Overview of Recovery After C-Section

Mom Holding Baby in the OR After a Cesarean
Photo © Peter Dazeley/Getty Images

About a third of pregnant people will give birth via cesarean section or c-section. In addition to being the birth of your baby, it is also abdominal surgery. This can mean you will have a different recovery than if you had had a vaginal birth. By knowing what to expect and planning properly, you can alleviate some of the stress and strain surrounding this recovery period.

Immediately Post C-Section

C-section recovery is done in stages. Right after your surgery is over, you will be wheeled into a post-operative recovery room. Usually, there are several beds in one room that are separated by curtains.

You will remain in recovery for a varied amount of time, depending on the type of anesthesia (general or regional) that you had. It's typically about a two- to four-hour period. If you had an epidural or spinal anesthesia, you'll stay in recovery until you are able wiggle your legs. If you've had general anesthesia, you may fall asleep and wake up repeatedly, and possibly feel nauseated.

During this time, the healthcare team will monitor your vitals, check the firmness of your uterus, and assess the amount of vaginal bleeding you have.

The First Few Days Post-C-Section

The best advice for recovery is to begin to move as quickly as you can. Obviously, you will want to start with simple things like breathing. While breathing sounds like an easy thing to, taking a deep breath can be difficult after a c-section. You'll need to try to breathe deeply as soon as you can after surgery and continue to do so frequently as you recover.

When you move to your regular room, some of your equipment—including your catheter, blood pressure monitors, and IVs—will come with you. The catheter will usually be removed the day after surgery. The IV will stay until your intestines begin working again, as evidenced by rumbling sounds and possible gas pain. Avoiding carbonated, hot, or cold drinks (which can make gas worse) can help reduce your pain.

You will feel pain from the surgery, but it's important to manage it early on. The less pain you feel the more likely you are to be up and moving about, which is key to a speedy recovery.

If you've had regional anesthesia you may have been given Duramorph prior to the removal of the epidural catheter. This provides pain relief for up to 24 hours after surgery, without the use of IV, IM (intramuscular) or oral drugs.

After that period—or if you've not had Duramorph—you may request medications for which your provider has left an order. Some patients have a special pump on their IV that lets them dispense their own IV pain medications (only when it the pump periodically unlocks). These are mostly used during the initial 24 hour period after surgery.

If you are nursing, be sure to tell your provider, as these medications can pass into breastmilk.

Tips for Your First Walk

One of the biggest post-surgery milestones is your first walk. It is important to walk as soon as you can after surgery to help prevent deep vein thrombosis (DVT).

  • Always begin walking with help.
  • Avoid the tendency to lean forward, stand up straight.
  • Do not look down. Instead, focus on an object as a goal, such as a the chair or the bathroom door.
  • Splint your incision by holding a pillow over it. Your insides will feel like they are falling out, but rest assured that they are held in places by several layers of stitches and staples.
  • Walk as frequently as possible—even if it's only a few steps.

Before you are able to walk (or if it will be a while before you are able to), your provider might have you use compression boots to help prevent DVT.

Your Incision

Don't be afraid to look at your incision. It's actually very important that you do, as you will need to monitor for signs of an infection. The first day it might be covered by gauze. You might also have special drains to help remove fluids that are collecting on the inside. T

here are different types of external incisions that may not match the incision on your uterus. Make sure to ask the provider who performed the surgery about the uterine incision.

The area may look bruised, red, and irritated. You will notice that there are staples or stitches. These will usually be removed within a few days of the surgery or will dissolve on their own like the internal stitches. Looking at the incision now will help you note and report changes that could indicate infection to your provider, should any occur.

One thing that surprises many people after surgery is the numbness and itching. Numbness after c-section is completely normal. It will usually go away in a few weeks but doesn't always. It does not mean that there is something wrong.

The best advice, whether you're at home or in the hospital, is to rest. Rest is very important after any birth—particularly when you have had surgery.

Ask that visitors wait for a while, enlist the help of hospital staff at keeping them to a minimum. Be sure to ask for help from your friends and family who offer, and sleep whenever possible.

Your Baby After a Cesarean

Your baby may need special care, particularly if that was the reason for the cesarean. They may spend extra time in the nursery. If this is the case, ask that your bed be wheeled to the nursery or go in a wheelchair as soon as you are able.

If your baby is doing well after the birth and is healthy, you might be able to hold your baby through the entire recovery room period and bring them to your postpartum room. Even if you are feeling sleepy or in pain, your family members can help you with the baby while in your room.

Breastfeeding is also still possible after a cesarean, although the positioning can be a bit trickier with your incision. Pain medication can relieve some of the discomfort and you can also talk to the hospital lactation consultant, breastfeeding educator, or your local La Leche League about positions to try.

Side-lying is a great position to nurse in because it takes little effort on your part and the baby avoids the incision. The football hold is also great, but prop up with a lot of pillows.

Emotions After a Cesarean

Your emotions, as with any new parent, will probably be all over the place for the first few days. In addition to the new parent feelings, you may have certain feelings about birth.

You may have been afraid when they told that you needed a cesarean or worried that it meant something was wrong with you or your baby. You might have felt relief as a healthy baby was born, or more fear if your baby had to go to the special care nursery.

You may feel disappointed about the way things went or that certain things didn't happen, like a vaginal birth or breastfeeding your baby in the recovery room. It's okay to have these feelings or questions.

Ask your provider, your partner, or the nurses questions about your c-section. They can help explain why the surgery was necessary. It's important to realize that these feelings need to be dealt with just as much as the physical healing.

Some people don't feel negative about their cesareans, and that's one part of the range of normal as well.

It's neither right nor wrong to feel either way, but it's important to remember that each side of the fence is valid and that we need to support the new mom, no matter how she feels.

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