahnee: (27:26)

Get a plan.


Nicole Alfred: (27:26)

Have a plan.


Tahnee: (27:34)

I guess our community in this area is really supportive of postpartum. For example, I have been pitched already four times in this pregnancy by postpartum doulas, just out and about saying, "Oh, do you have someone to come and look after you?" I'm like, "This is so funny." So, Byron.


Nicole Alfred: (27:53)

Wow. That's awesome.


Tahnee: (27:55)

Yeah, but the flip side is, it's not mainstream, this is very much a-


Nicole Alfred: (27:59)

No, if you can afford it.


Tahnee: (28:01)

Yeah. And even with my friend who's just given birth, we've done the meal train thing and I had a few people be like, "Oh, what's a meal train." And I was like, "Really?"


Nicole Alfred: (28:10)

Yeah, it's great.


Tahnee: (28:11)

But the people that don't know what a meal train is. One thing I've seen you really emphasise is rest, and I think I know women just... It's something I see around in my friends, in my community, women are really bad at resting anyway.


Nicole Alfred: (28:28)



Tahnee: (28:29)

Bad, very bad, myself included. And so it's adding that extra layer of complexity to what is already a major surgery, is getting up and moving too soon and trying to be superwoman. So can you speak a little bit to the role rest plays in your experience in recovering and how you would encourage someone to prioritise that, and timelines and that kind of thing?


Nicole Alfred: (28:52)

Well, having a plan of support is really important. Who's going to be there? Because you don't know how you're going to give birth, you don't. You hope for the best, you hope to give birth vaginally because that's how our bodies should be giving birth. But if the event it cannot happen because of a life or death situation or for a medical reason or whatever it is that you can't give birth vaginally, you're going to have a C-section, that's the only other option. So I think that we just need to plan for both in recovery. Because even you could birth vaginally and have a third degree tear and then really not be able to move very well.


Nicole Alfred: (29:35)

And so I think having a plan, knowing who your support system is, having friends, having family, having a partner, hiring someone if you don't have anyone nearby, this type of thing to physically help you, you need to eat at the beginning, if you have other kids, you need childcare. Just getting those things organised so that it takes pressure off you so that you can just lay in bed and focus on having the baby with you and just allowing your body to just not be doing a million things. With C-section recovery movement is important, but specific movements, not I'm going up and down the stairs a million times or, oh my God, some of the ones I've heard, going to mini golfing at 10 days postpartum, because it's your husband's birthday.


Nicole Alfred: (30:23)

What was another one? Two weeks after C-section, I wanted to go to the soccer game and had to drive and had to go... Oh no, one of them was at a pumpkin patch. It was just baby steps. Don't go from laying in bed for two weeks to all of a sudden want to jump out and do all these millions of things because your body is going to be sore. And if you have to be increasing your pain meds over time instead of decreasing it over time, which you're supposed to be doing, then that's a sign there that you're overdoing it. So listening to your body, first and foremost, is so important. And that's altered when you're on pain meds, and that's okay those first two weeks, because you need the pain meds to get you through the pain.


Nicole Alfred: (31:06)

But specific movements to get your body functional again is really important. The first thing I do after my C-section is do small knee lifts and then encourage my body to try to get up every so often to move around the room. It's going to help with gas, it's going to help with my pain management, it's going to help get me mobile quickly. We'll talk about belly wraps after.


Tahnee: (31:31)

Yeah. I've got them on my question list.


Nicole Alfred: (31:33)

Yes. We'll talk about those after. Having your support, having a plan for where you're going to be at in your house. People don't know they can actually order hospital beds to their house, they can rent them, because those hospital beds are amazing. They just press a button and it lifts you up and down. Because you can't use those muscles after a C-section, you just had surgery in your abdomen. It is so hard to move around, and you get used to that at the hospital. So maybe that's an option for you that you're going to have that. You're on an area of the house where you can have peace and quiet, so you're not constantly being distracted.


Nicole Alfred: (32:13)

Sleep is important if you are a sleeper, I'm not. My husband was bringing meals in my bed for the first at least two weeks, and then I was like, "Okay, I need to come downstairs because I'm bored?" But I wasn't going up and then down the stairs a million times, you just slowly integrate it, because the problem is, if you don't allow your tissues to unionise, to come together, to heal in those first two weeks and you're doing too much that's causing too much pulling on your tissue, it's going to open, and the likeliness of infection is high.


