Still, you’re going to need plenty of patience, rest, and support while you heal. Here’s an idea of what to expect as a C-section recovery timeline over the first hours, days, and weeks.

Just after delivery

After surgery, you’ll remain under close observation for a few hours. At this point, you still won’t have feeling in your lower body, and you may feel woozy or shaky because of the pain medication and the shifts in your hormones after giving birth. But, barring any complications, you’ll be able to cuddle and breastfeed your baby right away. You can have baby wrapped skin to skin with you in recovery just after getting out of the operating room. This will help baby regulate their body temperature, breathing, and heart rate, and prepare them for successful breastfeeding.

The first 24 hours after delivery

After the observation period is over, you’ll be moved to the postpartum recovery area. 

In many cases, the pain medication you were given for surgery will be effective for 18-24 hours to help you stay comfortable, as the regional anesthesia numbing your lower body will wear off after a few hours. Don’t be surprised when you’re encouraged to get out of bed soon after regaining feeling in your legs. Your care team hasn’t forgotten that you’ve just had major surgery. Movement is a critical part of the healing process and helps reduce the risk of blood clots. 

Soon after delivery, a nurse will usually massage your uterus to encourage it to contract to its usual size. The firm pressure stimulates contractions, which can be unpleasant. However, it’s important because it helps prevent heavy postpartum bleeding.

The day after delivery

The day after your C-section, your healthcare team will typically remove your catheter. Walking back and forth to the bathroom will now become part of your routine. Your doctors will also remove your bandages around this time and replace them with small, sticky bandages called Steri-Strips. These strips can get wet, so you’ll be able to shower. When you do, let the soapy water run over the incision area but don’t scrub. After your shower, gently pat the area dry. 

Expect to wear a pad for the first several weeks (no tampons while you heal). After birth, you’ll experience a completely normal vaginal discharge called lochia — a combination of red and white blood cells and mucus. The lochia will be red and heavier for the first few days after birth. Then it will transition to red-brown and then to pink/brown of lighter bleeding over the following 2-3 weeks. Eventually, it will become a paler, white discharge for the remaining 3-4 weeks before resolving altogether. 

Gas bubbles can be a real pain while you wait for your bowels to start moving normally again. All the walking you’re encouraged to do should help, as can a stool softener and anti-gas medication. 

Days 3-4

Most people will be cleared to go home around this time. If you have staples rather than dissolvable stitches, your doctor will usually remove them at this time. Don’t worry; the removal process shouldn’t be painful at all. 

Before leaving, you’ll be given the full rundown on incision care, plus all the dos and don’ts during your C-section recovery. Don’t be afraid to ask any lingering questions about your healing and life with your new baby. You’ve got direct access to a team of experts right now, and be sure you know who and what number to call once your home if you need to contact a provider urgently.

The first week at home

You’re going to need a lot of support after you leave the hospital. Round up your inner circle and get specific about exactly what you need. Try to rest as much as you can and delegate tasks like errands, cooking and housework wherever possible. If it’s an option for you, you could hire a postpartum doula to come to your home occasionally to give you a break from infant care, or to do some light cleaning, or food prep for you and your family. Some doulas also provide lactation support that can be crucial in the first couple of weeks.

Don’t try to lift anything heavier than your baby for now. If you have stairs in your home, consider asking someone to help you move your essentials to the first floor so you’re climbing them as little as possible. If you were sent home with prescription pain medication, know that it is perfectly acceptable to use it as directed by your provider. You have to take care of yourself in order to be present and able to care for your baby. As you near the end of your prescription medications, you may want to transition to an over the counter pain medication. Most, like ibuprofen and acetaminophen, are safe for breastfeeding. Talk to your doctor about which is the best option for you.

A heating pad can help relieve cramping as your uterus continues to shrink. Drinking plenty of water and taking a stool softener as well as making sure you’re walking daily can help with constipation. You should also take care to nourish yourself often and well. Your body needs extra energy to heal and to produce breast milk for your baby if you are breastfeeding.

Two weeks out

Even though you still have much healing to look forward to, you can expect to feel much better at this stage. You might have a two-week incision checkup with your doctor. In the meantime, watch for signs of infection, which include warmth, redness, swelling, or oozing at the incision site, as well as fever. Call your doctor right away if you notice any of these symptoms. 

Once you’re no longer taking prescription pain medication and can use the gas and brake pedals in a car without any pain, you may be cleared to get back behind the wheel. But expect that you won’t be driving for two weeks at the very least. 

One month after your C-section

By now, moving around will likely feel much more comfortable. And you should find that the vaginal bleeding stops between now and the six-week mark. Other good news: you can usually take a bath by now if you like. And your doctor might give you the go-ahead for some types of light exercise, especially if you were active before and during pregnancy. 

C-section recovery week 6 and beyond

Congratulations! By this point, many people feel nearly or fully recovered. Your incision will have healed, leaving a scar that will fade with time. However, you may continue to feel slight discomfort or numbness at the incision site for months to come.

