- May 4, 2023
Everything You Want (And Didn’t Know You Need) to Know About C-Section Recovery
- Postpartum Recovery
- April 19, 2021
Whether your C-section is planned or unexpected, whether it is something that made you feel disappointed or relieved, recovery after C-section is a process full of both emotional and physical challenges. Not only that, but Caesarean section recovery is different for everybody, meaning that you can’t entirely anticipate what you’ll experience until you go through it yourself. So if you’re nervous about healing after C-section, know that there’s nothing to be embarrassed or ashamed about.
To help ease your mind, we’re offering a concrete, practical guide full of C-section recovery tips and detailed information, including a timeline of what you can expect at every stage of Caesarean recovery. From what it’s like to go to the bathroom for the first time after your procedure to tips on how to care for your scar, we’re here to help.
Your C-section Incision and Scar
Before we look into the C-section timeline, let’s start with the practicalities of the incision and scar. They were on our minds a lot as we planned this guide, and you have probably thought about them both quite a bit since, in addition with baby, the scar will stay with you for the rest of your life. And the incision marks abdominal surgery which is an invasive operation and takes time to recover from.
Remember that while you are preparing for birth of any manner, there are options. Your go-to question when speaking with your health professionals should be “What are my options?”. Learn as you go, so you’ll be prepared and knowledgeable come what may.
The incision on your abdomen is usually 10-15 cm long, and there are two possible ways to cut:
A horizontal, low-transverse incision in your lower abdomen (“bikini cut”) is used in 95 percent of modern C-sections due to minimised location bleeding and better hold during future vaginal births. A vertical cut from between your navel to your pubic hair line (classic cut), is less common today. It is utilised if you or baby are in severe distress or you have a scar from previous surgery. Baby’s low position in-utero, or another unusual position may also require a vertical cut. This classic cut may be slightly more painful and take longer to heal as, despite it being the faster cut, it requires incision through the thicker parts of your uterus.
These incisions are made vertically through the abdominal muscle, the peritoneum (the fascial membrane which wraps around the internal organs) where some women may feel a slight pinching feeling, the uterus (bladder is moved down), and finally, the amniotic sac, where baby is reached.
As far as closing your C-section incision, your uterus is always closed with dissolvable stitches. The cut on your skin may be closed with one of three ways:
- surgical staples (which are fast and simple),
- non-dissolvable stitches (which take longer), or
- surgical glue (which gradually peels off as the wound heals).
With stitches and staples you have to go to the doctor’s office to have them removed about a week after your surgery. If you prefer one closure method over others, try and make that known to your doctor ahead of time.
Your C-section scar will most likely heal fine. However, some people are more susceptible to building overgrown scar tissue around the incision site. Generally younger (under 30), darker skinned women may find their scars looking strange. There are two ways the body ‘overheals’ a scar:
- A keloid scar occurs when scar tissue extends out from the wound, creating lumps of scar tissue that may be hanging or raising up firmly from the original incision line. Keloids often look like additional growths.
- A hypertrophic scar is thicker, firmer and usually more raised than normal scar. Unlike a keloid, it stays within the borders of the original.
There are many things you can do to promote your C-section scar to heal. We cover scar care more comprehensively under Physical Recovery, so keep reading!
Week-by-Week C-Section Recovery at a Glance
Now that we’ve covered the scary and lasting bits of C-section surgery, let’s get on with what your Caesarean journey may look like. Remember, that it is an individual journey that looks slightly different for everyone, but to prepare you we’ve timelined things you can expect at certain times prior and following your Caesarean. When you’re in it, recovering from as intense a procedure as a Caesarean can feel like it’s taking forever, but most women are cleared to go back to their normal daily activities after 6 to 8 weeks. So what exactly happens during this journey? Here is what you can expect at every stage, as well as tips you can use along the way.
Before Your C-Section
Preparing for operation can be incredibly helpful, but unfortunately, not everybody gets to choose a C-section. That being said, if you do have a C-section birth plan, you can start the process of healing early by knowing what to prepare ahead of time in order to help you with your recovery. And if your birth plan looks different, read on anyway because we fully believe you are able to take on anything – but you shouldn’t have to go into birth blindly. Sometimes things can go wrong and preparing for that while hoping for the best is the best advise we can give you.
The first thing we recommend is educating yourself as much as you can about the C-section process. Knowledge is power and knowing what to expect will make you feel more comfortable as well as give you the opportunity to advocate for yourself.
Perhaps you might choose to participate in our Pregnancy, Birth & Beyond series, an online education series that aims to prepare you for every facet of your pregnancy journey. Or, if you have questions specifically about C-sections or your personal situation, you’re invited to use Ask our Expert, our free of charge consultancy service where you’ll receive evidence-based information from experienced maternal health experts.