Nicole Alfred: (32:50)

And now you have to wait, even if it's a tiny little opening, you have to wait for it to heal from the inside out. It's not going to close on the outside like it does at the beginning where they manually close you and then you heal. If it opens because they've taken the stitches out or staples out whatever and now you don't have that extra security on the outside and it opens, it's still internally healing, but all those seven layers plus, because there's more than seven layers, that's all going to take its time healing from the inside out. So then now your recovery is now being delayed.


Nicole Alfred: (33:22)

Tissue healing is about eight weeks, six to eight weeks. And so now if you've opened up around two, three weeks, now your recovery's going to be even longer and it's just more frustrating, because then you've got to depend on other people more, you can't do the things that you want to do. You weren't even expecting this C-section, so you weren't expecting that you had to be taking it so slow. It is hard. There's a mental component there big time. But allowing your body to heal, especially those first couple of weeks, is so crucial at setting you up for a good, nice textbook recovery.


Nicole Alfred: (34:01)

Some things can come and happen, you can have hematomas, which is an internal bruise. Other things can happen, I've had people message me that have bacterial infection that is a rare bacteria. And so there's definitely things that can happen, you're not necessarily out of the deep water those first two weeks after a C-section, but you just have to listen to your body as much as you can and just know that you just have to be in the moment and not try to think too far in advance.


Tahnee: (34:33)

Hard for people to do.


Nicole Alfred: (34:34)

Yeah. It's very hard. Very hard.


Tahnee: (34:40)

I guess it's dropping in for me, because even with vaginal birth, they talk about that fourth trimester and having another three months in bed, and I know we study a lot of Dallas and ancient healing cultures, they have these months where you don't leave the house and you stay wrapped up and warm. And I'm really seeing that, especially with having surgery really that's this next layer of how important that is because it's gone into another dimension of just the idea of even those layers separating is like, "Oh my God, okay. That's really serious," because it takes time for these wounds to heal.


Tahnee: (35:18)

And so that does lead into binding a little bit because I know a lot of women attempted to use those binder things and I know they're recommended a lot postpartum. Mostly I've seen them on the internet, but I'm interested, what's your take on how they fit in.


Nicole Alfred: (35:34)

In Ontario specific, I can't speak for all of Canada, but in Ontario specific, our hospitals don't give us anything. I know in the US, a lot of their hospitals give them some a bandage, almost looking support thing. So it looks pretty soft, it doesn't look it's a hard structured core set type thing. The studies out there there's one in particular by the Kansas Journal of Medicine, I think it's 2018, it talked about how elastic abdominal supports binders, they call it, can help to reduce pain and blood loss. So really you're using this in the first two weeks.


Nicole Alfred: (36:15)

What I get contacted about is, "I don't how big my belly looks. I don't feel I have core strength, so I need something external to give me that core strength so I can do all the million things I want to do." And I'm like, "Those are Band-Aids. Well, the one for the core strengths, the Band-Aid, the one for your belly looking big, you're looking at a corset and a binder, and those things are restrictive and are not good for the pelvic floor, for the abdominal wall as it's healing. It's terrible actually.


Tahnee: (36:51)

Are they adding to the interstitial pressure then? Is that what's happening?


Nicole Alfred: (36:56)

Yes, exactly. Because the pressure has to go somewhere. So when you're squeezing in your torso, in the midline, the pressure either goes up into the diaphragm or down into the pelvic floor, and your core is a pressure system. And so you don't want to be adding pressure. The same with feeling your back pain or you don't have that back support to be able to move around after a C-section, well, that's probably because you're not moving properly. So you should be learning how to move properly, how to properly, the biomechanics of how you bend down to lift something, how you get into a chair, how you get out of a chair, you literally have to learn to walk again.


