Puerperium after c-section

Delivery by Caesarean section, also known as a C-section, differs significantly from a natural birth. This is associated with the differences in the postpartum recovery, such as scare care. Learn about the postpartum period following a C-section.

Pain after the birth

A C-section section is performed under subarachnoid anaesthesia or under general anaesthesia. Typically, the anaesthesia is administered also after the procedure, through a catheter, in a drip or injection.

A C-section involves making an incision in the woman’s abdomen and uterus. It is a serious procedure, and the incision site may remain painful for a long time before it heals completely. The doctor will prescribe suitable analgesics, e.g. in suppositories, which are not harmful for your baby if you are breastfeeding, and will help you to survive this most difficult time.

Side effects of anaesthesia

Unfortunately, the anaesthesia that you received affects your organism. Many women complain about headaches and back pain after subarachnoid anaesthesia. General anaesthesia can also cause headaches, as well as vomiting. Narcosis may lead to a feeling of disorientation and weakness.

Following a C-section, fast mobilisation is recommended; however, this should begin with a few simple exercises. Move your feet and hands to stimulate blood circulation. Do not get up on your own. Ask the hospital personnel how you should proceed, whether you can get up, and to what degree you can take care of your baby, e.g. start breastfeeding. Each case is unique, so find out if your condition allows you to make these first steps. Remember to avoid excessive exercise, and try not to stoop, which is frequent among women who are worried about their sutures and wound.

Urination and bowel movements

Once you can walk on your own, you can also go to the toilet. Following the surgical procedure there is a catheter that needs to be removed first. At the beginning, urinating and bowel movements can be difficult, and sometimes women experience a psychological barrier. They are afraid to contract the muscles, scared of the pain, and worry about the condition of the wound. Give yourself time. If you have problems with bowel movements, eat foods rich in fibre, dried fruit (plums), wholemeal bread and groats. If this does not help, try glycerine suppositories, as they are safe and will help you relieve your bowels. Exercise has a good effect on intestinal peristalsis, so the sooner you start walking, the better it is for your organism.

Surgical wound

You can take showers, but you should not take baths. If the dressing becomes soaked, change it. The sutures are removed approximately 7 days after the surgery. After 4-6 weeks you can start using ointments and creams to promote good wound healing and reduce the risk of keloid formation. The wound may be painful, and then become itchy. Wear loose underwear, and try to avoid friction in the wound area. Your clothes should be breathable, natural, and not too tight. Currently, the incision is made low, close to the pubic symphysis, and it is approximately 10 cm long. It is usually invisible even when wearing a bikini.

Remember!  If the wound is swollen or red, becomes more painful, oozes puss, or if you develop a fever, contact your doctor, as these may be signs of infection and inflammation.

Lochia

Lochial discharge does not apply only to women who had a natural birth. For women undergoing a C-section the uterus still needs to clean itself out, although there may be less lochial discharge than after a natural birth.

Uterine contraction

During the postpartum period, regardless of the type of birth, the uterus contracts. It may be quite unpleasant, and you may experience cramps that also increase during breastfeeding. This is due to the secretion of oxytocin, which plays a role in uterine contractions.

Breastfeeding

It is a myth that a woman who has had a Caesarean section cannot breastfeed. She can, although initially it may be a bit more difficult.

There is a reason for the saying that milk is produced in the mother’s head. For this to happen, lactation must be stimulated. The best stimulator is a baby put to the breast. Therefore, the sooner the newborn baby is placed on the mother’s breast, the better. After the procedure the mother cannot move freely, and she may find it difficult to find a comfortable position for breastfeeding. It is a good idea to ask a midwife or nurse for help.

The first comfortable breastfeeding position, right after the surgery, is the supine position. The baby lies at your side, across, where you can hold it with your arm. Later, if you can lie on your side, a side-lying position is also recommended after a C-section. Over the next few days, a “rugby hold” is very comfortable, as the baby does not touch your belly and so cannot hurt the sutured area. To initiate lactation, you should place the baby at your breast as often as you can.

If the mother is separated from the newborn, or skin-to-skin contact is prevented by her or the baby’s condition, expressing milk can help stimulate lactation. An electric breast pump is the most convenient option, although a manual breast pump is also acceptable. However, it may be difficult for a woman, tired after the surgery, to express milk manually.

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