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This guide is brought to you by Gravida, a postpartum support organization offering on-demand courses and advice to expecting and new moms. Gravida is run by Morgan Michalowski, a Nurse Midwife, Lactation Consultant, and Women's Health Nurse Practitioner. Morgan is also an Expert on the SocialMama app.
Ready for your Cesarean Section?
To prepare for the big day, ask your OB these questions:
- How many hours before my c-section should I stop eating and drinking?
- Do I need to discontinue or avoid any medications prior to surgery?
- Do I need to shower before coming to the hospital? Or use a special antiseptic soap or wash?
- Do I need to shave my bikini line?
It’s baby time! These things need to happen before you meet your baby:
- Be admitted to the hospital where your care team will explain what to expect and obtain signed consent. You can expect a physical exam, blood draw, IV, and IV fluids. Your baby’s heart rate will be monitored before and during the c-section.
- Go back to the OR (alone) for regional anesthetic with either a spinal or epidural. After you’re numb, a catheter is placed in your bladder where it will stay for approximately 24 hours.
*Heads up! If you have an emergency c-section and don’t have an epidural in place, you may need general anesthesia.
- Have your support person join you in the OR once you and the team are ready to get the show on the road!
*Pro Tip: Bring some tunes to help you relax during the c-section! You can also request a gentle c-birth, where you have a clear drape to see your baby born, immediate skin to skin if you and baby are stable, and first latch with the support of a nurse while your team gets you ready for PACU.
Your baby is here! What happens next?
- Spend your first few hours as a family in PACU (the recovery room) where a nurse will monitor your vital signs, heart rhythm, bleeding, and pain.
*Heads up: To ensure you don't bleed too much from your uterus postpartum, your nurse will need to do something called a fundal check. A fundal check is when someone presses on top of your uterus, or fundus, to confirm it's firm and center. To get through this experience, take pain meds, use ice packs, and have your nurse count to 3 before they start.
- Bond with your baby while you recover, if you both are stable.
*Pro Tip: Get some skin-to-skin time with the help of your nurse or support person! You can get a nesting shirt to keep baby safe in your arms while the pain medication wears off.
- Be cleared by the anesthesiologist and transfer to the postpartum unit where you will stay for 48-72 hours.
Here’s how to do PACU Like a Pro:
- Have a support person with you during your PACU recovery. You will be drowsy and have health devices attached to your body, making it difficult to move or lift your baby! Here are all the annoying (but totally necessary) devices keeping you healthy and safe:
Blood pressure cuff on your arm.
Pulse oximetry probe on your finger.
ECG leads on your chest to monitor your heart rhythm.
Compression socks and sequential compression device (or leg pump machine!) on your legs.
Fluid and pain medication running through your IV.
A catheter in your bladder.
Pad and mesh panties.
*Heads Up: you will still have postpartum bleeding from your vagina.
- Give your family and friends a heads up that only 1-2 support people are allowed in PACU. If family members wish to see the baby right away, they will have to rotate one at a time or wait until you are moved to the postpartum unit.
- Stay hydrated! Bring your own coconut water, bone broth, or herbal tea.
- Prepare for a longer PACU recovery if you had an emergency c-section with general anesthesia.
Mom’s First 24 hours:
- Expect to swell, particularly in your hands, feet, and legs, from all the IV fluids. It goes away in a few days!
- Feel better faster by walking within 24 hours to reduce pain, get your bowels moving, and eliminate gas.
*Pro Tip: Take pain medication and put on a belly binder before you get up for the first time.
- Protect your belly and reduce pain by holding a pillow directly over your incision for support when you cough or laugh. Use the same technique during the car ride home to soften the impact of a bumpy road.
- Keep your lungs healthy and prevent the build-up of fluid or mucus by using an incentive spirometer to practice deep breathing. It’s only natural to take shallow breaths when you’re in pain!
- Prevent nausea and vomiting by slowly introducing food because abdominal surgery makes your bowels sluggish.
*Pro Tip: Start with broth, soup, rice, or toast. If you feel nauseous, ask your care team about IV anti-nausea meds!
- Ask your OB provider for clear instructions on how and when to take pain medication. To prevent unnecessary nausea or vomiting is it better to take medication:
- With or without food?
- In the morning or at night?
Mom’s First 2 Weeks Postpartum:
- Load up on snacks, like yogurt, crackers or toast, to coat your stomach if you were prescribed pain meds.
- Use an app or set a reminder on your phone to take your pain meds at the right time! Or place medication(s) near something you use daily, like a toothbrush.
- Take Healthy Mama ‘Move It Along’ stool softener once or twice a day with a full glass of water.
*Pro Tip: Stop taking if you develop diarrhea or haven’t had a bowel movement within 1-3 days of starting medication. Discontinue after 1 week.
- Protect your back by wearing a belly binder for support.
Mom’s New Life:
- Have scar tissue pain? Try soft tissue mobilization. C-section pain can be relieved by massaging the scar and other things we call "soft tissue mobilization." Here’s how to know whether you might benefit from massaging the scar:
Pain/sensitivity at and around the scar.
Reduced mobility and elasticity; making bending forward and lifting uncomfortable, or they feel like that area is being pulled/tugged on when standing up straight and reaching overhead, which can affect posture.
Low back pain from compromised/weakened abdominal muscles.
Trigger points in abdominal muscles that refer pain to the urethra and clitoris.
Superficial nerve irritation surrounding the area of the scar.
- Ask you OB provider, once your scar heals, around 6 weeks postpartum, if you’re clear to start the massage process.
- Work with a physical therapist or body worker to learn advanced techniques. Here’s how to gently start the process at home:
Step 1: Place fingertips so the pads of your fingers are just above the scar line. Use Vitamin E oil to reduce scarring. It’s also safe to use coconut oil or olive oil for massage. You can add essential oils, like chamomile, lavender, or frankincense, to coconut oil for a little self-love during a time that’s not ideal. You can use 10-12 drops of essential oil for every 2 tbsp of oil.
Step 2: Lightly put your fingers on your skin and feel how mobile it is- move your fingers up, down, side to side, and in little circles.
Step 3: Can you move your skin in all directions? If not, notice where you feel resistance, work your fingers in the direction of resistance and gently hold until you feel it release.
Now you're ready to handle your C-section like a total PRO!
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About the Contributor:
Morgan Michalowski is a Nurse Midwife, Lactation Consultant, and Women's Health Nurse Practitioner. She is the Founder & CEO of Gravida, a postpartum organization offering courses and advice to help expecting and new moms navigate motherhood. Morgan is an Expert on the SocialMama app, providing on-demand, evidence-based general advice to mamas.
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