Nicole Alfred: (37:31)

When you're getting out of the bed after the C-section the first time, first of all, it's like, "I'm sorry, what? I have to get out bed? You just cut me open eight hours ago." Yeah. That in itself is a little nuts, but you do need to, it helps, it does help. So just that in itself, just having to learn how to walk again, you need to learn the biomechanics of your body and how to move again, and using something that's restrictive on the outside, it's not allowing your core muscles, your spinal muscles to turn on because your core turns on when you're about to move or something, always is turning on.


Nicole Alfred: (38:10)

And so if you're using something that's restricting you, you're not building your natural strength in there again. And people who want to use something, waste trainers, all this stuff, terrible, terrible. My friend ended up having the tummy tuck after her C-section, she was insecure about it, I was like, "It's your thing, do whatever makes you happy?" And they did give her a really restrictive waste trainer type thing after and she was like, "This is the best and I wish they would've given this after the C-section." And I'm like, "I get that, but it actually wouldn't have been good because your uterus is still shrinking after a C-section. Your pelvic floor is still very vulnerable after a C-section.


Nicole Alfred: (39:00)

And so you don't want to be using... So after a tummy tuck, you're like, how many you're postpartum at this point? That's fine. Yeah, it's not great for the pelvic floor in general, but you didn't just have a baby, your rib cage, your spine, your pelvis, everything shifts and moves from pregnancy, you can't just now go into this binder. So the idea of that traditional wrapping really tightly, I get it, I get it for why it was used, but the research out there is not showing that necessarily we need to be binding tightly as much as using more of a supportive elastic type of rap to give you that support.


Nicole Alfred: (39:48)

And it depends on how those traditional raps were done too because maybe they were being wrapped really tightly for two days but they were in bed not moving. And then once they were able to get to bed, they took it off, whereas people nowadays are like, "I'm just going to put that on and then go now clean my house or whatever." And it's like, "No, that's not a good idea."


Tahnee: (40:05)

Yeah. My understanding is they're very much a part of not moving, and they're used early to... And I can imagine energetically, there's a sense of closure and safety that that binding can bring, like a baby loves being [inaudible 00:40:24] that sort of... But you need to get to a point where you're not having this crutch or this thing supporting you. And it's interesting with the interstitial pressure thing because I'm fairly well educated to do movement, I come from movement background. And even with my pregnancy, I got very big and I had diastasis afterward. And I really noticed just because of, I guess, pregnancy as well that my breathing patterns had changed and there was a little bit of retraining there for me to do around how I was holding myself and my body-


Nicole Alfred: (40:55)

Everyone has, you know. Everyone.


Tahnee: (40:59)

And it's just nobody talks about that. Katie Bowman's work was really helpful for me at that time. It's basics. It's like, how do you get up out of bed? How do you sit down? How do you hold yourself? I think people forget that you've been through quite a major structural change in your body. And even if nature is amazing, also it's nice to have these tools. So are there any resources you recommend or any things people really look into in terms of the biomechanic side of things and how do you work with your patients with that, or your clients?


Nicole Alfred: (41:34)

When it comes to my recommendations, I tell everyone to see a pelvic floor physiotherapist while they're pregnant preparing for a vaginal delivery, especially, but even for a C-section because you're carrying a baby in your pelvis. And then also in postpartum, public physiotherapy should be a part of everyone's healthcare system. It is in some countries.


Tahnee: (41:58)

Yeah. France.


Nicole Alfred: (42:01)

You guys don't have, is it... Yeah, France. So you guys don't have that in Australia?


Tahnee: (42:03)

No. I didn't end up seeing one until three or four years postpartum. I didn't have any problems really, but I was just out of curiosity, I went and she could identify imbalances in my right left.


Nicole Alfred: (42:17)

You also do yoga. You know what I mean? Some people's bodies do recuperate very well because of what they do in their daily lives. Majority people don't have that. Majority of people are sitting at computers all day long, they're not moving their bodies the way they should be. So it's very different when you're coming from the type of lifestyle and background that you have, you probably were fine. You know what I mean? Some people are.


Tahnee: (42:41)

I feel like shit compared to how I used to feel. I was like, "I used to feel amazing."


Nicole Alfred: (42:46)

Yeah. You probably should have gone within the first couple of months postpartum, but with women severe pain or anything and have [inaudible 00:42:54].


