After your caesarean section (c-section) operation you will be moved from the operating table onto a bed. You and your baby will be taken to a small ward, which is sometimes called the recovery room.
You can continue having skin-to-skin contact with your baby while you’re in the recovery room. Your midwife will help you find a comfortable position for putting your baby to the breast.
If you and your baby are well, you will move to the postnatal ward after a few hours.
In the recovery area and on the postnatal ward, you will have:
- regular checks to make sure the anaesthetic is wearing off – your midwife will also check your breathing, heart rate, blood pressure, wound dressing and pain relief for the first few hours
- regular checks on the amount of vaginal bleeding you have – the midwife will also make sure you’re changing your maternity pads regularly
- a catheter to drain urine from your bladder - your midwife will check you have passed enough urine within six hours and will take the catheter out about 12 hours after the operation, once you are up and moving around
- compression stockings to reduce your risk of blood clots
- a needle in your arm (drip) to give you fluids until you’re eating and drinking again - you can usually eat and drink as soon as you feel ready.
Recovering from surgery
The speed of recovery from a c-section varies from woman to woman. There are many things that can affect your recovery, such as the type of c-section you had. But all c-sections are major surgery and you will need help with lifting your baby and getting out of bed for at least the first day.
You will need to stay in bed until the anaesthetic wears off. If you had a spinal or epidural anaesthetic, this usually takes a few hours. It will take longer if you had a general anaesthetic. While you’re in bed, you won’t be able to pick up your baby and so you’ll need help with feeding and nappy changing. If you need help, you can press a call button attached to your bed.
‘After my c section, I was able to have my husband with me and I had lots of support from the midwives, support workers and students. They were there to help me feed, change and lift my baby, which was a great support and allowed me to rest.’
You’ll need help to sit up in bed while you’re recovering from the anaesthetic. You may need help for longer than this if you have a lot of pain or tenderness in your abdomen (tummy area). Your hospital bed will have controls, which you can use to raise and lower the head of the bed and move the bed higher or lower off the floor.
‘I wish I had been told how hard and painful it would be to try and sit up in bed after a c-section.’ Sarah
Post-operation pain relief
Your wound is likely to feel sore and bruised for a few days or weeks. Your midwife may give you paracetamol or a non-steroidal anti-inflammatory drug (NSAID), such as ibuprofen or diclofenac, to relieve pain. NSAIDS may cause stomach problems but taking them with food should help. Tell your midwife if you think your pain relief is causing any side effects.
If you are still having pain, your midwife may offer you a more powerful (opioid) painkiller, such as morphine. These painkillers can make some people feel drowsy and sick. If this happens, your midwife will give you a different type of pain relief.
To help control any pain:
- take your pain relief regularly and on time, even if you don’t have pain at the moment
- tell the midwife straight away if you are still having pain.
The amount of pain relief recommended by your midwife or doctor should be safe for you to take while you’re breastfeeding. Small amounts of any medicine you take may pass into your breastmilk but they are unlikely to harm your baby if you take them as instructed. However, codeine or co-codamol (which contains codeine) may be harmful for your baby. Always check with your doctor, midwife or pharmacist before taking any medicines. Your midwife may give you painkillers to take at home, such as paracetamol or ibuprofen.
‘I felt I could manage the pain during the day but it seemed worse at night. I had to take a stronger painkiller each night I was in hospital. Afterwards, I made sure I took regular pain killers and kept on top of the pain. Keeping moving helped too.’
Your c-section wound
You will have a waterproof dressing covering your wound. Your midwife may ask you to take the dressing off 24 hours after your c-section so they can check your wound.Many women find it easiest to do this in the shower because the warm water helps to reduce any discomfort.
You may not need another dressing, but if you do, your midwife will remove it when they visit you at home.
Once your dressing has been removed, keep your wound clean using plain water. Avoid using soap and pat the area dry gently with a soft towel, rather than rubbing.
You may find it more comfortable to wear loose clothes and cotton pants that sit above your wound.
Your wound is closed with either stitches or clips. Some women have stitches that dissolve once the wound has healed. Otherwise, your midwife will remove the stitches or clips when they visit you at home, about five to seven days after your c-section.
Getting up and moving around
Once the anaesthetic has worn off, you’ll be able to stand up and go for a short walk. You are likely to feel wobbly the first time you get up and you will still have your catheter, so you will need the midwife to help you. Your abdomen (tummy area) may feel tender and heavy. Your midwife can give you some pain relief beforehand to make you more comfortable.
