The c-section recovery process is not always something you are prepared for. Often, you don’t even see it coming.
You feel a bit of pain, and figure it’s contractions. You pack your hospital bag in a frisson of excitement and make your way to the labour ward. Your entire birth plan is in order and you can’t wait to meet the little one.
In the labour ward, one hour leads to the next and before you know it 15 hours have passed. Next thing you know, there’s an oxygen mask on your face and you are being wheeled into the operation theatre for an emergency c-section.
This wasn’t part of the plan. You barely know what to expect out of the operation, let alone the c-section recovery process. Trust me, you’re not alone.
According to the Ministry of Health (MOH), approximately 30.5% of all deliveries in Singapore are c-sections. The figures have increased over the last 15 to 20 years.
Whether it is because women these days are ‘too posh to push’, or for medical reasons, c-sections are on the rise. As such, we need more awareness about the c-section recovery process.
Before going into the c-section recovery process, here’s a brief explanation of what happens during a c-section.
A cesarean delivery, also known as a c-section, is a major surgery that involves making an incision through your lower abdomen and uterus. A cut is made in the abdominal wall and stomach muscles are pulled apart to reach the uterus.
A c-section is a major surgery that cuts into the abdominal wall and pulls apart your muscles
Upon removing the baby and the placenta, the uterus and the incision are closed with layers of stitches.
As you can see, there’s a lot going on. The healing and c-section recovery process is definitely not as swift as the surgery itself.
As they are wheeling you back to the ward, you feel a stinging pain in your lower abdomen. Your hands are by your sides and your mind is riddled with questions. When do I get to sit? When can I walk? I feel like throwing up, can I? What about those stitches?
Fret not mummies. The c-section recovery process is an important period and you need to exercise caution. But it is not as daunting as it seems. If you do what you’ve got to do, and take the right steps to recovery, you will be back on your feet in no time. Having gone through four c-sects myself, let me assure you that it isn’t all that bad!
Dr. Ann Tan, Women Fertility & Fetal Centre, Mount Elizabeth Medical Centre, answers some of the most common questions mums have about the c-section recovery process and provides some tips on the aftercare.
Dr. Tan was formerly the Chief of Fetal Maternal Medicine at the Department of Obstetrics & Gynaecology, Singapore General Hospital and the past President of Perinatal Society of Singapore.
1. Mobility right after the operation?
As the c-section is considered major surgery, don’t expect to be up on your feet a few hours after the operation. Rest is of paramount importance to allow your wound to heal. Patients are usually required to be resting in bed for the first 12 to 24 hours after the operation.
The first day of the c-section recovery process is when you are the least mobile. It is unlikely that you will even think of walking considering how buzzed you might feel after the surgery. Strong painkillers are in your system as well. Even with the painkillers, women experience varying levels of pain subject to the size of their incision.
You will have drips to keep you hydrated and a urinary catheter to keep your bladder empty. And thankfully so. Imagine having to get off your bed every now and then in the midst of all that pain?
Dr. Tan strongly encourages her patients to walk the day after the c-section. Mobility is an important aspect of the c-section recovery process for it prevents deep venous thrombosis (DVT). DVT is when blood clots form in the deep veins in your legs.
Although you can’t walk for the first 24 hours or so, you can move. And the sooner you move, the sooner your body returns to normalcy. Simple movements such as rotating your feet, moving or stretching your arms and legs and even kegel exercises are perfectly fine.
2. Sitting? Standing? Walking?
The c-section recovery process is one that is gradual. You can possibly start sitting a few hours after the operation. However, you need to exercise caution not to use your core strength to sit. Remember, they have just cut right through your abdomen and wreaked havoc with the muscles. So take the burden off your core and draw strength from other muscle groups.
Enjoy your lovely hospital room and don’t be in a hurry to venture out
The nurses and midwives are ever willing to guide and assist you in your c-section recovery process. They are likely to demonstrate how you should turn to your side, get your legs off the bed then gradually lift the top part of your body to help you to sit down.
The same applies to getting off your bed to stand and eventually walk. When you first get your feet on the ground, don’t be alarmed if you feel dizzy. You have been lying in bed for a good 24 hours under heavy medication after all!
The key to the c-section recovery process is to take it easy. Hold on to the bedrails or to someone around you for support. Please do not attempt to be a heroine and wander out of the ward on your own. I know just how tempting it is for you to walk to the nearest weighing scale. But please mums, for your own safety, it is best to walk with someone next to you initially. Just in case!
3. Food and drink?
If there’s one thing I remember about the hours following my c-section, it is that I was famished. Be prepared mums, a part of the c-section recovery process is also holding off food for a bit. Depending on your situation, food can be delayed anywhere between a couple of hours to the next morning. You might also be started off with a soft diet or food that is generally light on your stomach.
The main reason for this is to prevent you from vomiting. The c-section recovery process is crucial in the first few days when your stitches are still raw. Vomiting may cause your stitches to rupture and that would spell serious trouble.
So please bear with the hunger pangs. Do not ask your friends or family members to sneak food in for you. It is best to abide by the rules. It might seem difficult but following the rules at the beginning will ensure the rest of your c-section recovery process is smooth-sailing.
You might want to stay away from the wheel for some time.
Singaporean mummies are generally busy people. Worse still if this isn’t your first child and you need to transport your older child or children to school, music class, swimming lessons, we all know the drill. Even if you feel up to driving, it is best to avoid it for the first couple of weeks.
