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Your C-Section: A 5-Step Recovery Guide

Have you just found out you’re going to have a C-section—or maybe you’ve just had one—and you’re wondering what your recovery will be like? While there’s no such thing as a typical C-section, or a typical C-section patient, there are a few points that many have in common. Here’s a look at what you may be feeling in the hours, days, weeks, and months after a Cesarean birth.

Post-Op: Moments after Surgery

Once your baby is born, you’ll be moved to a post-op recovery room where you’ll be closely monitored, usually for the next one to three hours.

A lot of what you’ll experience is based on the type of anesthesia you had, says Khalil Tabsh, MD, professor of obstetrics and gynecology at UCLA School of Medicine and chief of obstetrics at UCLA Medical Center. Women who’ve had general anesthesia will feel more groggy and sleepy than women who’ve had a spinal or epidural for pain relief, notes Dr. Tabsh. Pain and nausea are also more common in women who’ve had general anesthesia.

If you’ve had a spinal or epidural, you may be experiencing “the shakes.” According to Jennifer Hamm, MD, an obstetrician/gynecologist at Florida Hospital in Orlando, Florida, this uncontrollable shivering is harmless and is caused by a combination of the birth process and the medications you received in your spinal or epidural. If you received morphine through your spinal or epidural towards the end of surgery, you may also have an all-over itchy feeling—a common side effect. There are medicines which will help control the itching, should it become unbearable.

Recovery Room: The First Hours

If all is going well, you’ll be moved to your postpartum room. At this point, you may be feeling a bit overwhelmed by everything that has happened, especially if your C-section wasn’t planned. “It kind of takes you by surprise,” says Maureen Connolly, co-author of The Essential C-Section Guide.

Dr. Hamm notes that it’s important for new C-section moms to be reassured that they did everything they could for their babies, and that they didn’t do anything to cause the C-section. If you’re feeling sad, ask for the extra support you need.

You’ll still be closely monitored by nurses. Throughout your first day after delivery, you can expect checks of your vital signs, your incision, and your vaginal discharge. Your nurse will check the amount of urine you’re passing and will use a stethoscope to listen for bowel sounds. If you went through labor in addition to your Cesarean, she’ll need to examine your perineum for tears and bleeding. Your nurse will also assess your pain and help with pain management.

Your IV and a catheter will still be in place; however, according to Dr. Tabsh, many patients are encouraged to be out of bed within six hours of surgery. “The more patients ambulate, the faster they recover,” says Dr. Tabsh. “So move. Get out of bed as soon as possible.”

“I was up the afternoon after my surgery,” says Krissi Brakefield, who had a C-section for the birth of her second child and admits that getting out of bed the first time took some bravery. “I was thinking, ‘Oh my gosh, it feels like my guts are going to fall out!'” But Brakefield, of Dallas, Texas, notes that slow deliberate movement helped her recover more quickly.

What about breastfeeding? If you had a Cesarean due to a complicated pregnancy or delivery, or if you or your newborn are ill, it may take longer to begin nursing, says Dr. Hamm. But if you and baby are both feeling well, you may have started nursing in the recovery room. Expect to need help with breastfeeding, especially at first. Your hospital’s lactation nurse can help you find nursing positions—such as the football hold—that don’t put pressure on your tender abdomen.

On Your Feet: Day Two

You’ll probably be free of the catheter on your second day after delivery. And if you (and your bowels) are feeling well enough, you’ll begin eating and drinking again. “There are different schools of thought on this,” says Dr. Tabsh. “Usually patients can begin eating within 24 hours if they are passing gas.” Don’t expect big, heavy dinners from the hospital staff. You may start out with a “liquid” diet—with foods such as broth and gelatin—as your body recovers.

It’s best to start slowly, says Laura Muller. Muller, of Anchorage, Alaska, was feeling so good after her second C-section that she had the diet soda she’d been craving for months. “Bad move!” says Muller. “Carbonated beverages before the bowels start moving? Bad, bad, bad.” Muller was already troubled by gas pains, and her fizzy drink “propelled the pain into the stratosphere!”

Around this time, your nurse may also help you take those first post-op steps and will encourage you to stroll the halls to gain strength. (These first steps should only be done with a nurse present; and for the days following surgery, be sure to have a walking companion with you anytime you get out of bed.)

About this time, you may catch the first glimpse of your incision. Chances are, you’ll be surprised. “[I thought], where are the stitches?”, says Robin Folette of Talmadge, Maine. Folette notes that her incision was neat and tidy, and the stitches were internal. “I had no idea you could pull an eight-and-a-half pound baby out of a six-inch incision.”

It’s important to look at your incision so that you can recognize any changes that may indicate infection or other problems, says Dr. Hamm. Most women will have side-to-side incisions, known as Pfannenstiel incisions. Your incision will probably be between four and six inches long and may have staples or stitches, depending on your physician’s preference, and there may be some bruising and redness around it.

Pain control may be switched to oral medicine around this time. Everyone from professionals to patients has the same advice about pain meds: take them! It’s important to stay ahead of your pain, says Dr. Hamm. If you wait until one dose has completely worn off, it may take longer for the next dose to become effective.

Homeward Bound: Three to Five Days after Delivery

You’ll be going home from the hospital. “The first week or two you’re home, don’t push yourself,” says Connolly. “This is your time to be pampered.” In addition to coping with the aggravations all new moms face (such as constipation, night sweats, and mood swings), you’re recovering from major surgery. If you have visitors, put them to work running errands and doing household tasks so you can rest and get to know your baby.

You can also ease your recovery by continuing to be gently active and remembering not to lift anything heavier than your newborn, says Dr. Hamm.

Having a pillow on hand can help tremendously during these days after surgery. Press it gently against your belly to help soften pain when walking or sneezing, and tuck it behind your back to help you feel more comfortable when sitting. If you’re just not feeling well physically, don’t get discouraged, says Connolly. “With each day that goes by in the first two weeks, you typically feel a little better.”

Your Postpartum Checkup: Six to Eight Weeks Later

You’ll have your final postpartum checkup, and your doctor will release you for normal activities such as exercise and sexual relations. “[Most patients] are doing very well,” says Dr. Hamm. “You may feel some pulling around your incision. You’ll also probably have some numbness, as the superficial nerves have been cut, and if they are starting to grow back, you may be feeling some burning.”

Connolly notes that for many women, there is an emotional recovery in addition to the physical recovery. “It’s OK to grieve,” adds Connolly. “A lot of women say that if they tried to express their disappointment about having a Cesarean, they were told, ‘Well, you had a healthy baby, and isn’t that the goal?’ But you can feel both happy that you had a healthy baby and disappointed that you didn’t deliver vaginally.”

“My [first] C-section baby is now entering the second grade, happy and healthy and perfect,” says Muller. “I look at my incision as a well-earned battle scar, in a fight I fought for my child. [It's] more of a battle scratch now, and I wish that it was bigger to reflect how important it is. It is a visible, tangible sign that we belong to each other.”

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