It’s also a great idea to prepare yourself mentally and emotionally for your procedure. First, having realistic expectations is important in avoiding future disappointment or confusion. You may even want to visualize the day of your Caesarean, so you feel mentally prepared for it. Additionally, practising mindfulness techniques and deep breathing can help you keep calm when you go into the hospital. You might even want to choose a mantra that you can use while you are there to calm your mind and reduce stress hormones.
Finally, there are also more concrete steps you can take to prepare for your operation. For example, it can help to plan who you will want to be with you in the hospital and your operation room. Maybe you know your sister is fantastic at keeping you calm. Maybe your parents are great at speaking to doctors and can help you advocate for yourself in the hospital. Thinking of this ahead of time may end up being a big comfort to you during the day of your C-section.
Packing Your Hospital Bag
Bringing something to entertain you, comfortable cotton or disposal pants, a dressing gown, a nightdress, slippers, and loose clothing that won’t put pressure on your wound can make your recovery process in the hospital much more comfortable. Some women also pack cranberry juice which might reduce the likelihood of post-catheter urinary tract infection (UTI) and chewing gum or molasses to hasten the notoriously difficult first bowel movements after delivery.
The Delivery Day
Once your elective C-section day arrives, the first thing that happens is most likely paperwork. Following anaesthesia. If you already have epidural in place, your dosage is increased by the anaesthesiologist. Another option for anaesthesia would be intrathecal or spinal anaesthesia. We’re sorry to say, but both involve an injection into your back. Both also numb you from the ribcage down.
Next you are most likely given something to drink to neutralise your stomach acids, and then it’s time to move to the operation theatre, where your partner can scrub and suit up accordingly. A curtain will be placed over your stomach, and you will observe noises and quite a bit of activity. You can prep for this by asking who are going to be present in your delivery and have comments and questions as you go.
Planned or emergency, immediately after your C-section, you can expect to spend a few hours in a post-op room under observation, with staff monitoring your bleeding, blood pressure, and temperature. Like with most abdominal surgeries, you’ll have an IV for fluids and a catheter to collect your urine. Physically, you may feel a bit woozy from your painkillers, and you’ll still have numbness in your lower-body.
If it’s important to you to hold your baby, do skin-to-skin, or breastfeed at this point, you should be able to do so unless you’ve experienced some kind of complications. Don’t hesitate to request to do these things: it’s your right. Skin-to-skin will also release lots of happy-making endorphins in you, which can comfort you and boost your mood in a time that could be emotionally challenging.
Read more: Baby Bonding: Benefits of skin-to-skin contact
One Day After Birth
Once you’re released from the post-op area, you’ll be taken in a wheelchair to the postpartum recovery unit. You’ll have to wait a while before you can eat solid food, but you’ll be offered ice chips and a liquid diet in the meantime. This is standard after abdominal surgery in order to prevent intestinal blockage and allow your digestion to get back on track.
A nurse will massage your uterus to encourage it to shrink back into its normal size. This may be uncomfortable. Ideally, you’ll start to get out of bed and moving on the day of your C-section, as physical activity can help speed up your recovery. Walking will help ease gas pains, help you have a bowel movement, prevent blood clots, and start retraining your abdominal muscles to support your body.
Approximately 18 hours after your delivery, your pain meds will start to wear off, so your pain levels might spike then. You’ll continue to receive different types of pain meds (oral narcotics or IV pain meds) as long as you’re in hospital, but by the time you leave the hospital, you should be able to get by with non-prescription pain meds like ibuprofen. If you’re worried about managing your pain, you can speak to your doctor about being prescribed pain medication.
You’ll have your catheter removed the day after your surgery, allowing you to walk more and shower, which decreases your risk of infection. You’ll have to wear a pad for a type of discharge called lochia (aka leftover blood, mucus, and uterine tissue) that will continue for a few weeks post-op.
Having your first bowel movement after your C-section is a big deal, and most hospitals will not release you without first seeing that you can poo without prolapsing. A combination of pain meds, hormonal shifts, and major abdominal surgery can cause constipation, so to help move things along, you can take a stool softener. When the time comes for your first postnatal poop, it might be uncomfortable and painful, even making you feel like your incision is going to split open. Don’t worry, it won’t. Putting some gentle pressure on it can help you feel more secure.
Before you leave, your doctor may remove your incision staples if you have any and cover your scar with a sterile bandage, or you may have to attend an appointment in a few days to get them removed, depending on your situation and where you are. You’ll get advice about caring for your incision and instructions about what you can and can’t do in the weeks before your 6-week check-up. Depending on your situation, you’ll be released from the hospital after two to four days.
