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Recovery from Cesarean Birth

Childbirth can be one of the most gratifying experiences of a woman’s life, whether the birth is vaginal or cesarean. Like any other mother, you eagerly anticipate the first glimpse of your infant and assuming the tasks of motherhood. The initiation of the mothering role after a cesarean birth, however, may be somewhat delayed during the first postpartum days due to the stress of surgery and postoperative discomfort.

The baby born by cesarean receives basically the same care as the baby delivered vaginally. However, more suctioning of mucus to clear the baby’s airway is required since the baby did not travel through the birth canal, where pressure helps bring up excess fluid and mucus.

If you are awake during the birth, we recommend that you ask to see and touch the baby in the operating room. The baby will then be taken to the nursery by the pediatrician. The mother will have to be separated from the infant during the incision repair, but please remember that the father may accompany the pediatrician to the nursery.

Every effort will be made for the parents to be with the baby in the recovery room.

During Recovery

• The average stay in the recovery room is one to two hours. During this time, we’ll frequently check your blood pressure, pulse, and vaginal bleeding. Telephones are in the recovery room so that you may call relatives and friends in between these checks if you wish. We encourage your coach to be with you to assist with this and to provide comfort.
• Medication for postoperative discomfort is available. The postoperative discomfort experienced after a cesarean is different for every woman. Please let the nurses know when you are uncomfortable. While in the recovery room, the nursing staff may have to rotate or turn you; they may also ask you to cough and breathe deeply. In order to cooperate, you must be comfortable.
• Ask to have the baby brought to you. Early contact with the newborn is important, and holding your newborn is an experience without equal. Mothers who plan to breastfeed may want to begin doing so in the recovery room.

Immediately Postpartum
Plan for your coach to be with you when you return to your room. It is important to note that, as a cesarean mother, you may not be able to “mother” your child immediately. You may need time to adjust to your feelings about the surgery, the discomfort, and to center on yourself before reaching out to your child.

The presence of the coach to hold the baby, fill in the gaps of your memory, and meet your needs (sips of water, calling the nurse, rearranging pillows) all help to hasten this process.

The First 24 Hours After Delivery

• Intravenous (IV) fluids for 24–36 hours.

Catheter in bladder for 12–24 hours.

• Cough, turn, and deep breathe every two hours. The lungs require extra attention after surgery. Breathing must be as deep as possible, since all parts of the lungs need to be well ventilated so that the increased mucus will not sink to the bases, where it will be difficult to dislodge.
• Huffing is much easier, more effective, and less painful than coughing for the postoperative patient. Take a deep breath in and breathe outward, saying “Ha” briskly. This must be done quickly to dislodge any mucus. Support the incision with your hands, a pillow, or any other soft item, and rest assured that your stitches will not pull out.
• Get up and out of bed, with help, three or four times each day.
• Feed your baby on demand.
• Sip water as tolerated, progressing to a clear liquid diet.
• Medication for discomfort is administered through a patient- controlled analgesia unit (PCA); it may be continuous or controlled manually by you as needed.

First Day After Surgery

• IV usually remains until you are taking adequate liquids.
• Catheter is removed. Notify a nurse for assistance to the bathroom.
• Clear liquid diet will progress to cream soups and milk products, along with toast and crackers.
• Oral medication is available for discomfort.
• PCA is usually discontinued.
• You can sit up and walk to the bathroom with help. Start Phase 1 of post-cesarean birth exercises and progress to the next phase when comfortable.
• The large dressing on your incisions is removed, and a light dressing is reapplied.

Second Day After Surgery

• IV is usually removed.
• Diet progresses to soft foods when you’re passing gas easily. Drink plenty of fluids.
• Get up as desired and gradually increase walking.
• Gas pains may be uncomfortable, but they indicate the return of bowel activity. If you are unable to pass the intestinal gas easily, ask for a rectal suppository for relief.
• Staples are removed from the incision, and steri strips are applied. You may shower while using plastic wrap over the incision to keep it dry. If the steri strips become wet, ask the nurse for a hand-held hair dryer to dry them.
• The intestines are very sluggish after surgery. You will be given a stool softener with a mild laxative to assist you in having your first bowel movement more easily.
• Wear high-waisted underwear and use adhesive-backed sanitary pads for your comfort and protection.

Third Day After Surgery and Beyond

• Maintain a regular diet as tolerated.
• Get up and move about as desired.
• Continue to progress with post- cesarean birth exercises. Increase walking to a comfortable distance within two weeks.
• You may drive a car after two weeks.
• Lift nothing heavier than your new baby for the first three weeks.
• After six weeks, you may return to vigorous activity.
• You may resume intercourse when vaginal bleeding decreases, and when you are comfortable.
• Generally, you’ll experience only stiffness when sitting and rising. A prescription is available to take home if you are still uncomfortable.
• The incision does not need to be covered with a dressing unless you desire one. Steri strips are to be left in place for 10 days, then you may remove them. Blow dry strips after showering.
• You may take tub baths after 10 days.
• Bowel movements may still not be regular, so use a stool softener if necessary.
• You will have one postoperative appointment in the office at six weeks.