Going home after Cesarean section
Cesarean section is an operation, but for some reason, nature allows a quicker recovery that we see after different surgeries through a similar incision. The biggest difference between recovery from vaginal delivery versus recovery from cesarean section, is the Pain. The activity differences, and the precautions, are actually pretty similar.
The pain gets better, pretty quickly. Most patients need strong pain medication for 7-10 days after leaving the hospital. After that, ibuprofen and Tylenol are usually enough.
The bleeding will taper off, over the next week or two. There can be an increase in the bleeding, around three weeks after delivery, for a day or two, and then it goes away again. The bleeding should not increase from day to day. If the bleeding increases, more and more over three days, then call.
Keep the incision clean. Use soap and water, wash it well, and pat it dry. The only reason to cover it is to prevent any “leaking” from getting your clothes wet. Some incisions will drain, as part of the healing. The fluid can be clear, or red tinged.
The swelling will get worse before it gets better. The swelling typically peaks 3 or 4 days after delivery. The hand will be tight in the morning and the ankles will be swollen late in the day; and it can be WORSE than during pregnancy.
Overall, you should just get better. Each day should be better than the day before. If you are not getting better, call.
- Restrictions: nature will tell you what to do, or not to do. If it hurts, do not do it. The only problem with advancing your activity too soon is getting more sore than is necessary.
- Bandage: your incision should NOT be covered.
- Activity: There are NO specific restrictions for activity, after cesarean section. Nature will limit you with pain and fatigue. So, Take it Slow, Stop When it Hurts, and Do and Lift anything you want. Just be careful, and take it easy. Specific lifting restrictions don’t help, because everyone is different.
Let your body tell you what you can OR can not do.
- Lifting: As tolerated. Just don’t do anything suddenly, don’t Jerk to lift, and you should be fine.
- Exercise: Start with walking. You can add jogging or swimming, or anything, as tolerated. Delay the “core” stuff, like sit ups, for 6-8 weeks.
- Bleeding: There will be vaginal bleeding and discharge. The bleeding will typically taper over the next 2 weeks, but it can last for 4-6 weeks. If you have bleeding and cramps which persist past 4 weeks, Call. Tampons are fine to use after 2 weeks.
- Breast Milk: It takes about three days until the milk comes in. This means that most women are home when engorgement sets in. Breast feeding mothers will find no shortage of advice and recommendations, when it comes to how and when to breast feed. The essence of breast feeding is: “an empty breast and a wet diaper; everything else is just a detail.” Of course, sometimes it is all about the details. The best way to figure out timing, position, and all the details is trial-and-error. Breastfeeding classes are offered through the hospital.
- Shower and bath: The incision is water-tight within 24 hours after surgery. The bandage should be removed one day after surgery, and the incision should remain uncovered. Your first shower can be 24 hours after surgery. You can take a bath, too, but it may be too difficult getting in and out of the tub for the first 2-3 weeks. It is OK for the vagina AND/OR the incision to go underwater, including the pool.
- Pain Management: Ibuprofen and Tylenol are typically enough. If you have more pain, Vicodin (hydrocodone) or Percocet (oxycodone) are safe to use. You should have a prescription before going home.
- Driving: Narcotics, like Percocet and Vicodin, and driving don’t mix well. Once you are NOT taking any more narcotic medication, then you can take the “can I drive, yet” test. If you can Hop On One Foot, or Kick the Tire before getting behind the wheel, WITHOUT PAIN, then you can drive. You must be able to SLAM on the brake, suddenly, to be safe. If you are still having pain, you may hesitate to brake, and that can be disastrous. It may take 2-3 weeks before you can drive.
- Maternity Leave: We can fill out papers to “prove” you had a baby. Typical maternity leave is 8 weeks after Cesarean delivery, however some employers allow for more or less time. How much time you get, without medical complications, is based on your employment situation more than what we can say.
- Intercourse: You can have sex after the bleeding stops, and you feel you are ready. This can be as early as 3-4 weeks. YOU WILL NEED CONTRACEPTION. Breast feeding does not prevent pregnancy.
- Incision: Call the office if you have concerns regarding how well the incision is healing. The incision should hurt LESS day after day and it should not get red. The incision should NOT be covered. The incision may leak a little, and the liquid can be red, like blood. DON’T PANIC, just call the office.
- Postpartum Appointment: All women need a six week routine visit. This does not mean “stay away” for six weeks. It means if all is fine, see you in six weeks. If you are having problems, CALL.
- SPECIAL CIRCUMSTANCES: If you are on blood pressure medication, then you need an appointment for blood pressure check around One Week after going home from hospital. If you were on Lovenox for pregnancy, you will likely need to CONTINUE the shots for at least six weeks. Diabetes of pregnancy is typically cured at delivery, and you can stop the medication, stop the diet, and stop checking your sugars.
What to look for
The two most important things to watch for, and call right away should you experience them, are:
- Unexplained fever and body aches, like you are getting the flu.
- Cramps, which continue for more than 5 days.
Contacting the doctor
Dr. Mackey can be reached directly at 608.575.4519, almost any time. Please don’t hesitate to call or text if you need to. For less urgent question, you can Email Dr. Mackey. Nurse Ashley can be reached at 608.342.0986.
BEFORE YOU GO TO an Emergency Room, please try calling Dr. Mackey directly. If there is no answer, please leave a message and wait 15 minutes for a return call.
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