At your six-week checkup, your doctor might let you know that it’s okay to have sex. Keep in mind that when you are physically ready and emotionally ready may follow different schedules. Don’t rush this step and when you do decide to go for it, take things slow and steady.

Remember, everyone has their own healing timeline. So it’s crucial to listen to your body and not rush your return to normal. You’ve made it through six weeks of recovery with your now six-week-old baby. There’s so much to look forward to as your timeline together continues.

Reviewed by the Ovia Health Clinical Team

Sources

• “Births – Method of Delivery.” National Center for Health Statistics. Centers for Disease Control and Prevention. March 2, 2021. https://www.cdc.gov/nchs/fastats/delivery.html
• “C-section.” Mayo Clinic. Mayo Clinic. June 12, 2020. https://www.mayoclinic.org/tests-procedures/c-section/about/pac-20393655
• “Pain Management for C-Sections.” Yale Medicine. Yale Medicine. https://www.yalemedicine.org/conditions/anesthesia-for-c-section
• “Cesarean Birth FAQs.” Acog.org. The American College of Obstetricians and Gynecologists. 2021. https://www.acog.org/womens-health/faqs/cesarean-birth

Before we get into the nitty gritty details and discuss why we generally find that hospitals with lower C-section rates are better places to give birth, let’s discuss the context. 

A note about C-sections

C-sections can be lifesaving medical interventions — for birthing parent and baby — but they do come with higher associated risks, including for the birthing person, a 3x higher risk of blot clot, hemorrhage, or infection. And they are often performed when they’re not medically necessary,

Today, roughly 32% of all births in the U.S. are delivered via C-section. This is double or triple the optimal rate. 

So how can I avoid an unnecessary C-section?

One of the most influential factors in the method of delivery for a single patient is the hospital where a patient delivers. And hospitals’ C-section rates can vary by more than 10 fold, even within the same state! So considering the hospital you choose to give birth at is your first step in preventing an unnecessary C-section. 

Why do some hospitals have higher C-section rates?

There are lots of reasons some hospitals have higher C-section rates — oftentimes, due to scheduling issues or lack of space, providers make the decision to perform a C-section when labor isn’t progressing quickly enough. 

Hospitals with lower C-section rates tend to have more supportive care cultures — they tend to welcome doula services, encourage nurses to spend more time with patients, and avoid intervening unnecessarily during labor. All of these factors are not only helpful in reducing unnecessary C-sections, they’re also just good practice.

A common C-section misconception

Even if you’ve planned to have a vaginal birth, you might think that choosing a hospital with a higher C-section rate means that you’re in better hands if you do end up needing one, but this is a common misconception.  

Hospitals with high C-section rates don’t necessarily have more experience. Rather, they may just not have the care culture or staff necessary to ensure that all interventions are exhausted before moving to a C-section. 

So, what can I do next?

By selecting a hospital with a low C-section rate, you’re taking a step to reduce your risk of having a medically unnecessary, expensive, and risky operation. 

That said, there are many factors that influence your hospital choice and birth plan. For some, a C-section is the safest delivery option. No matter how you plan to give birth, you should feel empowered to make the best decision for you and your baby with your provider.

And if you are planning to have a C-section or you end up needing one, you might find this additional information helpful.

• What happens during a C-section
• When your birth doesn’t go as planned
• C-section recovery timeline

Is home birth a good fit for your family 

The first thing you’ll want to know is if your state allows a provider to help you give birth at home. Laws vary from state to state, and there are a few states where it may be considered illegal for a provider to attend your birth at home. 

If it is a legal option in your area, you’ll then want to consider your own health and pregnancy risk factors. Home birth is generally not a good fit for those with a baby who’s not head-down, those who are having twins or a multiple pregnancy, or those who have had a C-section before. 

A lot of other health conditions or risk factors could also mean a home birth isn’t a good fit for you, like having a bleeding disorder, high blood pressure, gestational diabetes, or a history of preterm birth.

What do the experts say?

Both the American College of Obstetricians and Gynecologists (ACOG) and the American College of Nurse-Midwives (ACNM) believe that every person has the right to make an informed choice about the location for childbirth, but there is still some conflicting information. 

According to ACOG’s analysis and position statement, there are lower rates of interventions and perineal tears when birthing at home, but there are also higher risks of poor outcomes for babies born at home, like higher rates of seizures. 

In contrast, recent studies highlighted by ACNM suggest that planned home birth for those who are low-risk and working with a qualified provider is just as safe for both parents and babies. They suggest that in these circumstances, home birth might even lower some risks, like the risk of getting a hospital-acquired infection. This may be particularly significant for those who are Black, Indigenous, People of Color, or living in a rural setting. 

