April is Cesarean Awareness Month. One third of all U.S. births happen by cesarean section. Whether a cesarean birth is planned or unplanned, recovering from major abdominal surgery while also caring for a newborn is no easy feat. Below are some recovery tips from Iowa City Birth Services co-owner and doula Grace Swartzendruber, who gave birth to her son by cesarean in 2015.
Don’t overdo it. This is so much easier said than done. I am one of those people who likes to think that they are the exception to the rule and that I don’t have to follow the doctor’s orders to the letter of the law, and I really set my healing process back because of that mindset. I climbed way too many sets of stairs, lifted way too many heavy loads (laundry, car seat, etc.), and really pushed myself when I should have just been laying in bed or on the couch, snuggling with my baby, resting and healing. Having a good support system in place is imperative. Whether these are friends, family, church members and/or a postpartum doula, it is important to have people you can rely on for things like meal preparation, light housekeeping, pet care, child care and emotional support. I love this postpartum lying in plan from Earth Mama Organics (formerly Earth Mama Angel Baby), and recommend it to everyone regardless of what kind of birth you are planning.
If you choose to breastfeed, nursing can be a challenge during the first few weeks due to pain at the incision site and in your abdomen. I found that nursing in a side lying position, or by using the football hold were the best positions during those early weeks as they put the least amount of pressure on my incision. If available, ask your partner be the one to get out of bed for middle of the night diaper changes, and also have them bring the baby to and from you for feedings. If bottle or combo feeding, have your partner prepare bottles and feed the baby overnight when possible. If you need to cough, sneeze or laugh, hold a pillow over your incision site to gently apply pressure while doing so to lesson the pain. Try not to sit straight up from lying down if possible. Roll to your side, press a pillow over your incision, and slowly use your other hand to push yourself up to sitting, while swinging your legs over the side of the bed or couch. If you are struggling with breastfeeding, don’t hesitate to reach out to a lactation consultant or visit one of the several local breastfeeding support groups in our community.
There were some surprises after my cesarean birth. For some reason, I was not expecting there to be any vaginal bleeding because I ended up delivering my son through my abdomen, not my vagina. However, whether you deliver your baby vaginally or by cesarean, you will still have postpartum discharge, also known as lochia. When the placenta separates from the uterus, there are open blood vessels in the area where the placenta was attached to your uterus, and those blood vessels will bleed into the uterus. Lochia continues for an average of five weeks after birth, and is comprised of blood, tissue shed from the lining of the uterus, and bacteria. I also was surprised by to learn that it is common to experience referred pain from my cesarean in my shoulder.
Once your cesarean incision has healed (staples are taken out or stitches dissolve or Steri-strips fall off), I recommend using this C section healing balm on your scar. In less than a year of use I could hardly see my scar at all, and the process of applying the salve each night before bed became a sort of healing ritual and practice of self love towards my body and my scar. Consult with your care provider, and after a 12 weeks have passed, Google and/or YouTube instructions for cesarean scar massage. This helps break up scar tissue and prevent adhesions from forming. You can also have scar tissue release done professionally by a licensed massage therapist such as Monica Basile at SEVA Healing Arts in Coralville.
After I had transitioned from my stash of hospital mesh panties, I found a support garment to be helpful. I used the high waisted C-panty. It has a silicone panel that goes over your incision site to protect and aid healing. They’re not for everyone, but it felt good for me to have something to hold everything in and provide gentle support. Alternatively, although these postpartum underwear weren’t around when I had my son, they look like a comfortable, non compression option and have great reviews.
You might have heard or read horror stories about your first postpartum bowel movement. I think there’s an extra level of intensity when you have a C section, because during surgery your bowels have been moved around and put back into place. The opioid pain medications given in the hospital after surgery can also contribute to the problem. I had pretty horrible, painful constipation, and the recommended over the counter stool softeners and laxatives didn’t help me at all. The thing that finally did was magnesium. I liked Natural Calm, which comes in a variety of flavors and sizes, but you can also find a number of different magnesium supplements online and at your local natural foods store. You should always check with your care provider before taking any new supplements. I also highly recommend the Squatty Potty to all pregnant and postpartum clients, as it helps align the body into a more natural position for bowel release, and I firmly believe that it helped me prevent hemorrhoids during pregnancy.
I found myself needing some extra emotional support to deal with my feelings and questions about my C section, which was not planned. In addition to the support I received from counseling, the Iowa City/Cedar Rapids Corridor is fortunate to have a local ICAN (International Cesarean Awareness Network) chapter, which holds regular support group meetings for anyone who has had a cesarean, and also offers education for those wanting to avoid a preventable cesarean. I found the support and camaraderie really helpful, and the chapter leaders are also a valuable resource for anyone considering a VBAC (Vaginal Birth After Cesarean). Here is a link to our local chapter’s facebook page, where you can post questions and find out where upcoming meetings are being held.
For more information and frequently asked questions about cesarean birth, check out our blog Understanding Cesarean Birth.
We hope you have found these tips and resources helpful. We’d love to hear from you what things you found helpful during your cesarean recovery – please join the discussion by commenting on our facebook post.
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