Maybe you always skip over the bits about the Caesarean Section. You are having a vaginal birth right? So many mums-to-be are solely focused on a having a vaginal birth. I FULLY support this as a goal. This is where all (ok most) birth conversations should start.⁠

BUT ⁠⁠In 2022, 1 in 3 women will have a Caesarean birth.⁠ ⁠If you are not open to learning about Caesarean birth, and this is the birth your body ends up needing, then you can feel completely blindsided by the process and how to heal. Healing for most women is both physical and mental. Some women deal with guilt on top of the physical pain of healing and this can impact on your start to motherhood. Being prepared for all possibilities helps with a positive mindset and helps you be prepared for whichever birth you body ends up needing.

1. How to cope with pain

Please take the meds. The objective is not to have breakthrough pain. Every woman is different as to the level of pain she feels and it is not a measure of how brave you are. Please don’t compare yourself to ANYONE else. In the hospital you will be given pain medication such as Tramadol, Voltaren, Endone and Panadol as needed. Most of my patients leave the hospital, anywhere from 3-4 days after birth, taking Panadol and Nurofen “as required”. By about one week after the Caesarean Pain medication intake are down to nothing or occasional doses only. If you need more than this, then that is ok too. Some women report sweats and hot flushes after birth, that’s usually your body readjusting to the new set of hormones and is not related to the Caesarean section. UNLESS there is accompanying high temperatures – that’s when you need to call the clinic.

2. How to move

For the first couple of days, make sure you have someone to help with positioning the baby for snuggles, nappy changes and feeding. I love it when my patients who have had a Caesarean section have their partner or support person stay to help in the hospital, particularly with getting the baby in and out of the crib. Otherwise, you will have the above bed hoist to help reposition yourself and you will be able to have help from midwives. You will be encouraged to get up within 24 hours. This is vital to get your blood moving and prevent clotting. You will feel tentative having your first shower, in the hospital you will have a nurse call button which for many women is reassuring. Please use this if you feel faint. When you are home, gentle walking with no heavy lifting, nothing heavier than your baby for at least 3 weeks. The way to get out of the bed is to first swing your legs around to the floor and then use your elbow, then hand to push yourself up. Be careful about twisting. (You will soon realise how often you twist!)

3. Your bowels

Drink 2-3 litres of water and eat fresh fruit. If you have the trifecta of constipation, haemorrhoids and fissures get some haemorrhoid cream that have local anaesthetic to numb your anus before you try to go to the toilet. I also recommend holding a towel over your scar to help you brace when you push. If it has been 3 day and there has still been no first poo, you may need to try a laxative or fibre supplement. Some hospitals may require you to attempt to “move your bowels” before you go home, if you are someone who needs home to make it all happen, then when you go home please make this a priority. Don’t ignore the call, putting off having your first poo can lead to constipation.

4. How to brace

When you sneeze and cough, in the first 4-6 weeks you might feel comforted to hold your incision wound. You could hold a pillow as you cough to help make you feel more secure. You are securely stitched up – the most up-to-date techniques are excellent – so don’t worry if you sneeze unexpectedly! 

5. How to care for the incision

You don’t have to do anything except watch for any signs of infection – redness, pus, soreness. Infections aren’t common and will respond well to antibiotics. Some women like to stick a pad to the top of their undies to cushion against the scar. I don’t recommend putting ice on the area, as we don’t want the ice to melt and the area get too moist.

6. Rest up

The essentials right now are You. Your baby. Full stop. You have had surgery plus grew a whole baby so your body needs time to heal. Surgical technique has advanced so much that you can get up the next day (unlike other abdominal surgery) but that doesn’t mean you have to push it! Even as an Obstetrician I got this wrong with my wife, Brigid and her fourth Caesarean. We were out walking two weeks after Rex’s birth and the walk ended up a bit too long. We were both overly confident with how well she was healing. She went pale, felt nauseous and one look at her and we jumped in a taxi for home. Be mindful of how fast the fatigue can set in.

7. See a physio

Caesarean birth doesn’t mean you can skip that post-natal physiotherapist appointment. There is still so much to learn about pelvic floor tone and function in your post-baby body. Ballarat Women’s Clinic’s Physio Belinda Matthews specialises in assisting with strengthening and supporting the function of your pelvic floor.

For more information on Caesarean recovery I have uploaded a podcast, which you can listen to here

Written by Gynaecologist and Obstetrician, Dr Patrick Moloney