Though ACNM and ACOG’s opinions differ on the overall safety of home births, both organizations believe that there are certain levels of care that should be in place to ensure the health and safety of the parent and baby. This means that the birth attendant should:

1. Be a certified nurse-midwife (CNM), certified midwife (CM), or physician who can provide the care you expect during pregnancy and birth.
2. Be able to access consultation with an appropriately licensed colleague when needed for problems that may come up during pregnancy and labor.
3. Have a plan for a transfer process if you do need to have your baby at the hospital or if you or your baby needs urgent care after birth.

Next steps 

If you’re thinking about choosing a home birth, here are some questions you may want to ask your potential provider to help you make the best and safest choice for you and your family:

1. Are you a CNM, CM, or physician who is licensed by the state to practice home birth?
2. How much experience do you have attending home births?
3. How close to the hospital should I live to be eligible for home birth?
4. Is my health and pregnancy low-risk enough to be safe for home birth?
5. What supplies do I need to have at home?
6. What supplies and medications do you bring with you?
7. How do you handle potential complications or emergencies, like excessive bleeding after birth or a newborn who’s having difficulty breathing?
8. How can you help manage my pain and comfort during labor and birth?
9. How often do people in your care transfer to the hospital, and why?
10. How do they get transferred, and are ambulances available near me?
11. Who will take care of me at the hospital if I do get transferred?
12. What is the cost of home birth care, what’s included, and is it covered by insurance?

Ultimately, you deserve to make the best possible choice for yourself, your baby, and your family. 

Reviewed by the Ovia Health Clinical Team

Read more

• Choosing where to deliver
• Building a birth plan

Sources

• Cheyney, Melissa, et al. “Outcomes of Care for 16,924 Planned Home Births in the United States: The Midwives Alliance of North America Statistics Project, 2004 to 2009.” Journal of Midwifery & Women’s Health, vol. 59, no. 1, 30 Jan. 2014, pp. 17–27., https://doi.org/10.1111/jmwh.12172. 
• Hutton, Eileen K., et al. “Perinatal or Neonatal Mortality among Women Who Intend at the Onset of Labour to Give Birth at Home Compared to Women of Low Obstetrical Risk Who Intend to Give Birth in Hospital: A Systematic Review and Meta-Analyses.” EClinicalMedicine, vol. 14, 25 July 2019, pp. 59–70., https://doi.org/10.1016/j.eclinm.2019.07.005. 
• Committee on Obstetric Practice. “Planned Home Birth.” ACOG, ACOG, Apr. 2017, https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2017/04/planned-home-birth. 
• Schmidt, Samantha. “Pregnant Women Are Opting for Home Births as Hospitals Prepare for Coronavirus.” The Washington Post, WP Company, 22 Mar. 2020, https://www.washingtonpost.com/dc-md-va/2020/03/20/pregnant-women-worried-about-hospitals-amid-coronavirus-are-turning-home-births-an-alternative/. 
• Krebs, Natalie. “As Home Births Rise in Popularity, Some Midwives Operate in a Legal Gray Area.” NPR, NPR, 5 Apr. 2022, https://www.npr.org/sections/health-shots/2022/04/05/1089927028/midwives-home-births. 
• Nethery, Elizabeth, et al. “Birth Outcomes for Planned Home and Licensed Freestanding Birth Center Births in Washington State.” Obstetrics & Gynecology, vol. 138, no. 5, 2021, pp. 693–702., https://doi.org/10.1097/aog.0000000000004578. 
• “Improving Our Maternity Care Now through Community Birth Settings.” National Partnership for Women & Families, National Partnership for Women & Families, https://www.nationalpartnership.org/our-work/health/maternity/community-birth-settings.html. 

Leasa Wright has been practicing yoga and meditation her entire life. She joins us today to speak a bit more about the benefits of prenatal yoga, how to get started, and why she’s so passionate about making time for a prenatal yoga practice. When she was pregnant with her first child, Leasa says, “I fell in love with empowering pregnant people. They need to feel strong and safe in their bodies.” She’s been teaching a prenatal yoga practice weekly ever since. 

While movement in general, and yoga specifically, can be beneficial at all times in your life, there’s something different about prenatal yoga. “Once I realized I was pregnant, I felt a sense of responsibility for that little being,” says Leasa. Plus, pregnancy can be hard on the body and it’s common to feel very sore if you’re not moving around every day. Prenatal yoga is a great way to integrate that movement, connect with your baby, and form a community. 

A couple safety notes before we dive in:

• Most people should wait until after the first trimester before starting a prenatal yoga practice.
• If you’ve never practiced yoga before, it’s a good idea to be a bit more cautious when starting out. Check in with your provider to make sure it’s a good fit for you. 
• To prevent injury, do all the modifications your instructor recommends and don’t push yourself. Especially if you haven’t practiced yoga before, it can be hard to know your limit, so go easy on yourself.

How is prenatal yoga different from a yoga practice for those who are not pregnant?

