What to Expect...After a C-Section
So, you've had, or are going to have, a Caesarian section. It may not be what you'd hoped or planned for, but the reality is that around a quarter of births in the UK today are by section – and there's surprisingly little advice and information out there for women about what to expect afterwards. I've had three – 2 emergency sections and an elective (planned) section. Here are my top tips:
1) Having a section, especially an emergency section, can be a big shock to the system – physically but, even more, psychologically. It can be hard to reconcile the dream birth you were imagining with the reality. Women can sometimes struggle to have that oxytocin 'rush-of-love' feeling which is important for bonding and breastfeeding. It doesn't help that you usually have to stay in hospital for at least one night (often longer), and post-natal wards are not exactly conducive to oxytocin! You can help by being very kind to yourself. If you know you're having a section, bring something into hospital that will make you feel cosy afterwards – your favourite pillow or blanket for example, tasty snacks, your own music. Have LOTS of skin-to-skin time with your baby – as much as you can – this is important for both baby's brain development and your oxytocin production, and will lower both of your stress hormone levels too. Have your partner stay with you overnight if you can (the hospital should facilitate this) – it makes a huge difference. If they can't, don't worry about ringing the bell for help from the staff as much as you need to – especially for help with breastfeeding. Don't beat yourself up about having 'failed' because you didn't push your baby out – you HAVEN'T.
2) While in hospital focus on resting, enjoying your babymoon while they're still so sleepy, and drinking lots of fluids! This is important because it will help with the inevitable constipation – the result of abdominal surgery, lying still in a bed, painkillers (especially codeine) and being dehydrated. Also, before discharge you need to pass your ‘TWOC' or trial without catheter. This means passing a good amount of urine three times over the course of a day, which shows your bladder is functioning properly after surgery. You need to drink lots to do this!
3) Also – take your pain meds! Even if you don't feel you need them. Take them regularly – if you don't, sooner or later you will experience pain and it's much harder then to play catch-up.
4) C-sections are very safe these days, but there are associated risks, afterwards which mean you need to be a bit more careful. These include infection, and blood clots which, while rare, can be very serious. You may be advised to have a course of Tinzaparin – this is a blood thinner which you inject yourself and works to prevent blood clots. This is scarier than it sounds. The syringes that you take home with you are easy to self-administer, using tiny needles, like epi-pens – and they could save your life.
5) To prevent infections, keep an eye on your wound. Ask your midwife how long to leave on the 'honeycomb' wound dressing (it's usually safe to remove it once home). The wound should look clean and dry, and have no redness around it. The stitches dissolve, so no need to have them removed. The dressing is supposedly waterproof – however it isn't bath-proof! If it does become sodden, remove it and speak to your midwife about whether to have it replaced. It's important to keep your wound dry – so dab it dry using a clean sanitary pad after showering/bathing. Make sure your pants sit above the scar (it's best to invest in some huge granny pants!) Other sources of infection may be internal – it's rare, but if your blood loss increases heavily or starts to smell funny, or you experience any achey/flu-like symptoms, let your midwife or labour ward know ASAP.
6) Once home, do as little as possible. And if you think you're doing very little, do even less. The danger with sections is that after a few days you start to feel ok, and then are tempted to think you're fully recovered and can get back to active life; only to find yourself in pain and exhausted. Remember your stomach muscles have been bisected so your core strength is hugely reduced. Sitting up in bed can be tricky – you can tie a long scarf to the end of the bed so you have something to pull on to help! Walking, lifting, climbing stairs, housework – approach all with caution. Which leads me onto...
7) Take note of offers of help, and accept! Don't be shy about taking people up on it – within a few weeks the novelty of a new baby tends to wear off but in those first days, if you're up for having visitors (and remember – you don't have to!), be upfront about what you need – childcare for older kids, school pick-ups, shopping, a home cooked meal, a run to Mothercare – just ask! People are usually very happy to help in exchange for a cuddle (from the baby, obviously – no-one is bothered about cuddling you any more!) And be clear about what you need from your partner– they likely have no idea how tiring, stressful and uncomfortable the first days post-partum with a section are. And there are things they can do to help, like always making sure you have a drink and pillows when you're feeding, taking over with the dressing/winding/changing once you've finished feeding, taking baby out for a walk while you shower in peace. Soon you'll be fighting fit again, but take the help while you can.
Kate is a doula, trainee midwife, theatre maker and mum of three from Brighton. She runs Mrs Lark's Songtime and SaltLick Theatre.