About 1 of every 3 newborns in the United States are delivered by cesarean section, or C-section. That’s when the baby comes out through a cut in the mother’s belly and uterus rather than going through the birth canal and coming out through the vagina.
Afterward, you can expect to spend 2-3 days in the hospital with your new little one as you recover.
After C-Section Surgery
Most women are awake for the C-section, and you should be able to hold your baby right away. You’ll be taken to a recovery room, where nurses will check your blood pressure, heartbeat, and breathing and keep an eye on you.
You may feel sick to your stomach, groggy, or itchy from the drugs used to numb you during the surgery. You may be given a pump so you can change the amount of pain medication that’s going through a thin tube into your veins.
In the days after surgery, you can expect:
- Vaginal discharge: You’ll likely have vaginal bleeding for several weeks after delivery. This is how your body gets rid of the extra tissue and blood in your uterus that kept your baby healthy during pregnancy. The first few days, you’ll see bright red blood that will gradually get lighter -- turning pink, then brown, to yellow or clear before it stops.
- Afterpains: It’s normal to have things that feel like menstrual cramps for a few days after delivery. They narrow the blood vessels in your uterus to help keep you from bleeding too much. Ask your doctor if you can take an over-the-counter pain medication.
- Breast swelling and soreness: The first 3-4 days after delivery, your breasts make something called colostrum, a nutrient-rich substance that helps boost your baby’s immune system. After that, your breasts will swell as they fill up with milk. You can help ease tenderness by nursing or pumping, and putting cold washcloths on your breasts between feedings. If you’re not breast-feeding, wear a firm, supportive bra. Don’t rub your breasts -- that will cause them to make more milk.
- Hair and skin changes: You may notice your hair thinning in the first 3-4 months. This is normal. It’s caused by changing hormone levels. (When you were pregnant, high levels of hormones made your hair grow faster and fall out less.) You may also see red or purple stretch marks on your belly and breasts. They won’t go away, but they will fade to silver or white.
- Feeling blue: After you bring your baby home, you may find yourself going through a roller coaster of emotions. You might feel worried, anxious, or very tired during the first few weeks of motherhood. Called the “baby blues,” this comes from hormone changes. If you feel this way beyond a couple of weeks, though, call your doctor. You may have postpartum depression or anxiety, a more serious condition that happens in about 15% of all new moms. Talk therapy or antidepressants can usually help.
C-Section Incision Care
Your doctor will send you home with detailed instructions -- for instance, how long to keep your cut bandaged, how often to change bandages.
Here are some tips for taking care of your C-section incision:
- If the cut is closed with stitches, staples or glue, you should be able to remove the bandage and take showers, but check with your doctor first. Letting the water run down over the wound should also help with cleaning.
- When you’re washing, use mild soap and water and clean it lightly (don’t scrub, particularly if your incision is closed with steristrips or glue). Pat dry.
- Don’t soak in a bath or hot tub or go swimming until your doctor says you can.
- Try over-the-counter pain relievers such as ibuprofen or acetaminophen to manage incision pain. Ask your doctor what they recommend.
- A heating pad set on low or a warm washcloth can help with pain around your belly.
- Keep an eye out for any signs of infection. Let your doctor know if:
- Your incision is red, swollen or hot to the touch.
- It’s leaking discharge
- You develop a fever.
- Your pain is getting worse not better.
- You are having heavy bleeding
Tips for Healing After a C-Section
The area around the stitches, staples, or tape on your belly will be sore for the first few days. Keep it clean to prevent infections. You can do a few other things to speed your recovery:
- Take it easy. A C-section is a major surgery. Don’t lift anything heavier than your baby for the first couple of weeks, and keep everything you might need within reach.
- Support your stomach. Hold your belly when you sneeze, cough, or laugh to keep it still.
- Ease your pain. A heating pad (set on low) or a warm washcloth can help with pain around your belly. You may also need acetaminophen, ibuprofen (Advil, Motrin), or other pain relievers. Most are safe to take if you’re breastfeeding.
- Drink fluids. You’ll need to replace the water you lost during delivery as well as what you lose if you nurse your baby.
Eat fiber-rich foods and smaller, more frequent meals. Try a fiber supplement if you are having constipation.
Breastfeeding After a C-Section
You can start nursing almost right away. Your body will make milk about as quickly as after a vaginal delivery. Here’s what you need to know:
Medications: You probably got pain-numbing medicine, such as an epidural, during your C-section, but it isn’t likely to affect the baby much. Your baby may be sleepy, but that should pass and they should be eager to nurse. You may be tempted to ask your doctor to cut back on your pain medicine, but it’s important that you stay comfortable. Pain can mess with the hormone that helps you make milk. If you have any questions about how the drugs you’re given can affect breastfeeding, ask to speak to the hospital’s breastfeeding specialist.
Nursing positions: The site of the surgery may make it hard to find a comfortable position to nurse your baby. You can put a pillow over your stomach to ease the baby’s weight, or try these:
- Football hold. Cradle your baby’s neck in your palm, and rest their back on your forearm. Tuck the feet and legs under your arm and then lift your baby to your breast.
- Side-lying hold. Lie down facing your baby, and use your hand to bring your nipple to their lips. You can place a pillow behind their back to keep them from rolling.
Returning to Physical Activities After a C-Section
You can try gentle exercises a few days after the C-section:
- Deep breathing: Take 2 or 3 slow, deep breaths every half-hour. This can help prevent lung congestion from sitting in bed so much.
- Shoulder circles: Sit upright and roll your shoulders 20 times in both directions every hour to help with stiffness.
- Gentle stretching: Stand against a wall and raise both arms slowly above your head until you feel the muscles in your belly stretch. Hold for 5 seconds, and then relax. You can do this up to 10 times a day to boost flexibility around your stitches.
Try not to do too much housework or other activities for the first couple of weeks. Check with your doctor before returning to any of these activities, but in general you will have to wait:
- 4-6 weeks before doing heavy exercises that involve your belly or lifting anything larger than your infant
- 2 weeks before you can drive a car
- 3 weeks (once you have a healed incision) to take a bath or go swimming
Get your doctor’s OK before having sex again.
When to Call a Doctor
Once you get home, check the site of your surgery regularly for signs of infection. Here are some things you would need to let your doctor know:
- Your incision is red, swollen, hot to the touch, or leaking discharge
- You have a fever higher than 100.4 F.
- You have a lot of vaginal bleeding, it smells bad or has unusually large clots.
- Your pain is getting worse, not better.
- You have swelling, bumps, pain or heat in your calves (which can be signs of a blood clot)
- You have pain, redness or warmth, which are signs of infection
- You get a very bad headache that does not go away.
- You notice swelling in your hands, arms, or feet.
- You notice vision changes or have difficulty seeing.
- You have a cough, shortness or breath or pain in your chest, which could be a sign of a blood clot.