Tahnee: (42:54)

And I was like, "If I'm symptomatic, I'll see someone," which is something I would do differently this time is don't wait for something to show up. And for me it was like, I don't actually even remember why I started going, but I was doing a lot of Pilates and I was like, "I still feel this disconnect. I used to be able to feel this real connection to my pelvic floor and this sense of union through my body and I don't have that anymore since my pregnancy. And it's very subtle, but I can feel it." And that was what sent me on that little adventure.


Tahnee: (43:28)

And a lot of her work I'm using in this pregnancy, I'll go see her again postpartum it's just such a useful thing to have. In France I believe, is it six sessions they get covered by the government?


Nicole Alfred: (43:44)

Probably yeah. Probably something like that if it was once a week. It's essential. It's essential whether or not your healthcare system pays for it or not is essential. So that's something I always recommend working on your scar. So a lot of times it's simply just looking at your scar. Some people don't even look at it because they're so traumatised. They just cannot stand to look at their scar. I'm like, "How do you not just look down though and you just only look up on." I don't know, I guess sometimes their belly hangs over it so they don't have to look at it.


Tahnee: (44:22)

So by working, you mean massage and gentle touch?


Nicole Alfred: (44:25)

Yeah. Massaging but even just touching, just touch your scar. I know after my birth, my husband was really traumatised because he thought I was not going to be coming out alive and I know for him it was like, "No more kids." And I was like, "Well, not yet but one day." He was 29, I was 30, we were still young enough to have time to figure out if we wanted one more. But I remember it was six months after my C-section and I was just laying in bed, it was Christmas morning or something. And I remember just telling him like, "I'm okay. I'm here, I'm okay."


Nicole Alfred: (45:01)

And I remember taking his hand and just placing his hand over my incision and then placing mine on top. And just we just laid there and breathed and just connected. I share that with a lot of people because I'm like, "You should try it." You know what I mean? If you're having a hard time, a difficult time, if you feel traumatised, imagine what your partner feels because they were there too and they love and care about you so much. And so just getting used touching it. I've had people say, "I would rather stab myself in the eyeball with something rather than touching my scar." I'm like, "Wow. That's definitely amount of trauma right there."


Nicole Alfred: (45:38)

Why would you want to stab yourself in the eyeball, can you just touch a scar, or, "I have to drink some wine before I go and touch my scar." And it's like, "Yeah." Definitely addressing the trauma is a big part of what I do and a big part of my journey. And I did put it off. I've been there.


Tahnee: (45:57)

How long compared to your daughter, obviously, it sounds you had a much different experience, but with your son, how long did it really take you to accept that that was you? I know that's really hard to put a timeline on, but-


Nicole Alfred: (46:13)

I think I'd even had a hard time just talking about my birth story. I had a hard time telling it. I remember I told it for the first time I did a blog post because I was blogging my pregnancy. It was seven years ago when a lot of us were blogging.


Tahnee: (46:25)

When it was blog time.


Nicole Alfred: (46:27)

Yeah. Before Instagram. And I remember I blogged about it and I had the one person, she was like, "I'm never having kids." And I was like, "Oh my gosh, I am so sorry, I traumatised you." And just even the response from other people being like, "Wow, Nicole that was difficult. Wow." And I remember just thinking like, "Okay, I don't want the pity party. I don't want that response, so how can I tell it differently?" And then it just took me while to figure out how to tell my story in a way that was authentic, but also not off putting. And so that was a part of it. And then I think just the whole connection to my body and accepting my body and all of that, it took years.


Nicole Alfred: (47:11)

My son was six by the time I saw a psychotherapist about my birth trauma. And the first time I went, I just started crying. I'd never met her before and I was just like, "I think I have still some trauma, but I don't think about it every day, but I'm preparing for another C-section, so I really want to have a great experience this time." And she was just like, "Okay tell me about it." And then literally just waterworks came out. I'm not that type of person, I don't just cry over everything. I cry about some things or if Oprah's on and something really sweet about moms and I cry, but I don't just have waterworks.


