C-section recovery timeline: What to expect in the first few weeks

While a caesarean section is a very common procedure, there can still be a lot of unknowns about the surgery itself and the recovery period.

A lot of the literature around giving birth focuses on preparing for the labour and caregiving tips for new parents for those precious first days.

It's important to keep in mind that C-section recovery is recovery from major surgery, so we've gathered the most up to date advice on what to expect--from experts only.

Types of caesarean sections

Generally speaking, a caesarean birth can be classified as being either planned (elective) or unplanned (emergency).

There are many reasons why a caesarean section may be performed, including:

Planned C-section

A caesarean section is considered to be elective if there is a reason that prevents the baby from being born via vaginal birth.

This is a decision made after many consultations between patient and doctor based on the individual circumstances of the patient.

For example, you may opt for caesarean delivery if:

• You have had a previous caesarean section (or multiple caesarean births)
• The baby is in the breech position (feet or bottom first)
• Your placenta is covering the cervix (birth canal), partially or completely
• The baby is lying sideways and is not able to be moved by the doctor
• You are having a twin pregnancy and one of the babies is in the breech position

It's worth noting that some caesarean section procedures are performed due to the mother's preference, and this is something that should be discussed between the patient and doctor.

Regardless of the reasons why you opt for a vaginal delivery or a C-section, remember that it's a personal and complex choice that is really nobody's business except for the individual and their doctor (and of course, the baby).

If you are pregnant or planning to become pregnant and want to find out more about this procedure, be sure to discuss this with your healthcare professional.

Unplanned C-section

There are many reasons why an emergency caesarean section may be performed:

• Your labour is not progressing
• There is a concern for the health of the baby during or prior to labour
• There are complications for the mother, such as severe pre-eclampsia or severe bleeding
• There is a life-threatening emergency for you or your baby

What to expect: C-section recovery

Immediately after

Unlike minor day procedures that view 'recovery' as something that happens at home, a C-section is major abdominal surgery, so the recovery process starts as soon as the baby is out.

Immediately after the procedure, you can expect to experience the following:

• Your baby will be lifted out of the cut and carefully checked.
• You will be given your baby to hold pretty soon after this, with skin-to-skin contact a major priority as it can help solidify the bond between mum and baby and can help with breastfeeding. If you are unable to hold your baby for whatever reason, your support person will most likely be able to hold the baby.
• The umbilical cord will then be cut and the placenta removed.
• Typically, an injection will be given to help your uterus contract and minimise any bleeding, and antibiotics will be administered to prevent infection.
• The doctor will then stitch the layers of muscle, fat and skin back together, and a dressing will be applied to the wound.
• You will then be taken to a recovery room until you are ready to go to a ward. If you have had a general anaesthetic, you will most likely wake up in the recovery room. Once you're awake, you'll be able to hold your baby again.

The first 24 hours

• You will be encouraged to breastfeed. It's been shown that the earlier you start to breastfeed, the easier it is likely to be for both you and your baby, so this may occur in the recovery room.
• Make sure to ask for as much support as you need with breastfeeding as having C-section surgery can make it harder to start. The Royal Women's Hospital advises that if your baby is unable to feed on the breast, you'll be supported in expressing milk. This may be needed eight to 10 times every 24 hours.
• When you are feeling pain, tell your midwife or hospital staff so they can provide you with pain relief medication. This may make you a little drowsy, but for your comfort, it's helpful to stay on top of the pain.
• You may need an IV drip for the first 24 hours or so after the surgery until you have recovered from the anaesthetic.
• You can start to drink plenty of fluids as soon as you feel able to.
• Your midwife or doctor will advise when you can eat again. In some cases, early eating and drinking are encouraged and staff may provide chewing gum to help start your appetite.
• The catheter will remain in until the anaesthetic has worn off and you have normal sensation in your legs and can walk to the toilet. This may not happen until the next day.

