Pregnancy is much comparable to an odyssey, a long and eventful experience. After harbouring her unborn child for many months, the mother’s wait finally comes to a closure under the grand setting of labour or childbirth. It can indeed be a moment of overpowering emotions for the mother, and everyone else whose attention has now been shifted to the new member. However the care of a pregnant mother should not end with childbirth, especially in case of a C-section delivery.
In this article we will take a look at the various aspects of postpartum recovery after a C-section delivery.
- What is a C-section?
- What happens during a C-section?
- How long should the mother stay in the hospital after a C-section?
- What is to be expected during the first few days after a C-section?
- What is the normal time to recover after a C-section?
- How soon can the mother start breastfeeding her baby after a C-section?
- How should the mother care for the C-section wound after the procedure?
- When does it become necessary to consult a doctor for symptoms, after a C-section?
What is a C-section?
A C-section or a “Cesarean section” is defined as the delivery of the baby through an incision in the abdominal wall and the uterine wall.
The overall incidence of C-section delivery rates have increased worldwide over the last 20 years, due to the safety afforded to surgery with the advent of effective antibiotics, blood transfusion and improved anaesthesia.
Some C-sections may be planned, whereas some happen unplanned, due to emergencies.
A C-section may be performed for the following indications:
- Fetomaternal- Both maternal and Fetal complications coexist.
- Fetal- When prompt delivery is needed for fetal well-being, and vaginal delivery is to be avoided for the sake of the fetus.
- Maternal- When safe vaginal delivery is unlikely, labour is contra-indicated or prompt delivery is needed to safeguard the mother’s health
More than 75% of C-section deliveries are performed due to prior C-section, Dystocia, Fetal distress or Breech presentation.
What happens during a C-section?
After proper preoperative procedures and effective anaesthesia, the obstetrician makes a horizontal incision in the skin and the abdominal wall, low down on the pelvis. Some women may have a vertical cut as well.
After the abdomen is opened, a second incision is made on the uterus, which is typically a horizontal incision. This ruptures the amniotic sac surrounding the baby. Once this protective membrane is ruptured, the baby is removed from the uterus, the umbilical cord is cut, and the placenta is removed. The baby is then examined and given back to the mother for skin-to-skin contact.
Once the delivery and afterbirth are completed, the incisions made to the mother’s uterus are sutured, which will ultimately dissolve under the skin. The abdominal skin is closed with stitches, which are removed before the mother leaves the hospital.
A lower segment uterine incision is preferred over an upper segment one, because the healing of the former is better and risk of rupture in a subsequent pregnancy is low.
How long should the mother stay in the hospital after a C-section?
The procedure of a C-section delivery alone only takes around 10-15 minutes to complete, and an additional 30 minutes to complete suturing.
The mother may need to stay in bed for a full day after C-section, after the anaesthesia wears off. Hospital stay is typically between 2-4 days.
What is to be expected during the first few days after a C-section?
The new mother may feel soreness in the abdominal area, after a C-section. Healing of the skin and nerves around this area takes time. The doctor will monitor her closely for 24 hours to look for any signs of discomfort, or complications. Regular inspection of the surgical wound will be done, to ensure its proper healing.
Sometimes there may also be some gas build-up in the abdomen, which may be relieved by medications. Walking is a little difficult initially, but the pain gradually decreases in a few days. The mother is allowed to start by drinking fluids and the switch to a light diet within six to eight hours of the surgery. She will be given pain medications to combat the post-surgical pain, and mostly these are continued for upto 2 weeks.
The mother may also experience bleeding and discharge for about 4 to 6 weeks after surgery, which gradually changes colour from bright red to pink and then to yellow-white (lochia).
Some things to remember during post C-section recovery phase are:
- Get plenty of Rest: The new mother should give her body the time to heal itself, and should get adequate rest. The mother is advised to rest, whenever the baby is resting.
- Minimize Exertion: During the initial few days, it is recommended to take as little physical exertion as possible. When coughing or sneezing, hold the incision site with the hand, in order to protect the suture. Avoid strenuous exercise, but take gentle walks. This helps the body heal and prevent constipation and blood clots.
- Take the medications regularly: The mother will be prescribed pain-relieving medicines and sometimes blood thinners, which need to be taken without fail.
- Focus on good nutrition: eating a healthy and balanced diet ensures the health of both the mother and the baby, who is dependent on the mother’s breast milk for nutrition. The mother should also drink plenty of water, to produce adequate breast milk, and to prevent constipation.
- Sexual Intercourse: Physical recovery from a c-section takes up to six weeks. However the recovery varies from different individuals. Sometimes sexual intercourse after a C-section may be painful for the mother, and hence it is ideal to consult the doctor before this.
- What is the normal time to recover after a C-section?
A C-section is a major surgery, and it indeed takes a toll on the mother’s body for weeks afterward. The ideal recovery time varies between 4-6 weeks, but ultimately it depends on how the mother feels physically and emotionally.
How soon can the mother start breastfeeding her baby after a C-section?
After a C-section, breastfeeding must be started within 1-2 hours post-delivery or as soon as possible, in case the mother has not regained consciousness.
How should the mother care for the C-section wound after the procedure?
The scar of a C-section will remain intact, throughout the life of the mother. As time progresses, It will become a little faint, but will never completely vanish. Initially, the scar is puffy, raised, and darker than the rest of the skin. Later, it starts to shrink and tends to lighten and fade to almost match the surrounding skin. Healing may normally be associated with itchiness, and loss of sensation around the wound initially.
Proper wound care can be done by:
- Wearing loose clothes that don’t chafe the wound site.
- Keeping the wound clean and sterile.
- Avoiding exertion
- Supporting the abdomen and wound site when coughing, sneezing etc.
- Lying on one’s back while sleeping.
When does it become necessary to consult a doctor for symptoms, after a C-section?
The healing process after a C-section, is time consuming ang lengthy. It is important to allow the body time to revitalize itself. Sometimes during recovery, Itching and pulling sensations around the incision as well as numbness may be experienced. These are normal and will pass.
However in case of the following symptoms, it is necessary to seek urgent medical help, as it may point to infection:
- Painful urination or a burning sensation while passing urine
- Post-surgical abdominal pain which becomes progressively worse.
- Loose stools
- The wound becomes red, swollen or painful
- Would has a discharge or pus
- Vaginal bleeding that does not reduce, or becomes heavier
- Rise in body temperature (fever)
- Cough, chest pain or dyspnoea
- Swelling of legs