The Ultimate Guide to C-section Recovery
Having a C-section birth may be something you prepare for, or it may come as an unexpected surgery during labor. Either way, the C-section itself is just the start of a 6-week journey to full recovery.
C-sections are major abdominal surgery, and while it is very common (about 30% of births in the US happen via C-section), many moms kinda stumble along in their recovery, trying to take in the overwhelming and sometimes complicated advice given to them by their doctor all whilst coming down from a cocktail of surgery drugs and pain medication...and ya know...giving birth to a new human being.
Clearly, that is NOT the best time to absorb information. And you likely won't see your provider until six weeks post-birth for a checkup (yay American maternal healthcare system!).
So. Whether you are planning a C-section, want to prepare for a “just in case”, or if you have just had a Cesarean and don’t quite know what to expect, I’ve created this guide to walk you through all the major stages of cesarean recovery, how you can help yourself heal faster, and what to watch out for.
The first day
What to expect
If there are no complications, you will spend time in a post-op room right after your surgery where you are monitored for a few hours (usually until you’re conscious and/or your feet and legs start to regain feeling). You will then be transferred to a Mommy / Baby room where you will be for the next few days. For the first day, you will be given a liquid diet of ice, juice or broth until you are cleared for solid food.
Nurses will message your uterus to encourage shrinkage (Heads-up, it’s NOT like a spa message), and you will bleed vaginally (yes, even with a C-section!). Generally, nurses will also help you change your pad during your hospital stay. Side note: plan for the largest pads you’ve ever seen in your life, covered with sexy net style boyshort postpartum panties. (Tip: ask for extra of both to take home for the early days - thank me later)
Your incision site may bleed slightly, and you might not feel much until your anesthesia wears off at about the 12–18-hour mark. At that time, you will be given fairly strong pain medication to help deal with the pain that will be there. (Tip: if you experience an itchy reaction to the pain meds, be sure to keep a hairbrush or back scratcher nearby)
You will also be encouraged to get out of bed for a short time. You won’t feel like it, but it’s important to get up out of bed the first day as it aids in your recovery.
For the first day you will have a catheter in place, so you don’t have to keep getting up for the bathroom.
Things to watch out for
You are most heavily monitored during the first day of your recovery, so any potential medical issues should be identified immediately by your healthcare team. Here are some things you will want to tell your care provider right away about if you notice it:
Bleeding: vaginal bleeding is normal for a C-section birth, so don’t be alarmed that it will last up to a few weeks, just as it would in a vaginal birth. However, if the bleeding is incredibly heavy (ie - soaking through a pad hourly), you need to let your provider know right away.
Incision: Your incision may produce a bit of bleeding through the stitching, but again, anything more than seepage should be reported to your nurse. Maternity underwear without lace top might be the least uncomfortable at your incision site at this point.
Fever: If you feel a fever, it could be a sign of infection, so tell your provider immediately.
Pain: If your pain level is increasing rapidly do not delay in asking for more pain medication. It is a lot harder to manage pain once it becomes unbearable, so communicate your pain level honestly with your nurse – this is not the time to try and brave through pain!
The first week
What to expect
It’s common to have a hospital stay of about 3-4 days for cesarean recovery. During this time your catheter will be removed (yay!), and you will be getting up more often to go to the bathroom and to help get your bowels functioning again. Keep in mind that your perineum may be swollen, sore, and uncomfortable during healing...which is usually an unexpected side-effect of a C-section.
You will still be on pain medication and at this point which may cause you some itching and/or nausea, but that is a minor irritant compared to the pain without them.
You will be allowed to take your first shower (yay again!), and your IV will be removed (third yay!). Solid food will be back on the menu, so be sure to eat nutritionally dense food that will help restore your energy.
As you begin eating solid food, your digestion may not yet be back “on”. The abdominal surgery you just had will have temporarily turned your digestive system off, so it is highly recommended you take a stool softener to get things going again. Drinking lots of water, moving and taking an anti-gas medication will also help get things back on track and make having a bowel movement much less painful. Side note: the first postpartum poop is a whole thing!
Things to watch out for
Bleeding: Again, remember to watch for excessive bleeding vaginally or from your incision site. Vaginal bleeding will remain heavier in the first week still and begin to dissipate after that, lasting roughly six weeks.
