What Are the Signs of Infection After a C-Section?

Surgical incision and uterine infections are relatively common after a cesarean section (C-section), and millions of babies are delivered via this method every year. According to the Centers for Disease Control and Prevention (CDC), 31.8% of American babies are born this way.

And while Whitney B. You, M.D., MPH, an assistant professor in the Department of Obstetrics and Gynecology at Northwestern University's Feinberg School of Medicine, says cesarean sections are generally safe, infections can occur. Approximately 3 to 15% of people who have a C-section will get an infection in the uterus, belly, or incision site.

Here's what you need to know about the signs of C-section infection and how to properly prevent and treat them.

What Are the Signs of C-Section Infection?

A C-section scar can get infected if bacteria enter it—and, if this bacteria spreads, a uterine or abdominal infection might develop. Symptoms usually appear within a few days of surgery.

Signs of an infected C-section incision include:

• Redness around the incision
• Abnormal swelling around the incision
• Fluid leaking from the wound
• Increasing pain at the wound site, or pain that doesn't get better
• Heavy bleeding at the wound site

Common signs of an internal or uterus infection after a C-section include:

• A fever over 100.4ºF degrees
• Increasing abdominal pain
• Chills, fatigue, body aches, or flu-like symptoms
• Foul-smelling vaginal discharge

Risk Factors for C-Section Infections

The risk of infection depends on the reason for the C-section, says Pamela Promecene, M.D., professor and obstetrician with McGovern Medical School at UTHealth/UT Physicians in Houston. For example, a planned C-section has a slightly lower risk than an emergency C-section, since doctors and patients have more time to prepare for the surgery.

What's more, certain parental factors increase the risk of infection after a C-section, including obesity, poorly controlled diabetes, having a previous C-section, taking immunosuppressant medication, and smoking, says Dr. Promecene.

People who are allergic to penicillin may also have higher odds, adds David Colombo, M.D., director of maternal-fetal medicine at Spectrum Health. "When giving antibiotics, we adjust the type we give to the patient based on their weight and allergies. If someone is unsure if they have a penicillin allergy, they should talk to an allergist to get tested," he says.

Can You Prevent a C-Section Scar Infection?

If you have a planned C-section, the doctor may request that you shower with a special antibacterial soap prior to the procedure. Patients are usually discouraged from shaving beforehand, Dr. Colombo adds. And "antibiotics are given routinely before cesarean section to decrease the risk of uterine infection," says Mabel Wong, chief of the OB-GYN department at Kaiser Permanente in Hawaii.

People with diabetes can also take measures to limit their chances of infection. "If you have diabetes, it is best to control your sugars in the time just before and just after surgery," says Dr. Promecene. "The doctor can guide you on how to best manage your sugars."

Once you head home from the hospital, it's important to follow wound care instructions to prevent an infected C-section incision. This usually means cleaning the scar and changing the bandages regularly. You should also avoid placing the baby's weight directly on your wound.

A few other steps to prevent infection after a C-section include:

• Waiting to have sex: Do not have sex or insert anything into the vagina for at least six weeks during the postpartum healing process.
• Treating your pain: Your doctor may recommend taking over-the-counter pain medications or using ice packs and heating pads to help alleviate any discomfort and pain.
• Avoiding heavy lifting: As your body heals from surgery, avoid any activity that could cause physical injuries, such as heavy lifting or high-intensity workouts. The Mayo Clinic recommends not lifting anything over 25 pounds.

How Are C-Section Infections Treated?

A C-section incision infection or uterus infection will likely be treated with antibiotics (intravenous antibiotics if you're still at the hospital and prescribed oral antibiotics if you're home). Your prescribing doctor will select the appropriate antibiotic for your specific infection. In severe cases, they may conduct a small surgery to prevent further complications.