The First Week After Having a Cesarean Section

One woman's daily journal on recovering from a c-section.
Birth Stories Unplanned C-section
Birth Stories Unplanned C-section

Day One

When I was pregnant with my first child, it never occurred to me that I'd have a c-section. But after three hours of pushing, I no longer cared that the birth I envisioned wasn't to be -- I just wanted it to be over. And compared to the 20 hours that preceded it, the surgery was no big deal. But just as I wasn't prepared for a c-section, I was also unprepared for the recovery. Here's what my first week was like, and what you can expect if you end up giving birth via cesarean section.

First, I was wheeled into the recovery room. I remember feeling shaky and cold but I wasn't in any pain because the anesthesia hadn't worn off yet. This must be a common reaction (due, I was later told, not to the anesthesia but to the fact that I was wearing just a gown in a cool room for an hour) because the nurse asked if I'd like a warm sheet to wrap around me. I gratefully accepted. I was incredibly thirsty -- I wanted a Coke more than anything! But all I could have were ice chips. I'd just had abdominal surgery, after all, and my digestive system wasn't fully functioning.

After a couple of hours, I was wheeled to my room in the maternity ward. As the anesthesia wore off, my incision began to throb. I was given morphine administered through an IV, which made me feel out of it, but allowed me to sleep. (By the time I gave birth it was 10:00 at night.) After a day on the morphine drip, I was stepped down to Percocet, which I took orally. Most doctors will urge you to take the pain relief when offered -- not only will you feel better, you'll recover faster. I was still hooked up to an IV to stay hydrated and to a catheter to urinate. It sounds awful, but the thought of going to the bathroom was pretty terrifying so I didn't mind. That first night, and for the rest of my stay, I was shocked to be woken up every three or four hours to have my temperature taken. It seemed to be counterproductive, when what I really needed to recover was rest. But as Lani Miller, MD, medical director of Providence Maternal Care Clinic in Portland, Oregon, explains, infection is a risk when you've had major surgery, and fever is one of the telltale signs of infection.

Day Two

The nurse took the catheter out the next morning. When I finally made my way to the bathroom, I was shocked at how much blood passed with my urine -- and how much blood had soaked through the maxi pad I was wearing. The bleeding, I was relieved to discover, was entirely normal and unrelated to my c-section. Most women bleed heavily the first few days after giving birth. The bloody discharge is called lochia. Basically, it's a combination of leftover blood, mucus, and tissue from the uterus. As the bleeding tapers off, the blood looks more pinkish or brownish in your pad. You may have a white or yellowish discharge for several weeks or even a few months. It's also not uncommon to spot blood for several weeks, and even a few months, after the birth. The good news: It didn't hurt to pee, though I couldn't imagine having a bowel movement.

The nurse urged me to walk around. It was the last thing I felt like doing. But according to Dr. Miller, moving around restores circulation and normal digestion, helping to pass gas and move food down the pike. If it hurts too much to walk, Dr. Miller says you need to ask for more pain relief.

Just getting out of the hospital bed was a major ordeal. I finally figured out a strategy: I propped myself up on one elbow, then pushed off with the other arm. I also discovered that lowering the bed and creating a sharp angle where my head rested made it easier to slide out. (This can be harder or easier depending on what angle your bed is at when you're trying to get up and how well you use the hospital bed rails. I found it harder to get up at home with no rails.) It felt as if I was pulling the incision if I stood up too straight. (Dr. Miller notes that it may feel as if your stitches are going to come apart, but the skin has been immensely stretched out and there's no risk of that happening.) I adopted a hunched-over shuffle as I dragged my IV behind me. Once I got going, I felt surprisingly okay and was able to do three laps around the maternity ward.

Everyone was strangely obsessed with gas. They kept asking if I had passed gas. Until this momentous milestone had occurred -- which would indicate that my intestines were in working order again -- I couldn't eat any solid food. So meals consisted of drinks, soup, and gelatin.

My doctor switched me to an oral painkiller. I took it every four hours, and it worked well. Basically my day consisted of doing laps around the maternity ward, resting and hanging out with my husband, trying to get the hang of breastfeeding, and gazing at our new baby, who luckily wasn't that hungry yet and slept a lot. He'd spend the night in the nursery so I could rest without being constantly woken up.

At the nurse's urging, I also took my first shower. I was freaked out at the thought of water hitting my wound but was told not to worry. Washing my hair and the scent of soap on my body gave me a real boost.

Day Three

I felt like I'd been run over by a train. I was much more sore and tired than the day before. I'm guessing this had nothing to do with surgery and was more related to all that unproductive pushing catching up with me. I wanted to make calls to say hi to everyone, but I was so exhausted I couldn't even pick up the phone.