It’s important to move around soon after your c-section to reduce the risk of blood clots. Other ways of reducing this risk include:
- drinking plenty of fluids
- wearing compression stockings
- having a daily injection of a blood-thinning drug after surgery – your midwife will tell you if you need this and for how long.
Only use medical compression stockings that your midwife has given you. They will measure your lower legs to make sure the stockings fit you properly. You’ll need to wear the stockings day and night for as long as your midwife advises, only taking them off to shower. You will normally only have one pair so you may want to wear slippers to stop them getting dirty.
Your catheter will be taken out about 12 hours after your operation, as long as you’ve been able to get out of bed. This feels uncomfortable but it isn’t painful. Once your catheter is out, you will be able to walk to the toilet and have a shower. It can be a good idea to ask someone to walk to the bathroom with you the first time in case you feel unsteady on your feet.
Your midwife will encourage you to drink plenty of fluids after your catheter is removed. They may ask you to measure the amount of urine you pass the first couple of times you go to the toilet, to check you don’t have any bladder problems. Tell your midwife if you have any discomfort when you pass urine.
The bathrooms are usually large enough for you to take your baby’s cot in with you, if you don’t have someone to look after your baby while you wash. Some hospital showers have seats, which can be helpful if you find it difficult to stand for very long. Don’t worry about getting your wound dressing wet – they are waterproof so your wound will stay dry.
‘The day of the surgery, I stayed in bed with a catheter in place. The next morning, the midwife helped me to get out of bed and have a shower. There was a pulling feeling in my abdomen that was very uncomfortable but they advised me to keep my hand pressed against it, which helped.’ Laura
Vaginal bleeding after a c-section is normal. It lasts for two to six weeks after the birth and mainly comes from where the placenta was attached to the womb.
Trapped wind and constipation
It can take a few hours or days after your c-section for your bowel to start working again. In some women, this can cause painful trapped wind and constipation. Some pain medicines can also cause constipation.
Chewing gum may help to get your bowel working and help you feel more comfortable.Some women say that peppermint tea helps to relieve trapped wind. Drinking prune juice may help with constipation.
‘I had very painful trapped wind. A midwife offered me some peppermint tea and within minutes the pain was gone.’
To help you manage constipation:
- drink 6-8 cups of water a day
- eat regular meals
- don’t put off going to the toilet and give yourself plenty of time to go
- when you’re sitting on the toilet, put your feet on a footstool or a pile of books
- move around as much as you can.
Your baby after a c-section
As long as you are both well, you and your baby will stay together on the postnatal ward after your c-section. This is an important time for you, and your partner, to bond with your baby, for example, by having skin-to-skin contact.
Your baby may cough up mucus in the first few days after your c-section. Mucus is usually pushed out of the baby’s lungs during a vaginal delivery, but this doesn’t happen during a c-section. The mucus can make it harder for your baby to feed and it can be worrying for you but it is normal and should get better after a few days.
‘My baby kept coughing up mucus, which meant I had problems breastfeeding her.’
When can I go home?
You will usually stay in hospital for between two and four days. If you and your baby are well, and you have someone to help you at home, you may be able to go home after 24 hours.
You may not feel ready to go home, especially if this is your first baby or if you or your baby have needed extra help. Your hospital midwife will help you with any problems you may be having and may be able to put your mind at rest.
Once you are home, you’ll have support from your community midwife and your health visitor. The midwife will visit you the day after you get home. They will visit again five to seven days after your c-section, to remove your stitches or clips and check how you and your baby are doing. They will let you know how often they will visit and when they expect to discharge you from their care.
You will also have support from your health visitor. They may visit you at home to begin with, then you will usually visit them at a regular clinic. Your midwife or health visitor can put you in touch with other parents and local support groups.
When you leave the hospital with your baby, someone else should drive you home. If you don’t have any family or friends who can take you, book a taxi. You shouldn’t drive until you have recovered.
Don’t forget your baby’s car seat.
Preventing blood clots
Before you leave hospital, your midwife may give you a supply of a blood-thinning drug to reduce your risk of blood clots. You may have had injections of this drug each day since your c-section.
The midwife will show you how to inject yourself. You will need to have the injections once a day for about a week after your c-section. If you have a higher risk of blood clots, you may need to have the injections for up to six weeks.
If you’re worried about doing the injections yourself, you can ask a family member or friend to do it for you. But they’ll need to be available to give you the injection at the same time each day.