10 Tips for C-section Recovery
Cesareans are a very common way to deliver babies in the U.S., accounting for 31.9% of births. According to the CDC, the C-section rate in Alabama is 34.4%. This means roughly 1 out of 3 moms are birthing their babies via cesarean, this rate is higher among non-Caucasian populations. It is often viewed as a routine abdominal surgery, but there is no denying that this surgery is a major event for the body. Whether the birthing person labored first and had an unplanned cesarean or chose to schedule their C-section, it is still a surgery and all surgeries require an intentional approach to healing. I’ve coached and talked with a lot of moms who have had C-sections, planned and unplanned, and while all of their experiences vary, it turns out there’s a lot of information they don’t tell you when you leave the hospital about C-section recovery.
But before we get into the recovery, let’s take a quick look at cesarean birth.
*Feel free to skip these next few paragraphs if you would rather not read about what you experienced or if it triggers you in any way*
A cesarean is a surgery in which the abdominal wall is cut, the abdominal muscles manually separated, and the uterus cut to birth a baby. The OB will make a small incision in the uterus and typically an assisting physician presses on the top of the uterus to birth the baby. The obstetrician will manually remove the placenta and may actually lift the uterus out for repair as well. The abdominal muscles are then repaired and the incision in the abdominal wall closed.
Most likely the birthing person will be awake during this procedure, so a support person or two is key during this time. Many women experience shaking or trembling during or after the procedure. They may also feel nauseated, anxious, and panicked. In the few hours and days after birth via cesarean, the nurses will assist you with getting up and moving around. Some movement is incredibly important after cesarean delivery to prevent blood clots. Pain levels may be high, so staying on top of medicine during this time is important. Most women find they feel supported in the hospital after their C-section, but aren’t prepared for what things may be like at home.
With the help of some amazing women in the Birmingham chapter of ICAN (International Cesarean Awareness Network) who were kind enough to share their C-section recovery stories and tips with me, I was able to take a peek into what recovering from a cesarean is like, a few days after leaving the hospital and weeks+ down the road. As it turns out, there are some pretty crucial things being left out of the hospital discharge information that could make recovery post-surgery with a teeny babe a lot easier, physically and emotionally.
1. You Will Still Bleed.
I actually hear this a lot. Women think that since they didn’t give birth vaginally and there was “no trauma” down there that they won’t bleed down there afterwards. The truth is, you may bleed for just as long as or longer than someone who had a vaginal birth. Every body is different, so we all heal differently. But why do you still bleed?
When the placenta is detached from the uterus, it leaves behind an open wound the size of a paper plate. Don’t believe me? Check this out. Like any open wound, there is bleeding. The way the uterus heals is by shrinking down on itself to cover that wound. That’s why nurses palpate your belly after birth, to check that the uterus is doing its thing properly, which doesn’t make it any more comfortable but at least you know why they are subjecting you to torture every 5 seconds post-birth. Uterine massage may be even more uncomfortable after your C-section, applying pressure to the incision during the massage may help ease some discomfort.
2. Your Core May Need Extra Support.
The core goes through a lot during a C-section. It isn’t uncommon for the core to feel completely unsupported after the procedure. While many hospitals give out belly binders to reduce pain and facilitate core healing, many women report not really loving the belly bind.
In my professional opinion, the belly bind could actually increase pressure in the abdomen, leading to more pressure on the pelvic floor. And the way that it falls could be uncomfortable for a C-section incision. These SRC Recovery Shorts are a great alternative to a belly binder and are full panel (I just love a full panel) so they actually cover the incision and don’t cinch at the waist as much.
Husband dare to make a joke (that you actually thought was funny) the first few days after your C-section? Anything that places outward pressure on the incision, think coughing, sneezing, laughing, can be SUPER uncomfortable- like maybe your insides are falling out or you’re going to pop open your incision. Gently pressing on the incision with a rolled up blanket or towel can help give the belly more support under pressure.
3. Standing and Lying Down Might Be Tricky
That feeling of your insides falling out? I’ve heard from so many women who say they felt just that while lying on their side to sleep. Just like above, the core muscles have been through a ton. While the abdominal wall, muscles, and fascia are healing, many women find it really uncomfortable to lie either on their side or on their back for a few weeks after their procedure. Sleeping upright reduces pressure on the abdominal muscles and the incision.
Alternatively, a lot of women find it really hard to stand upright after a C-section, like there’s too much pulling. Think about it- you’ve got an incision that is trying to heal- standing upright could take some time not only because it’s natural to protect an injury, but also because your body is working on healing that incision. While you should try to stand up straight when you can, don’t push through pain or strain to get there. As soon as you feel comfortable, slowly start to stand up a little straighter. If the pulling feeling still occurs after the incision is healed, look into scar massage (actually, do it anyway!)