​​Prenatal yoga is a curated collection of customized asanas/yoga poses that cater to the shape of the pregnant body. A person’s center of gravity changes during pregnancy and they lose the ability to fold inward. This leaves a person with an unbalanced yoga practice if they continue to sit out postures in a traditional class. Prenatal yoga classes offer a balanced sequence of joint mobility exercises, seated postures, standing postures, hip openers, breathing, and relaxation exercises — leaving out the contraindicated postures, but still offering an overall, accessible, and whole body practice.

How can it benefit people during pregnancy (physically and emotionally)?

There are so many reasons to choose to participate in prenatal yoga. It offers the opportunity to connect with your baby and it gives you the chance to connect with other people who are making the same healthy lifestyle choices as you. It’s common to form friendships and build relationships in a class environment. And that community can help alleviate anxieties you may be having about becoming a parent. 

As far as physical benefits: prenatal yoga can improve your sleep, reduce stress and anxiety, and increase the strength, flexibility, and endurance of muscles needed for childbirth. Additionally, it can help to decrease lower back pain, nausea, headaches, and shortness of breath by lengthening the muscles around your rib cage. From your physical body to your emotional state, prenatal yoga can be a key ingredient to a healthy, happy pregnancy.

Where should we start?

For many, pregnancy is a time to make your health a top priority. Ensure you get plenty of sleep overnight, as a growing baby uses up a lot of energy. A well-balanced diet of nutrient-dense foods will also help to boost your energy. Finally, staying active is a key aspect of pregnancy self-care and can be extremely beneficial for managing certain symptoms associated with pregnancy.

Any advice for slowing down when the stress of pregnancy is overwhelming?

Try mindfulness, yoga, meditation, and massage to bring your mind into a peaceful state so you can cope better with the busyness of daily life. Take yourself to a place where your mind and body can be still, allowing you to focus inward and breathe deeply.

Simple things like getting enough rest, eating well, exercising regularly, and seeking support from trusted friends and family can increase your resilience in stressful times. And check in with your partner. You and your partner can act as a support system for one another during this time.

What about creating space in your day?

If you can, try to schedule naps during your day to get more sleep and restore your energy. Take catnaps during the day, even if you just rest your eyes for 15 minutes with your feet up. Book yourself regular pamper sessions at home. A night in with a favorite facemask is a lovely way to treat yourself.

Set aside time for the hobbies and activities that were a part of you before you became pregnant. And try to keep in touch with the friends who add value to your life by scheduling an assortment of standing dates with your circle. 

Any tips for integrating a prenatal yoga practice into your routine? 

A simple first step is to make sure you have correct posture at work by learning some good stretches to practice at your desk during breaks. 

Sign up for an in-person workshop at a local studio who specializes in prenatal yoga. And don’t apologize for making yourself a priority. If it’s easier, try an online yoga class so you can practice from the comfort of your own home. 

If you’re having trouble getting started or staying consistent, ask a friend to be your accountability buddy to ensure you show up to practice. 

How can people make sure they’re staying safe in their practice?

Start by asking your doctor, midwife, or doula for local recommendations. Always attend your scheduled prenatal visits and talk to your provider if you have questions or concerns about your pregnancy. They are a great resource you should take advantage of during this time.

If you’re wondering if a yoga studio offers certified prenatal yoga classes, call and ask if they are certified in prenatal yoga by Yoga Alliance, the organization that sets standards for yoga teachers nationwide. Knowledge of the dos and don’ts of prenatal yoga is one of the most important reasons you should seek out a qualified prenatal class. 

You should always avoid internal twisting, belly compression, and heated yoga classes. Any balancing poses should be done with extreme caution, against a wall.

How can I safely continue my practice postpartum?

The best way to ensure you’re ready to resume practice is to get the approval of your healthcare team first. The standard guidelines recommend waiting 6-8 weeks after birth before continuing your practice. Sometimes that can be longer, depending on your birth experience – ask your provider. 

What’s your favorite part of your yoga practice?

Community. I taught my first prenatal yoga classes during my first pregnancy and have remained connected to those mamas to this very day. You can expect to form beautiful connections with others during prenatal yoga. The bond you create with other pregnant people is one that carries into postpartum and beyond. If there’s anything a community needs, it’s to be full of strong, empowered, and supportive mothers.

Yoga has brought me strength, mindfulness, breathwork, and awareness of my body, which has helped my physical and personal growth tremendously. I am so grateful for this practice and how it has manifested itself into my life’s work.

Read more

• Prenatal pilates
• Low-impact exercise during pregnancy

Is it safe to exercise during pregnancy?

For most people, exercise is safe during pregnancy. However, not all types of exercise are equal. It’s important to discuss with your healthcare provider which types of exercise are right for you. Some people with certain medical conditions, such as placenta previa, high blood pressure, or heart and lung disease may be very limited in terms of exercise and should have a detailed discussion with their providers about which activities are safe for them to participate in and specific limitations they have throughout their pregnancy.

What are the benefits of exercise during pregnancy?

