If you've delivered by caesarian then not only are you a new mum, with all the excitement, joys, challenges and post-partum discomforts that entails, but you're also recovering from major abdominal surgery. Women have different experiences of recovering from caesarians, but generally you can expect some pain around the incision for several weeks after the birth and it's usual for the wound to take six weeks or even longer to fully heal. With all that you can expect the recovery period to be significantly longer than after your average vaginal birth, but there's plenty you can do to make the recovery period more positive, both for you and your baby.
1. Coping with the pain - More likely than not there will be abdominal pain after a c-section, which will be at its worst for the first two days, after which it usually subsides significantly. However, the painkillers you are given are usually very effective. This is great, of course, but it can also lull you into a false sense of security: In the first day after the section you may think that you won't suffer much from pain, as the painkillers do such a great job, only to later have an unpleasant surprise when the painkillers wear off. So do accept the painkillers you are offered - you can decide later what you do or don't need but at least you'll have them to hand. When you are in pain don't wait until it is very bad before taking medication, as this will make it harder for the painkillers to work.
If you're worried about taking painkillers while breastfeeding then talk to your doctor.
2. Be realistic - It will help you enormously, mentally and emotionally, if you're realistic about the progress of your recovery after a c-section. If you expect to simply bounce back within days then you're likely to end up feeling frustrated and negative - emotions which will be picked up on by your baby. So make sure you've read widely on what to expect during recovery and pay attention to the advice handed out by the doctors and nurses at the hospital.
3. Avoiding wind - You may have thought you'd be seeing the end of excessive wind with the end of pregnancy, but painful wind is common in the first few days after a caesarian and may be felt elsewhere around the body, not just in the abdomen. The same tips that eased the problem throughout pregnancy will help: avoid greasy and spicy foods as well as carbonated drinks. Warm drinks such as fennel tea can help relieve the wind, as can taking gentle exercise, such as a short walk, or rocking in a chair.
4. Get support - Now isn't the time to strike an independent pose, so don't be afraid to ask for help from friends, family, health professionals and, if necessary, counsellors. If you're concerned about anything to do with your recovery then do ask questions and seek help. It's far better to take a few minutes of your doctor's time to ask whether something is normal than it is to worry about it, which will disturb both you and, by extension, your baby.
5. Move around - Now we're not talking about getting out the aerobics tapes or going for long walks in the park right away, but as soon as the doctors tell you it's ok to move around a bit then do start to incorporate gentle activity into your day. Get up and walk around a little, rather than staying in bed, and encourage your circulation to get the healing process going. At first the idea of getting out of bed might seem daunting, but with each day that goes by you'll be able to do a little more.
Save proper exercising for a few weeks after the operation when you're feeling a bit more normal and are healing well. When exactly you can start exercising again will depend on how you're recovering and for many women it will be about six weeks. Once you do start exercising it will give you an important pick-me-up and help you on the road to recovery, but take it very easy at first and get the go-ahead from your doctor before getting out your trainers.
6. Caring for baby while avoiding straining - In the hospital there will probably be constant reminders to avoid straining your wound, once home however it might not be so easy. Getting up out of bed can strain your stitches and lifting anything remotely heavy, not to mention numerous household chores, will be simply out of the question in the first few weeks. Even lifting your baby may be difficult at first but that doesn't mean you won't be able to care properly for her, and the development of intimacy between the two of you needn't suffer because of a the operation.
It's a good idea to plan your day around being on one floor, or even in one room, of your home at first as carrying your baby up and down stairs isn't practical for the first few weeks. Get your partner or family members to help you organise changing, bathing and other essential baby care items so that everything you are likely to need is close to hand to make it as easy as possible on you.
Some kind of support will reduce the strain of getting in and out of bed without always relying on someone else for help - you could try a strap or two tied to the bottom of the bed to pull yourself up on without straining your abdomen. If you're having a planned c-section and can organise everything beforehand then all the better.
7. Don't overdo it - In your eagerness to recover it's easy to bite off more than you can chew, especially once you're back home when you can see chores going undone and piles of ironing building. It's important that you don't take too much on however - this is a time when it will pay to act a little like the princess on the pea. You'll have enough on your plate coping with recovery and getting to grips with caring for your new baby, so get your partner or other family members to help around the house and do the shopping. If that's not possible, or even if it is, consider hiring someone to come in to help for a while, so that you're left as fresh as possible for the time you have with your baby.
8. Screen your visitors - Any new parents need time to adjust to life with a new baby and while friends may want to come and welcome your little one to the world, it's not the best time for entertaining. This is all the more true if you're recovering from a c-section. Put off the kind of visitors who will come to coo over baby and expect cups of tea and hostessing and welcome instead those who will turn up with ready cooked meals and a cleaning cloth tucked under one arm. If you don't want people to visit then have no compunction about saying so nicely.
9. Talk about it - Most advice on c-section recovery focuses on your physical recovery, but you may also need time to recover emotionally, particularly if the circumstances surrounding your section were traumatic, unpleasant or just very unexpected. After an unplanned caesarian some women may feel very disappointed that they were unable to deliver vaginally: for some women the operation can even lead to depression. You may feel let down by the medical team and feel anger, or a sense of failure and guilt that you could have prevented the operation yourself had you done things differently - which you couldn't. It's important to work through all these feelings by talking about them with someone sympathetic. You may have some kind of debriefing opportunity with your midwife after the birth where you can discuss what you were disappointed by. It may also help to write things down. Confronting your feelings and giving them an outlet should allow you to move on and focus completely on enjoying your baby. Online forums such as the one here on ThinkBaby can be a useful source of advice and support from women with similar experiences.
If you are displaying any symptoms of depression it's important that you talk to your doctor about it and seek professional help.
10. Breastfeeding - Apart from being best for baby, the intimacy of breastfeeding can give you both important bonding time together and may help with your emotional recovery after a c-section.
Catheters, pain killers and a sore wound may make breastfeeding more challenging at first, but some women will have no problem at all. You might have to try a few feeding positions out to see what works best for you and your baby. One way to ensure you don't put any pressure on your healing wound is to lie on your side with your baby lying next to you to feed. Cushions will help you find and maintain a comfy position, as well as to support your baby during feeds - V or banana-shaped nursing cushions are particularly good.
Seeing a breastfeeding counsellor can be a huge help in getting things going and if you're having a planned c-section then take advantage of the fact to ask in advance for support and tips on breastfeeding post-op so that you're as well-prepared as possible.
While breastfeeding is generally best for you and baby, this doesn't hold true if struggling to breastfeed is causing you anxiety and unhappiness. If you feel it's just not right for you then make the switch to bottle feeding without feeling guilty.
Whether or not you're planning a caesarian it can pay to be well prepared in knowing what's involved, you can find out more about the procedure itself, and why it's performed, here.