Knowledge is Power.

LET’S LEARN ABOUT THIS WHOLE C-SECTION THING…

PART ONE: GENERAL INFO

What happens in a C-Section?

An incision (typically transverse) is made through the skin and abdominal wall, the abdominal muscles are separated, and then another incision is made at the peritoneum and the uterine wall. The baby is delivered through these incisions. The uterus is then closed by sutures that are dissolved by the body. The doctor will use a surgical thread, staples, glue or a combination for skin closure. Typically these are absorbed by the body as well with some time.

Hospital stay is typically between 2-4 days post-op.

Many hospitals no longer have a nursery option so the baby will be with you 24/7. The bassinet is next to your bed, but it can be very challenging to reach for and lift them after your surgery. Plan to ask nurses and partners for assistance. Use the head of bed and pillows to prop yourself as needed to decrease strain on the abdomen. Your practitioner will have you on a pain management plan via medications.

Normal post-operative symptoms include:

• Bruising

• Soreness

• Pain/numbness around incisions

• Swelling

• Mild cramping

Abnormal symptoms include:

• Discharge/odor from incision

• Fever, chills

• Leg pain

• Shortness of breath

• Heavy bleeding

• Worsening pain - intensity that prevents performing daily tasks (showering, eating, getting out of bed, etc.)

If you have any of these abnormal symptoms, call your doctor.

PART TWO: ACTIVITY PRECAUTIONS

Lifting Precautions:

Lifting precautions are given by your medical provider to avoid lifting anything over the weight of your baby (technically 8-10 pounds) in order to protect the repair. Here are some recommendations on how to lift the baby:

• Use your hips and legs to help.

• Keep the baby close to you (vs. extending out) as you lift and put her down.

• Exhale as you lift and brace your abs in (vs. holding breath and bearing down).

Also note: Do the best you can. It’s unrealistic to expect mothers to lift with perfect mechanics 100% of the time.

Transfers:

You’ll notice how much effort is required to transfer in these early days. It is tough to get in/out of bed, on/off the couch, etc. Using breath to brace and stabilize is a helpful strategy. Think about exhaling and gently drawing in your core just before you perform the task.

Splinting with a pillow can be helpful as well. Take a bed pillow and lightly compress it to your abdomen as you exhale and perform the task. See an example of this in the videos below.

SIT TO STAND:

For increased support getting in/out of a chair or sofa, scoot to the edge. Inhale to prep for the movement. Exhale and draw in your abdominals just before you press up with your legs into stand. Use your arms to help as needed. You can also splint with a pillow if this is painful as shown in the video below:

IN/OUT OF BED:

To get in/out of bed with least amount of strain, you’ll want to apply the log roll technique for the first 6 weeks (or longer if needed): Sit on bed and then lie down on your side. Exhale as you then roll to your back. Reverse this to get out of bed. It’s worth mentioning that this is not how you should be transferring as you develop strength in the abdomen later in your recovery. I sometimes see women who still get in/out of bed like this months out of surgery which is not necessary. This is a temporary modification. Take a look below:

Abdominal Binders: To Wear or Not to Wear?

I typically only recommend an abdominal binder when it feels absolutely necessary to have this support. Meaning, if pain is preventing you from performing normal daily tasks, caring for your child, etc., an external abdominal support may be indicated. The reason I don’t always recommend this is because it decreases the need for your abdominal stabilizers to turn on automatically. We want these muscles to be retrained to contract early on in the rehab process. I suggest wearing it when needed during activity, but take it off if you are resting or doing your exercises. You should not need to wear this for more than two weeks.

Take a look at this video for suggestions on how to wear the binder:

If you do prefer an abdominal binder, I recommend something like Bodily’s Belly band. You want to put this one tight enough that is provides external support and feedback, but not so tight that the abdominals and ribcage cannot expand freely. I also love Bao Bei’s postpartum support bloomers. They support from the bottom up instead of creating a corset-like support like the binder:

Bodily Belly Band Example

PART THREE: HELPFUL INFORMATION FOR THE EARLY WEEKS

Lochea. It happens even with a C-section.

Having a c-section does not exclude you from postpartum bleeding. Expect lochea (blood and discharge) to occur until about 4-6 weeks postpartum. It should gradually get lighter as time passes. Blood starts off as being more red/pink and heavier and progresses to being more brown and lighter. If you notice that bleeding gets heavier or progresses from being brown back to red/pink, it could be an indication that you did too much activity the day prior. 

I highly recommend getting a peri-bottle for home! This is used to rinse the area of bacteria after using the bathroom instead of wiping. You can usually get one from the hospital or order a Frida one online.

Your first postpartum poop

Your first and subsequent poops early on can be tough (see section below about gas pain). Thanks to constipation, it can be tough to pass a BM. If you labored prior to your c-section, your pelvic floor is still recovering as well.

Here are some helpful tips:

• Get a squatty potty: this handy stool puts your pelvis and pelvic floor in a position that relaxes the muscles and allows for an easier exit with less strain. 

• Stay hydrated: aim to consume one half to full body weight in ounces of water each day, especially with breastfeeding/pumping.

• Brace/splint abdomen with pillow as mentioned above in order to help generate some pressure to push with less pain

• Exhale as you push. Blow out and relax the pelvic floor (think “flower blooming at the anus”). This decreases straining.

• Supplement with magnesium citrate (if OK with MD) - a natural, gentle laxative that helps relieve constipation by loosening stools. I like Calm gummies or powder (linked in “helpful products” page.

• MD may also recommend continuing to take medication like Colace or Miralax. Speak with your practitioner about this.

Gas and Bowel Pain

After any abdominal surgery, it is not uncommon to experience gas and/or bowel pain. This can be caused by a combination of anesthesia, medications, or inflammation from the surgery itself. Here are the best means of managing discomfort:

• Movement - nothing strenuous, but ambulation helps moves things along

• Chewing gum

• Gentle abdominal massage

• Hydration

• Nutrition - specifically fiber-rich foods, avoiding foods that cause extra gas

• Peppermint tea

Showering

You can typically shower 24 hours after surgery. You can remove the bandage, but the steri-strips will stay on. You can allow water and soap to run over your incision. Gently pat it dry with a clean towel afterwards. 

Steri-strips will eventually fall off within the first 2 weeks post op. If they don’t fall off themselves, you can gently remove them at the 2 week mark.

Should I Ice the Area?

Ice can help relieve soreness and swelling in those first few days/weeks. Having an ice pack handy to use on and off throughout the day is useful.