Cesarean Recovery

Now what?

You may have many questions after your caesarean. Hopefully this fact sheet will help provide some answers. If you have any other questions, please feel free to contact us.

What can I expect the first few days?

You will be in the hospital 2 to 3 days after a caesarean. The trend is toward a shorter stay for those with a normal recovery. During this time your dressings will be changed, IV and catheter removed, vital signs taken, uterus massaged to keep it firm, and urine output measured. Like vaginally born babies, unless your baby has any signs of respiratory problems, infection or other problems, you can have him/her room-in with you.

How long will my stitches stay in?

Your internal stitches will start to dissolve within a couple of days after the birth. They do not need to be removed.

If you have external staples, they are usually removed on day 6. If you would like to go home on day 2, your midwife can remove them during a home visit.

Should I be resting in bed the whole time?

Following any major abdominal surgery it is important that you rest. However, it is also important that you spend some time each day up and walking around. The sooner you do this, the better you will feel. As you stand up, you may be afraid that your insides are going to fall out, but don’t worry, you have been stitched securely in separate layers. You may have a gush of blood from your vagina, since the lochia (blood and tissue from the uterine lining) pools in the vagina while you are lying down. Your instinct will be to slump forward and do the “caesarean shuffle.” Stand as tall as possible from the very beginning, because it becomes more difficult later.

Walk about as much as you can, as it will help prevent or relieve gas pains. Try to walk to the toilet rather than using the bedpan. Remember to regularly do circles with your ankles and feet since this helps reduce risks of complications after abdominal surgery. If you have any odd pains in your legs, be sure to let the nurses know. Once you have passed gas, make sure you are keeping well nourished. It will be very difficult to establish breastfeeding and keep up your own energy if you do not eat properly.

What can I eat?

When you progress to solid foods, eat a balanced diet, which includes lots of fiber. Drink at least 8 glasses of water a day. To help reduce gas, which can be very painful, avoid very hot or very cold or bubbly drinks and use this exercise.

I’m in pain a lot of the time. What can I do about it?

Ask for painkillers. You cannot effectively rest or take care of your baby if you are in pain. Over the first week or so you will find you need fewer painkillers each day.

Will my cesarean affect breastfeeding success?

It can be more difficult to establish breastfeeding after a caesarean but not impossible. You may need some extra support from someone to help you lift the baby into your arms for each feed over the first few days. It may take a few extra days for your milk to come in but this should not be a problem – your baby can get all of her/his nutrition from colostrum. Make sure you are eating and drinking enough to help your milk supply become established (you can eat once you have passed wind after the operation).

Is there anything I should be careful of?

A caesarean is major abdominal surgery. You must take care of yourself, making sure you are resting enough and eating a healthy balanced diet. Try to find someone else to take over all the household chores in the first few weeks as well as prepare your food, so you are able to concentrate on your baby and yourself. Don’t lift anything heavy like a toddler or a baby bath full of water, until at least six weeks after your birth.

How long will my scar feel uncomfortable?

Your scar will itch, feel numb or have sharp pains for a while. Most women find the scar becomes less uncomfortable by about six weeks postpartum. However, for some women the scar can be still uncomfortable for several months. If you are concerned about the way your scar feels or looks discuss this with your midwife. Of course, if you notice anything unusual, such as swelling, oozing or a bad smell, report it to your doctor immediately.

Will I always be able to see my scar?

The scar will fade over time and once your pubic hair begins regrowing it will be difficult to see.

Who can I talk to about the reasons for my cesarean?

For many women it is important to understand the reasons for their caesarean – especially if they had hoped for a vaginal birth. Your midwife will have a copy of your labour notes, which she can talk through with you. This may help answer some of your questions.

I’m feeling very emotional. Is this normal?

Many feelings accompany a caesarean birth – from wonder, gratefulness and joy, to anger, disappointment and despair. This is normal. A caesarean often means the loss of a dream of a natural birth or a perfect outcome. You may have positive and negative feelings at the same time. You might feel tremendous gratitude and love for your healthy baby while at the same time feel very disappointed that you had to have a caesarean.

Caesarean mothers often experience feelings that come and go: anger, sadness, relief, guilt, fear, disappointment, depression, inadequacy, jealousy of mothers who had natural births, powerlessness, confusion and hopelessness. Negative feelings are stronger if your labor had been traumatic, if you feel you were misled by your caregivers or unprepared by your childbirth educator. It doesn’t help that a common reaction by caring but misinformed people is to feel that if you have a healthy baby that you should be happy and satisfied. In reality the issue is much more complicated. Resolving your feelings and healing take time.

Certain things make the emotional recovery easier. Cry if you need to – tears are very healing. Talk about your feelings. Join a caesarean support group. Find a knowledgeable counselor. Write in a diary or journal. Write letters to those involved and tell them exactly how you feel (you don’t have to send the letters.)  Write the story of the birth experience and what you have learned from it. Acknowledge your incredible courage: you were willing to undergo major surgery for the sake of your baby! Educate yourself about caesareans and when you are ready, reach out to another caesarean mother and help her with your experience and knowledge. There are many good books available, as well as information and support on the internet.

Will I ever be able to have a vaginal birth?

Many women go on to have subsequent children vaginally – called VBAC, Vaginal Birth After Caesarean. Research now shows that vaginal birth, even after caesarean, is usually safer, except in rare cases. Women having VBAC births have their own special needs: while many are eager for the opportunity of a vaginal birth, others find it difficult to convince themselves to go through labor again and try to have their baby vaginally. It is good to do lots of research and find lots of support.

International Cesearean Awareness Network, www.ican-online.org

Will I be able to have midwifery care with my next pregnancy?

Midwives often take care of women who have had a previous cesarean section. Many of these women go on to have vaginal births. Ideally you will have had 24 months between pregnancies to give your uterus time to fully heal and form a strong scar.

In fact, Madawaska Valley Midwives has a handout dedicated to the topic of vaginal birth after cesarean. If you would like to see it before you are pregnant again, feel free to ask us for a copy.

Credit: Thanks to Pomegranate Midwives in B.C. for this sound information on caesarean recovery. This document is originally from their website and we are pleased to share it with our clients with a few modifications and omissions that make it more appropriate for women in our care.