Recovery After C-Section: Timeline and Tips
You may have been prepared for your Cesarean section, but do you know what to expect after the operation? Our C-section recovery guide will help you prep for side effects, scar care, and everything in between.
About one-third of all babies are born via Cesarean section in the United States today. Still, in many childbirth classes, a C-section delivery—and the recovery that follows—is not covered in much depth, if at all. Here's what you need to know about recovery after a C-section.
One Hour After C-Section
Immediately after surgery, you'll move to a post-operative area where you'll remain under observation, with hospital staff monitoring things like bleeding (from your vagina and incision), blood pressure, and temperature. An IV will deliver fluids and a catheter will collect your urine in a bag, which eliminates the need to get up for the bathroom.
At this point, you still won’t have sensation in your lower body because of the anesthesia, and you may feel a bit shaky and woozy from morphine in your IV. The good news: Barring complications, you'll be able to hold and breastfeed your baby right away.
One Day After C-Section
After several hours (considering there aren’t any complications), you'll be wheeled from the post-op area to the postpartum recovery unit. You may be offered ice chips and then switched to a liquid diet (think broth and juice) until your doctor clears you to eat solid food.
Following your surgery, nurses will massage your uterus to encourage it to contract and shrink to its normal size. (Sadly, this isn't as soothing and spa-like as it sounds.) You'll be encouraged to get out of your bed, if possible, on the same day. Yes, you just had major abdominal surgery—but the activity will help speed your C-section recovery.
C-section pain typically spikes 18 hours after delivery. "That's when the pain medication you were given with your spinal anesthesia wears off," says San Diego perinatologist Sean Daneshmand, M.D. At that point, you will be given an oral narcotic; or you may have "patient controlled analgesia," in which pain medication is delivered through your IV. By the time you go home, you will probably only need a nonprescription anti-inflammatory such as ibuprofen.
Two Days After C-Section
Doctors will likely remove your catheter on the morning of the day following your C-section surgery. This means you'll be walking—at least to the bathroom and back, and possibly farther. "After the first day, we recommend increasing activity as rapidly as possible, but do recognize that this may cause C-section pain," says Aaron B. Caughey, M.D., a former member of the American College of Obstetricians and Gynecologists committee on obstetrics practice. "Increased physical activity helps with circulation, improves bowel function, and will get you back to baseline sooner."
You also can shower within a day of your surgery; doing so helps reduce the risk of infection. "Don't scrub your incision, but let the soapy water run over it," Edelman says. (Your bandages will be removed about 24 hours after surgery and replaced with small sticky bandages called Steri-Strips; it's fine if these get wet.) Dry the area by gently patting it or using a blow-dryer set on cool.
Prefer to take a bath after a C-section? Unfortunately, submerging yourself in water is only safe once the incision has healed—generally seven to 10 days after surgery.
At this point in your recovery after C-section, you’ll be wearing a pad for bleeding, which may last several weeks following delivery. (Yes, even after a C-section!) This totally normal discharge is called lochia, and it's a combination of leftover blood, mucus, and uterine tissue.
After your IV is removed, you'll be asked about your C-section pain (repeatedly!) and given medicine as necessary. By this point, if not earlier, you're likely eating solid food. Swelling after a C-section is completely normal, and gas pains can be excruciating. They should pass within a week, once your bowels are moving normally again (abdominal surgery causes them to "shut down" temporarily, so pooping after a C-section might not come easy). In the meantime, taking anti-gas medication and a stool softener will help—and so will walking around. Your physician might also recommend taking simethicone tablets (Gas-X), which help alleviate gas and bloating.
Four Days After C-Section
Although moms who give birth vaginally generally stay in the hospital for about two days, the C-section recovery timeline has you staying for approximately four days. Of course, this is dependent on your insurance coverage and barring any complications. Before you leave, your doctor will remove your staples, if you have them (sutures will dissolve on their own) and cover your incision with Steri-Strips, which are similar to paper Band-Aids and should fall off on their own.
You'll be advised on caring for your incision; keeping the wound clean and undisturbed is your best course. "There have not been any good scientific studies demonstrating that any of the over-the-counter preparations are better than just proper wound care," says Rajiv B. Gala, M.D., the American College of Obstetricians and Gynecologists' young physician at large.
You'll also be instructed not to lift anything heavier than your baby, and to avoid sex, tampons, and douching until after your six-week check-up. The American College of Obstetricians and Gynecologists recommends not placing anything in the vagina for several weeks to prevent infection. Driving after a C-section is a no-no, and so is taking the stairs. You might recruit a partner to move your essentials downstairs if you have a multi-story home—or, at the very least, batch your trips so that you climb stairs only when it's essential.
Week 2 of C-Section Recovery
You'll see your doctor again for a postpartum check-up to examine your incision, which should not show excessive swelling after C-section, redness, or signs of infection. (If you see these signs, or are running a fever higher than 100.4°, call your doctor.) Discuss any concerns you have, and ask for an update on recommendations regarding activity.
Although you're only two weeks out from a major abdominal surgery, you should expect to feel tremendously better by this stage. But keep in mind that you’ll feel C-section pain and cramping for several weeks. "Whether you delivered vaginally or by C-section, it takes six weeks for the uterus to contract to its normal size," Daneshmand says. Resting a heating pad or hot-water bottle on your belly (but not on the incision) can help; so can ibuprofen.
You can still expect to look pregnant at this stage (and much longer, for many people) before your uterus shrinks down to its original size
Week 4 of C-Section Recovery
By this point, you'll be moving more swiftly and comfortably, taking longer walks, and noticing your bleeding taper off. But keep your expectations in check. "Don't compare your recovery to someone else's because our recoveries vary as much as our genetics, and comparisons will only frustrate those who take a bit longer to recover," says Shawn Tassone, M.D., an Austin, Texas-based Ob-Gyn and author of the books Hands Off My Belly! and Spiritual Pregnancy. "Listen to your body, and if things hurt, slow down; if you feel tired, rest as much as you can. And it's okay to take the pain medications prescribed to you by your provider."
Week 6 of C-Section Recovery
Good news: You're likely fully healed now! "Full recovery from an uncomplicated cesarean section can range between four and six weeks," says Dr. Gala, who notes, "The healthier you are before surgery, the quicker the recovery."
At this point, Dr. Tassone says, most of your sutures, if you had them, will have been about 50 percent absorbed, your uterus will be back down to its normal size, and you'll be free to have sex. "Some women may still have pain if they're bumped along the incision, but for the most part the wound is perfectly healed at this point, and you can resume all normal activities," he says.