Planned and scheduled. Unplanned and emergency. C sections are on the increase with an average of 31% of births in the UK in 2023. This is a 50% increase over the last 20 years where 1 in 5 births were by caesarean section. Now we're looking at 1 in 3 births, and climbing. A surgical birth is not the easier option. Recovery takes longer than a vaginal birth with more pain and restrictions.
With caesarean births being quite common, it's so important to understand recovery. We hear stories and see friends out and about or back to housework and responsibilities within a few days. WHAT THE HECK! A caesarean section is MAJOR abdominal surgery, with a totally dependent baby to care for as well! A mother's main focus after any birth is her recovery and caring for her baby.
Your first 24 hours after a Caesarean section
These are some of the most common side effects of an epidural and caesarean section:
- Nausea and vomiting
- Shaking
- Itching
- Feeling faint
- Shoulder tip pain
Within the first 12-24 hours the midwives are going to try get you standing and walking to the bathroom so they can remove your catheter.
- Try standing as straight as you can with no hunching over.
- Keep your shoulders back and away from your ears
Make sure you have someone with you before attempting to stand up for the first time. Take your time.
- Ask for help if your partner is not allowed to stay with you on the postnatal ward. Use that call button for help getting your baby out the bassinet, for help with breastfeeding, etc
- Move slowly.
- Stay on top of your medication. Take meds when they are due (every 4-6 hours), not when you start feeling sore.
- Don't rush home. Get the support you need before heading home.
Components affecting Caesarean Section Recovery
- Your recovery is going to be easier if both you and your baby are well and healthy.
- Immediate skin-to-skin will keep oxytocin levels high in both you and your baby, bringing a sense of calm, peace and bonding. Initiating breastfeeding within the first 3 hours will help establish breast milk production in the coming days.
- Your recovery will be easier if it is relatively quiet on the postnatal ward, or your birth partner/doula can remain with you.
Recovery may be more difficult if
- you've had a difficult pregnancy.
- you had a long/complicated labour.
- there were any complications through the surgery eg. postpartum haemorrhage.
- Lack of support.
What's normal after a Caesarean Section?
Naturally, after major abdominal surgery, you are going to feel pain. Many layers have been cut or moved out of the way to get to your uterus and deliver your baby. In the first 2-3 days, take the pain relieving medication when recommended, don't wait until you feel uncomfortable.
Your dressing will stay on for around 2 days before being removed. It's totally normal to see a yellow or pinkish discharge, or crusts forming along the incision site. As healing progresses, itching is also normal. Ensure you keep the wound clean and dry.
You will have vaginal bleeding (lochia) that lasts 2-6 weeks. This is from where the placenta detached from the wall of your uterus. The bleeding may be quite heavy for the first couple of days, becoming lighter and turning from red to pink/brown. You may find too that breastfeeding increases the bleeding.
Feeling tired is normal too. The anaesthetic and pain medication will have an effect on your energy levels, so too will waking through the night and attending to baby's needs. Ensure you have nourishing meals and one handed snacks for your recovery. If your c-section was unplanned, take people up on their offer of help by asking them to make you a meal and/or snacks.
Many feelings around your birth may arise, especially if it was unplanned. You may feel angry, disappointed in yourself, confused or totally overwhelmed. Having this additional pressure after having your baby adds pressure to your recovery journey. When feelings seem to overpower and overthrow you, please reach out for additional support. Speak to your GP, midwife or health visitor. Nipping postnatal depression early can save you further distress.
A supportive network where you are safe to express your feelings can truly help. If you find that this support is lacking, consider a postnatal doula who can come in a few hours each day. She can offer you physical support (help feeding, housework, meal prep etc) she can be a safe space to talk through your thoughts and feelings, and she can sign post you to other specialists (eg breastfeeding consultants, pelvic floor therapists, osteopaths, sleep specialists etc) See more here for postnatal services
When to get Medical Advice
The NHS website gives a comprehensive rundown of the c-section procedure, risks, recovery and when to call for advice. If you have ANY concerns don't hesitate to call your midwife/consultant.
- Severe pain
- Leaking urine
- Pain on urinating
- Heavy vaginal bleeding with large clots (Larger than 50p coin)
- Site of wound becomes red, hot, swollen and painful
- Discharge/pus/foul smelling fluid coming from the wound
- Cough, shortness of breath
- Swelling in lower leg/legs
- Headache when lying down
Your recovery after a Caesarean Section
I roped in the help from my Instagram followers, and got some wonderful tips that I hope you find helpful too!
- Have pillows in the car for you journey home, to hold your incision when going over bumps and around corners.
- You can never have enough pillows to support you in bed and when feeding baby.
