Tips for recovery after a caesarean

Tips for recovery after a caesarean

By Mater Mothers' Hospital

After a caesarean birth you will be uncomfortable for a few days. Taking regular pain relief is very important to your recovery. Let your midwife know if you require any pain relief or anti sickness medication. Your catheter, drip and wound drain (if you have one) will be removed in the first one to two days depending upon your recovery.

It is important to let your midwife and/or physiotherapist know if you are having difficulty passing urine, passing small amounts of urine or having accidental loss of urine.

Maintaining good hygiene is important to prevent infection:

• Shower daily and dress in fresh clothes
• Do not use a hair dryer on the wound, as drying the wound delays the normal healing process
• If your wound oozes fluid or blood — report this to your doctor or midwife immediately

Postnatal exercises are especially important after a caesarean section to get your muscles working again, but take things at a gentle pace. The midwife or physiotherapist will tell you when you should begin them.

Mobility and exercises

Initially after your operation you will be resting in bed. During this time it is important to do deep breathing and leg exercises regularly. Bed exercises and walking around will reduce the likelihood of chest infections and blood clots in your legs.

It is normal to have increased swelling of your hands and feet after the birth. Continue to drink fluids, go to the toilet regularly and rest with your legs above the level of your heart.

Walking will also help to reduce the swelling of your feet, relieve stiffness and the discomfort of trapped wind.

Please discuss any concerns with your doctor or midwife.

If you have not passed wind, or have some wind pain, try:

• Pelvic rocking and knee rolling
• Gentle wind massage: start at the lower right side of your tummy, using a gentle slow circular motion as you slowly move up to waist level, move across the belly button and down the left side
• Standing, lean forward onto the end of the bed and do some gentle hip circles
• Warm showers
• Frequent walks
• Relax on the toilet in the “hips flexed” position

How to protect your incision when you cough

Sit forward in a chair if possible. If in bed, bend your knees up. Place both hands over your wound, anchoring your fingers onto the pubic bone, with your forearms resting firmly across the abdomen. Draw in the pelvic floor and hold arms in firmly as you cough.

While still in bed, you can:

• Take five or six deep, slow breaths each hour—relax your shoulders as you exhale
• Bend ankles up and down, tighten thigh and buttocks muscles
• Gently draw in the pelvic floor muscles, pause, then let go
• Draw in the pelvic floor muscles before and as you move your legs, but always keep breathing—this protects your tummy from strain With both knees bent up, try slow, gentle:
  • pelvic rocking
  • knee rolling
• Change the position you are resting in, often
• Aim to do these exercises two or three times each hour
• If you are feeding your baby in bed, make sure you are not resting on your tailbone:
  • If sitting, put the back of the bed right up, place a small pillow / rolled up towel behind your lower back. Try not to slide down the bed.
  • If lying on your side, make sure your head and neck are supported on a pillow. Ensure that your body is not twisted; a pillow between your knees might feel more comfortable.

Planning for home

On the day you go home you will be independently caring for yourself and your baby. Your pain will be controlled with medication and your wound will be free from signs of infection, ie. no redness or drainage. While you should be able to perform all the normal activities to care for yourself and the baby, you should avoid doing anything which will cause you significant discomfort.

Gradually you will be able to return to your full range of duties. This can take a variable amount of time between two and six weeks. Listen to your own body.

Debriefing after birth

For some women the decision to have a caesarean will be made weeks before the birth. For other women the decision is made during the labour. Either of these scenarios can occasionally leave a woman and her partner feeling disappointed, confused, distressed or feeling a loss of control.

It may be helpful to talk about these feelings with the doctor or midwife and have your questions answered. You may also like to speak with a pastoral care worker or the patient representative or you may wish to access a community support group that focuses on emotional wellbeing. This may be beneficial in the days/weeks or even months after the birth of your baby. If you would like to discuss any aspects of your operation or care please discuss with your obstetrician.

Pain relief at home

If your pain increases after you go home you should consult your obstetrician, GP or nearest hospital. If you have any concerns regarding your pain relief, safety of any medication or how the medication is affecting you, please call your GP or pharmacist.

Acknowledgments and references Staff of Mater Mothers’ and Mater Mothers’ Private and Mater Private Hospital Redland Mater Consumer Representatives Maternity Coalition Caesarean Awareness Network Australia Birthtalk: Support, Education and Celebration of Birth Understanding NICE guidance—information for pregnant women, their partners and the public (2004) National Institute of Clinical Excellence

Find out more about Mater Mothers' Hospital at www.matermothers.org.au