How to recover from a Caesarean (C) section?

Dear Dr. Mo: How to recover from a Cesarean section?

Dear reader: It is important to know that, after any surgery, the recovery is done in stages, it is gradual and it takes some time and effort but in the end, all was worth it.

After an intensive care unit (ICU) in which you are taken immediately after surgery to wear off the anesthetic and to wake up (length of time spent there varies, depending on the type of anesthesia, its intended duration and complexity of your surgery) while being closely monitored for vital signs and for uterus firmness and possible bleeding from the uterus (it should contract down – this could be painful), you are moved to your room – usually after a couple of hours. In it you spend the rest of the hospital recovery and there you usually have your first contact with the baby.

Move

Recovery may be painful but it will happen

The best word of advice I can give to anyone recovering from a Caesarian section (C section) is to begin to move as soon as possible. This movement you can start while still in ICU with breathing – as simple as it may sound, it is not – taking deep breaths could be difficult and this little exercise should be undertaken as early on as possible and as frequently as possible.

Once in your room, you may still be hooked up to some equipment like the I.V. drip, blood pressure monitor, you may still have your catheter inserted although it is removed early in the recovery process.
Your intestines need to start working again and until that happens, the I.V. line will likely remain. You will know when they re-start – you will hear and feel the sounds of deep rumble and should start passing gas (this may cause some pain as the gas build up stretches the intestines). All this is good development and albeit somewhat painful, it is an important event and most of us are relieved when it occurs.
Avoid cold, hot and carbonated drinks as they could worsen the gas issue.

As I said, movement is the best piece of advice. Once out of the ICU, a major thing is your first walk. It could be scary but it has to happen as soon as possible. There are a couple of things you can do to make it easier:

Take a pillow and support your incision with it – hold a pillow over it. This will buffer the feeling of your gut falling out – don’t worry; they won’t because several layers of stitching are holding them in place.

Do not attempt your first steps alone – have someone there to help you, you need it.

I know you will want this, but do not look down – look ahead – into a wall, another bed, a chair, an imaginary friend, whatever.

Try not to bend or lean forward (resist this strong tendency) but rather stay straighten up.

Even a couple of steps matter a great deal, so do this as frequently as you can.

Walking after surgery is important to prevent a condition known as Deep Vein Thrombosis (DVT) – if you cannot walk, speak to your doctor about ways to prevent DVT; there are compression bandages and similar things to assist you.

Pain

Another thing is pain management and here I can only say that once the anesthesia wears off you may wish to speak to your doctor about possibilities because there are some medications to manage this pain but these will get to your milk and it is important to discuss it with your doctor. If you had an Epidural, this may be painful as well and some local anesthetics can help but all this has to be done in consultation with your doctor.

Incision

Now, there is this other part of the whole C-section business to deal with and that’s of course, your section or the incision.

I know that some would disagree but I advise you to look at it – even if it doesn’t feel good in the beginning – look at it. Depending on the situation there may be a drain or two coming out of it to remove excess fluid that’s being produced in the wound and naturally, the incision and some surrounding area will not look pretty, it will be bruised, red, irritated, swollen etc. This is all normal but it is important that you know your incision well to detect any changes (especially for the worse) and to be able to inform your doctor as soon as you detect something. The incision may become infected or very rarely it may even begin to open up so you need to be aware of it and report it immediately.
The stiches on the incision will either dissolve or fall out on their own or will be removed by your doctor.

Women report a feeling of numbness and/or itching and that is something that should go away within a few weeks; even if it doesn’t go away entirely, it is not an indicator of anything wrong so don’t worry.

If your baby is healthy you may begin breastfeeding as soon as you get the milk flowing, which is usually almost immediately, but it may take a day or two to get it fully going. Lying on your side is probably the most comfortable way to do this as it avoids your incision.

Lastly, do not feel negative about your Cesarean. The incision will heal, the pain will subside and eventually go away and the scar will become pale and hardly visible. What’s important is that you focus on your baby and try to heal quickly both physically and emotionally to be fit and ready to enjoy your new family.

To end with an important piece of advice: Rest! Sleep whenever possible and think of restricting visitors until you feel fully recovered.

Coping with the aftermath of C-section is as challenging as everything that follows it but motivate yourself with what it brought – a new life – and that’s the most valuable thing there is.

Yours in health,

Dr. Mo