Having a c-section can be a daunting and stressful experience, especially if a medical complication occurred during labour and your c-section was unplanned. You might feel unprepared for what’s to come afterwards.
Even if you were prepared for your c-section, you might be concerned about the recovery period and what to expect in the days and weeks that follow.
Having as much information as possible about what to expect following a c-section can empower you to have a more positive and less stressful recovery period.
Knowing what to expect after a caesarean can also help you prepare for recovery and make sure you have adequate support in place.
What is cesarean birth?
Whatever the reasons you required a c-section, one thing is for certain: you are going to need some serious time and support during the recovery process after major surgery.
A c-section involves major abdominal surgery for the birth of your baby. You will require an anesthetic, either by an injection into your spine back or you’ll be asleep if it is an emergency. You will also require a urinary catheter and a cannula that goes into the vein.
Be sure to call on those who can help you at home with meals, general housework, and driving.
Relax, take pain medication if required, indulge in self-care, and enjoy your new baby experience. Read on below for some helpful information about the cesarean section.
You might be interested in our article Gentle C-Section | 11 Ways To Have One.
Immediately after c-section surgery
Straight after your major surgery, you will need to spend some time in the recovery room (post-surgery area). You’ll need to be monitored, to ensure your vital signs are stabilized and you are not having adverse reactions to medication.
Hospital staff will monitor any bleeding from your incision site as well as vaginal bleeding (to check for a possible blood clot). The hospital staff will also check your incision is healing with no signs of infection. Your blood pressure and temperature will also be monitored. The cannula in the vein will remain in place to provide fluids and pain medication.
The catheter, which collects urine and empties your bladder, will also remain, usually until the next day. You’ll be encouraged to get up to walk to the bathroom; this is an important part of c-section recovery.
When you’re ready, you will be moved to your room. You’ll still have no feeling in the lower part of your body and you could be feeling a bit woozy and shaky. If your baby is with you, ask for help to hold him, skin to skin, above your incision site. It’s okay to breastfeed if your baby is interested. While you are waiting for the anesthetic to wear off, spend the time snuggling up and getting to know your baby.
Most women experience very itchy skin in the first few hours after the surgery. This is a side effect of a narcotic that might have been used during the c-section. The itchiness will reduce as the drug leaves your system.
Some women have a reaction to the anesthetic and develop severe shakes during surgery and afterwards. The spinal block, or epidural, dilates your skin’s blood vessels and you lose a lot of body heat. The shaking will disappear as the drug wears off but the recovery nurse or midwife can provide you with extra blankets, if needed.
Your blood pressure could drop as a result of the epidural and, especially if you had a general anesthetic, you might feel nauseous upon recovery; again, these are reactions to the drugs used and the symptoms will fade very soon.
An annoying side effect of c-section surgery that might occur is shoulder pain. This is a sharp pain beneath one or both of your shoulder blades. It’s due to air entering your abdominal cavity during the surgery. Your body will gradually absorb the air pocket over the next few days, and the pain will disappear.
Very rarely, women experience severe headaches and swelling at the site of injection into the spine. If this happens, it’s important to tell your care provider immediately so methods for relief can be discussed.
Pain medicine after a cesarean birth
Some women need effective pain management after experiencing a c-section; others are up and about within a few days and feel little incision pain. This could be due to individual differences in pain tolerance, or what happened before or during the c-section. How you feel about your experience can also contribute to the level of pain you might feel afterwards.
There are several medications, taken individually or in combination, which will offer pain relief after your c-section. Your midwife or anesthetist will recommend which drugs will best help you to cope. If you continue to experience pain, then you should alert your midwife or healthcare professional to your condition, so that she can help alleviate your distress.
Please remember that it can be better to ‘stay on top’ of the pain, as some of the drugs work best when they reach a certain level. If you force yourself to cope with pain to the point where you desperately need pain relief, then you might not get the full benefit of the pain medicine.
Some types of pain medication are:
Narcotic medication might include pain relievers, such as codeine, morphine, or pethidine. If possible, it’s better to use these drugs in moderation as they can cause constipation, which is not a pleasant experience after a c-section. If they are used, make sure you drink plenty of fluids, and keep mobile. Some doctors or nurses might recommend a stool softener be taken with narcotics.