Nicole Alfred: (47:45)

So for me it was a realisation that I really was holding onto it and just having her, a professional say, "Yes, you experienced birth trauma." And I think I only went for three or four sessions and it just made me feel so just healed, so whole because it wasn't just the fact of what I went through it was also, and you can never deliver vaginally. You can't even attempt a V-birth because of now you have a T, it almost looks a T incision, but it was just a tear down from the C-section scar in your uterus. So that's super dangerous, they won't allow you to deliver vaginally. And so being of my background, it was hard to deal with that.


Nicole Alfred: (48:28)

So yeah, it took months, it took years for all the various parts of healing. And the experience I had last year, they literally pulled her out and showed us her. I did skin to skin right away with her, which was super incredible. They usually need someone in the room to help hold, not your partner, because they're afraid they're going to pass out, but a medical professional there like a nurse to hold the baby for you. And I was able to have that. And they showed her to us right away and we were like, "Let's do this again." It was just so great. And I told them, I said, "I want you to walk me through everything. I want to know what you're doing, what layer you're working on. I want to be a part of this birth. I don't want to just be laying here and you're just cutting me open like a surgery. This is my birth and I'm reclaiming it to make it the best that I can make it."


Nicole Alfred: (49:20)

And so that would be my advice to someone is if you know you have to have a C-section, you do have options. We don't have the clear drape in Canada, but I know some parts of the world do, and skin to skin and being able to have those moments with your baby that you get to mimic vaginal birth is just super great for maternal outcomes with mental health. It makes a huge difference and the studies are showing it.


Tahnee: (49:46)

Well, that's something I've heard from women, they don't feel like they've given birth because almost it's been done to them, if this makes sense, rather than they've been an active participant, and especially, if they've had the experience of vaginal birth, they understand what that feels like, you're very much in a co-creative dance with the baby. So I think that's such a beautiful piece of advice is to, I guess, depending on your level of comfort with which layer it is, but to see how you can create a participatory experience with the medical professionals. And it does sound like they're a lot more open, again from the things I've been hearing lately, where they are open to skin to skin, they're open to this kind of-


Nicole Alfred: (50:31)

That's recent. That's all recent, because when I gave birth to my son, I just saw a doctor in Toronto. He was doing as studies on doing that skin to skin for the maternal mental health outcomes. And I remember when I had did my postpartum checkup with him, I was like, "Yeah, what's up with this skin to skin thing? Is that something I can try since I have to have a C-section?" He's like, "Well, there's a reason why there's a barrier." He's basically saying my chest is not as clean as my vagina or something." I'm like, "This makes no sense."


Tahnee: (51:00)

That makes no sense.


Nicole Alfred: (51:01)

And especially because with a plan, they make you wash with a solution the night before and the morning of so it's super clean. That was seven years ago when he was an older doctor that was retiring, but that was the mentality. And so it's really only been recent in I would say, North America and maybe even Australia, they've really been encouraging this. And maybe it's social media because we're actually seeing this now and we're saying, "Hey, I want this." And I think that's great. I think that's the power of online world is that not that we're getting lots of advice, that's all over the place and hard to follow, but is that we're being exposed to things that we didn't even know was possible.


Tahnee: (51:43)

Yeah. I completely agree. And I think that's the silver lining of what can be at a bit of a nightmare platform, but things like Instagram where there's this visual medium where you're able to see, I've learned so much about caesarean through following you and seeing other birth accounts that cover what that looks like. It's like this whole world that I didn't even know existed. And I think it's so important for me or yourself with that stuff. And even just birth, I'll show my daughter birth videos because I'd like her to be at my birth.


Tahnee: (52:16)

I'm like, for a five-year-old to see birth all the time, I'm like, "Well, that's such a psychologically a really different place to start your journey as a woman from." the only thing I ever heard about birth was from my mom's friends and it was mixed, not option that positive. It's nice that we can start as a community to build that and maybe change culture. Because I find that really fascinating that this lack of follow up care, it makes me wonder, is a something insidious or is it just that they don't even think about it? Or do you have any thoughts on what's behind this ignorance?


Nicole Alfred: (53:02)

I think that majority of the healthcare systems are built upon that patriarchy that everyone talks about, this patriarchy, white supremacy, all that stuff. And I think I'm not going to get all political in here, but I definitely think that whoever started the systems were not women, were not people who were birthing people and pregnant people and people with vaginas. And so I think at the time, that's what they knew, just at the time they used to put women under general anaesthesia and then birth their babies and be like, "Here you go." And then now we realise that actually that's not a good idea, we're not going to do that anymore.


