What to expect after your C-section

CHANCES are, if women could have it all their way they would have a traditional, vaginal delivery, particularly because it does not carry as much risk and it does not involve major surgery.

Sometimes, though, according to obstetrician-gynaecologist Dr Leo Walker, for the sake of mom, baby, or both, a Caesarean section (C-section) is the best way to avoid situations in which the baby is in distress or the mother is at increased risk of complications.

“A Caeserean section is the surgical delivery of a baby that involves making incisions in the mother’s abdominal wall and uterus. This process can be particularly taxing on your body, especially since, like any other major surgery, there is a protracted healing process that has to take place and general rules and recommendations concerning post-partum care,” Dr Walker told All Woman.

Dr Walker pointed out that, while the recovery time may differ from woman to woman, post-partum care will play a crucial role in the collective process. He said that, among other things, the woman and her support team will need to pay close attention to her diet, physical activity, physical and emotional support, and incision care.

After surgery

Immediately following delivery of the newborn, providing there are no immediate concerns, it is recommended that skin-to-skin be initiated, as well as the establishment of breastfeeding. “Breastfeeding can actually begin during or immediately after the C-section, and will ultimately accelerate involution of the uterus and contribute to minimising blood loss,” Dr Walker advised. Some studies also show post-partum weight loss in some women, though not all nursing mothers notice an effect.

He also advised that an important part of post-operative activities is walking. “Once the effects of the anaesthesia have worn off, patients are encouraged to initiate ambulating. Walking short distances four times a day for at least five minutes at a time reduces the risk of developing blood clots in the lower limbs post-surgery,” Dr Walker advised.

Incision care

“The healing process for surgical skin wounds is quite swift and starts from about 48 hours post-surgery. The superficial layer of the wound forms a thin barrier, thus limiting the access that bacteria has to the wound,” Dr Walker explained.

“As a result, wound dressings can be removed as early as two days post-surgery. Particularly, adhesive dressings should be removed slowly and in the direction of hair growth,

He said that once the skin edges of the wound are healed and the dressing is removed, patients can be advised to shower.

Exercise

Whether you are a beast in the gym or you just want to work on shedding the baby weight, exercise is never a bad idea; however, it is always good to get clearance from your doctor first. Dr Walker was also quick to caution women that exercising should start slow — choose light, non-strenuous activities, then slowly increase. “As you increase the time spent exercising, you must pay close attention to your level of discomfort and keep in mind post-partum complications — don’t put your body under too much stress, especially initially,” Dr Walker advised. He underscored that pelvic floor muscle exercises, also known as Kegel exercises, may also help to reduce the chances of urinary incontinence post-delivery.

Physical activity

“It’s common practice to advise women to avoid lifting anything heavier than the infant or around 6 kg (about 13 pounds) for at least the initial four weeks after surgery,” Dr Walker encouraged. He said that this is necessary to avoid the effects of excess pressure and stress on the healing wound. He said that this might not be practical for all women, particularly mothers with other small children, but as best as she can she should try to take it easy. “Ultimately, this is simply a recommendation and not a guideline derived from well-designed, robust studies; however, this is not a go-ahead for moms to take on big tasks, or to constantly do heavy lifting as you don’t want to disrupt the incision healing,” he said.

Diet

Patients may resume a normal diet within six hours of surgery as it helps to accelerate intestinal recovery and reduces the risk of post-operative bloating and vomiting, Dr Walker advised. He said that, if the patient’s stomach is upset, which happens from time to time, she may need to try bland, low-fat foods like plain rice, toast, and yoghurt until she feels better.

He said that having a healthy, balanced diet is very important to ward off constipation to reduce the chances of bowel straining which could put pressure on the incision. If you are a breastfeeding mother, Dr Walker said that it is important that you ensure that you drink plenty of water to boost milk production and that you stay away from alcohol so that you don’t pass it to the baby in the breast milk.

Sexual activity

Of course, another major concern for patients and their partners is the resumption of sexual activity. “A decision on when to resume sexual intercourse is typically a decision for the patient — she should be comfortable and ready to engage in penetrative intercourse. On average, most patients will resume penetrative intercourse approximately six weeks post-surgery,” Dr Walker advised.

Dr Walker said that it is also a general recommendation that contraception plans be discussed with your doctor before engaging in unprotected intercourse to reduce the chances of unplanned pregnancy.

Emotional support

Women’s emotional reactions and adjustment to Caesarean birth vary widely. This can be particularly difficult for women who are undergoing a major operation for the first time. The trauma of the event can cause women to feel varying degrees of guilt, sadness, disappointment, loss of self-esteem, and anger, which may sometimes lead to post-traumatic stress disorder. It is important that, if this is noticed, that adequate intervention is made to ensure that the mother learns to cope with her emotions and works on healing so she can take care of her baby and herself. It is important, too, that her partner, other family members, and friends recognise that a large part of her healing will be dependent on their support, love, and care.