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C-section Recovery Guide

Monday, February 15, 2021

Approximately 25-35% of all deliveries in North America are by C-section (Cesarean section). Some of these are planned while others are the result of complications that arose during labour.

A C-section is major surgery and will require recovery time. If you have gone through labour in addition to the surgery, you can expect an even longer recovery time.

When people have surgery, such as having their appendix removed, they know must rest and take time to heal. The same should apply to C-section recovery. The difference is, however, that you also have a newborn to care for. Your rest will be in 1 or 2-hour blocks only and there may even be company to entertain!

It is important to be realistic in your expectations of yourself throughout your c-section recovery. Be sure to enlist the help of others with tasks such as cooking, cleaning and laundry.

Getting mobile

Most women will stay in hospital for 2 to 4 nights after a c-section. Nurses will assist you to get up and walk a few steps as soon as possible after your surgery. Although this will be uncomfortable, it will help to speed your healing. Start with just a few steps and gradually increase the distance you walk.

Walking is important to keep the blood circulating in your legs. This will decrease your chances of developing a blood clot (deep vein thrombosis or DVT).

Symptoms of a blood clot in your leg include:

  • severe pain that is increases when you pull your toes up towards your head
  • red area on your leg that is warmer to touch than surrounding areas
  • one leg that is significantly more swollen than the other

These symptoms should be reported to your healthcare provider.

Your bowels temporarily shut down during surgery. This can result in a painful accumulation of gas. Walking helps the gas to work its way through the bowel. Some women will experience a “referred gas pain” in their shoulder area. You could try drinking Peppermint tea; some women say it helps!

Managing Pain

You will require pain medication after your surgery. Most pain medication is compatible with breastfeeding. Check with your healthcare provider or pharmacist if you are unsure.

Try to take your pain medication regularly for the first couple of days after surgery. Being pain-free will allow you to move more easily and care for your baby more comfortably.

It is important to take pain medication before you are discharged from the hospital. The effort involved in transferring to your vehicle, then getting settled at home can result in increased pain.

Incision pain should decrease each day. If you find that you are starting to forget your pain medication, it is a good sign that you are healing well.

Coughing or laughing

It can be uncomfortable to cough or laugh after surgery. “Splinting” your incision can help. Use a folded towel to put firm pressure with your hands on either side of the incision while you cough or laugh.

It is important to know that while it may be uncomfortable, your incision is sutured in many layers and can withstand sudden movements.

Bowels

Keeping your bowel movements soft will make them easier to pass without using your stomach muscles. A gentle stool softener may be prescribed. Drinking plenty of fluids and having a high fibre diet will also help.

Vaginal Bleeding

You will have some type of vaginal discharge for several days following a C-section.

Your discharge will typically be a red bloody flow for 3-5 days, followed by a pinkish watery flow for another 10 days. See this post to learn more.

Breastfeeding

Breastfeeding can begin as soon as you are comfortable after a C-section. If you have had a general anaesthetic, you may breastfeed as soon as you awake. If your C-section was done without a general anesthetic, you will likely be able to breastfeed as soon as baby is born.

It can be challenging to find comfortable nursing positions after a C-section. Many women like to use the football hold, side lying or laid-back position to keep the weight of baby off their incision.

Learn more about positions for breastfeeding in our Simply Breastfeeding From Day One online class

This guide will help you understand what to expect as you recover from your c-section

Emotions

Women can experience a wide range of emotions in the weeks after a C-section. Some may feel relief that surgery finally ended a long and difficult labor. Others may feel let down that they were unable to give birth vaginally, the way they had envisioned during their pregnancy. Still others have mixed emotions. There is no one right way to feel after a C-section.

If you are having feelings of disappointment or frustration regarding your C-section, it is important to talk about it. Talking about your feelings helps to resolve the issue in your mind. Feel free to ask your doctor or midwife for explanations about why the surgery was necessary. Give yourself time to reconcile your birth experience with what you had envisioned.

If you find you are struggling with your feelings beyond the first few weeks, talk to your healthcare provider. Postpartum blues are common in the first few weeks but if they do not resolve or the symptoms worsen, you could be suffering from postpartum depression and may benefit from treatment and a support group.

Hospital discharge

The day of discharge from hospital will be a busy day. You will likely see your doctor and be given discharge instructions by your nurse. Packing up baby and transferring from your hospital room to the car to your home can take a lot of energy. This will not be a good day to entertain company at your home.

Once home, remember to rest as much as possible. Try to limit trips up and down stairs. Ask your support people to help you set up diaper change stations close to where you will be resting.

You will need help for the first few days at home. Enlist the help of your partner, other family members or friends. If you can afford it, hire someone to do the cleaning and laundry.

Incision

Most C-sections are done with a bikini incision, a 4 to 6 inch incision just above your pubic bone. The incision has many layers of stitches. The outermost layer may be stitched with dissolvable sutures or metal staples. If you have staples, a healthcare provider will remove them five to seven days after the surgery.

At first, the incision will be bright red and may be slightly raised. It will take 4 – 6 weeks for the incision to fully heal and it may feel itchy as it heals. The red scar will gradually fade and become flush with your skin.

It is not unusual for the area around the incision to be numb. This is due to a disruption of the nerves during surgery. The numbness may last for several months but normal sensation should eventually return.

It is normal to have a small amount of a watery yellow discharge from your healing incision. Notify your healthcare provider if:

  • your incision is red, warm to touch, and swollen
  • you have a fever
  • you have increasing pain, despite taking your pain meds
  • you have thick yellow or yellowish-green discharge from your incision

Activity guidelines

Because your abdominal muscles have been cut, it is important not to lift anything heavier than your baby for approximately 6 weeks. Car seats are heavy. If you need to make a trip alone with your baby, leave the car seat in your car and carry only your baby.

Avoid driving until your incision is well healed. Lifting your foot from the gas to the brake pedal contracts your stomach muscles. You will want to be sure you can do this without hesitation before you resume driving.

Be patient with yourself. Your recovery will take time but you will eventually be able to return to your former level of fitness. Continue with short walks but avoid strenuous exercise for at least six weeks. Check with your healthcare provider before resuming your fitness regime.

Sexual intercourse

After a C-section, you should be physically ready to resume sexual intercourse in about 6 weeks. You may or may not be emotionally ready at that time. It is normal to feel tired and “touched out” with the demands of caring for a newborn. Discuss with your partner what is right for you.

It is normal for breastfeeding women to have decreased vaginal secretions. Using a water-based lubricant may help intercourse to be more comfortable.

You may need to be creative with positioning to find one that is comfortable for you, not putting too much pressure on your incision.

Pregnancy can occur before you have had your first menstrual period. Speak to your healthcare provider about methods of family planning and choose one that is right for you.

C-section recovery takes time, the amount of time varies from mother to mother. Women who have gone through labor prior to their C-section will need more recovery time than those with a planned C-section. Try to be patient with your body throughout this healing time and take advantage of any help offered.

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References:
  1. “Breastfeeding After Cesarean Birth.” La Leche League International, 2019, www.llli.org/breastfeeding-info/breastfeeding-cesarean-birth/.
  2. “Breastfeeding After Cesarean Delivery.” HealthyChildren.org, 2009, healthychildren.org/English/ages-stages/baby/breastfeeding/Pages/Breastfeeding-After-Cesarean-Delivery.aspx.
  3. “Caesarean Section.” HealthLink BC, 2017, www.healthlinkbc.ca/health-topics/tn8162.
  4. “C-Section.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 9 June 2018, www.mayoclinic.org/tests-procedures/c-section/about/pac-20393655.

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