Narcotics can be given by injection into your leg muscle every 3-4 hours. If you have an IV in place you might receive a ‘fixed dose infusion’, via a patient-controlled analgesia pump, which enables you to self-medicate, as needed (you will be instructed how to use this pump).
If you had an epidural and the catheter is still in place after the surgery, you might receive small doses through this. Another way of receiving this medication is via a single spinal injection.
Paracetamol might be offered alone, if you’re coping well with pain, or in combination with the above narcotics, to reduce the amount of drugs needed.
The suppository contains an anti-inflammatory drug to help you cope with pain while it reduces any abdominal inflammation you might be experiencing. This drug is inserted into your rectum, and is quickly absorbed. It’s usually given twice a day.
It’s important to know you have the right to be informed about the possible side effects of any drugs used to help manage pain after your cesarean section. If you have any concerns about how these drugs might affect you or your baby, especially if you are breastfeeding, you should discuss your worries with your health care provider.
Over time, you will be given lower doses of pain relievers to see how your body is coping. Your midwife or doctor should guide you towards a gradual reduction in pain medicine during the time leading up to your discharge.
You might be interested in reading RANZCOG – Caesarean Section guidelines.
Drinking and eating after a cesarean section
It’s wise to start with fluids and clear foods, and possibly even solid foods, quite soon after your surgery. Your midwife or doctor will advise you about any restrictions in your individual case, and the reasons for them. Each hospital will have guidelines related to this, so you need to check that it’s okay before eating or drinking anything.
Generally, if you had an epidural or a spinal block, then your fluid intake will not be restricted. You may drink any fluids – such as water, juice, and cordial – and eat clear foods, such as soups and jellies.
You mustn’t start eating solid foods until you’ve passed wind, which is a sign that your intestines (which will have been ‘relaxed’ during your surgery) are beginning to function normally again. At this stage in your recovery a light diet is best, until your intestines become better able to handle your food intake.
Once you’ve had a bowel motion you can eat whatever you like. Healthy snacks are especially important to maintain physical health. It’s really important to keep up your fluid intake, especially if you’re breastfeeding, so always be sure to have a glass of water close at hand while feeding your baby.
It’s recommended that you try really hard to drink at least 8 glasses of water a day. This will prevent dehydration and help make up for any blood loss you experienced. It will also keep your bladder functioning well and help prevent constipation.
Urinating after a cesarean section
When your urinary catheter is removed you might be asked to measure the amount of urine you pass on the first day without it. You will be supplied with a special measuring container in which to urinate, so don’t forget to hold on to your urine until the midwife has noted the amount.
If you’re having difficulties urinating, then you might like to try some ways of triggering the urge – such as turning on a tap, hopping in a warm shower, or pouring a small amount of warm water over the area. If the difficulty persists, then the catheter might need to be reinserted.
Some of the drugs given to you during the surgery, or for pain relief afterwards, might affect your bladder function. It would be worthwhile investigating this as a possible cause of any problems you might encounter in regaining normal bladder function.
Some women experience physical trauma related to the urinary catheter. If you feel any burning pain upon urinating, especially if it persists, you need to let your doctor or midwife know about the problem.
To help prevent any bladder problems, try to urinate at least every couple of hours during the first day or so. This will prevent the pain caused by a full bladder putting pressure on your c-section incision.
If you experience incontinence (leaking urine) seek advice from the midwife or women’s physiotherapist. Ask about exercises that you can perform to increase your ability to maintain bladder control (pelvic floor exercises, etc). It’s common during pregnancy to experience some incontinence, as a result of your growing pregnant belly applying pressure to your bladder, and/or the normal relaxing hormonal effects of pregnancy itself. Having a c-section doesn’t mean you won’t experience a weakening of your pelvic floor muscles, and it’s important to address any problems early on.
Another problem some women experience is the lack of the sensation that tells you your bladder is full and you need to urinate. This is also something that should be brought to the attention of your doctor or midwife.
