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 can help you prepare for recovery and make sure you have adequate support in place.
What To Expect After A C-Section
Here’s what to expect after your c-section:
Immediately After Surgery
Straight after a c-section, you will need to spend some time in recovery. You’ll need to be monitored to ensure your vital signs are stabilised and you are not having adverse reactions to medication.
Staff will monitor any bleeding from your incision site as well as vaginal bleeding. Your blood pressure and temperature will also be monitored. Your IV will remain in place to provide fluids and pain medication.
The catheter, collecting urine and emptying your bladder, will also remain, usually until the next day. You’ll be encouraged to get up to walk to the bathroom, which is an important part of 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 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 anaesthetic to wear off, spend the time snuggling up and getting to know your baby.
You might 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 lessen as the drug leaves your system.
Some women have a reaction to the anaesthetic, 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 anaesthetic, 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. The air pocket will be gradually absorbed by your body 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 relief methods can be discussed.
Pain Relief After a C-Section
Some women need effective pain relief after experiencing a c-section; others are up and about within a few days and feel little 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 have afterwards.
There are several medications, taken individually or in combination, which will offer pain relief after your c-section. Your midwife or anaesthetist will recommend which drugs will best help you to cope. If you continue to experience pain, then you should alert your midwife 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 medication. Some types of pain relief are:
- Narcotic medication: specifically, pethidine and morphine. These 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.
- 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.
- Narcotics: These might be 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.
- Paracetamol: This 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.
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 c-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 care provider.
Over time you will be given lower doses of pain medication to see how your body is coping. Your midwife or doctor should guide you towards a gradual reduction in pain relief during the time leading up to your discharge.
Drinking and Eating After a C-Section
It’s wise to start with fluids and clear foods, and possibly even solid foods, quite soon after your surgery. Your midwife/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 if it’s okay before eating or drinking anything.
Generally, if you had an epidural or spinal block, then your fluid intake will not be restricted. You may drink any fluids – such as water, juice and cordial – and eat such clear foods as soups and jellies. But you mustn’t start eating solid foods until you’ve passed wind – this 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, then you can eat whatever you like. 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 C-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 an 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 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 issues early on.
Another problem sometimes experienced, is the lack of that 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 C-Section
Within the first couple of days after your c-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. Avoid straining while having a bowel movement; this has the potential to cause haemorrhoids or possibly prolapse.
Avoiding constipation is important, as the added pain and discomfort can be very distressing. Drink plenty of water, eat a fibre-rich diet and, if possible, limit the amount of narcotics you take for pain relief. If you continue to have problems with constipation your midwife might suggest you use a stool softener.
Vaginal Blood Loss After A C-Section
Your midwife will ask to view your sanitary pads over the first few days after your c-section, to check the amount and colour of vaginal blood loss.
The flow might increase when you breastfeed your baby, as breastfeeding hormones encourage uterine contractions. When you stand up, your flow might suddenly increase as well, as a result of gravity. You might also pass some 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, then ask your midwife to check your discharge for you.
At first, your blood loss will be bright red, and slightly heavier than a normal period – although 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 colour will alter to a paler red, then a brownish-red colour. 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 doctor for advice.
Caring For Your Wound After A C-Section
You might have received antibiotics while still in theatre, 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, allowing the wound area to air-dry is best.
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. Big underwear rather than bikini briefs are a good option, as the waistband will be 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 or redness, 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.
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’, and 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 is sleeping.
Even if your 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 in those first few days of caring for your brand new baby.
Tips to help you get some rest:
- A ‘Do Not Disturb’ sign is great – both in hospital and at home. During your pregnancy you can make your own personalised one, with an explanation that Mum and Baby are having a nap. Take the phone off the hook and catch up on sleep!
- 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.
- Keep your baby close by during the night, not 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 organise some time during which your partner, or someone else you trust, can care for your baby while you have a nap all by yourself.
What About Sex After A C-Section?
Whether you have 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 do, try to organise what 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. 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, the lowered estrogen levels can reduce the 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. Give your partner this article to read, for insight on the reasons why women aren’t interested in sex after birth.
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.
What to Expect Emotionally After A C-Section
The emotions that 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 if on the day, something ‘happened’ that wasn’t expected (e.g. your child needed paediatric help, or your anaesthesia didn’t work as well as expected, etc) then you might need to deal with the emotional trauma that is 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.
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. While 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.