If you’re getting ready for parenthood, you may have a ton of questions about C-section recovery. Well, you’ve come to the right place. There’s a lot to discuss, and because C-sections are major surgery, preparation is helpful even if your plan is to have a vaginal birth. You may have heard from a friend that recovery was tough, possibly even tougher than they anticipated. But there are a few common experiences you can prepare for (and chat about with your doctor) so that you’re a little more prepared if you wind up having a C-section. Below, ob-gyns share the details of what C-sections and C-section recovery really entail.
What is a C-section?
C-sections, or cesarean births, are surgical procedures that involve making incisions in the uterus and abdomen to deliver a baby, the American College of Obstetricians and Gynecologists (ACOG) explains. (This next part is a pretty intense explanation of what exactly that involves, just so you know.)
During the actual C-section, your obstetrician will cut horizontally or vertically through your skin, your subcutaneous fatty layer (which is loose connective tissue found under the skin), and the fascia, the tough, web-like connective tissue that surrounds all your body’s organs, Alyssa Quimby, M.D., assistant professor of obstetrics and gynecology at the University of Southern California, tells SELF. That allows them to make an incision into your uterus to deliver your baby, along with the placenta. After the delivery, your doctor stitches back your top layers, but your fascia eventually closes on its own, which can create scar tissue that will soften over time and be less noticeable on the outside (but it may never disappear completely). C-section deliveries are fairly common—32% of U.S. births are C-sections, the Centers for Disease Control and Prevention (CDC) says.
When is a C-section necessary?
There are a few specific reasons that people might get a C-section. Those include protracted labor, which means that your labor is going more slowly than doctors would like, the Merck Manual explains. Your provider might also opt for a C-section if your baby is in a breech position or if there’s an unusual heart rate pattern (which might require you to deliver quickly), the Merck Manual says. Additionally, your provider might consider a C-section if you’re pregnant with twins (or other multiples), you’re carrying a very large baby, or there are problems with the placenta, the ACOG says. If you have a condition like HIV or herpes that you can pass along during vaginal birth, your doctor might opt for a C-section, and the procedure might be your best bet if you have a condition like high blood pressure or diabetes, to avoid the specific kind of stress a vaginal birth puts on your body.
Your ob-gyn may also recommend a C-section if you’ve had one before, but this isn’t a given. Depending on the reason for your previous C-section, you may potentially be a good candidate for a vaginal birth after cesarean section (VBAC), the ACOG explains. People who had C-sections because of a nonrecurring reason (i.e., breech birth, twins, fetal distress) are the best candidates, Dr. Quimby says. But other factors impact the decision, including the type of incision your doctor used during your other C-section, the number of C-sections you’ve already had, and whether or not your hospital will allow it, the ACOG explains. The biggest concern with VBAC is uterine rupture, which means the uterus tears open where the C-section scar is, the ACOG explains. It’s rare, but a real risk because it can be harmful to both you and your baby. Some hospitals don’t have the staff to handle VBACs and the potential delivery complications. If that’s the case and experiencing a vaginal birth is important to you, you may want to see what other options you may be able to explore.
What can you do to prepare for a C-section?
Even if you aren’t planning to have a C-section, it’s still important to talk to your doctor about what it might entail (and anything else you should know). Why? Because there are so many changes that can happen during delivery, and if your care team suggests that you have a C-section, your doctor might not have enough time to talk through those things in the moment, the Mayo Clinic explains.
You can also chat with any friends who have already had C-section births, so they can give you the inside scoop (like anything special you should pack in your hospital bag). It can also be a great idea to talk to your loved ones about how they can support you during a C-section recovery (which you can get some insight into by reading the next few sections). Even if you can’t anticipate exactly what you’ll need, it’s helpful to have these conversations ahead of time.
If your doctor is recommending a C-section and you’ve scheduled one in advance, there are certain medical things that your provider might do to prep. For instance, your doctor might refer you to an anesthesiologist to talk about any complications you might have with anesthesia, the Mayo Clinic explains. They might schedule some blood tests to check your hemoglobin, a type of protein in your blood that carries oxygen to your body’s organs (and carries carbon dioxide from your organs back to your lungs), the Mayo Clinic explains. If your hemoglobin levels are low, you might be anemic, which—in severe cases—can increase your risk of premature birth and other complications, the Mayo Clinic says.