When You Get Home from the Hospital
Immediately upon getting home from the hospital and for the first few weeks, it’s ideal to plan to take things as easy as possible to give yourself the opportunity to rest and heal. Be prepared for this part of things to be a bit difficult. Not only will you have to avoid a lot of activities and be experiencing pain and discomfort, but you’ll also be adjusting to a baby.
Be gentle with yourself. The challenges are part of the journey, and it’s totally normal to have a hard time adjusting. It’s okay if you get a bit behind on chores like cleaning as you heal and get used to a new routine.
Recovery can be a long process, and you are going to need every help you can get. It might be a good idea to hire a babysitter to help with taking care of your baby or older kids in the family. A babysitting service like the Finnish Babysits may help you quickly connect with an experienced and trustworthy babysitter in your local area.
One to Two Weeks Postpartum
One to two weeks after your delivery, you’ll have a postpartum check-up, during which your doctor will examine your incision and give you advice. This is the time to ask any questions you may have about concerns and recommendations for how to proceed.
You’ll still have some C-section recovery pain and cramping as your uterus continues to contract to its normal size, but the good news is that you’ll most likely be feeling much better by this point. Using a heating pad or a hot-water bottle on your belly might ease your discomfort, and it’s totally normal to still be taking painkillers at this stage if you need them.
Four Weeks Postpartum
A month after your C-section, you can expect to be able to be more comfortable moving and walking around. Your bleeding should start to subside, and you’ll be feeling like yourself again. That being said, it’s still as important as ever to take your cues from your own body (as opposed to your expectations of recovery or comparisons with other people’s journeys). Listen to your body and rest as much as you need to. This is also a good time to check in with yourself and your mental health. How are you feeling? Are you getting enough support? Answering these questions can help guide you in asking for support when it’s necessary.
Six to Eight Weeks Postpartum
When you go to see your doctor for your six-week appointment, chances are good you’ll be healed! Your uterus will have gotten back to its normal size, you shouldn’t experience much pain, and you’ll be able to resume your normal activities (provided that your doctor gives you the all-clear).
Congratulations! You’ve done it!
If you don't think you are quite there yet, talk to your doctor about it. Maybe you could benefit from physiotherapy or someone to talk to. And if you experience pain, don't let anyone tell you that continuing pain is normal. Yes, it might take longer for you to fully recover, but there are many things professionals can help you with if you experience pain and continuing discomfort!
Now that you have a good sense of what you can expect from your C-section recovery journey, let’s talk about the nitty-gritty of what your healing will entail. We’ll go through the physical side of things, and touch on the mental healing process as well.
Firstly, it’s a good thing to remember that any delivery, C-section included, will have very real side effects. You may experience cramping, nausea, weakness, and fatigue. It may be uncomfortable to cough, sneeze or even laugh. Your body will feel tender, and it may take some time to get your bearings. Which is why it’s good to know these things before the nausea hits.
While you’ll slowly be able to do more and more walking, it’s important to refrain from heavier physical activity for the entire six-week period, until your doctor clears you to go back to it. Lift nothing heavier than baby and do avoid anything creating abdominal pressure. Avoiding sex and tampons immediately after delivery will lower your risk of vaginal infection, so that is something you might want to consider, especially if you are an avid tampon user – pads for the time being only! And sex… Well, it’s usually the last thing on a new parent’s mind. Don’t be concerned if sex and intimacy look different after you give birth; it’s completely normal.
It’s important to sleep as much as possible, as rest helps your body to recover. Try to sleep whenever your baby does - you both need the rest.
Caring for Your Incision
Speaking of your incision, let’s talk about those tips and tricks for healing we promised earlier. C-section scar care is one of the most important parts of your Caesarean recovery process because getting an infection there is an incredibly unpleasant complication you just don’t want to deal with. Thankfully, it’s not too complicated to take care of your incision; you just have to be mindful about it.
First and foremost, you should follow your doctor’s instructions for C-section scar recovery. They know your case best and are the best resource for specific information on what you should do. That being said, generally speaking, C-section incision care requires you to:
- Keep it clean: there’s no need to cover the area in shower but you’ll want to avoid scrubbing. Instead, just let soapy water glide over the incision site.
- Keep it dry: carefully pat your belly dry instead of vigorously rubbing with your towel. Note that you definitely should avoid a bath tub, hot tub, or a swimming pool.
