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After a Caesarean Birth

Though birth by caesarean is not an unusual procedure, there is no denying that the experience places additional demands on your body and recovery. Your stay in the hospital will be a day or two longer, and once at home you should keep in mind that you are recovering from major abdominal surgery, as well as adjusting to life with a newborn.

Breastfeeding After a Caesarean

Birth by caesarean does not interfere with your ability to produce milk. Breastfeeding positions such as sidelying, the football hold, or sitting with a pillow cushioning your incision will be more comfortable. Ask the nurses for suggestions.

Stimulate your baby by moving his arms and legs and breastfeed if possible. If your baby is too sleepy to nurse initially, just let him become accustomed to your touch, smell, and the feel of your breast. Continue to offer your breast every two hours.

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Catheter and I.V.

The urinary catheter is generally removed when you have recovered from the anesthesia and you are able to walk to the bathroom.

Under most circumstances, the I.V. will be removed when you are able to drink fluids, usually in about a day, unless an infection occurs and antibiotics are required. Generally, you will not be allowed to eat solid food until your bowel activity returns. Frequent moving and walking are the best ways to encourage the return of your bowel activity and prevent gas.

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Pain Relief

After the anesthesia wears off, you will feel some incisional pain. Depending upon your pain tolerance and the type of anesthesia used, the pain will vary. Pain medication will be provided upon your request. Pain medication is prescribed with breastfeeding in mind. You need to be able to enjoy your baby; this is no time to be in severe pain!

Coping with Pain
It is not beneficial to wait too long to ask for medication as it will only increase the pain (making it harder to control) and increase tension.

On the first day, taking medication at regular intervals instead of only when the pain is severe will help you to feel more comfortable. Each day the discomfort becomes less for most women and frequently very mild, or no medication is needed within a few days.

Some of the medication will go to the baby, but not in large doses that could be harmful. Consider taking the medication one-half hour before breastfeeding, so nursing will be more comfortable and relaxed.

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Once You're Home

Try to rest as much as possible the first few weeks at home. Be easy on yourself, and remember that you are recovering from birth, major abdominal surgery, and adjusting to life with a newborn! Don't try to be super parents! Let others help you.

Physical Adjustment
Let others take care of household chores and other responsibilities. The more rest you allow yourself during the initial recovery period, the faster your recuperation. It takes time for your abdominal muscles to regain their strength and flexibility. Don't expect to continue your activities as before for awhile.

Emotional Adjustment
Many emotions may arise after a caesarean such as relief, anger, resentment, disappointment, or guilt. Some new mothers may wish they had had a more active part in their delivery experience or wish the decision for delivery by caesarean had been made earlier. You may find it helpful to discuss these feelings with your partner and the medical staff. They may be able to give you some information that will enhance your understanding of your birth. Be sure to ask.

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Tips for Partners

In addition to the general awkwardness that any new parent will feel with a new baby, the greater physical adjustments the mother must make after a caesarean means she will need help with care of the baby and daily chores.

Assist her by positioning the baby for feedings.

Encourage her to walk by walking with her.

Make arrangements to minimize stair climbing at home during the first few weeks.

Assist her in lifting or carrying heavy objects the first few weeks (especially other children).

Encourage her to take frequent rest breaks. This is especially important for recovery after surgery.

Encourage the mom to rest with her baby. It is easier to heal with the baby around.

Change the baby's diaper.

Assist with or hire help for household chores, meals, etc.

Minimize your work obligations if possible, so that you can spend time together and with the baby.

Do the grocery shopping and laundry.

Exercises After a Caesarean

Guidelines:

Progress at your own rate. Gentle exercises are important in order to facilitate healing of the muscles.

For the first two or three days, support your incision with your hands or a pillow for comfort.

Relax and breathe deeply throughout and between the exercises, exhaling on the effort. Do NOT hold your breath.

Support your head and shoulders with a pillow for comfort.

Start by doing each exercise twice.

You can begin these exercises as soon as you recover from the anesthetic.

Abdominal Breathing

Place your hand above your navel.

Inhale: abdomen rises upward; stretch your abdominal muscles outward.

Hold for a count of five.

Exhale: while pulling your abdominal muscles in.

Hold for a count of five. Repeat three to five times.

Ankle Circles

Make 10 circles with your ankles, clockwise and counterclockwise. Repeat three to five times.

Leg Bracing

Cross your ankles and straighten your legs. Tighten your thighs and squeeze your buttocks together.

Hold for a count of five. Repeat three to five times.

Walking
Follow the instructions of the nursing staff and begin to get out of bed and start walking as soon as possible.

Leg Stretches

Lie on your back with one knee bent.

Keep your back flat as you slide the heel of your bent leg up and down.

Repeat with the other leg. Work only within the range in which your back can be kept flat. Repeat three to five times with each leg.

Kegels (Pelvic Floor Exercises)
Kegel exercises strengthen the muscles of the pelvic floor. These muscles are weakened by the birth process and should be exercised immediately after birth. However, it may be somewhat difficult to do these exercises soon after your delivery; do as many as you can and gradually the tone will return.

Squeeze the pelvic floor muscle for three seconds, relax the muscle for three seconds, then squeeze again.

Begin with 10 three-second squeezes, three times a day. Increase repetitions gradually.

Work up to doing 50-100 Kegels each day.

Pelvic Tilt

Lie on your back, with your knees bent.

Tighten your stomach and buttock muscles.

Allow your pelvis to tilt upward.

Flatten the small of your back against the floor as you inhale.

Hold for a count of five.

Relax and exhale. Repeat three to five times.

CAUTION: DON'T arch your back, bulge your abdomen or push with your feet to obtain this motion (as in example on right).

Sit-ups

Elevate your head with a pillow and bend your knees. Tuck your chin, exhale and reach towards your knees.

Hold for a count of five. Inhale as you release. Repeat three to five times.