Right before your procedure, you might have to shower with special antiseptic soap, and your doctor might ask you not to shave your pubic hair within 24 hours of the surgery, the Mayo Clinic suggests. In the event that your pubic hair needs to be removed, the Mayo Clinic says that surgical staff will handle it right before your C-section.
What should you expect during and after your C-section?
Once you’re at the hospital, a medical professional will clean your abdomen and place an IV in one of your veins to deliver medicine and fluids, the Mayo Clinic says. Your doctor will likely insert a catheter into your body to collect urine as well, the Mayo Clinic explains. Additionally, you’ll probably receive regional anesthesia, which allows you to stay awake during the procedure but numbs the lower part of your body, the Mayo Clinic explains. Emergency C-sections may require general anesthesia, which means you’re not conscious during the delivery.
After your C-section—as your anesthesia starts to fade—your care team might encourage you to drink water and walk around a little bit (more on this later). Here’s the rub: Immediately after a C-section, and even weeks after, it can be pretty darn painful to sit up and put your feet on the floor. While you’re in the hospital, you can avail yourself of the magic of the hospital bed, which can prop you up with the push of a button and has rails that you can use for support, not to mention around-the-clock medical care. But you won’t have these amenities indefinitely (a post-C-section hospital stay is usually about two to four days, the ACOG says). Once you’re home, experiment with rolling onto one side as a way of easing yourself up, using a pregnancy pillow like PharMeDoc Pregnancy Pillow ($40, Amazon) for leverage, or asking your partner or whomever is around to give you post-birth support to lend a hand when you want to get out of bed.
Along with pain while walking, you may experience serious stinging or burning while peeing, or you may not feel that you’ve fully emptied your bladder. These symptoms are thanks to the catheter. (People who get epidurals during vaginal births may experience the same sensation.) “It’s totally normal to be irritated and should clear up in a few days,” says Dr. Quimby.
You should also expect some mild cramping that might worsen if you’re breastfeeding, bleeding, and discharge (that might include clots) for about four to six weeks, and pain near the incision, the ACOG says. “Your doctor will prescribe you pain meds, which you should take,” Dr. Quimby says of the overall pain you might feel after your C-section. “That’s what they’re there for.”
As days turn into months and years, it’s important to remember that your body has changed. For instance, “when your obstetrician cuts through those layers, they may cut some nerves, which can result in the loss of feeling,” Dr. Quimby says. It’s not unusual for the numbness to last for several years.
Are there things to avoid when you get home?
We’ve mentioned that getting up and around won’t be comfortable, so you can rule out jumping right into your old routine (or the new super-parent routine that you might have planned). In fact, you should plan to be sidelined for several weeks, the ACOG explains. “That means no lifting anything heavier than your baby, no pushing and pulling motions, and no deep bending until your incision heals,” Angela Jones, M.D., founder of AskDrAngela.com, tells SELF. In the real world, that translates into no carrying the laundry basket, no vacuuming or walking your dog, and no emptying the dishwasher for at least the first two weeks. Being able to actually stick to these recommendations clearly hinges on having a supportive partner or post-birth support person like a parent, who can make sure you’re not straining yourself in any way that could be painful or harmful. “You’ll also have to get used to sitting in the passenger seat for up to the first two weeks as driving is often a no-no, at least until you are comfortable looking over both shoulders without any pain and hitting the brake without wincing,” Dr. Jones says.
As for exercise, walking is great right off the bat. But wait a full eight weeks to make sure you’re entirely healed before you do any type of ab work, including Pilates, yoga, and even swimming, and talk about any exercise questions or plans with your doctor at your postpartum check-up before diving in. “We need to let that incision heal,” Dr. Jones says. And, for what it’s worth, it’s best to avoid penetrative sex for at least six weeks as well, the ACOG explains. (And if you’re not in the mood to have sex after six weeks, that’s completely valid.)
Here are a few other C-section recovery tips and insights to keep in mind.
C-sections are major surgeries, which means they can come with complications. To that end, it’s good to know the difference between normal C-section recovery and signs of health issues that need treatment. For instance, if you have a fever or your incision is red, swollen, or leaking discharge, you should contact your provider, the Mayo Clinic says. And, if you’re bleeding or soaking through more than one pad an hour (and passing clots that are the size of an egg or bigger), you should check in with your doctor about potential complications, the Mayo Clinic explains.
