C-section recovery: What to expect

If you're planning to have a cesarean delivery — also called a C-section — or you want to be ready in case you need one, you might have questions about recovery. How much pain will there be? What breastfeeding positions might work best? Understand how to take care of yourself and your baby after a C-section.

After a C-section, pain and tiredness are common. To help with healing:

• Get enough rest. It's important to keep moving after a C-section, but you also need to get enough rest. If family and friends can help you with daily tasks, let them. Rest when your baby sleeps. For the first couple of weeks, don't lift anything heavier than 10 to 15 pounds.
• Seek pain relief. Your healthcare professional might suggest ibuprofen (Advil, Motrin IB, others), acetaminophen (Tylenol, others) or other medicines to relieve pain. Most pain relief medicines are safe to take while breastfeeding.

Check your C-section wound for signs of infection. A member of your healthcare team likely will tell you how to care for the wound before you leave the hospital. Contact your healthcare professional if your wound is red, swollen or leaking fluid. Also seek care if you get a fever or if the area around the wound changes color. It may be red, purple or brown, depending on your skin color.

You can begin breastfeeding soon after a C-section. You might start in the delivery room. Breastfeeding positions that work well after you've had a C-section include:

• Football hold. Put a pillow along your side and use a chair with broad, low arms. Hold your baby at your side, with your elbow bent. With your open hand, support your baby's head. Face the baby toward your breast. Your baby's back will rest on the pillow and your forearm. Support your breast in a C-shaped hold with your other hand.
• Side-lying hold. You and your baby lie on your sides. Your baby faces your breast. Support your baby with one hand. With the other hand, grasp your breast and touch your nipple to your baby's lips. Once your baby latches on to breastfeed, use one arm or a pillow to support your own head. Use your other arm to help support the baby.

For support or information about breastfeeding, contact a person who specializes in breastfeeding, called a lactation consultant. Ask your healthcare professional to suggest someone.

While you're healing from a C-section, you're also healing from pregnancy. Here's what to expect:

• Vaginal discharge. After delivery, a mix of blood, mucus and tissue from the uterus comes out of the vagina. This is called discharge. The discharge changes color and lessens over 4 to 6 weeks after a baby is born. It starts bright red, then turns darker red. After that, it usually turns yellow or white. The discharge then slows and becomes watery until it stops.
• Contractions. For a few days after a C-section, you might feel contractions. They are sometimes called afterpains. These contractions often feel like menstrual cramps. They help keep you from bleeding too much because they put pressure on the blood vessels in the uterus. Afterpains are common during breastfeeding. Your healthcare professional might suggest a pain reliever that you can buy without a prescription. They include acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin IB, others).

• Sore breasts. A few days after giving birth, you might have full, firm, sore breasts. That's because your breast tissue overfills with milk, blood and other fluids. This condition is called engorgement. Breastfeed your baby often on both breasts to help keep them from overfilling.

  If your breasts are engorged, your baby might have trouble attaching for breastfeeding. To help your baby latch on, you can use your hand or a breast pump to let out some breast milk before feeding your baby. That process is called expressing.

  To ease sore breasts, put warm washcloths on them or take a warm shower before breastfeeding or expressing. That can make it easier for the milk to flow. Between feedings, put cold washcloths on your breasts. Pain relievers you can buy without a prescription might help too.

  If you're not breastfeeding, wear a bra that supports your breasts, such as a sports bra. Don't pump your breasts or express the milk. That causes your breasts to make more milk. Putting ice packs on your breasts can ease discomfort. Pain relievers available without a prescription also can be helpful.

• Hair loss and skin changes. During pregnancy, higher hormone levels mean your hair grows faster than it sheds. The result is more hair on your head. But for up to five months after giving birth, you lose more hair than you grow. This hair loss stops over time.

  Stretch marks won't go away after delivery. But in time, they'll fade. Expect any skin that got darker during pregnancy, such as dark patches on your face, to fade slowly too.

• Mood changes. Childbirth can trigger a lot of feelings. Many people have a period of feeling down or anxious after giving birth, sometimes called the baby blues. Symptoms include mood swings, crying spells, anxiety and trouble sleeping. These feelings often go away within two weeks. In the meantime, take good care of yourself. Share your feelings, and ask your partner, loved ones or friends for help.
• Postpartum depression. If you have large mood swings, don't feel like eating, are very tired and lack joy in life shortly after childbirth, you might have postpartum depression. Contact your healthcare professional if you think you might be depressed. Be sure to seek help if:
  • Your symptoms don't go away on their own.
  • You have trouble caring for your baby.
  • You have a hard time doing daily tasks.
  • You think of harming yourself or your baby.

  Medicines and counseling often can ease postpartum depression.

• Weight loss. It's common to still look pregnant after a C-section. Most people lose about 13 pounds (6 kilograms) during delivery. This loss includes the weight of the baby, placenta and amniotic fluid.

  In the days after delivery, you'll lose more weight from leftover fluids. After that, a healthy diet and regular exercise can help you to return to the weight you were before pregnancy.

The American College of Obstetricians and Gynecologists says that postpartum care should be an ongoing process rather than a single visit after your delivery. Check in with your healthcare professional by phone or in person within 2 to 3 weeks after delivery to talk about any issues you've had since giving birth.

Within 6 to12 weeks after delivery, see your healthcare professional for a complete postpartum exam. During this visit, your healthcare professional does a physical exam and checks your belly, vagina, cervix and uterus to see how well you're healing.

Things to talk about at this visit include:

• Your mood and emotional well-being.
• How well you're sleeping.
• Other symptoms you might have, such as tiredness.
• Birth control and birth spacing.
• Baby care and feeding.
• When you can start having sex again.
• What you can do about pain with sex or not wanting to have sex.
• How you're adjusting to life with a new baby.

This checkup is a chance for you and your healthcare professional to make sure you're OK. It's also a time to get answers to questions you have about life after giving birth.