Pain: Remember that the pain associated with major abdominal surgery is REAL. Stay the course on pain meds and adjust as necessary with the help of your nursing staff. There will be adjustments to your pain regimen after the IV is removed and you are switched to oral medication. If possible, sleep at an incline to minimize core discomfort when getting in and out of bed for nighttime feedings.
It important to note that severe, persistent pain is never considered normal. If you feel severe abdominal, pelvic pain or postpartum cramps at home or in the hospital, it requires urgent attention.
Difficulty Breathing: When you aren’t in a hospital being monitored, this is the kind of thing you need to pay attention to. Anesthesia is known to hamper normal breathing which can often lead to the buildup of mucus in the lungs. This can sometimes cause a condition called atelectasis. While it is most common right after surgery, it is also known to develop after a person has returned home from the hospital. Seek help immediately if you start having trouble breathing.
The first month
What to expect
After about a week post-op, you and your baby will be settling in at home while you continue your recovery. While it’s important to continue gentle movement like walking from room to room in the house, going to the bathroom and lifting your baby, you must continue to take things easy for the first six weeks. Sometimes painkillers can mask the physical discomfort to the point that you overexert yourself, so remember to be gentle.
Remember, you have a wound the size of a paper plate inside your uterus where your placenta detached. Go slow and give yourself time to heal.
Your incision will continue to heal with the help of steri-strips, and you can continue to shower but do not submerge in water until your provider gives you the all clear.
Things to watch out for
Wound healing: Your incision should heal rapidly at this point, and should not show any signs of swelling, redness, bleeding or discharge.
Overall: You should be feeling MUCH better throughout month one than you did during the first week. Expect some abdominal pain if you are exerting yourself too much, and some on-and-off pain and cramping from the surgery. You should still move slowly and carefully, but if you are finding you are feeling extremely weak, fevered, shaky or your pain increases, see a doctor immediately.
The second month
What to expect
Congratulations, mama! If all is going well, you should be fully healed by around the 6-week mark. You will be moving faster and lifting more by week six, but don’t be afraid to still ask for help! C-section or not, you have a new baby. You will be consistently feeding your baby, perhaps pumping, getting very little sleep and may be trying to manage your other kids as well.
Most of your sutures will be absorbed and your internal wounds will be mostly or completely healed. You will also be free to resume having sex, although it’s perfectly normal to not feel ready (give yourself all the time that you need).
Things to watch out for
Sex: while it’s completely safe to have sex after about week 6, you may feel some pain or discomfort along the incision site, so adjust position accordingly. Lube, intimacy and foreplay are your friend. Remember, it’s supposed to feel good. 😉
Bleeding: You may resume your normal period very quickly. So, don’t be startled if you start to bleed after the first month or two! As long as bleeding is within the normal realm of your cycle, you don’t need to be alarmed. If you’re breastfeeding, your period might not resume until you stop. Side note: you CAN get pregnant very soon after birth, even while breastfeeding.
Opinions: This is perhaps the biggest thing to watch out for – and deflect – after your cesarean birth. Just like any other birth, people will seem very eager to give you their feedback on how you look, your weight, your recovery time and just about everything else. Don’t fall into the comparison trap, and lovingly set boundaries if you feel uncomfortable with the “feedback” you are getting.
If you follow these guidelines and the advice of your doctor, your cesarean recovery will take less time and be less painful. If you want to create a C-section experience that feels less scary and provides a more natural birth experience, you can learn more about a gentle cesarean and see if it’s right for you.
Emotional recovery
Up to this point, we’ve covered your physical recovery, but it’s important to take care of yourself emotionally as well.
Birth, especially surgical, can be heavy for some people. If that’s you, know that you’re not alone. Acknowledge your feelings, rather than stuff them down. Healthy mommy and baby are important, AND your feelings matter. Processing your birth while caring for a new baby and a new Mother is a lot, and you don’t have to do it alone. If possible, talk to a non judgmental friend, a postpartum doula, or a therapist that specializes in postpartum. And you can always find support in the Empowered Moms group on Facebook - a community full of kind, non judgmental and supportive moms.
(Gentle reminder: this post is not medical advice. Please consult with your provider for medical advice friends. Other possible complications for Mothers from C-sections: Extended hospital stay, Incision pain, Increased blood loss, Infection, Rehospitalization and/or admission to the ICU, Bowel, bladder or ureter injury, Hysterectomy, Blood clots, Anesthesia complications, or Death (although very rare).