Nicole Alfred: (53:48)

So I definitely think a lot of it comes with empowerment and women's rights to healthcare. Women can vote and ask for equal pay and all this stuff, but I'm like, "What's women's healthcare like though?" We're still fighting about birth rights or pregnancy rights in North, not Canada, thank goodness. But I know in the US the rights to what a woman can do with her body if she's been raped and get pregnant. You know what I mean? So when we're looking at the way the systems are set up, they're not set up for rehabilitative care and stuff like that.


Nicole Alfred: (54:27)

That's all complimentary medicine that a lot of doctors are good with now with massage therapists and physios to be like, "You have pain, go there." But as far as there being an actual system for people during the reproductive times, it's not there. A lot of healthcare care systems are based off of either some scanning, so X-ray, ultrasound, MRI, CAT scan. And then the way that these Western medicine doctors, the way that they heal the body is with prescription medicine. And so yes, it has its place and thank goodness for it when we need it, but someone who's given birth vaginally or is past that initial healing of their incision of their C-section, we don't need medicine, we need the rehab.


Nicole Alfred: (55:20)

We need that connection back to our bodies again on not just a physical level, on the mental, emotional, spiritual level as well, because birth and becoming a mother is not just a physical thing, it's not like, "Oh, now I got a sidekick." It's a transformation, it's a lot of work, it's draining, it's exhausting, there's no pay, there is no option. We can't just get up and go out of the house and go run an errand, we have to be like, "Hey, everyone in the house, I need to go do these things. You guys good, because I got to go." Whereas I know sometimes the partners will just leave the house or just be like, "Yeah, I got to go somewhere."


Nicole Alfred: (56:03)

And it's like, "What? But what? You didn't tell us." Because there's not that natural instinct of you are in charge of no matter what happens, it's you. And that's a lot of responsibility that we have as birthing people. And so these little people depend on us to guide them, and if we're feeling not guided with our own parenthood or our own recoveries, it's just not setting up a good system, a good relationship. I tell my son, he used to be like, "Mommy," when he was really little, "Why do you have that on your back? Or why do you have the extra skin?" He never said fat, but he'd point out my fat belly or whatever it was.


Nicole Alfred: (56:49)

And I was like, "I grew you in inside of here." And I'd show him my scar and say, "You came out of here. This is where mommy gave birth to you." I don't tell him how traumatising it was, that I almost died. He doesn't need to know that because that's not a part of his journey into the world, but at the end of the day, how I relate to my body and how I take care of my body, he's watching, and my daughter will watch too. And so I think that we need to advocate for ourselves. I hear so many people on my Facebook group and on Instagram and they're just like, "My doctor brushes me off or told me, what did you expect? You had a C-section."


Nicole Alfred: (57:29)

And when they actually talk to the doctors, they'll say like, "It'll probably take a year for you to feel good again." That's not what they're saying, they're telling patients at six or eight week's appointments, "Go back to regular activities." They're are not saying it's going to take a year for you to start getting into your activities again, they're saying, "Oh yeah, you're good. Go back to regular activities." Well, I can tell you, the majority of people that do that, don't feel good. They'll maybe start their workouts again and maybe they increase it a little bit and all of a sudden their back is killing them and they have to stop everything. And they feel like they're 70 years old. You know what I mean, when they're 25, 30.


Nicole Alfred: (58:08)

I think you really need to advocate for yourself, you really need to do your research to really know what's out there because it's just not going to be given to you. And the amount of people that are like, "Oh, I wish I had you 19 years ago or 20 years ago." I work with people that are years postpartum like 30 years and I'm working on their scar because their pelvic physio was working internally on them and they're just like, "I need you to work on the scar," because it's restricting their bladder. It's causing bladder issues because scar is the adhesions inside will start to cause issues with some of the organs because the proximity


Tahnee: (58:44)

Well, that's something I really wanted to flush out a little bit because I studied abdominal massage and we talked a lot about scarring and how we can end up with bowel issues, you can end up with uterine issues, menstrual issues, bladder issues, but this is not common knowledge. So what can you tell us about what you see in clinic or in practise when you're actually dealing with poorly healed scars? Is it those kinds of things are more or?


