Manual lymphatic drainage and brushing during the early postoperative period after cesarean section.

INTERVENTION: In the first day after cesarean section, women will be an instructed about the manual lymphatic drainage and brushing techniques. Instructions will be performed face‐to‐face with a physiotherapist working in the maternity ward (a member of research team). It will last for about 20 minutes. Each participant will receive the necessary equipment: a drainage brush (surgical brush) and a printed instruction with photos illustrating each technique (proprietary, created for this study). Then the participants will perform the manual lymphatic drainage and brushing on their own ‐ from the first to the fourth day after cesarean section. Women will be instructed to perform manual lymphatic drainage and brushing 3 times a day for 10‐15 minutes. Drainage will be performed both manually (gentle finger movements) and with the surgical brush described above (brushing; also gentle movements), in the following sequence: 1. Drainage of the lymph nodes in the mandible ‐ circular movements (manual); 2. Drainage of lymph nodes in the supraclavicular and subclavian fossae ‐ sliding and then circular movements (manual); 3. Abdominal drainage: Above the navel, upward movements, and below the navel, downward strokes, then circular movements (manual); 4. Drainage of the inguinal pits (movement from the inside out) ‐ sliding movements and then circular movements (manual); 5. Drainage of the groin (movement from the inside out) ‐ sliding and then circular movements (with a brush); 6. Abdominal drainage: Above the navel, upward movements, and below the navel, downwards ‐ sliding movements and then circular movements (with a brush). The patients will be visited daily by the physiotherapist who gave them tips on lymphatic drainage (a member of the research team) and asked how they are doing. Patients CONDITION: cesarean section; ; cesarean section Physical Medicine / Rehabilitation ‐ Physiotherapy Reproductive Health and Childbirth ‐ Childbirth and postnatal care Surgery ‐ Other surgery PRIMARY OUTCOME: scar quality (with The Patient and Observer Scar Assessment Scale)[before intervention (on the first day after cesarean section) and after intervention (on the fourth day after cesarean section)] scar quality (with Vancouver Scar Scale)[before intervention (on the first day after cesarean section) and after intervention (on the fourth day after cesarean section)] SECONDARY OUTCOME: quality of life (with 36‐Item Short Form Survey (SF‐36))[before intervention (on the first day after cesarean section) and after intervention (on the fourth day after cesarean section)] self‐rated depressive symptoms (with The Beck Depression Inventory)[before intervention (on the first day after cesarean section) and after intervention (on the fourth day after cesarean section)] INCLUSION CRITERIA: Primiparous women after cesarean section delivery. Age between 20‐40 years. Alive newborn born not earlier than 37 weeks of gestation APGAR 9‐10. Physiological pregnancy. The transverse incision. Provided informed consent prior to commencing the study.