Incorporating movement or exercise during your pregnancy has many benefits to your health. Exercise keeps you mobile and strong. Varied types of movement contribute to your flexibility, circulation, and stamina. All of these benefits help minimize some of the symptoms of pregnancy such as backaches, leg cramps, constipation, bloating, and swelling. It’s also been shown to help boost your mood and energy levels and help you sleep better. 

Regular exercise and movement during pregnancy can help prepare your body for labor by improving muscle tone, strength, and endurance and may even reduce labor time and lower the chance of an unplanned cesarean. 

How much exercise should I be getting?

It’s recommended for most pregnant people to get 2 ½ hours of moderate-intensity exercise per week. Moderate intensity means your breathing becomes faster and deeper, your heart rate increases, and you break a sweat. An example would be going for a brisk walk. To get your 2 ½ hours of exercise in, try breaking it up by exercising for a half hour each day. You can also try fitting in bursts of 10 minutes of exercise 3 times a day.

What types of exercise should I avoid?

Certain types of exercise, like high-contact sports, are not recommended during pregnancy due to their impact on your growing baby. You should also avoid activities where you could fall and exercise in very hot environments (like hot yoga). If you are exercising to the point of exhaustion or so hard that you can’t talk, you may be pushing it too much. Listen to your body and when it’s telling you to slow down.

Tips

Incorporating movement and exercise into your day is important during pregnancy. Going for a walk with a friend or heading over to your favorite yoga class are great ways to get some movement into your daily routine. If you have questions about what kind of exercise is right for you, contact your healthcare provider and they can offer some tips and options. And as always, pay attention to your body’s cues while exercising so you don’t injure or overwork your muscles.

Reviewed by the Ovia Health Clinical Team

Read More

A prenatal visit calendar

Skin changes when pregnant

Sources

• “Exercise during pregnancy” The American College of Obstetricians and Gynecologists. The American College of Obstetricians and Gynecologists. July 2019. https://www.acog.org/womens-health/faqs/exercise-during-pregnancy
• Mayo Clinic Staff. “Pregnancy and exercise: Baby let’s move!” Mayo Clinic. Mayo Clinic. March 12, 2021. https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/pregnancy-and-exercise/art-20046896
• “Exercise during pregnancy” March of Dimes. March of Dimes. September 2020. https://www.marchofdimes.org/pregnancy/exercise-during-pregnancy.aspx
• “Exercise during pregnancy” American Pregnancy. American Pregnancy. n.d. https://americanpregnancy.org/healthy-pregnancy/is-it-safe/exercise-during-pregnancy/

OB/GYN

You’ve likely heard about OB/GYNs, but here’s the formal definition. An OB/GYN is a doctor whose specialty is obstetrics (the branch of medicine dedicated to childbirth and the care of women giving birth) and gynecology (the branch dedicated to the reproductive system).

Many women with low-risk pregnancies who plan to give birth in hospitals often choose OB/GYNs as their primary care providers during pregnancy, but when it comes time for delivery, they are safe in the hands of other providers like nurses or midwives. For women with high risk pregnancies, OB/GYNs are the recommended birth providers because they are the most well-equipped to deal with any complications and surgeries like C-sections.

If you’re considering giving birth at a birth center or other non-hospital setting and want an OB/GYN present, it’s important to note that OB/GYNs often serve as consultants at birth centers, but likely will not be present unless there are complications. Find out where your OB/GYN delivers as you create your birth plan.

Midwife

Midwives are healthcare providers who offer comprehensive care to childbearing women during pregnancy, labor, and birth. Midwives are also trained to serve as primary care providers Midwives can provide much of the same care that an OB/GYN can.

Women with low-risk pregnancies who work with midwives often experience fewer medical interventions, and may deliver babies in a variety of settings, including hospitals, birthing centers, and homes.

One of the biggest differences between a midwife and an OB-GYN is a difference in philosophy — midwives view pregnancy and birth as natural life events rather than major medical events. If this philosophy rings true for you and your pregnancy is low risk, a midwife could be a great fit.

Birth Doula

Birth doulas are labor coaches who help prepare you mentally and emotionally for delivery, and guide you through it. Doulas know about every facet of the labor process and can help you get a firm grasp on what will definitely happen, and what could.

Doulas can be useful for women who have had other pregnancies as well, because every pregnancy and delivery is different. It’s important to note that doulas are not doctors, and so may not be knowledgeable about a specific high-risk or complicated pregnancy. Postpartum doulas can also help you adjust to life with your new one and breastfeeding.

Birth Partner

Think of your birth partner as your right-hand. This person could be a partner, parent, sibling, or friend, as long as they are a person who supports you and you feel you can trust. Delivery is intense, and someone who helps you work through stress and discomfort is an ideal match for delivery day.

You get to decide who joins you for the birth journey, so spend a little time thinking about who can help you prepare for delivery and join you for the process.

Read more

• Building a birth plan
• Finding the delivery location that is right for you

Why does this happen?

Experiencing anything new and unknown is scary — especially when it involves your body and your baby. You may be worried about the health of your baby, the pain of giving birth, being left alone in the delivery room, or the unknown delivery time. 

