What to expect after a C-section

If you’re planning a cesarean delivery or you want to be prepared in case you need to have a C-section, you might have questions about the recovery process. How much discomfort will you experience? What breastfeeding positions might work best for you? Understand how to take care of yourself and your baby during C-section recovery.

Treat your C-section incision with care

During the C-section recovery process, discomfort and fatigue are common. To promote healing:

• Take it easy. Rest when possible. Try to keep everything that you and your baby might need within reach. For the first couple of weeks, avoid lifting anything heavier than your baby.
• Seek pain relief. To soothe incision soreness, your health care provider might recommend ibuprofen (Advil, Motrin IB, others), acetaminophen (Tylenol, others) or other medications to relieve pain. Most pain relief medications are safe for breastfeeding women.

Look for signs of infection

Check your C-section incision for signs of infection. Contact your health care provider if your incision is red, swollen or leaking discharge.

Experiment with breastfeeding positions

You can begin breastfeeding almost immediately after the C-section. Breastfeeding positions that work well during C-section recovery include:

• Football hold. For comfort, put a pillow along your side and use a chair with broad, low arms. Hold your baby at your side, with your elbow bent. With your open hand, support your baby’s head and face him or her toward your breast. Your baby’s back will rest on the pillow and your forearm. Support your breast in a C-shaped hold with your other hand.
• Side-lying hold. Lie on your side and place your baby on his or her side, facing your breast. Support your baby with one hand. With the other hand, grasp your breast and touch your nipple to your baby’s lips. Once your baby latches on to breastfeed, use one arm to support your own head and the other to help support the baby.

For support or breastfeeding information during your C-section recovery, contact a lactation consultant.

Manage other postpartum signs and symptoms

While you’re recovering from your C-section, remember that you’re also recovering from pregnancy. Here’s what to expect:

• Vaginal discharge. After delivery, you’ll begin to shed the superficial mucous membrane that lined your uterus during pregnancy. You’ll have vaginal discharge made up of this membrane and blood for weeks.

  This discharge will be red and heavy for the first few days. Then it will taper, become increasingly watery and change from pinkish brown to yellowish white.

• Contractions. You might feel contractions, sometimes called afterpains, during the first few days after the C-section.

  These contractions — which often resemble menstrual cramps — help prevent excessive bleeding by compressing the blood vessels in the uterus. Afterpains are common during breastfeeding, due to the release of oxytocin. Your health care provider might recommend an over-the-counter pain reliever.

• Tender breasts. A few days after birth, your breasts might become full, firm and tender (engorgement) once they begin making milk. Frequent breastfeeding on both breasts is recommended to avoid or minimize engorgement.

  If your breasts — including the dark circles of skin around the nipples — are engorged, latching might be difficult for your baby. To help your baby latch, you might hand express or use a breast pump to express a small amount of breast milk before feeding your baby. To ease breast discomfort, apply warm washcloths or take a warm shower before breastfeeding or expressing, which might make milk removal easier. Between feedings, place cold washcloths on your breasts. Over-the-counter pain relievers might help, too.

  If you’re not breastfeeding, wear a supportive bra, such as a sports bra. Don’t pump your breasts or express the milk, which will cause your breasts to produce more milk.

• Hair loss and skin changes. During pregnancy, elevated hormone levels increase the ratio of growing hair to resting or shedding hair. The result is often an extra-lush head of hair — but now it’s payback time. After delivery, you’ll experience hair loss up to five months after delivery.

  Stretch marks won’t disappear after delivery, but eventually they’ll fade from red to silver. Expect any skin that darkened during pregnancy — such as dark patches on your face — to slowly fade as well.

• Mood changes. Childbirth triggers a jumble of powerful emotions. Many new moms experience a period of feeling down, anxious or inadequate, sometimes called the baby blues. Symptoms include mood swings, crying spells, anxiety and difficulty sleeping.

  The baby blues typically subside within two weeks. In the meantime, take good care of yourself. Share your feelings, and ask your partner, loved ones or friends for help.

• Postpartum depression. If you experience severe mood swings, loss of appetite, overwhelming fatigue and lack of joy in life shortly after childbirth, you might have postpartum depression.

  Contact your health care provider if you think you might be depressed, especially if your signs and symptoms don’t fade on their own, you have trouble caring for your baby or completing daily tasks, or you have thoughts of harming yourself or your baby.
• Weight loss. After your C-section, you might look like you’re still pregnant. This is normal. Most women lose 13 pounds (6 kilograms) during birth, including the weight of the baby, placenta and amniotic fluid. During your recovery, you’ll drop more weight as your body gets rid of excess fluids. After that, a healthy diet and regular exercise can help you return to your pre-pregnancy weight.

The postpartum checkup

The American College of Obstetricians and Gynecologists recommends that postpartum care be an ongoing process rather than just a single visit after your delivery. Contact your health care provider within the first 3 weeks after delivery. Within six to 12 weeks after delivery, see your health care provider for a comprehensive postpartum evaluation.

During this appointment, your health care provider will check your mood and emotional well-being, discuss contraception and timing of future pregnancies and review information about infant care and feeding. Your provider also will talk about your sleep habits and issues related to fatigue, and do a physical exam. This might include checking your abdomen, vagina, cervix and uterus to make sure you’re healing well. In some cases, you might have the checkup earlier so that your health care provider can examine your C-section incision. Use this visit to ask questions about your recovery and caring for your baby.