Immediately Post C-Section
C-section recovery happens in stages. Immediately 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. The amount of time you will remain in recovery varies, 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 can 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 start moving as quickly as you can. Obviously, you will want to start with simple things like breathing. While breathing sounds like a simple thing to do, 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 bladder 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 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 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.
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 with gauze. You may also have special drains to help remove fluids that are collecting on the inside. There 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.
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 chair or the bathroom door.Support your incision by holding a pillow over it. Your insides will feel like they are falling out, but rest assured they are secured by several layers of stitches and staples.Walk as frequently as possible—even if it’s only a few steps at a time.
Before you are able to walk (or if it will be a while before you can), your provider might have you use compression boots to help prevent DVT. 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 any changes that may indicate infection to your provider. 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, and don’t hesitate to 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 if your bed can 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 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. Besides 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 normal too. 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.