The first few days in hospital

Most women stay in hospital between two to five days after a caesarean birth although this can vary. During this time:

• Walking around (carefully) can help with the recovery process, as well as prevent blood clots and swelling.
• It's also important to get as much rest as you can, especially in those first few days and weeks.
• You may have trouble with bowel movements for a short time after the operation. It helps to drink plenty of water and eat high-fibre foods to avoid constipation.
• When it's time for the dressing to come off, you will be given instructions on how to keep the wound covered, clean and dry. This will help it to heal faster and reduce the risk of infection.

The first few weeks at home

In Australia, postnatal care from a midwife is available to all women who give birth in a public hospital.

A maternal health nurse will check in on how your recovery is progressing.

While a caesarean section is a commonly performed procedure, like all surgeries, there are some risks to look out for.

Always talk to your doctor or midwife about any concerns you have. Some problems to look out for include:

• Abdominal pain or wound pain that is getting worse and is not helped by pain medication
• Ongoing or new back pain
• Pain or burning when passing urine
• Constipation
• Abnormal vaginal bleeding or unusual discharge
• Any weeping or incision pain from the C-section incision, or signs of infection

Tips for C-section recovery

It's normal to want to spend the first few weeks with your new baby as much as you can, but after major surgery, it's important to look after yourself (it always is, of course, but especially now).

Get as much rest as you can and ask for support and help.

This includes your extended family, friendship group and community. It takes a village, right?

Some other helpful tips:

• Do not lift any weight that is heavier than your baby, and be extra careful of your back when you lift.
• If you are in pain, you may not be able to lift up your baby until you are fully recovered (for example, bending over and into a cot, or lifting a heavy washing basket).
• Keep taking pain relief as needed and check-in with your doctor or midwife if you have questions about this.
• Try to take a gentle walk every day.
• Do the recommended pelvic floor exercises. Regardless of whether you had a vaginal birth or a caesarean section, your abdominal muscles and pelvic floor muscles have weakened after pregnancy. You can read more about this and access factsheets about physiotherapy on the Royal Women's website.
• Prioritise comfort. Some women prefer loose clothing, but others choose firm compression underwear or postnatal leggings for added support.
• Avoid sex until you are comfortable. It is normal for it to take weeks, or even months, before you are ready to have sex again.
• Numbness or itching around the scar is normal.
• When you feel ready, join a mother's group. Finding a community and talking to people who have similar experiences to yours is incredibly beneficial.

Kin's C-Section Recovery Bundle is also incredibly helpful in the days and weeks following birth.

This handy kit includes a trio of items that protect and heal your wound while supporting separated abdominal muscles.

The Mesh Panties are postpartum briefs that are designed sit above your incision for maximum comfort, while the Belly Band gives you targeted compression where you need it most — around your C-section incision and abdominal muscles.

The kit also includes Nourishing Cream — a belly butter formulated for wound recovery and to reduce scarring.

The formula includes gotu kola, cyclopentasiloxane and vitamin B5 to aid healing of the skin, and witch hazel to reduce the appearance of scars and firm up postpartum skin.

How long do C-sections take to heal?

It may take up to six weeks for a full recovery from a C-section.

Like all medical procedures, every individual's experience of recovery varies and is dependent on a range of factors including pre-existing health conditions, adverse reactions or allergies to pain medication.

While we're mainly discussing recovery from the physical surgery, it's important to be mindful of how you are feeling in these first few weeks (and beyond).

Some women experience postpartum depression or feelings of trauma around the surgery and it's important to reach out to your doctor, partner or trusted friend if you are concerned about this.

Long term care after a C-section

Many women who have had a caesarean section go on to give birth vaginally with future pregnancies.

This is commonly referred to as 'vaginal birth after caesarean section' or VBAC (for those who love a snappy medical acronym).

It is not likely that you'll have any ongoing issues from having a caesarean delivery, but if have any concerns, or you become pregnant again, chat about this with your doctor.