Nicole Alfred: (59:09)

You know what, for some people like you were saying, you felt pretty good after your birth that you actually didn't go back until three years. So some people, again, and even my friends, I'm the one that's like, "Oh, you peed a little bit when you sneezed or you have this or you have that, go see a pelvic physio." And I'm always on them and they're just like, "Yeah, yeah, whatever." And some people, they have to wait for it to get really bad for them to want to do something about it. And so with some of the scars that I see, they're a lot older people. People just get so used to being in pain or they get so used to living in discomfort that they don't realise that they don't have to stay in that.


Nicole Alfred: (59:50)

When I've worked on the older scars and I use a machine in my practise called the Dolphin Neurostim, it's made here in Toronto, but it's a very gentle low grade current to help break down the scar tissue.


Tahnee: (01:00:05)

Kind like a TENS machine.


Nicole Alfred: (01:00:06)

Kind of. It's classified as a TENS, but it's not. I was just like wearing my TENS-


Tahnee: (01:00:12)

Not as strong?


Nicole Alfred: (01:00:13)

Yeah. You don't feel the impulse and TENS really fluctuates in its current. So this one just low sustained. So it's very different in that way. And then it also works off of acupuncture principles too. So it's a really awesome cool tool.


Tahnee: (01:00:28)

I'm a huge fan of acupuncture. My saving grace.


Nicole Alfred: (01:00:32)

Yeah. It's a really cool tool. It's a pain management tool too, it's super awesome. So I use that on the scars and then I'll do my manual therapy on it. If it's an older scar, obviously with can get in a lot deeper really quickly instead of having to wait so many treatments. And I've had people when I've worked on scars and they were in shock like I just performed magic on them or something. They were like, "I haven't for 10 plus years not felt that area. It's been an area where I felt this connected from or where I had numbness or where I just didn't feel it. And now all of a sudden I feel it, you've brought it to life."


Nicole Alfred: (01:01:11)

And so it's just a really interesting experience. And then you want to look at symptoms. Lower back pain symptoms go away, the urinary incontinence stuff goes away, other organ stuff, I've had people who have had large intestine surgeries and stuff like that. Those symptoms start, their bowel will start working better. So it's just you get the physical symptoms, but then you also get the sensations of just the presence of that area. And maybe it's the trauma that's being held in there too that's just finally getting released. Well, a lot of tears happen on my massage table, a lot of tears.


Nicole Alfred: (01:01:49)

That's my disclaimer. I'm like, "Okay, so we're working your scar today, so I'm just letting it's normal to cry." And they're just like, "What? No, I feel great about my birth." And then 40 minutes later I'm working on their scar and just like, "I don't know why I'm crying." And like, "It's okay. It's okay."


Tahnee: (01:02:10)

I think that's such a great, and that's something for home play, that was something... I think what you're saying about women that don't want to look at their scars, I think when we have a scar, it's like, "Oh, okay. That's like an injury and maybe I just shouldn't touch it." but really I think just encouraging people to get in there and self-massage-


Nicole Alfred: (01:02:30)

Touch it.


Tahnee: (01:02:32)

Yeah. Obviously you will never be as intense as a therapist might be on an old scar because I've had-


Nicole Alfred: (01:02:38)

Better than nothing. Better than nothing.


Tahnee: (01:02:41)

Exactly. Yeah. Just to get the energy moving there and to work through that. And I guess that's something partners can do. How long would you wait before working on, six to eight weeks or even longer, or?


Nicole Alfred: (01:02:52)

I usually get people starting touch around their scar once the incision is closed. So after a couple of weeks, even if they're doing gentle massage, always push towards the incision to not create any pull on the tissue. We do a lot of techniques for skin desensitising, which will help the numbness. And you need a full week to rest so that your sensory nerve in that area can start to regenerate and heal, so it needs time to heal. And then after about a week, it will start regenerating. And sensory nerves are really resilient nerve so they can actually regrow past one year after the surgery.