Beyond the fear of childbirth, it’s common for pregnant women to also fear motherhood. “Will I be a good enough mother?” “Will I be able to provide my baby with everything they need?” “Will I still be able to juggle a career and social life with a child in tow?” These are just a few questions that might be popping up in your head before giving birth. Like childbirth, motherhood can be overwhelming. And also like childbirth, you will know what to do when the time comes. Talk to those who have been through it before. Establish a support network to help through the early days.

And if you’re feeling very anxious or anxious for prolonged periods of time, it’s time to speak with your provider about finding professional support too. 

Can anxiety about childbirth affect childbirth?

Women who experience disturbed labor due to stress can limit the amount of oxytocin they produce during childbirth. With more oxytocin, contractions can increase in speed and strength. Other disturbances can lead to longer labor like bright lights, muscle tension, and pain. 

Staying calm during labor is difficult but can improve your experience. Think about the things that make you feel calm in your day to day life: practicing breathing exercises and visualization, listening to music, looking to your partner or family members for support. You might also want to consider hiring a doula to help you feel calm and confident going into labor and supported throughout it. 

Additionally, particularly for first time parents, having more information about what the process of giving birth is like can help decrease fear and anxiety.

Knowledge can mitigate fears

Learning about the process of giving birth and the techniques to ensure your labor goes as smoothly as possible are both key components to easing your anxiety. Here are ways to face your fears head-on. 

• Speak to your provider about what to expect 
• Pack a hospital bag filled with your essentials
• Hire a doula to support your throughout pregnancy and postpartum
• Talk to your friends who can positively speak about childbirth and motherhood 
• Work through your fears with a therapist
• Attend Lamaze classes to learn breathing and relaxation techniques
• Find a support group for mothers-to-be
• Remember: Your baby doesn’t expect you to be a perfect mother and neither should you

Reviewed by the Ovia Health Clinical Team

Read more

• How to take care of your mental health during pregnancy
• Prenatal exercise and movement FAQ

Sources

• Arfaie, Katayoun, et al. “The Role of Fear of Childbirth in Pregnancy Related Anxiety in Iranian Women: A Qualitative Research.” Electronic Physician, Electronic Physician, 25 Feb. 2017, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5410899/. 
• Slade, P., et al. “Establishing a Valid Construct of Fear of Childbirth: Findings from in-Depth Interviews with Women and Midwives.” BMC Pregnancy and Childbirth, BioMed Central, 18 Mar. 2019, https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-019-2241-7. 
• “Can Fear Prolong Labour?” BellyBelly, 17 Feb. 2021, https://www.bellybelly.com.au/birth/can-fear-prolong-labour/.

How can doulas help?

Starting in pregnancy, doulas can support you by helping you learn more about labor and delivery, answering questions you have about the process, and helping make sure that you know all your options before the big day. Doulas can also support you throughout labor, helping you position your body to find more comfort, offering hands-on touch to provide relief and promote calm, and helping you communicate with your healthcare provider to ensure that you feel in control during the process.

And because, in many instances, you might not deliver your baby with the healthcare provider who has been seeing you throughout your pregnancy, a doula can serve as a great source of consistency and stability throughout your pregnancy journey. They can even provide you with support postpartum as your body recovers, as you learn to breastfeed (if you choose to) and care for an infant, and as you adjust to how this major transition reshapes your life. 

Another big way doulas offer support is by helping you to advocate for the kind of care you want and need. Self-advocacy when it comes to the medical care you’ll receive during this time is hugely important, especially if you experience a medical professional who is not really hearing you. Because you’ll have been working with your doula for sometime and they’ll really understand what you want and need — and because you’ll likely be very comfortable speaking with them honestly about your wants and needs — they can help back you up, communicate your needs, and make sure you’re heard.  

In addition, recent research shows that doulas can help lead to better health outcomes. Folks who work with doulas are less likely to experience complications that involve them or their baby, are less likely to have a baby with low birth weight, and have higher rates of breastfeeding.

Why it’s important to find one who gets you

Clearly working with a doula has some major benefits, but how can you choose one who’ll be best for you? It can be incredibly helpful to work with a doula who can provide you with personalized support — physically, emotionally, and educationally. Often finding a doula who works in your community — someone who you feel you can really connect with and speak with honestly — is the best choice.

How doulas can play a role in helping with birth equity

Health inequity in the United States has devastating consequences for Black women and families, who experience disproportionately worse maternal and infant health outcomes for a number of reasons — including limited access to care, dismissal of pain and other health concerns, and higher rates of underlying health conditions — racism and unconscious bias in the healthcare system are huge factors in each of these areas.

Doulas can play a role in improving  birth equity, which is “the assurance of the conditions of optimal births for all people, with a willingness to address racial and social inequities in a sustained effort.” There are, for example, doula groups run by and for Black women, so that those doulas can really understand what the people they are working with are going through, the challenges they may be facing, and can help support all of their unique needs. A personalized doula experience, where you really feel like your doula understands your unique needs and wishes, can greatly improve health outcomes. 

