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Don't expect your recovery to be complete the moment you leave the hospital. "There is considerably more pain after a Cesarean section than after a vaginal delivery, and most patients aren't able to jump up and take care of their baby by themselves right away," says Patrick Duff, MD, Professor of Obstetrics and Gynecology, Residency Program Director, and Associate Dean of Student Affairs at the University of Florida.
I never thought I would have a C-section, so I didn't have any help lined up when I got home. If you don't plan on having the surgery you may be in for a surprise. More than a quarter of all babies born in 2002 were surgically delivered, according to data from the Centers for Disease Control and Prevention. Some C-sections are elected, but many are unanticipated. It always pays to prepare for any eventuality. Don't be afraid to ask for help from family, friends, or a childcare service well in advance of your scheduled due date.
Friends and family can also help you through the emotional pangs that come after any delivery, and especially after a C-section. You may feel a sense of disappointment, just as I did, because you had planned on a vaginal birth. Or you may experience the typical "baby blues" that affect as many as 80 percent of new moms. These feelings are perfectly normal.
In addition to the normal recovery aches and pains, you may have other unwelcome side effects. One is constipation. If you're going for four or more days at a stretch without having a bowel movement, drink more water and add fruits and other high-fiber foods to your diet (prunes, etc.). If diet alone doesn't help, ask your doctor to recommend a mild laxative, such as Metamucil or Colace.
You may experience some cramping and discharge (first reddish, and then gradually changing to a pale yellow) as your uterus begins to shrink. The discharge, called lochia, may persist for up to six weeks after delivery.
Complications from a C-section are rare, but they become more of a concern with repeat deliveries. "Most women who have Cesarean sections are young and healthy, so it's not common to see complications," says Dr. Shiffman. "But we're now seeing women with repeat C-Sections. The more C-Sections a woman has, the more likely she is to have complications."
The most common post-operative complication is infection, which can occur in the lining of the uterus, in the wound, or within the urinary tract. Call your physician if you notice any of the following symptoms: fever, a foul-smelling discharge, abdominal pain, painful urination, redness around, or drainage from, the incision.
After a C-Section
You'll have to take it easy for a few weeks after your C-section. "The tissue beneath the skin--the muscle and fascia (the fibrous membrane that encloses the muscle)--takes a minimum of four weeks, and as much as six weeks, to regain most of the strength it had before the operation," explains Dr. Duff. "For that reason, patients shouldn't do strenuous activity in that period of time--for example, running, cycling vigorously, or swimming laps." When you do start exercising again, go slowly. Walk for a few minutes at a time or do gentle stretches. Kegels (pelvic floor exercises) will strengthen the muscles that support your bladder and help prevent incontinence, which many women experience after childbirth.
If you're feeling up to it (which you may not be if your baby is awakening you every two hours of the night), you can resume having sex within four to six weeks, provided that you have your doctor's approval.
Thinking about the Next Pregnancy
Just because you've had a C-section once does not mean you have to have one again with subsequent pregnancies. Although there are risks associated with vaginal birth after C-section (VBAC), more than 70 percent of women who attempt it are successful. Your doctor can help you determine whether your benefits outweigh your risks.