4. You Might Have Trouble Getting Up to Soothe Your Baby.
I heard from a lot of women who were surprised that they couldn’t move around very well to pick up and soothe baby. From a professional standpoint, this makes total sense. Your body just went through a major surgery and one of the biggest jobs of the biofeedback system is to protect your body. Naturally, one thing your body won’t let you do is jump right out of bed, or even twist to grab baby out of a bassinet. Having your husband hand you the baby can be a huge help during this time when it is SUPER uncomfortable and hard to move. Unfortunately, someone might not be there all the time. Here are a few tips to make this a bit easier:
· Get a step stool and place it by your bed- this helps reduce abdominal pressure while climbing in and out of bed
· Use your arms to push yourself up to sitting and move both legs at the same time while getting up- again reduces pressure on the abdomen
· Hinge at the hips or squat to pick up baby instead of bending at the waist (shout out to prenatal training!)
· Rest when you can- if someone is with you- take it easy and have them hand you baby for a while
Another great option, if you have the means, would be to hire a postpartum doula to help you during those first few weeks. Not only can they help make sure you’re getting the rest and nourishment you need, they can also help provide you with physical and emotional support as well as breastfeeding help!
5. Nursing May Be Uncomfortable.
Just like sitting and lying down, finding a comfortable position to nurse in might be challenging. A lot of nursing positions may put too much pressure on the incision. Some positions may not work for you and your baby. Nursing in a position like the football hold might be good if you’re feeling too much pressure on the incision in traditional holds. Additionally, using a nursing pillow may help support both you and baby well- also using pillows, rolled up blankets, and other things to prop the pillow up higher is a great way to make nursing a little easier post-surgery.
6. You Might not Feel the Urge to Pee.
Bladder symptoms are super common post-birth, to an extent. While they are common, common does not equal normal. After a C-section, a lot of moms report not feeling the urge to pee until it becomes super painful or they just go. Sometimes birth can cause temporary nerve damage and most of the time, this will resolve after a few weeks. The easies reminder to go to the bathroom is nursing. If you aren’t feeling bladder sensations, try to go to the bathroom every nursing session.
If this persists more than a few weeks, call your doctor and/or midwife. I also suggest women go see a pelvic floor physical therapist after birth- with the help of a physical therapist, issues like incontinence, pelvic pain, and scar numbness can be addressed.
7. Move, but Don’t Overdo It.
Movement is super important after C-section, as it helps prevent blood clots. But there’s also a huge difference between movement necessary to prevent clots and too much movement. As mom, we can often get so caught up in caring for the house, little people, ourselves, our husbands, the dog…. You get it. It can be really hard to rest. And a lot of moms report feeling fine very quickly after birth. Hold up, momma, your body still needs REST!
Have a support person help you with as much as they can when they are around. Rest when you can and move when you feel like it- short walks are ok also, if you are feeling up to it (emphasis on SHORT.) If you notice increased bleeding or pain, that’s your body telling you that was a little too much movement- listen to these cues
8. You May Experience Side Effects for Longer Than You Think.
Sure, you expect to feel uncomfortable and weird after birthing your baby, but women who have had a tear that needed stitching or a C-section can experience soreness or side effects months or years down the road. Some women report feeling tingling, numbness, and pulling at or around their scar for months or years after a C-section. While this is common, seeing your pelvic floor physical therapist can help you figure out if this is a symptom that is normal or if it can be resolved.
9. Recovery comes in Waves.
Just like any recovery, there are good days and bad days. You might feel fine one day only to notice a huge change in how you feel a few days later. Listen to those messages. It can be easy to overdo it on the days you feel good- being on your feet a lot or bending and lifting a lot.
My good friend and leader of the ICAN Birmingham chapter, Sarah Holsombeck, comments on her recovery:
“Pain levels and ‘feeling back to normal’ tend to ebb and flow. There are different stages of healing, but remember that your body has just experienced a major surgery. I know I overdid it a couple weeks after both c-sections because I was eager to feel "normal" again and finally kinda sorta did at the 2 week mark. But I really paid for it and was in a lot of pain both times as a result of thinking things were normal again (when I really probably just had my first ‘good’ day in a long while.)”
So many women are struggling to feel “normal” again after birth, both physically and emotionally. That “normal” feeling may come in waves, and that is OK.
10. Grief Also Comes in Waves.
So many women struggle with feelings of grief surrounding birth. This is something women can experience regardless of whether they had a vaginal birth or a C-section. Some women struggle with feelings of guilt, that they didn’t birth the “right way” or give birth at all. Some women don’t bond with their babies immediately or don’t feel like their baby is their own. Some women experience PTSD after their birth.
A lot of women grieve the loss of the birth experience they so carefully planned.
Grief, just like recovery, comes in waves. It may be months or years before those little grief boxes are unpacked. It is ok to grieve, to pack away feelings, and to feel angry or upset about your birth.
That being said, it’s a good idea to have your partner brush up on some signs of postpartum depression, anxiety, and psychosis so they can gently nudge you towards help if they are concerned.
Cesarean births are absolutely important for some moms and babies- that should not be ignored. The information women are given post-surgery, however, should account for way more than “don’t bend, lift, or drive and I’ll see you in 6 weeks.” There are also amazing support groups that are cesarean-specific, such as ICAN. Click here to find one in your area. Whether your cesarean was planned or unplanned, I hope these 10 tips help make your recovery a little bit easier.