I still hadn't passed any gas. I contemplated lying, as I was getting hungry and was sick of the limited liquid offerings, but I decided that the hospital food was probably not worth the risk. I didn't walk around as much as the day before. But when I forced myself up, I noticed again that getting in and out of bed was the only painful part.

Day Four

I finally passed gas, so I got to eat real food. Not that the hospital meal was anything to get excited about, but I asked my husband to bring me a muffin from the outside world. It tasted heavenly. I was still bleeding "down there" but it was definitely less. My gait was a little faster and more confident.

The nurses were urging me to leave because I was doing so well. (Translation: we need the bed.) I agreed, even though I'd only been in the hospital for three nights and my insurance would cover one night more. I was tired of being woken up in the middle of the night to have my temperature taken, and I longed to bring Jack home.

Before I could leave, I had to have my staples removed. As promised, it didn't really hurt, though it pinched. I left with a prescription for the same narcotic painkiller I'd been taking, and a handout that included instructions for caring for my incision. The handout advised me not to drive for at least two weeks and to avoid walking up and down stairs, lifting anything heavier than my baby, and exercising for at least six weeks.

On the way home, we stopped for some stool softener. I hadn't had a bowel movement yet, and the nurse suggested that I start taking a stool softener. (Friends who'd had a c-section were horrified that I hadn't been taking one the whole time in the hospital. I made a mental note that if I'm ever in this situation again, I'll request it as soon as I'm coherent.) The ride home was surprisingly uncomfortable. Every bump we went over (and there were a lot) made my incision throb. I decided it would be no problem to avoid driving for a while. It was late by the time we finally got home, as Jack had been circumcised earlier that day and we couldn't leave until he peed. We ended up waiting around for hours.

Day Five

It was wonderful to be home and cocoon together as a family. I ignored the advice about the stairs. All our bedrooms -- and the only shower -- are upstairs, so I didn't see how it was possible to avoid them. I was probably up and down the stairs 10 times in a few hours.

By 3:00, I was regretting that I hadn't insisted on one more night in the hospital. I was completely wiped out and Jack was nursing every two hours. My breasts hurt, plus my bleeding, which had been subsiding, was much heavier. Dr. Miller says that this scenario is very common. As soon as you walk in the door, you are immediately twice as active as you were in the hospital, she says. You have to pace yourself. She suggests setting up a centrally located area on the main floor, where the affairs of the house can take place, and resting on the couch. Shower upstairs in the morning, sleep in your bed at night, but otherwise stay on the main floor.

I also regretted that I had turned down offers from both my mother and mother-in-law to set up camp in our house for a few days to help out. I thought having an extra person around during this "getting acquainted period" with our new baby would get on my nerves. But in hindsight, I realize that the extra help would have been worth the annoyance.

What about the return of heavy bleeding? That's pretty common too, according to Dr. Miller. It's often a sign that you're overdoing it. But it also may just be that you're noticing it more. If you're in bed much of the day, the blood stays in your vagina, then comes out when you urinate. If you're walking around, it's more likely to collect in a pad. Dr. Miller says that if you're soaking through a maxi pad within an hour or two more than once, you need to call your doctor.

I finally had a bowel movement, which was not fun. Dr. Miller notes that c-section patients are especially prone to constipation as narcotic pain relief slows down the intestinal track. Spending a lot of time lying down is another risk factor.

Day Six and Beyond

By day eight, I'd weaned myself off of the painkillers, so I assumed that it was okay to drive. You definitely can't drive while you're still taking narcotics, says Dr. Miller. But you should also refrain from driving if you're still in pain, as it could inhibit your reaction time and your ability to manipulate the pedal and hit the brakes.

My stomach looked a little less swollen, though it would take several weeks more until all of the fluid and gas from the anesthesia were eliminated from my system. All in all, my recovery took longer than those of friends who gave birth vaginally, but the worst of it was really over by the time I left the hospital.

I slowly got back to feeling like my old self, but it took longer than I thought it would. I bled off and on for weeks more, which Dr. Miller says is normal. My incision is often itchy and occasionally throbs a little.

Months Later...

The faint purple scar on my abdomen is the only physical reminder of the fact that Jack came into the world via c-section. It's about five inches long -- I measured! I'm amazed that a seven-pound baby was actually maneuvered out of such a small opening. When friends ask me what it's like to have a c-section, I tell them that the recovery is no picnic and that they should really hope for a vaginal birth. But I can also honestly say it's not the worst thing. There are even a couple of advantages -- namely no episiotomy pain and a few more days in the hospital before you're on your own with a newborn. And when you look at your baby, it doesn't matter how he came into the world, just that he's here and he's healthy!


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