Bowel movements after a cesarean section
Within the first couple of days after your cesarean section, you should feel the need to move your bowels. This can be a scary experience in itself, as you’ll feel unsure as to how much pushing your wound can withstand. It can be reassuring to apply gentle pressure, with the palm of your hand, over the wound area while taking deep breaths. Avoid straining while having a bowel movement; this has the potential to cause hemorrhoids or possibly prolapse.
Avoiding constipation is important, as the added pain and discomfort can be very distressing. Drink plenty of water, eat fiber-rich foods and, if possible, limit the amount of narcotic pain medicine you take for pain relief.
You don’t need to be worried. If you continue to have problems with constipation, your midwife might suggest you use a stool softener.
For more information, read about The First Postpartum Poop – 10 Things You Need To Know.
Vaginal blood loss after a caesarean section
Your midwife will ask to view your sanitary pads over the first few days after your cesarean section, to check the amount and color of vaginal blood loss.
The vaginal bleeding might increase when you breastfeed your baby. Breastfeeding hormones encourage uterine contractions, which might feel like menstrual cramps. When you stand up, your flow might suddenly increase as well, as a result of gravity.
You might also pass some blood clots, although they shouldn’t be too big. If you’re concerned about anything to do with the amount, or consistency, of your blood loss or blood clots, then ask your midwife to check your discharge for you.
At first, your blood loss might be bright red, and slightly heavier than a normal period; however, it shouldn’t exceed one sanitary pad per 4 hours. If it does exceed this, then advise your midwife.
The loss will decrease over the next week and the color will alter to a paler red, then a brownish-red color. The flow should stop after a week or so, although light blood loss can last for about 6 weeks after the birth and isn’t a cause for concern. It differs for each woman. If you are worried, contact your midwife or call your doctor for advice.
Caring for your wound after a c-section
You might have received antibiotics while still in theater, and the surgeon will have placed a sterile dressing to cover the incision site. These safeguards will help reduce the likelihood of infection.
The day after your c-section you’ll be encouraged to get up and have a shower. This is usually when the sterile dressing is removed. You should gently wash away any dried blood from around your wound; use water only, as soap might irritate. Dry the area by patting it with a towel. If it’s possible, allow the wound area to air-dry; this is the best method.
Before you are discharged from hospital the doctor will remove any staples used, and will cover the incision with sterile strips, which are similar to bandaids. In some cases, however, staples might remain until a postpartum follow-up.
You’ll be instructed on how to keep your wound clean and undisturbed. You might find it uncomfortable if clothes rub directly onto your wound; your maternity clothes might be the best option for the first few weeks. Most women prefer bigger underwear rather than bikini briefs; a good option is to have the waistband higher than the wound area.
Your wound might continue to feel uncomfortable for some time after the surgery. During certain activities, some women experience mild pain and pulling sensations for several months afterwards. In the majority of women, this goes away after a time. If you’re worried about these sensations, discuss them with your midwife or doctor.
If you notice any swelling, redness, abdominal pain, or increased pain anywhere, or if your wound weeps blood or other fluids, please bring this to the notice of your midwife or doctor as soon as possible – especially if the symptoms are associated with pain or fever. These are possible signs of infection.
You might be interested in our article C Section Scar – 9 Most Common Itching & Healing FAQs.
Finding time to rest after your c-section
It usually takes longer to recover from a c-section than from a vaginal birth and it’s important to take care of yourself through the postpartum period (the six weeks after birth). There’s no putting off healing until ‘later’; rest is a big part of the healing process. Eat well, have plenty of support in place, and try to get some sleep while your baby sleeps.
Even if the c-section was planned, it’s not uncommon for women to feel very tired after the surgery. If your c-section was unplanned, you might also be dealing with emotional shock. You might find in the first few days that you want to limit visitors to immediately family only, so you can rest and recuperate. After a c-section, some women find it difficult, or even embarrassing, trying to get mobile again when there are lots of visitors present.
Don’t hesitate to ask for support from the staff, family, and friends, especially during the first few days of caring for your brand new baby.
