Cesarean Postpartum Period — Things to Learn
The average stay in the hospital after a cesarean is 3 to 4 days. The IV and catheter will remain in place for approximately 24 hours following the surgery. The IV will provide you with nourishment and adequate fluids until your intestines begin to function again. The catheter will give your bladder time to recover from the surgery and keep it empty until you are able to walk to the bathroom yourself. If you are given narcotics through the epidural catheter, you may have a device attached to your finger known as a pulse oximeter. This device measures the amount of oxygen in your blood to ensure adequate levels, since narcotics can decrease your respirations.
Your diet at first will consist of liquids and will be gradually increased to a regular diet. Adequate intake of fluids is important to ensure proper kidney function, to prevent dehydration and fever, and to build an adequate milk supply.
You will be encouraged to get up and walk around 12 to 24 hours after your surgery. Walking promotes good circulation, which reduces the chance of blood clots, and it also helps relieve gas. Your first attempt at walking will be the most difficult, but each successive attempt will be easier. Some doctors order support stockings or an abdominal binder for their patients.
Even though you will have given birth by cesarean, you will still have a vaginal flow. You can use beltless pads, placing them in your underwear or in mesh panties provided by the hospital.
You may feel discomfort in one or both of your shoulders as a result of a collection of blood and air under your diaphragm. The pain is felt in the shoulders because of nerves that connect with the diaphragm. If you had general anesthesia, you may have a sore throat because of the tube inserted down your throat.
You will have abdominal pain for several days following the surgery. If you had an epidural, you may have been given a single dose of a narcotic injected into the catheter prior to its removal in the recovery room, or you may receive a continuous infusion of a narcotic via the epidural catheter. If you had general anesthesia, pain medication can be provided by a patient controlled analgesia (PCA) device. The narcotic is given through the IV tubing and is controlled by the patient intermittently pressing a button for a small dose of medication. Or, your doctor may order intramuscular injections of medication every 3 to 4 hours.
Once the epidural or IV is out and you are taking fluids orally, you will be given pain medication in pill form. You will most likely need it to be able to interact comfortably with your baby. Also, use your relaxation techniques to maximize the effect of the medication.
As your intestines begin to function again, you may experience sharp gas pains. Avoid apple juice and carbonated beverages, which can increase gas. Hot tea and lemon water will be more soothing. Use a heating pad while in bed, and begin walking to help the gas to pass. Some doctors order medication to aid digestion.
As your incision heals, it will probably itch, possibly for several months. Wear cotton panties rather than nylon during this time. Your doctor will remove the clamps or staples from your incision before you leave the hospital and place strips of tape (Steri-Strips) over the incision to keep the edges together. This tape will peel away and fall off during the next week. You and your partner may want to look at the incision together before going home.
Rooming-in is especially important for the cesarean couple to help them develop feelings of attachment to their baby. You will need assistance, however, since you will have difficulty moving around for several days. Do not hesitate to ask for help from the nursing staff. If you have a private room, your partner will most likely be welcome to stay with you around the clock. Rooming-in will also help you to get breastfeeding off to a good start. For comfortable nursing positions fr cesarean mothers, see “Breastfeeding Following a Cesarean Delivery“.
Once you arrive home, you will need household help for the first few weeks. Housework should not be one of your priorities at this time. Setting reasonable goals and expectations for yourself and your baby will make life much easier for all concerned. Take time to relax, and nap when the baby does.
Your recovery will be more rapid if you concentrate on your health and the baby’s welfare, rather than on entertaining visitors or cleaning the house. Continue taking your prenatal vitamins and maintain a high level of protein in your postpartum diet. A healing wound requires lots of protein, just as a growing fetus does during pregnancy. Nutrition plays an important part in how strongly your incision heals.
The correct time to resume sexual relations is different for every couple. Your decision should be based on whether the placental site has healed, which is signaled by cessation of vaginal discharge, and on the amount of abdominal discomfort you are experiencing. Your doctor’s advice and your own desire for sex are also important factors.
While you are not dealing with an episiotomy, you are coping with an abdominal incision, which is even larger and more painful than an episiotomy. During sex, you may find some of the positions that you used during the last months of pregnancy to be most comfortable. (For a discussion of sexual relations following birth, see “Postpartum Sex“.) Many women experience a changed body image. Because of their incision, they worry that they are no longer attractive to their husbands. You may need lots of reassurance that you are still appealing.
Your emotional recovery from your cesarean birth can take from 2 to 6 months. Your feelings may vary from relief that it is over to painful depression. You may find that you need to be reassured that you did nothing wrong and that you are not inadequate or a failure. Cesarean delivery is simply another way to give birth safely. Contact your local cesarean support group for help and information.
- Take the baby to see her in the recovery room, if possible.
- Help her position the baby at her breast.
- Stay with her overnight in the hospital to help with the baby.
- Reassure her that she did well and that sometimes events happen that cannot be controlled.
- Help her find relief from gas pain by encouraging her to walk, giving her warm liquids to drink, and urging her to avoid carbonated beverages.
- Make sure she has help at home.