Caesarean section - after

Information about what you need to be aware of the first couple of days following a caesarean section.

Congratulations

Congratulations on the birth of your child. There are many things new parents have to deal with just after the birth of their baby. We have put together this pamphlet to help answer many of the questions you may have. We are also happy to provide advice and guidance while you are admitted to hospital.

At the hospital

Skin-to-skin contact

If you and your child are doing well, the child will be placed on your chest immediately after birth for skin-to-skin contact and so it can seek out your breast. In some cases, your child will need to be checked and may need help breathing before being handed to you. The child can also have skin-to-skin contact with your partner or companion.
Skin-to-skin contact is important for breastfeeding, as the contact stimulates the hormones that start milk production. This contact will also help your baby maintain a stable body temperature, increase blood sugar levels and stabilise heartbeat and breathing.                    

Observation of you and your child

We will keep a close eye on you for the first few hours. This will usually take place in a recovery room. We will watch out for any bleeding from your uterus, and check your blood pressure, heartbeat and the oxygen levels in your blood. You will later be moved to a regular maternity room.

The urinary catheter and drip will be removed

Once you can get out of bed and walk to the bathroom, we will remove the catheter and drip so you can move about and begin caring for your child.

You will receive pain-relieving medicine

You will be in pain after a caesarean section. We will provide you with two different types of pain-relievers four times a day to help ease the pain. You will also need morphine during the first 24 hours, and we will give this to you as needed. We will regularly ask you to assess your pain on a scale from 1 to 10.
You can breastfeed while taking pain-relieving medicine.

You may feel pain in your shoulder

After a caesarean section, some women experience a sore right shoulder, as trapped air in the abdominal region places pressure on the nerves leading to the shoulder. This is normal and the pain will disappear within a few hours, or two days at the most. The more you are able to move about, the sooner the trapped air will disappear. You can use a heat pad to alleviate the pain.

Move about

Even if you are in pain and feel tired, you should move around as much as possible to avoid blood clots, weakened muscles and constipation.

Avoid constipation

When you have had an operation in the stomach area, you may find it difficult to get rid of air and move your bowels. To help your stomach get back on track, we recommend moving about, eating high fibre foods and drinking lots of fluids. Chewing gum can also get your intestines moving again. We recommend that you chew gum at least three times a day for a total of one hour until your intestines are back to normal. We will provide you with a mild laxative until you have had a bowel movement. The stomach will usually get back on track within three to four days.

You can take a shower

You can take a shower even with a bandage on. We will remove the bandage to check the incision after 24- 48 hours. In some cases, you may need to wear the bandage for a bit longer. We will discuss this with you.

Keep the incision clean

Let the incision air dry after bathing. It must be kept as clean and dry as possible.

Vaginal bleeding

It is quite normal to bleed from the vagina after a caesarean section. The bleeding will correspond to a heavy menstrual flow and will decrease gradually during the first week. You will then experience a bloody or brown discharge for six to eight weeks. We recommend that you only use pads because tampons and menstrual cups can increase the risk of infection.

Remember to urinate

It may be difficult to tell whether you need to urinate. You should urinate no later than four hours after the catheter has been removed, and then approximately every four hours in the first few days, even if you don’t feel like you need to urinate. This will help the uterus shrink to its normal size. You may experience a burning sensation when urinating. This may be due to the catheter or because your bladder was nudged during the surgery. This will disappear in the course of a few weeks.
Make sure to drink about 2 litres of fluids a day.

How to get out of bed

Follow these steps:

  • Bend your legs and roll to one side. Make sure that your hips and shoulders are aligned.
  • Lift your upper body by placing your elbow on the mattress as you keep your legs together and swing them over the side of the bed.
  • Use your arms to push yourself to a sitting position.
  • Place your hands on the bedside and push yourself up to a standing position.

Follow these steps in reverse when you get into bed.

Illustration of how to get out of bed after a caesarean.

Breastfeeding

When you give birth via caesarean section, your milk production may be a little delayed and it can take longer to begin breastfeeding for several reasons. One of the reasons is that the hormones released during a vaginal birth are not released during a caesarean.

To help you begin breastfeeding we recommend that:

  • you place your child at your breast at least eight times a day and every time your child shows signs of wanting to suckle.
  • have as much skin-to-skin contact with your child as possible during the first few days.
  • you stay patient and keep trying. For most people, breastfeeding has to be learned. We are happy to help and advise.

Find more information on our website

You can find more information on our website about the period after birth, breastfeeding, caring for your child and other practicalities.

Going home

If you are still wearing a bandage

If we have not removed the bandage before you leave the hospital, continue wearing it for as long as directed. Keep it clean and dry and cover it when you bathe. Remove it if it gets very wet.
Removing the bandage is easiest after bathing as your skin will be damp.

The stitches will dissolves after about three weeks

The small plasters covering the incision will usually fall off by themselves. If they do not, you can remove them after one to two weeks. The stiches will dissolve within three weeks.

Beware of infection

It is normal for the area around the incision to be swollen and sore. However, keep in mind that the incision can become infected. This rarely happens, but if it does, it will need to be treated. Contact your general practitioner or dial 1813 to reach the medical helpline outside your general practitioner’s opening hours if you experience one or several of the following symptoms (if you develop any of these symptoms within seven days of giving birth, then contact us):

  • Increased soreness
  • Increased redness
  • Increased swelling
  • The area around the incision feels warmer
  • Discharge from the incision
  • The incision opens up
  • Unexplained fever over 38 degrees centigrade.

Continue taking pain-relieving medicine

If you need pain-relieving medicine once you get home, we recommend that you take 2 x 500 mg paracetamol, possibly combined with 2 x 200 mg ibuprofen, no more than four times a day.
When you begin to gradually reduce the dosage of pain-relieving medicine, begin with the ibuprofen.

Avoid heavy lifting

To protect your stomach muscles, we recommend that you do not do any heavy lifting while taking pain-relieving medicine. Of course you can carry your child. Make sure to hold your child and other objects close to your body when carrying them.

Caring and protecting your scar

Once the incision has healed and becomes a scar, do not visit a solarium or subject the scar to direct sunlight. The skin around the scar is particularly vulnerable to sunburn and can be darkened by direct sunlight. The dark colour will not disappear with time. We recommend that you keep the scar covered for six months after the operation, and then meticulously use sunscreen with a high SPF. You can also use moisturiser to soften the skin around the scar.

Future pregnancies

If you had your child via caesarean section this time, this does not necessarily mean you will need to have a caesarean section next time. During your next pregnancy, discuss how you want to deliver with your obstetrician.
If you want a vaginal birth during your next pregnancy, there must be at least 18 months between this delivery and your next to make sure that your uterus has completely healed. 

Practicalities

Avoid driving

Do not drive until you have stopped taking pain-relieving medication and you feel that it is responsible. Do not drive or ride a bike while taking strong pain-relieving medication or if you still cannot use your body as normal.

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