Tips to help you get some rest
Try some of these ideas:
- A ‘Do Not Disturb’ sign is great – both in hospital and at home. During your pregnancy you can make your own personalized one, with an explanation that mum and baby are having a nap. Take the phone off the hook and catch up on sleep
- While in hospital, you can ask your partner to remind visitors not to stay too long. It can be exhausting if you’re entertaining when you should be resting. The same applies at home, for those first few weeks of recovery
- During the night, keep your baby close by rather than in another room – at least for the first few weeks. If you keep your baby’s cot near your bed, you won’t have far to go to attend to your baby’s needs
- If your baby’s presence keeps you awake (those little sniffling noises can be daunting to a new mum), then organize some time during which your partner, or someone else you trust, can care for your baby while you have a nap all by yourself.
You might also like this article on Postnatal Depletion – What It Is And How To Recover.
What about sex after a c-section?
Whether you had a vaginal or c-section birth, the same rule applies: have sex when you feel ready. Many providers recommend waiting until vaginal bleeding has ceased, to avoid infection, while others recommend waiting until your 6-week postnatal follow-up.
Before you have sex, though, organize what type of contraceptive you will use. It’s wise to allow your body time to physically heal from your c-section before becoming pregnant again.
You might need to try a few different positions during sex if you’re still feeling some pain or want to avoid pressure on the wound area. Discuss with your partner the possibility that you might need to stop during sex if this is a problem.
The wound, and the area surrounding it, can remain numb for months (or up to a year) after the surgery. This is due to nerve stretching, or damage, resulting from the incision, and surgical trauma to the area. The feeling should eventually return. It might be a good idea to explain this numbness to your partner, as it can be disturbing to be touched on this numb area.
If you’re breastfeeding, your lowered estrogen levels can reduce vaginal secretions that are normally present during sexual activity. If this is the case, you might need to purchase a water-based lubricant gel to replace your natural secretions, to enable sex to be more enjoyable.
You might not even feel like having sex. This can become quite a challenge for couples, especially if partners do not understand why you aren’t interested. Your partner might appreciate some insight on the reasons why women aren’t interested in sex after birth.
You might both like to read our article 10 Reasons Why She Doesn’t Want Sex With Me After the Baby.
Women who have given birth via c-section can still experience painful intercourse and other sexual problems. Your doctor or midwife can help if you run into trouble.
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What to expect emotionally after a caesarean?
The emotions you might experience after a c-section will depend very much on whether you chose to birth in this way, or whether you had been aiming for a natural, uncomplicated vaginal birth. Your emotions will also be affected by what actually occurred during the c-section birth of your baby.
If you prepared yourself for a c-section, and everything went well on the day, then you might have no emotional issues connected with the c-section at all. You might flow straight back into everyday life with very little difficulty, apart from the normal, and necessary, physical healing.
If you planned a c-section birth but, on the day, something ‘happened’ that wasn’t expected – for example, your child needed pediatric help, or your anesthesia didn’t work as well as expected – then you might need to deal with the emotional trauma connected to these experiences.
You might also have wanted a natural birth and, in late pregnancy or on the day, events did not go as planned, so an emergency c-section became necessary. An unplanned c-section can be a traumatic experience for some women, increasing the risk of postpartum depression.
The degree of emotional trauma associated with each of these situations usually relates to the ‘why’ of the c-section, how much control you had over the birth experience, and the progress and outcome of the surgery.
You might find some relief by talking about your feelings – to your partner, family, friends, or the midwives and the doctors who were involved in your care. It might help to have more information about the ‘why’, so you can process some of the strong emotions attached to your memories.
If you were planning a vaginal birth, it’s normal to experience some grief at the loss of such an integral life experience. We envision how our children’s births will unfold on the day and, when things don’t go as planned, we can sometimes feel grief at the loss of this important milestone.
These feelings might not arise immediately following the birth of your child. It can take time before you experience any sense of grief or loss over your planned birth. Often women are told to feel grateful for the medical help they received. Although there is no denying you are grateful, it’s important to acknowledge your feelings and avoid letting them become overwhelming. A healthy baby is important but, at the same time, it does matter how you feel about your birth.
You might be interested in reading Why You Should Have A Post Natal Month After The Birth.