You deserve support

So if you’d like to work with a doula, try and seek one out in your community who you connect with and who understands where you’re coming from. A quick internet search may help you find independent doulas or doula groups in your area (DONA International, a leading doula certifying organization, has a database to search by location). You may also want to ask your healthcare provider if they have any recommendations. And it’s also worth noting that some healthcare offices and community clinics may even be able to help get you set up to work with doulas in your community, some of whom may be available to support you at no cost during pregnancy and postpartum.

Doulas can be expensive and inaccessible for some people to hire on their own, so even if free community doula services are not available through your healthcare office or clinic, many student doulas do offer free or discounted services. So if you’re interested in doula services, start your search today. You deserve to have the kind of support a doula can provide. 

Read more

• How to advocate for yourself as a patient to get the care you deserve
• Why bringing a support person with you to appointments can help you advocate for the best healthcare

Sources

• Kenneth J. Gruber, Susan H. Cupito, Christina F. Dobson. “Impact of Doulas on Healthy Birth Outcomes.” The Journal of Perinatal Education. 22(1): 49-58. Winter 2013. Retrieved August 31 2020. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3647727/.
• “Find a Doula.” DONA International. DONA International. Retrieved August 31 2020. https://www.dona.org/what-is-a-doula/find-a-doula/.
• “Obstetric Care Consensus: Safe Prevention of the Primary Cesarean Delivery.” The American College of Obstetricians and Gynecologists. The American College of Obstetricians and Gynecologists, 2016. Retrieved August 31 2020. https://www.acog.org/clinical/clinical-guidance/obstetric-care-consensus/articles/2014/03/safe-prevention-of-the-primary-cesarean-delivery.

Still, you’re going to need plenty of patience, rest, and support while you heal. Here’s an idea of what to expect as a C-section recovery timeline over the first hours, days, and weeks.

Just after delivery

After surgery, you’ll remain under close observation for a few hours. At this point, you still won’t have feeling in your lower body, and you may feel woozy or shaky because of the pain medication and the shifts in your hormones after giving birth. But, barring any complications, you’ll be able to cuddle and breastfeed your baby right away. You can have baby wrapped skin to skin with you in recovery just after getting out of the operating room. This will help baby regulate their body temperature, breathing, and heart rate, and prepare them for successful breastfeeding.

The first 24 hours after delivery

After the observation period is over, you’ll be moved to the postpartum recovery area. 

In many cases, the pain medication you were given for surgery will be effective for 18-24 hours to help you stay comfortable, as the regional anesthesia numbing your lower body will wear off after a few hours. Don’t be surprised when you’re encouraged to get out of bed soon after regaining feeling in your legs. Your care team hasn’t forgotten that you’ve just had major surgery. Movement is a critical part of the healing process and helps reduce the risk of blood clots. 

Soon after delivery, a nurse will usually massage your uterus to encourage it to contract to its usual size. The firm pressure stimulates contractions, which can be unpleasant. However, it’s important because it helps prevent heavy postpartum bleeding.

The day after delivery

The day after your C-section, your healthcare team will typically remove your catheter. Walking back and forth to the bathroom will now become part of your routine. Your doctors will also remove your bandages around this time and replace them with small, sticky bandages called Steri-Strips. These strips can get wet, so you’ll be able to shower. When you do, let the soapy water run over the incision area but don’t scrub. After your shower, gently pat the area dry. 

Expect to wear a pad for the first several weeks (no tampons while you heal). After birth, you’ll experience a completely normal vaginal discharge called lochia — a combination of red and white blood cells and mucus. The lochia will be red and heavier for the first few days after birth. Then it will transition to red-brown and then to pink/brown of lighter bleeding over the following 2-3 weeks. Eventually, it will become a paler, white discharge for the remaining 3-4 weeks before resolving altogether. 

Gas bubbles can be a real pain while you wait for your bowels to start moving normally again. All the walking you’re encouraged to do should help, as can a stool softener and anti-gas medication. 

Days 3-4

Most people will be cleared to go home around this time. If you have staples rather than dissolvable stitches, your doctor will usually remove them at this time. Don’t worry; the removal process shouldn’t be painful at all. 

Before leaving, you’ll be given the full rundown on incision care, plus all the dos and don’ts during your C-section recovery. Don’t be afraid to ask any lingering questions about your healing and life with your new baby. You’ve got direct access to a team of experts right now, and be sure you know who and what number to call once your home if you need to contact a provider urgently.

The first week at home

You’re going to need a lot of support after you leave the hospital. Round up your inner circle and get specific about exactly what you need. Try to rest as much as you can and delegate tasks like errands, cooking and housework wherever possible. If it’s an option for you, you could hire a postpartum doula to come to your home occasionally to give you a break from infant care, or to do some light cleaning, or food prep for you and your family. Some doulas also provide lactation support that can be crucial in the first couple of weeks.