Additionally, if you had a condition like preeclampsia—high blood pressure that causes your organs to work abnormally—during your pregnancy, you are more at risk for something called postpartum preeclampsia, which usually happens within 48 hours of giving birth (but can sometimes happen up to six weeks later), the Mayo Clinic explains. It can be hard to detect, the Mayo Clinic says, but symptoms can include changes in your vision (like light sensitivity, blurriness, and losing your vision temporarily), abdominal pain, headaches, decreased urination, and swelling.
C-sections might also put you at risk for something called venous thromboembolism, which is when blood clots develop in your veins, SELF previously reported. When these blood clots happen in your arms and legs, that’s called deep vein thrombosis, and when they travel into your lungs, that’s known as a pulmonary embolism, which can be life-threatening. So if you notice swelling, pain, warmth, or redness in your limbs, or if you have trouble breathing or pain that gets worse when you cough or take a deep breath, you should definitely contact your provider.
Dr. Jones recommends getting up and walking as soon as you can after surgery and drinking water to help with swelling and constipation. Excessive swelling that is warm and painful to the touch could be a cause for concern, but it’s very normal for your feet and legs and even hands and face to swell after any type of delivery and particularly after a C-section. “Between that and all the IV fluids you received during labor and/or at the time of your C-section, that fluid has to go somewhere,” Dr. Jones says.
And, when it comes to pooping—or rather, not pooping—there are a few possible culprits behind postpartum constipation. “Pregnancy hormones tend to slow everything down digestive-wise, and things don’t just miraculously return to normal immediately after delivery,” Dr. Jones says. “So if you were having issues with constipation during pregnancy, they are not likely to resolve spontaneously once your baby is delivered.”
Complicating the constipation problem? Those pain meds. Many have a side effect of constipation. Though it’s undeniably difficult to get up and move around, even a short walk around the hospital floor can help get things moving again (ask for help if you’re feeling woozy). You can also try a stool softener, like Colace ($9, Amazon). According to the Mayo Clinic, Colace is safe to use if you’re nursing, but you should still check with your doctor before trying any new medications during pregnancy or while postpartum.
“It can be difficult to situate your newborn in a position that you can maintain for upwards of 20 minutes comfortably when you have an incision on your lower abdomen,” Dr. Quimby says. “I encourage my patients to play around with different positions.” Many find the football hold, where you literally tuck your baby in along your forearm up to your breast like, yup, a football, to be the most comfortable post-C-section, she says. (Confused? See if your hospital has a lactation consultant who can help.) You could also try a breastfeeding pillow like the Boppy Bare Naked Nursing Pillow and Positioner ($60, Amazon), or a stack of soft throw pillows of different sizes and shapes to help get the baby in a good position.
You just had a baby and major surgery, possibly after hours of labor, so a good night’s sleep is inevitable, right? Not so, in a majority of hospitals. You’ll have your vitals checked (including blood pressure and temperature) every few hours, likely for the duration of your stay. And if you gave birth at what’s known as a “baby-friendly” hospital, your care team will likely be intent on establishing breastfeeding ASAP, which can make it even more difficult to sleep at the hospital. Not to mention that you’re taking home a newborn, which obviously comes with a whole other set of sleep difficulties for parents.
Physical changes are only one aspect of the postpartum experience. Parenthood brings mental changes and shifts with it too. While lack of sleep and changing routine are bound to take a toll on you (baby blues are real), there is a chance that you might be grappling with postpartum depression as well. And, if you had an emergency C-section or had planned on having a vaginal birth but needed a C-section anyway, it could have an especially severe impact on your mental health. In fact, a 2019 study published in the Journal of Health Economics found that when pregnant people had an unplanned or emergency C-section, they were 15% more likely to experience postpartum depression.
If for more than two weeks after your C-section you’re experiencing symptoms that make it hard to care for your baby or go about your life, like intense sadness, loss of appetite, mood swings, heightened anxiety, and a lack of joy, the Mayo Clinic suggests reaching out to your provider. If you don’t feel comfortable reaching out to your doctor, you (or someone who loves you and who you trust) can look into other modes of support, like a postpartum doula or finding a qualified therapist. You can also seek out support groups and online communities that may help you feel like you’re less alone.