A recent study reveals Cyprus has six times the recommended rate of Cesareans. ALIX NORMAN meets the expert who’s addressing what doctors fail to disclose about this major surgical procedure

If you’re a Cypriot woman with children, chances are you’ve had major surgery, complete with full-blown spinal or epidural anaesthesia, massive incision, and stitches that can take up to an hour to complete! That’s a Caesarean for you. In terms of medical procedures, it’s considered major surgery. And Cyprus has one of the highest rates in the entire world…

The World Health Organisation sets the ideal rate for C-sections at between 10 and 15 per cent of all births. Yet 35 per cent UK deliveries, half of those in Turkey, and 55 per cent of those in Brazil are Caesareans. And then there’s Cyprus, where the latest figures suggest a staggering 61 per cent of births are via C-section!

“Three out of five children on the island are not vaginally birthed,” says women’s health expert Anastasia Uvarova. “Yes, a C-section can be very necessary, especially in cases such as placenta previa (where the placenta covers the exit), labour arrest (in which natural labour fails), or any other condition that threatens the life or health of mother and/or child.

“But many other C-section procedures are scheduled unnecessarily, especially in Cyprus. And while there are multiple reasons for this, there are also multiple complications that can follow – after effects that women are simply not being told about.”

The founder of Alpha Physio Care and a pioneer in women’s health, Anastasia has worked for the NHS, completed extensive training with the Australian Physiotherapy & Pilates Institute, and is a specialist in both OMT Osteopathic Articulation and Pelvic Obstetric and Gynaecological Physiotherapy. And she’s worried about the lack of objective childbirth education women in Cyprus receive.

“Horror stories and misleading advice abound on this island,” she reveals. “For example, you often hear that every subsequent birth after a C-section must also be a Caesarean – but that’s simply not the case: Vaginal Birth After Caesarean is routine in Europe. It’s an indication of how little information women on this island are given or encouraged to find. And that,” she warns, “can lead to a host of problems.”

“Every other birthing mother seeks help from a pelvic health specialist after a C-section,” she suggests. “Common complaints include scar numbness and pain; ‘C-section shelf’ where the belly hangs over the incision; the abdominal separation of diastasis recti; increased period pain; worsened endometriosis; and painful intercourse.

“These are not small problems! Any one of them is a life-changing complaint that can appear a month, a year, or a decade or more after surgery. I’ve seen hundreds of women who’ve had back pain for years, never realising it stemmed from their C-section; women who’ve suffered painful sex ever since surgery, but never put two and two together.”

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Caesareans are considered major surgery

Such physical effects can be absolutely debilitating. So can the psychological implications. But in Cyprus, the mental and emotional effects (especially in cases of an emergency or unexpected C-section) are discussed even less frequently than the physical complications.

“‘You have a healthy baby,’ mothers are told. ‘What more do you want?’ But feelings such as disempowerment, guilt, failure, loss of connection to baby, depression, anxiety, trauma, body image, relationship changes, loneliness, and fear of future pregnancies are very common after a C-section birth,” says Anastasia. “Both physically and psychologically, any family in which the baby does not have a happy, healthy, well-functioning mother can be compromised.”

Where appropriate, Anastasia advocates professional psychological help from a birth trauma psychotherapist. But for the physical complications, she maintains there is a huge amount women can do to help themselves given the knowledge. “Not everyone has the time or money to access professional help,” she explains. “And what mothers are not being told by their healthcare providers is that there’s a lot they, themselves, can do.”

To this end, Anastasia has released the island’s first online course for those who have had a C-section.

“When post-C-section mothers come to me, much of what I do is teach them practices they can use at home. These are techniques no doctor mentions. And yet they’re absolutely essential to ensure to relieve physical distress and reduce the likelihood of future complications.”

It’s these that Anastasia has put into ‘C-section Scar Massage & Recovery Techniques’, a comprehensive online video course designed to help any mum who has ever had – or is considering having – a C-section.

Calmly and clearly addressing everything from simple scar massage to pelvic floor recovery, Anastasia takes viewers from post-surgery massage of the abdomen and diaphragm (during which time the scar tissue itself must not be directly manipulated) through to exercises that target core healing and beyond.

“In these 17 video lessons, every stage of healing is covered,” she explains. “Each technique and exercise comes with appropriate variations and in-depth explanations of the whats, whens, hows and whys. All that local hospitals offer mothers is a tube of silicone gel and a pat on the back! What I’m trying to do is give mums the in-depth info they need, including comprehensive information on scar healing, massage, benefits, indications, and contraindications; downloadable pdfs; and the option to contact me personally.

“Whatever you may have been led to believe, a C-section is major surgery. And it can have far-reaching implications for mind, body, and wallet. This course ameliorates post-Caesarean complications, delivering comprehensive guidance in the privacy of your own home and at a fraction of the cost of multiple physio visits.”

While C sections remain the birth mode of choice in Cyprus, Anastasia will never be short of work. And she fully recognises that the lack of education is not going to change overnight. “In the meantime,” she concludes, “this online video is a long-term investment in mothers’ physical and emotional wellbeing…

“Too many women in Cyprus are being told they need C-sections, and too many are left without the knowledge they need to recover their strength, confidence and sense of self post-surgery. It’s time to rewrite the narrative of C-section recovery, one that acknowledges the profound impact it has on every aspect of a woman’s life.”

For more information, visit https://alphaphysiocare.com/, the Facebook page ‘Alpha Physio Care Ltd’, the Instagram account @alphaphysiocare, or the YouTube page ‘Alpha Physiocare’