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Recovering from a Cesarean Delivery

There are many similarities in recovering from a vaginal delivery and a Cesarean delivery. However, there are some distinct differences you should be aware of if you had a C-section.

In the Hospital
Immediately after your C-section, you are taken to a recovery room or recovery area for about an hour. Here you will be watched for any signs of problems, such as bleeding or pain. Your blood pressure and other vital signs, such as pulse and temperature, are checked frequently. At this same time, your baby may go to the nursery to be weighed and evaluated, but he is often returned to you while you are still in the recovery room. This is a good time to begin nursing your baby. When you leave recovery, you will go to a room where you will spend the remainder of your time in the hospital.

How long a woman stays in the hospital after a Cesarean delivery varies quite a bit. Most women stay for 2 to 4 days after delivery. Your insurance company or HMO has the greatest say about this, not you or your doctor. An average stay is 3 days after a C-section.

Dealing with Contractions, Pain and Bleeding
If the incision from your C-section gets red, oozes pus or yellow fluid, bleeds or becomes painful, call your doctor.

Cramping and contraction of your uterus are normal and desirable after a C-section. Contractions of the uterus help control and decrease bleeding after your delivery. With a C-section, there is pain from the surgery itself, but at least you won't have episiotomy pain.

Pain control after a Cesarean is accomplished in different ways. If you had an epidural or spinal anesthetic for the surgery, you may be able to have pain medicine injected through the epidural or spinal catheter; this is called Duramorph or epidural morphine. Medication usually offers pain relief for the first 24 hours and helps you avoid painful injections or pain pills for the first day after surgery.

Other choices for pain relief are those traditionally used following surgery, such as injections of pain medications (Demerol or morphine) through an I.V. or into a muscle during the first 24 hours after delivery until you are able to eat. Once you're able to eat, you may be offered oral pain medications, such as mild narcotics (Tylenol #3 or Lortab) or anti-inflammatory pain medications, such as ibuprofen.

It is normal to bleed vaginally after a Cesarean; this continues for several days up to a few weeks. It should decrease each day. The nurses will check to see it is not excessive and instruct you what to look for after you go home.

If you were in labor for a long time before delivery, you may be exhausted. Get some rest so you're ready for the challenges awaiting you at home. Don't be afraid to accept help or suggestions from the nurses or others at the hospital. There are specific areas the nurses can help you with and teach you about, such as nursing, caring for your baby and warning signs of problems when you go home. Meeting Visitors
Greeting visitors who come to see you in the hospital (actually they really come to see the baby!) can be most enjoyable. Set aside some quiet time for you and the baby, though; use the time to recover somewhat before you go home.

Dealing with Inconveniences
In most cases with a C-section, a catheter is placed in your bladder through the urethra (the small tube from the bladder to the outside) to keep the bladder empty and out of the way during surgery. The catheter is usually left in place for 12 to 24 hours after the surgery. This is something to talk to your doctor about if you are planning a C-section or after the surgery, if it is unplanned. Different doctors handle it in different ways.

Problems with gas or bowel movements are more common following a C-section than with a vaginal delivery, but there are things you can do to minimize them. Get up and walk around as soon as possible. You may need help with this at first. Drink plenty of liquids; this is more important than trying to eat solid foods in the first few days after delivery. Sitting in bed and taking pain medications, vitamins or iron can all cause changes or problems with your bowels.

The sooner you get moving, stop taking pain medications and start eating a more normal diet, the sooner your bowels will return to normal. Laxatives or stool softeners are available, if necessary. Although it may seem unpleasant, passing gas is a good sign that your bowels are working.

The doctor and nurses will check your C-section incision daily for infection or bleeding while you are in the hospital. If staples were used on the incision, they are usually removed before you leave the hospital on the second or third postoperative day. This may seem a little soon, but don't worry; the layers of tissue that really hold you together are deeper. Deeper sutures will dissolve on their own, but that takes weeks or even months. If sutures were used to close the skin over your abdomen, they may have to be removed or they may dissolve on their own. Most doctors place Steri-strips (like small pieces of tape) on the incision that stay on for 3 or 4 days. Before you leave the hospital, the nurses will show you how to take care of the incision and advise you of warning signs to watch for when you go home.

Going Home
When you go home from the hospital, you will be eating, drinking and walking. Your incision is likely to be sore, and you will still be bleeding vaginally. Most women need mild pain medication after they go home; you will be offered prescriptions before you leave the hospital. Sometimes pain or bleeding increases when you increase your activities. However, you should see an overall decrease in pain and bleeding every day.

Your doctor will recommend that you not drive if you are taking pain medicine or have other problems, such as anemia. You may not want to drive for a few weeks, if you are uncomfortable or have trouble getting in or out of your car. Resuming Activities
It's OK to increase your activity gradually, but try not to be in too big a hurry. Usually friends or family are more than happy to help out. Let them! Save your energy to take care of yourself and your baby. This includes stairs—plan ahead! If you're running up and down the stairs all day, chances are you will have more pain and tire more easily.

Certain activities may not be a good idea because of increased pain, or they may cause complications and slow down your recovery. During the first few weeks, don't lift anything heavier than your baby. Vacuuming probably isn't going to be harmful, but it may cause you discomfort because of the stretching or pulling.

Don't start exercising or resume sexual relations. Most doctors will want to see you in the office 10 to 14 days after your C-section to check your incision and see how you're doing. This visit is a good time to ask how soon you can safely resume activities and what level of exercise is appropriate for you.

From week 2 to week 6, you will notice gradual improvements in your energy every day. By 6 weeks, you can usually do anything you want. In the months to come you may not see big changes, but you will experience subtle improvements.

Taking Precautions
Most doctors suggest that you don't have sexual relations until after your 6-week postpartum visit. In most cases, you won't be ready for relations before this time because you're still bleeding, in pain or tired. Resuming relations too soon can be harmful because of possible infection or increased bleeding. This kind of activity may delay your recovery.

Wait to start exercising until after your doctor gives you the go-ahead. You can gradually increase your activity, but don't try anything strenuous or uncomfortable until your doctor approves of your exercise plans at the 6-week postpartum visit.

Your doctor will explain what warning signs to be alert for, such as pain, bleeding, fever or signs of infection. If you feel that something is not right, call your doctor's office—he or she expects this and has specific people to help you with problems. Good sources of information include the nurses in the birthing center or hospital where you delivered or the emergency room. Many areas have nurses available 24 hours a day who you can call for advice.

Getting Back on Your Feet
The rate of recovery from a Cesarean delivery is different for every woman. Usually you can return to your normal activities after your 6-week checkup, if you're not having problems. Be prepared to go slowly. A C-section is surgery that requires an abdominal incision. Besides the normal recovery from surgery, you have a full-time job (night and day) caring for your baby!

When you go home from the hospital, you'll be able to get in and out of bed on your own and you will be walking. Certain activities, such as bending or lifting, may be uncomfortable; take things slowly. Your recovery will be smoother if you take care of yourself, rest when necessary and increase activities gradually.

Taking Care of Baby
Most new parents feel overwhelmed and inadequate with their new responsibility. Be assured—you'll do great and learn as you go! There are many ways to get help—friends, family, your pediatrician's office and even people you meet in the hospital. Care of your baby after a C-section should be the same as the care required following a vaginal delivery. As the weeks pass, you will settle into a routine at home for feeding, sleeping and caring for your baby.