- Use a pillow to hold your incision when coughing, sneezing, laughing or crying
- Peppermint tea and chewing gum is incredibly helpful for shoulder tip pain and gas. (Avoid fizzy drinks)
- Wear big 'granny' pants/Bridgette Jones pants (cotton is preferable)
- Wear lose fitting clothing.
- Clean wound with warm water and thoroughly dry the wound daily
- Use a hair drier on the cool setting to dry if needed.
- If you have an overhang, use wound pads, kitchen towel or a sanitary pad on the front of your underwear to keep the area dry.
- REST. Even if you feel like you've rested enough, rest more! PLEASE!
- Don't lift anything heavier than your baby.
- Move slowly. Use a rope/twisted sheet tied to the end of the bed to help you up.
- Don't compare your recovery to others. Take one day at a time.
Nutrition after a caesarean section
.Of special concern is supporting digestion after a c-section, as well as providing the body with healing, repairing and restorative nourishment.
Soft, Warming Foods
Having soft warming foods supports digestion where there will be better absorption of essential nutrients. Think of warm soft-cooked foods over raw and cold foods. Using warming herbs like ginger, cinnamon, turmeric, cardamom etc assists in healing and reducing inflammation. eg. Beef and vegetable stew, chicken noodle soup.
Bone Broth Based Foods
Numerous minerals and essential amino acids can be found in bone broths that will assist in tissue repair. Not only is bone broth restorative and healing, it is also hydrating which will help support digestion.
Bone broth is easy to prepare and can be used in batch cooking and easily frozen. If you can't make your own broth, make sure you buy broth that has BONES on the ingredient list. Use bone broth in soups, stews or as a warming beverage.
Fibre Friendly Foods
Think of foods that will gently support your digestion, especially in the first week post surgery. You may have been prescribed a stool softener and laxative post surgery, so your foods should be gentle and comforting. Think of avocado, berries, chia seed puddings, fermented foods (eg. Kimchi, sauerkraut), cooked soft vegetables
C-section and Bonding
Many women have been told that bonding may be delayed after a caesarean birth. This may be true for some mums, but not always the case.
Oxytocin is our bonding hormone. It is released when we feel safe, undisturbed and unobserved. We can encourage this by keeping mum and baby together as soon as possible in the operating room.
Activating our senses will encourage bonding too. So look at your baby, touch him/her, smell him/her, talk to him/her. Skin-to-skin will also encourage oxytocin in both you and your baby. Do it often, for as long as you can. Skin-to-skin will also encourage baby to find the breast and initiate breastfeeding which will release even more oxytocin! More bonding!
When at home, continue with skin-to-skin while you are recovering. Baby will settle easier, and your recovery will be quicker as you are taking time to rest well with your baby close by.
If you are finding bonding is still difficult after a couple of weeks, chat to your GP or health visitor. They can signpost you to the right resources.
Perhaps you found your baby's arrival difficult, even traumatic:
- You can request your notes and/or a birth debrief.
- Reach out for additional counseling www.birthtraumaassociation.org.uk
- The 3 Step Rewind can help you process and re-frame your birth experience
Scar Rehabilitation
Scar sensitivity or numbness is very common post surgery, however, you can rehabilitate the area quite easily. Get a small box or basket and go through you cupboards and drawers for materials of differing textures. Think silk, wool and linen. Then look for other textures like a baby's hairbrush, cotton wool, glass ball or marble.
Gently touch around your scar with the different fabrics and and tactile goodies. Start with the softer materials and objects. When you feel comfortable, move closer to the incision site, stopping if there is any pain. Change directions, move back and forth,pree in zig-zags or circles. Vary the pressure.
If there is numbness, using different textures will stimulate the nerves, helping to restore feeling back to the area.
With scar sensitivity, using lots of different textures will cause the nerve endings to re-set themselves and relax.
If the scar is uneven, lumpy with areas thicker than others, you can mobilise the scar. Make sure the area is fully healed. Using both hands, you can pinch the tissue between your thumb and forefinger and gently roll the skin backwards and forwards. You can pinch with both hands and gently pull your hands away from each other. Using the same pinch with hands, alternate directions backwards and forwards and swap direction.
You can perform these routines 3-5 x weekly, taking 5-7 minutes of working on and around your scar. Just ensure the scar is fully healed.
Recovery after a caesarean section is tough. It takes strength, courage and patience-all great qualities to have and nurture as a mother. When it gets tough, please reach out to your support group and be open, honest and vulnerable with them, asking for their help. This is part of building that village that is so often talked about. Let's start encouraging and normalising asking for help. If you have the time to plan for your c-section, even as a back up plan, work in the recovery support too! Having thought through a plan that will work for you and your family will set you up for a good recovery.