Top 5 Tips For The First Week Home After A C-Section.
Cesarean rates in Canada have been climbing over the last several years. In fact c-sections accounted for 29.1% of all deliveries in 2016-2017 and are the most common surgery performed in Canada! Yet, the rehabilitation offered after a c-section is basically non-existent. Clearly, there is a gap in our current healthcare system and a significant lack of support for mom’s in their postpartum recovery. Because C-sections are so common, it is often forgotten that it is a major open abdominal surgery. So, whether planned or unplanned, recovery from a cesarean will likely look much different, and will typically take longer, then recovery from an uncomplicated vaginal birth.
Most women who have a cesarean report being unprepared for the realities of managing their post-operative recovery. Women have reported being unprepared for the duration and intensity of pain, lack of mobility and restrictions in everyday tasks at home.
I had an emergency cesarean at the beginning of February, and I was surprised by how uncomfortable I was and how limited my mobility was that first week home! Which is why I wanted to give you my top 5 tips for managing your first week home after your c-section.
Tip 1: Managing The Postpartum Swelling
If you have a c-section, you will likely be given an IV of fluids and medications before, during and after surgery. These fluids can cause a significant amount of retention and swelling. I was shocked at how swollen my feet, ankles and abdomen became! Do not be alarmed if your feet and belly feel swollen for DAYS after your surgery. The solution? Drink water, and lots of it. The more hydrated you are, the faster the swelling will ease. You can also try compression socks/stockings (trust me, my shoes did not fit for three days). You should however, be concerned if swelling is excessive and painful in your calves, red hot or shiny. This could be a sign of a DVT (blood clot) and you should notify your healthcare provider immediately.
Tip 2: Brace Your Incision
Your incision will likely be located a few inches above your pubic bone, and on the front of your abdominal wall. It will be painful or uncomfortable to move in any way that uses your core, like rolling, sitting up in bed, standing and even walking the first few days. Solution? Use a pillow or your hands, and gently press the pillow up against your incision and hold it there as you move. This bracing technique also works well, if you need to cough, sneeze or laugh (which can all be painful for the first few days to weeks postpartum). The gentle compression helps support the incision and reduce pain and pulling on your scar. Another option is a postpartum belly wrap or underwear that has a bit of gentle compression. Note this is not a waist trainer, girdle or rigid brace. Your belly wrap should be soft, and flexible. If you try a belly wrap and it doesn’t feel good, simply take it off and wait 1-2 weeks before trying again. Do NOT use a postpartum belly wrap or band if you have any type of wound infection of healing issues. I used the bellies inc postpartum ab system, but didn’t start wearing it until the second week home. I will do a separate post on my thought on the postpartum belly band, but if you’re interested you can check it out here: Bellies Inc: Postpartum Ab System
Tip 3: Furniture Risers
This one might seem a little bizarre, but it made my life way easier and less painful for the first week or two at home. The lower the surface (couch, chair, bed), the harder it is to get up out of it! We purchased furniture risers for a chair in our living room, so that I could breastfeed comfortably and we slept in the spare bedroom for the first 2 weeks because the bed was higher and therefore easier for me to get in and out of without pain (which is important when you’re up every few hours tending to a newborn baby). We purchased a cheap set of furniture risers from Canadian Tire.
Tip 4: Breathe As You Move!
This one might seem obvious but many moms fall into the pattern of holding their breath. When you think something might be painful, or when you brace yourself to get up out of bed, lift or carry your new baby, it is very common to hold your breath as you do it. But, if you hold your breath, there's an increase in intra-abdominal pressure (meaning more pressure in your belly), which can cause increased strain on your new incision and increases pressure on your pelvic floor. If you exhale during your movement, the pressure is controlled and expelled out of your mouth, your deep core muscles will engage better and your pain will decrease significantly!. Exhale, as you lift, bend, roll, and stand! This is also a great tip if you’re experiencing any postpartum back or pelvic pain. Focus on your breathing can significantly improve your pain-free mobility in seconds.
Tip 5: Keep Your Bowels Moving.
You just had major abdominal surgery, which likely involved some heavy medication and antibiotics and you’ve also likely been prescribed some form of ongoing pain-control like tylenol or ibuprofen. These medications are known to cause constipation and after a c-section, the first bowel movement can be scary! The key is to avoid constipation before it starts and to avoid bearing down or holding your breath while you’re on the toilet. There’s a few things you can do to help ensure a smooth exit: 1) bring dried prunes or other high fibre foods to the hospital with you, pack them in your hospital bag and no I’m not kidding. Eating 3-4 dried prunes a day can help stimulate your bowels! I used them throughout pregnancy and will continue to use them postpartum. 2) Drink lots of water, both cold and hot (in the form of teas or broths that they offer you at the hospital. This can help with any trapped gas you may have following the surgery which can be SUPER uncomfortable. 3) Take the stool softener that your provider offers you, and if they don’t offer, ask for one. If you’re getting ready to go home and it’s been more than 2 days since your last bowel movement, taking a stool softener is a proactive way to get things moving, before it gets too uncomfortable! Talk to your healthcare provider if things aren’t moving on their own. 4) Last tip: squatty potty! The squatty potty is a special stool that tucks under your toilet seat. You do not need this specific brand of stool but I highly recommend using something to prop your feet up. Using a stool under your feet when you’re going to have a bowel movement, allows for better alignment of your rectum, and therefore requires less pressure and less effort from you (meaning less strain on your incision) and a more comfortable poop.
That’s it! My top 5 tips for your first week home after your cesarean!
I also want to add here that having support at home for the first 1-2 weeks will also make a world of difference. Having your partner or a family member home with you, to do the diaper changes and the cooking duties while you rest and feed the baby. Your partner does EVERYTHING else ( I mean really it’s the least they can do!). Don’t stress about laundry or cleaning and resist the urge to “push” through pain or discomfort in order to get things done. If you push yourself too hard in the beginning, you risk setting yourself back and prolonging your recovery.
If you’re interested in learning more about c-section recovery and core and pelvic floor rehabilitation, sign up below for our email list and follow us on instagram @theathleticpelvis and @collingwoodpelvichealth for exercise demonstrations and information about upcoming classes/workshops.
References:
Examining Cesarean Section Rates in Canada Using the Modified Robson Classification, Jing GU et al, 2019.
Women’s perspectives on caesarean section recovery, infection and the PREPS trail: a qualitative pilot study. Weckesser et al, 2019.