After the Cesarean

The first days and weeks after childbirth can be physically and emotionally exhausting, especially when also recovering from major abdominal surgery. Most people don’t plan on a cesarean birth, but the reality is that about one in every three births nowadays is a c-section.

How a person feels after surgery depends on many things. The type of anesthesia used and any reactions it might have caused (drugs to relieve nausea or itching often result in drowsiness). Was the cesarean performed before labor started or after many hours of hard labor? Are there other existing or developing illnesses impacting recovery? Does the baby need special care? All these factors contribute to a person’s physical and emotional state postpartum.

Immediate skin-to-skin contact after birth is the norm even with a cesarean. Sometimes the ability to effectively handle the baby right after birth may be impacted by the inability to move freely due to pain, feeling groggy, and/or medical equipment such as IVs and blood pressure cuffs getting in the way. A partner, doula or family member can help facilitate skin-to-skin contact and watch for cues that indicate the baby is ready to latch. Taking photos of skin-to-skin and/or nursing in those first hours can be precious and reassuring later if memories are hazy.

An important part of early bonding is being able to comfortably interact with and enjoy the baby. Choose pain medications compatible with breastfeeding and stay on schedule with meds. Keep pain under control to allow for more ease in getting up and around. Take advantage of the adjustable hospital bed to help make moving more manageable. Raise the side rails to assist when moving or rolling over.

Breastfeeding can be healing after a cesarean. Rooming-in allows for easy access to the baby for feedings, however the ability to be up and about soon after birth varies. It may be difficult to get the newborn from the baby bed without assistance. Some hospitals require another adult to be present in order for the baby to remain in the room post-op. A doula, friend or family member might need to spend the night at the hospital to enable rooming-in if the other parent needs to go home to sleep or care for other children.
If the baby is not able to nurse right away, hand expression or pumping can be started in the first hour or so. When ready to nurse, the football or clutch position using plenty of pillows is often most comfortable as it minimizes pressure on the incision.

Because there may be a delay in the milk coming in after a cesarean, it pays to be proactive by being discharged with a hospital-grade breast pump if there are any issues at all with breastfeeding. Take advantage of breastfeeding support available in our community from hospital and independent lactation consultants, doulas, Nursing Mothers Counsel and WIC.

Getting plenty of fluids, good foods and the support needed to rest are important to recovery. At home, simplify life as much as possible, call on friends, family and/or a postpartum doula to help with cooking, household chores and other children. Even with extra help, mood swings are common after any birth and especially after a cesarean. Many people find it is too much to try to process the birth right away – they’ll need time and support before they are ready. Plans to revisit the birth at some point will be easier if parents request a copy of the hospital birth records before leaving the hospital. This ensures information is available when ready to examine the experience more closely. The organizations, Speak Up Santa Cruz, and Postpartum Support International, can help with local and national resources if postpartum depression or mood issues develop, or if parents just want a little extra support.

The International Cesarean Awareness Network, (ICAN) offers information and support for those experiencing a cesarean birth or planning a vaginal birth after a cesarean. Lamaze International has an article on avoiding an initial cesarean. Birth Network of Santa Cruz County offers a listing of childbirth related resources, including doulas, childbirth educators, support groups, counselors and more.

By Laura Maxson, LM