- Air it out: Air promotes healing of skin injuries like a C-section incision. While walking around naked ma or may not sound enjoyable to you, wearing loose enough clothing that does not rub or press on your wound will suffice.
- Keep your appointments: remember to get your stitches or staples removed. Make also sure that you attend your doctor’s (or nurses or midwives’) appointments at the right frequency; your medical facility will be able to help you time these correctly as the appointment times and frequency after C-section may differ from vaginal birth.
- Hold off on exercise. This is not the time to start lifting weights or training for a marathon. Avoid bending or twisting your body or making sudden movements as much as possible, and don’t pick up anything heavier than your baby.
- Get moving. Movement reduces your likelihood of developing blood clots, so pop baby in a pram and get walking as soon as you can!
You can also massage your scar to break up scar tissue. Incision site massage can prevent excessive scarring and make the scar appear less noticeable (but not invisible!). Get the go ahead from your doctor before attempting to start scar massage as you may accidentally introduce bacteria or damage the healing tissue.
Initially, the scar may be really tender, red, and painful. In this stage, it may be best to leave it be for a few more days, or work around the scar, moving the tissues above and below. Talk with you medical professional about how to massage your belly. However, there are a lot of great YouTube videos on C-section incision massage, but as a rule of thumb you’ll want to gently, with a few fingers, see if the scar and deeper tissues are pulling more in some direction and start working on moving the scar and later on the tissues with your fingertips towards the opposite side.
Other options to minimise scarring include silicone sheeting and silicone gels and creams. We don’t know why silicone works so well; it just does! Consult with your doctor before trying topical scar treatments, especially if your section happened recently.
And remember to cover the site from sun for the first year and limit the light exposure. Sunscreen is good, but shade is better!
There are different treatment options if your scar has developed keloids, or you don’t like how it healed. Non-surgical methods such as laser therapy or steroid injections may be something you might want to look into. Surgical options cover scar revision and even tummy tuck – but keep in mind that these should not be considered too early as it can take up to 12 months or even longer for the scar to settle fully.
The look of a C-section incision can tell you a lot about what’s going on inside the wound. Watch for signs of infection, including:
- Swelling or redness of the incision site
- Intense abdominal pain
- Oozing from the incision site
- Incision pain that doesn’t go away or gets worse
- Body chills
- Fever higher than 38º
- Painful urination
- Foul-smelling vaginal discharge
- Bleeding that contains large clots
- Leg pain or swelling
If you have any symptoms of infection, contact your doctor immediately!!!
If you’re suffering from C-section incision pain, and you are cleared from any infection, there are a few things that can help provide you relief:
- Taking painkillers like ibuprofen
- Putting gentle pressure on your incision when doing activities that can exacerbate your pain, such as coughing, laughing, or sneezing, in order to support it
- Putting a warm washcloth or heating pad on your belly
- Supporting your abdomen by holding your belly or wearing a support band
Exercises to Do After a C-Section
While you can’t go back to a normal workout routine for six weeks after delivery, doing C-section recovery exercise can help make you feel better. Gentle walking and stretching, deep breathing, and shoulder circles are all good options. With the risk of sounding a bit woolly, consider doing mental exercises where you visualise how you want your healing to look like. Many mums have found this beneficial, as well as people recovering from other surgeries and trauma. Anything more intense than that can wait.
Though you can’t be doing any ab workouts just yet, you can help speed up your recovery after birth and reduce complications by using a support band like our Core Restore Postpartum Support Band, which helps support your incision and abdominal muscles. It will also help you to recover your core strength too.
Nutrition for Faster C-Section Recovery
One way you can encourage your body to heal faster is by eating a healthy diet, which will then carry on to providing your baby with the best nutrition through your breastmilk. What you eat also has a huge impact on how your bowel movement picks up again following your fast prior to a planned C-section.
If you have experienced any sort of infection relating to your Caesarean, your bowel may have suffered from significant paralysis. It’s important for your health and wellbeing to introduce solid foods slowly. Liquid foods following a C-section can really help get your bowel moving again. We recommend for example mushy plums or plum sauce, the kind meant for babies you can buy at your local grocers. Other baby food is good too, but plums are high in fibre and encourage your body to regain its’ normal operations. Once your bowel movements are normalised, feel free to start munching the solids!
Following the immediate recovery period, once your bowel has regulated itself, the ideal post-operation diet includes:
- Fibre: Foods high in fibre and plenty of fluids can help relieve constipation.
- Protein: The building blocks of our body tissues, protein helps you heal.
- Vitamins: A diet rich in vitamins helps repair tissues, skin, and ligaments.
- Iron: Because the body can lose a lot of blood during surgery, iron-rich foods are important.