Reason being, when driving, you might need to apply an emergency break in the event of any unforeseen circumstances. Your wound needs to be healed for you to apply this emergency break without causing yourself harm.
Mums, if you absolutely must transport your child somewhere, remember that options are aplenty. In addition to your hubby, there’s Grab Car, Uber and of course calling up your regular taxi companies. Focus on the c-section recovery process and worry about driving later!
5. When can I sweat it out?
High impact exercise will have to wait for a bit.
Yes, we know you cannot wait to put on those running shoes and run off that infamous mummy tummy. We hear you. We definitely feel you. However, as mentioned earlier, the c-section recovery process should not be rushed. Dr. Tan emphasises that a rule of thumb is to start exercising after six weeks. And to take things slow and easy.
Most mummies will visit their gynaecologist for a six-week check up on your c-section recovery process. This is when your doctor will have a look at your wound and how it is healing. This determines if you get the green light to start exercising.
In the meantime, Dr. Tan advises performing pelvic floor exercises as soon as you feel comfortable enough to walk around. A good time would be a week into the c-section recovery process.
While mothers usually focus on exercising for weight loss, Dr. Tan stresses that they should focus on building back the core strength and pelvic floor strength. This should be done before mums attempt to run.
“The core and pelvic floor muscles were stretched by the pregnancy and these have to regain their tone prior to high impact workouts,” says Dr. Tan.
Bear in mind that everyone heals differently. Even the same person heals differently for each c-section. Barely a month past my first c-section, I was exercising and could fit into my pre-pregnancy clothes in no time. I definitely can’t say the same about my 4th c-sect.
Even if you get the green light after six weeks, if you feel pain or experience heavy bleeding upon exercising, please stop. Focus on the c-section recovery process and exercise only when your body is ready for it.
Don’t worry mums, if you really feel conscious about your post-baby body, Spanx is always an option!
6. How about sex?
Yes, now that the baby is finally out, you and your man are eager to spice things up under the sheets. Be patient though, for your c-section recovery process is ongoing. Dr. Tan’s take is that the return to sex is similar to exercise.
“One would hope that the couple is in the right frame of mind to reconnect physically after six weeks”.
Rushing into sex before the six weeks required for the c-section recovery process is not a good idea. You risk infection and may cause injury to lacerations that are in the process of healing. Do also remember that you may end up pregnant even if your postpartum period has not returned.
On another note, please take the necessary precaution in whatever form of contraception that works for you. You should not be getting pregnant right after a c-section!
7. Another baby?
The next question is inevitable, when can one think about having the next baby? Heads up, you are likely to get hugely varying answers for this question.
The minimum required time for the c-section recovery process before you get pregnant is six months says Dr. Tan. “But the optimal time between two pregnancies has been estimated to 18 months after the first c-section to the conception of the next” she adds.
Take it easy mums. Give your body a chance to recover properly. I cannot emphasise enough the importance of not rushing the c-section recovery process.
8. Postnatal massage?
Go ahead and pamper yourself with postnatal massage after a few weeks.
Postnatal massage is growing in popularity. Many Singaporean mummies swear by this to aid the c-section recovery process and to help them to lose weight.
Dr. Tan says that one can enjoy a postnatal massage and wrap after a c-section.
Do exercise caution mummies, as postnatal massages usually include a uterus massage. It is best to wait for the six-week check-up. If your gynaecologist gives the green light then go ahead. Most postnatal massage therapists in Singapore do recommend waiting at least three weeks after a c-section.
RELATED: Postnatal massage in Singapore: The comprehensive guide
Tips for c-section recovery process
Dr. Tan recommends eating good protein and good fats to recover well. She explains that Zinc and Vitamin C are micronutrients that assist with tissue repair.
Some doctors may also prescribe Vitamin E to aid in the c-section recovery process. Whatever supplements that are prescribed, please take them! It is also best to avoid seafood during this period.
2. Care for stitches
When you are in the hospital, the nurses will clean your wound with antiseptic solutions on a daily basis. You will be sent home with a dressing that keeps your wound dry. Usually, this is a special plaster that prevents water from touching your wound. You should not be rubbing soap on your incision at this point.
Somewhere between seven to ten days after your surgery, your stitches will be removed. Your doctor may prescribe Collagen cream or other gels to lubricate the seam and to prevent keloids from forming. This also aids the external part of the c-section recovery process.
Upon removing the stitches, you can shower and allow water or soap to run over the wound. However, do exercise caution not to rub your wound. During the initial stages of the c-section recovery process, it’s best not to expose your wound to water that is too hot.
3. Surgical binder
The day after your surgery, your doctor is likely to ask you to put on a surgical binder. This is of tremendous help in the c-section recovery process. Firstly, it offers firm support and prevents too much movement. If you need to cough, this comes in really handy.
The compression of the binder reassures you that the incision won’t rip apart or burst open. In addition, the binder helps to tighten loose skin and prevents the sagging stomach from hurting your fresh incision. The pressure the binder exerts on your incision also reduces scar tissue formation.
On a concluding note about the c-section recovery process, here is what Dr. Tan has to say to mums:
Be patient. The baby took nine months to develop in you and grow in you. Your abs are naturally stretched. While a c-section might seem as if your baby came out of a ziplock bag, it does not guarantee that the abdominal muscles will spring back. No, it doesn’t work that way.
It takes time to recover. The c-section recovery process is gradual. So be KIND to yourself. Take TIME to heal and work out to your pre-pregnancy state.
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