Tahnee: (01:03:29)

So even if you're a year postpartum and you're not having-


Nicole Alfred: (01:03:33)

You can still start working on your sensations with the skin desensitising. And a lot of people don't know that. It's never too late to start, never too late to start any of it. A lot of people again, will focus on how their scar looks and I'm like, "That's the tip of the iceberg, what's happening under, that's what we want to focus on." You can use ointments and oils and silicone strips and whatever you want. I don't really recommend these things because to me, again, I'm worried more about the function, can you function? The aesthetic stuff, that can be taken care of professionally by someone who else? Like med spa or something if it really bothered you. But for me, it's the function, teaching people to do the work to help themselves is I think really important.


Tahnee: (01:04:30)

Well, that's the best place to end because that's what you do. You do coaching and you have these online programmes. I wanted to share that with people because I think you've been through this, you've had the professional experience, you've done the research. I think it's such a great offering to women because I get people write to me that are eight months plus postpartum and they're like, "My back still hurts?" And I think, "Well, you need specialised care. It's not something you go to your yoga teacher, your Pilate teacher about, it's something you go to... " But then it's like, "Well, who?" Because the doctors they're generally like, "Oh, that's normal."


Tahnee: (01:05:09)

So it's one of those things. So I'm so excited to share your work. And so it's and you have Instagram and Facebook. Is there any other places people can go to connect?


Nicole Alfred: (01:05:18)

I would just say, go to my Instagram C-Section Recovery Coach or you can look up Nicole Alfred. I have all the links in my bio, even for my Facebook group.


Tahnee: (01:05:28)

We'll link to all of those in our show notes.


Nicole Alfred: (01:05:31)

Yeah. The Facebook group's great, right now we're about 4,000 people all around the world just sharing their stories and asking if things are normal because they don't know because no one tells them, so they just don't know if anything's normal. The online programme, the C-section Recovery Method just got launched this week. It's actually version two of that, but I am full pledged into my coaching and wanting to help as many people around the world as I can and just share as much information as I can.


Nicole Alfred: (01:06:04)

If I can create little like 15-second Instagram videos for people to see, I will do that just to get the message out there. But my main focus is trying to change the narrative with C-sections and not to promote them like they're better than something because they're not, we should avoid them if we can, but not talking about it is not helping anyone, and not preparing for it is not helping to empower anyone with birth because birth is birth. It's not vaginal or C-section, it's giving birth to a child or children. And so we need to be able to have that information at our fingertips.


Nicole Alfred: (01:06:44)

So I'm happy to be here. I've been talking about it for years and it's finally coming to fruition. And so I'm just so pumped right now to be able to show up like this, I'm just like, "The time is right."


Tahnee: (01:06:59)

Yeah. I think you said it before, we were talking about that you were destined to do this work. I think it's really powerful that you have such a strong background and now you're able to bring this forward into the world. So congratulations, because birthing a business is just as much as birthing a child.


Nicole Alfred: (01:07:18)

It's very different world because you just want to help everyone. So when someone's like, "Can you tell me how to do this?" And you're just, "Professionally I can't be liable, I can't say anything." You just want to help everyone. And it's hard because people are really suffering, especially in certain countries where there's nothing, not even what we get here in our Commonwealth countries that we're from? Just share, keep sharing, share as much as we can and keep connecting and knowing that you're not alone in how you're feeling and things are common to experience, but they're not normal to live with.


Nicole Alfred: (01:07:57)

That's the biggest thing, I think, that people should take away. And that you can actually do something about it. There are tools and step by step methods to actually know how to get out of feeling the way you are and transform you into feeling a way better version of what you want to feel


Tahnee: (01:08:15)

Amazing. So if you want bash and you are listening, contact Nicole, she is amazing. And I really want to thank you for your time today because I know you've had a busy day with your first ever webinar as well. So congratulations.


Nicole Alfred: (01:08:28)

Oh, thank you. Thank you for the support. I love that.


Tahnee: (01:08:32)

Yeah. Really great what you're of bringing out into the world. So thanks again, Nicole.


Nicole Alfred: (01:08:36)

It was my pleasure.


Tahnee: (01:08:36)

And for those of you listening, get in touch.

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