- Fluids: Drinking a lot of water will aid with digestion and producing enough breast milk.
An ideal day of eating will include lots of fruits and vegetables for their fibre and vitamins, healthy, lean sources of proteins such as lentils and eggs, and whole grains, which can offer iron and fibre.
Of course, the process of recovering from delivery, surgery, and the thing that combines them both – a C-section – is not just physical. There is a major mental aspect to it, too, as your emotions are sure to be affected by the experience, as well. In fact, it’s a shame that so much emphasis goes onto physical recovery, with mental health often going overlooked. It is equally important to take care of yourself mentally post-Caesarean as it is to do anything else mentioned above.
Psychologically, it can be incredibly challenging adjusting to motherhood, regardless of how you delivered. And, unfortunately, C-section mothers can often feel blindsided by an unexpected change in their birth plan if they had an emergency Caesarean, or lesser-than, like their body failed them or they are not a “real mother” because they did not deliver vaginally.
You may even experience postpartum depression, something that is relatively common in all new mums - Caesarean or vaginal birth aside. Between 10 to 15 per cent of mothers’ experience postpartum depression and it isn’t yet entirely understood why, although it’s thought that the immense chemical, social, and psychological changes a new mother undergoes are a factor.
All of this is normal. Feeling self-doubt as a mum is common. But know that your body went through an incredible process of growing and birthing another human being: You are a superhero. Whether the birth happened through a C-section or vaginally is of little consequence - one type of birth does not have any more inherent value than the other.
And while emotional whirlwind is commonplace, many mothers would benefit from having someone to talk to, and you shouldn’t hesitate to reach out to support resources just because it’s normal to feel stressed, sad, or overwhelmed.
If you’re struggling with continuing baby blues, postpartum depression, or feelings of self-doubt, we highly encourage you to reach out for support. From speaking to your friends and family to inquiring about help from your medical team to reaching out to a therapist to participating in postpartum mum’s groups both online and in-person, there are people who want to help you - and there is no shame in seeking that help.
Breastfeeding After a C-Section
Many new mums have concerns about breastfeeding after C-section and, unfortunately, there is a lot of misinformation out there about the topic. The reality is that breastfeeding after Caesarean is not so different from breastfeeding after vaginal birth. You should be able to do it immediately after your delivery, even while in your post-op recovery room. While Caesareans can delay breast milk production by a couple of days, your milk will come in eventually, and you can encourage its production by breastfeeding or pumping regularly, breastfeeding on demand, and doing skin-to-skin with your baby.
If you do know that you want to breastfeed after your Caesarean, it’s important to make that wish known to your medical staff. You can also plan to have a lactation consultant, a doula, or another knowledgeable person with you in the hospital to help you get started with breastfeeding, even complications prevent it from being an option immediately after birth.
Read more: Breastfeeding after C-section
Getting Pregnant After a C-Section
Another concern that new mums often have about Caesarean recovery is surrounding the issue of a 2nd pregnancy after C-section. You may be wondering how you can deliver your second baby after C-section, whether it will hurt your scar, and so on.
Generally speaking, it’s recommended to wait at least a year before a second pregnancy after Caesarean in order to give your body (and your scar) time to fully recover. There is a higher risk of uterine rupture when you deliver vaginally after a C-section birth, although it is rare. The decision about whether to have a vaginal birth after caesarean (VBAC) or an elective repeat caesarean section (ERCS) is personal, based on several factors including your pregnancy history, your health history, and your 2nd child pregnancy after Caesarean. For the most accurate personal information, your maternal health care team is your best resource.
That’s pretty much it. Or, really not at all. Like we said in the beginning, your C-section journey may look something like we’ve outlined here, or it may be different. Whichever the case, we’ve compiled many key bits to prepping and recovering from C-section, almost all the way to fully regaining your strength. See, that’s the bit that takes time. Concentrate on recovering and getting to know your baby. Your new normal will settle, and you got this!
FAQ’s based on What to Expect
Is it normal for the incision to itch?
Itching is common in all wound recovery, C-section included. The nerves of the area have been affected, and we’re afraid the only way is to deal with it. Do not scratch! If it gets unbearable, you can apply cold pressure on the area or consult with your pharmacist about a sunburn cream that might take the edge off.
Is it normal for the incision site to smell?
Your incision site should not smell, especially if you are keeping it clean, dry, and aired. Talk with your doctor as this could be a sign of infection.
Is it normal for the incision site to feel numb?
Many C-section mums report feeling numbness or tingling sensation on the incision area, so this is normal. If it worries you, definitely bring it up at your doctor’s appointment.
by Lola&Lykke Team
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