A Mother's Guide to C-Section Recovery
In the
United States, as many as 1 in 4 women who give birth will do so by Caesarean
Section (C-Section). During this surgical procedure, an incision is made through
the abdominal wall and uterus. The incision may be made across the bottom of the
abdomen above the pubic area or, in a line from the navel to the pubic area. As
with any major surgery, a period of recovery is expected and needed. With all
the concerns of a new mother, it is easy to neglect the fact that the woman's
body is not only recovering from 9 months of pregnancy, but also major abdominal
surgery.Some commonly reported problems following a C-section include:
- Pain when coughing or taking deep breaths
- Severe gas pains
- Tenderness, itching, and/or numbness over the incision
- Difficulty with certain movements, including moving around in bed,
reaching overhead, and nursing
- A feeling of pulling over the abdomen
- Difficulties/pain with bowel and bladder
Knowing what can be expected and understanding that the recovery process
after a C-section takes time is very important for the new mother and can help
ease some of her anxiety.
What to Expect: In the Hospital
After a C-section, you can expect a 3-5 day stay in the hospital before going
home. While in the hospital, you will be encouraged to get out of bed to walk as
soon as possible, usually the day of or day after delivery. You will need
assistance and you may have to work through some discomfort, but taking some
steps will help keep fluids from collecting in the lungs and will increase
circulation. While lying in bed, you will be encouraged to periodically wiggle
your feet, rotate you ankles, and stretch you legs to prevent blood clots.
Activities that put stress on the abdominal muscles, such as laughing or
coughing, will probably cause discomfort. Your nurse can instruct you on how to
use a pillow to put pressure over your stomach during these activities to lessen
this pain.
What to Expect: Back Home
Take it easy and avoid lifting anything heavier than your baby for eight
weeks. As for any new mother, accept offers from friends and family to help out
with daily activities, and try to get sleep whenever possible. Gradually
building up your walking endurance is a great step towards increasing your
overall fitness level and will go a long way in increasing intestinal motility
and even improving your mood. Initially, abdominal binders can be worn to help
keep the abdominals tight to prevent pulling of the incision site.
In terms of pain relief, prescription painkillers may be used for up to a
week after surgery, followed by a transition to over-the-counter pain relievers.
Remember not to take aspirin or drugs containing acetylsalicylic acid if you are
breast-feeding. It's not uncommon to have occasional pains in the surgical area
during the first year after surgery.
You will also need to monitor the healing of the incision site. It can take 4
weeks or more for a cesarean incision to heal. Once the incision site is closed,
you should start using your fingers to mobilize the scar by moving you fingers
against the scar grain, making a circular motion and even rubbing the area of
skin around the scar with some cream to prevent adhesions from forming.
What to Expect: Getting Back in Shape
Knowing when and how to return to activity and exercise is a common concern
for most mothers after a C-section. A Physical Therapist can help identify and
address many areas of need, including abdominal/trunk weakness, pelvic floor
dysfunction, lifting and nursing techniques, and pain modulation via
Transcutaneous Electrical Nerve Stimulation (TENS) Units.
Generally, you can begin gentle leg lifts and some isometric exercises around
4 weeks, depending on how you feel. It is usually recommended to avoid using
free weights, bar bells, clean and jerk, and abdominal muscles for at least 4-6
weeks after delivery, and never without caregiver clearance. Moderate exercise
can usually begin around 6-8 weeks with doctor approval. It will probably take
several months to return to your former fitness level.
Whether your C-section is intentional or unplanned, the birth of your child
can still be just as beautiful as you anticipate it to be. For more
information on recovering from a C-Section, read Maureen Connolly and Dana
Sullivan's book, The Essential C-Section Guide: pain Control, Healing at Home,
Getting Your Body Back and Everything Else You Need to Know About a Cesarean
Birth.
By: Kathleen Olsen, SPT, Professional Therapy Services Inc.
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