Recovery after a caesarean

After a caesarean (C-section), midwives and nurses will look after you in the recovery room until you're ready to go to the postnatal ward. The midwives will:

• check your vaginal bleeding
• monitor your pain
• check your wound and dressing

If you are awake, you can usually hold your baby straight after a caesarean. If you have had a general anaesthetic, as soon as you are alert, you can begin skin-to-skin contact and possibly breastfeeding.

Skin-to-skin contact is sometimes called kangaroo care. It's important after birth to help you bond with your baby and improve your chance of breastfeeding more easily. Your partner or support person can do skin-to-skin contact if you are unable to.

Sometimes after a caesarean birth, your baby may have difficulty breathing and may need to be moved to a special care nursery (SCN) or neonatal intensive care unit (NICU).

You will usually stay in hospital for 2 to 5 days after a caesarean.

You will feel pain for at least a few days. It's important to manage your pain, as this will help your recovery. Tell the midwives if you are in pain. They will be able to give you pain-relief medicines and guide you on how much you can safely take.

You will stay in bed until your epidural or spinal anaesthetic wears off. You can do breathing and leg exercises while in bed. A nurse or midwife will help when you first get out of bed, which usually happens in the first 1 to 2 days. They will also help you to have your first shower after your caesarean.

Once you can get up, you should walk gently every day to reduce your chance of getting a chest infection or blood clots. A physiotherapist may give you exercises to help strengthen your muscles. It's important to take things gently after a caesarean and follow the instructions from your healthcare team.

You can usually start to breastfeed your baby very soon after a caesarean. Having a caesarean may cause a slight delay in your milk coming in. Don't be discouraged — often it just takes a little more time, and support is available if you need it.

If you are unable to breastfeed after a caesarean, ask your midwife to help you express colostrum (the first milk you produce after your baby is born). To express colostrum means to collect the first milk your breasts produce, usually by hand-expressing it into a clean container.

Colostrum has lots of protein and antibodies to build your baby's immunity.

When you start breastfeeding, ask your midwife to help you position your baby. It may be more comfortable to:

• have a pillow on your lap to protect your wound
• lie on your side
• hold your baby under your arm, with their feet towards your back

General self-care

It's important that you look after your body when you come home after having your baby. You should try to:

• get as much rest as possible
• eat nutritious food
• avoid lifting anything that weighs more than your baby
• take short walks on flat ground when you feel able

You can continue to take regular pain-relief medicine to make sure your pain is well managed. Ask your doctor, midwife or pharmacist which pain medicines are right for you.

You may not feel ready to have sex for weeks or months after having a baby. Listen to your body and wait until you feel comfortable. Read more on sex after having a baby.

Wound care

Here are some tips to help you take care of your wound at home:

• Make sure you keep your wound clean and dry.
• After you shower gently dry the wound by patting it with a towel or let it air dry.
• Wear loose clothing over the wound.
• Check your wound regularly for signs of infection, such as redness or swelling.

If your wound has been closed with staples, these will need to be removed around 7 days after your caesarean. If you had stitches, they will usually be dissolvable stitches. This means they will be gradually absorbed by your body.

It's normal to have some wound pain in the first few months after a caesarean. You may also notice a change in sensation around your wound. For most women these symptoms improve after 3 to 6 months, but for some women they may last longer.

Support at home

Looking after your new baby can be hard. After a caesarean you should try to avoid doing anything more than gentle movement.

Ask family and friends for help as you recover from your caesarean. They may be able to help with:

• house cleaning
• cooking meals
• caring for your other children

Read more on bringing your baby home from hospital.

Driving

Talk to your doctor or midwife about when it's safe to drive. This is usually after you have fully recovered and may take 2 to 6 weeks. Before going back to driving make sure you:

• can safely do an emergency stop
• are not feeling too sleepy due to interrupted nights or medicine side effects
• are covered by your car insurance after a caesarean birth

You may feel a range of emotions after a caesarean, especially if your caesarean was unexpected. Emergency caesareans can happen very quickly and may be a traumatic experience for some parents and support people.

Here are some tips for managing your emotions:

• Talk to a midwife immediately after the birth about your experience.
• Talk to your doctor, midwife or maternal child health nurse about how you feel.
• Ask for practical and emotional support from friends and family.

If your caesarean birth was traumatic, it's possible to develop post-traumatic stress disorder (PTSD) or postnatal depression. Signs you might not be coping emotionally include having:

• feelings of guilt or anxiety
• nightmares
• difficulty going to sleep or staying asleep
• hyperarousal (always feeling on high alert)

If you have negative feelings about your birth, it's best to get support as early as possible. If needed, your doctor will recommend therapy, peer supports or medicines that can help.

You should see your doctor around 6 weeks after giving birth for your postnatal check-up as well as a check-up for your baby.

If you have any problems or concerns before then, see your doctor as soon as possible.

It's often possible to have a vaginal birth after caesarean (VBAC). This can be a safe choice for many women.

However, your chance of pregnancy complications increases with each caesarean you have. Complications can include:

• problems with the position of the placenta
• problems with your placenta detaching after the birth
• needing hysterectomy, which would prevent you from having any future pregnancies

Sometimes a planned caesarean for your next birth is a safer option than a vaginal birth.

Discuss your birth options for your next pregnancy with your midwife and doctor, including:

• your birth preferences
• the risks and benefits of each option
• how long you are recommended to wait between births

This will allow you to make an informed choice. In Australia you have a right to make a shared decision with your healthcare team.

The Australian Breastfeeding Association has a breastfeeding helpline you can call on 1800 686 268.

Birth Trauma Australia has more information about caesarean section and birth trauma.

If you, your partner or support person needs emotional support, you can contact:

• Lifeline on 13 11 14
• Beyond Blue on 1300 22 4636
• PANDA on 1300 726 306

Languages other than English

• The Royal Women's Hospital has fact sheets in a range of languages to support pregnancy, birth and recovery.
• You can also find translated health information through Health Translations Victoria, including:
  • going home after a caesarean birth
  • managing your pain following a caesarean
  • contraception after you have had a baby