Don’t try to lift anything heavier than your baby for now. If you have stairs in your home, consider asking someone to help you move your essentials to the first floor so you’re climbing them as little as possible. If you were sent home with prescription pain medication, know that it is perfectly acceptable to use it as directed by your provider. You have to take care of yourself in order to be present and able to care for your baby. As you near the end of your prescription medications, you may want to transition to an over the counter pain medication. Most, like ibuprofen and acetaminophen, are safe for breastfeeding. Talk to your doctor about which is the best option for you.

A heating pad can help relieve cramping as your uterus continues to shrink. Drinking plenty of water and taking a stool softener as well as making sure you’re walking daily can help with constipation. You should also take care to nourish yourself often and well. Your body needs extra energy to heal and to produce breast milk for your baby if you are breastfeeding.

Two weeks out

Even though you still have much healing to look forward to, you can expect to feel much better at this stage. You might have a two-week incision checkup with your doctor. In the meantime, watch for signs of infection, which include warmth, redness, swelling, or oozing at the incision site, as well as fever. Call your doctor right away if you notice any of these symptoms. 

Once you’re no longer taking prescription pain medication and can use the gas and brake pedals in a car without any pain, you may be cleared to get back behind the wheel. But expect that you won’t be driving for two weeks at the very least. 

One month after your C-section

By now, moving around will likely feel much more comfortable. And you should find that the vaginal bleeding stops between now and the six-week mark. Other good news: you can usually take a bath by now if you like. And your doctor might give you the go-ahead for some types of light exercise, especially if you were active before and during pregnancy. 

C-section recovery week 6 and beyond

Congratulations! By this point, many people feel nearly or fully recovered. Your incision will have healed, leaving a scar that will fade with time. However, you may continue to feel slight discomfort or numbness at the incision site for months to come.

At your six-week checkup, your doctor might let you know that it’s okay to have sex. Keep in mind that when you are physically ready and emotionally ready may follow different schedules. Don’t rush this step and when you do decide to go for it, take things slow and steady.

Remember, everyone has their own healing timeline. So it’s crucial to listen to your body and not rush your return to normal. You’ve made it through six weeks of recovery with your now six-week-old baby. There’s so much to look forward to as your timeline together continues.

Reviewed by the Ovia Health Clinical Team

Read more

• C-section incision area
• Mental health postpartum

Sources

• “Births – Method of Delivery.” National Center for Health Statistics. Centers for Disease Control and Prevention. March 2, 2021. https://www.cdc.gov/nchs/fastats/delivery.html
• “C-section.” Mayo Clinic. Mayo Clinic. June 12, 2020. https://www.mayoclinic.org/tests-procedures/c-section/about/pac-20393655
• “Pain Management for C-Sections.” Yale Medicine. Yale Medicine. https://www.yalemedicine.org/conditions/anesthesia-for-c-section
• “Cesarean Birth FAQs.” Acog.org. The American College of Obstetricians and Gynecologists. 2021. https://www.acog.org/womens-health/faqs/cesarean-birth

Unplanned but not unprepared

A C-section may be planned ahead of time if you’ve had one previously or develop certain pregnancy complications. But sometimes, people find out they will need one once labor is already underway. In those cases, things can move quickly, and the sense of urgency may feel overwhelming and scary. Having an understanding of what a C-section entails — before, during, and after — can help you feel more in control. 

Rest assured, your medical team is highly experienced in delivering babies this way. They know every step they have to take to keep you and your baby as safe as possible. While they may look very busy and hurried, you should also know that it is always within your rights to ask questions. You aren’t inconveniencing them. This is your body and your baby and you deserve to understand your provider’s decisions.

In most cases, your partner or support person can be by your side for a cesarean birth. While they may have to wait outside as you’re getting situated in the operating room, as long as you’re awake for the procedure, they should be there right by the head of your bed with you.

Know that It’s completely normal to have some difficulty letting go of the birth you had envisioned. It may take time — like any grief process — to work through everything you feel afterwards. 

What will happen?

A C-section is a surgical procedure. This means that you’ll be moved into the operating room. It’s a very bright, sterile environment that can be intimidating and it’s often a little chilly in the operating room. You can ask for a warm blanket across your arms if that feels comforting. Because you’re having surgery, you will be given fluid and medication through your intravenous (IV) line. You’ll lay down on the operating table and your abdomen will be washed. Then, you’ll have a blood pressure cuff and a pulse oximeter (clip on your finger to measure your oxygen levels) placed for monitoring. If you don’t already have one, a nurse will likely insert a catheter to collect urine as well. 

Regional anesthesia vs. general anesthesia

In most cases, you’ll receive regional anesthesia — typically a spinal or epidural block — so you’ll remain awake during the procedure but you won’t feel any pain. This means you’ll still be able to experience the birth and be ready to greet your baby immediately after delivery. In rare situations or emergencies, general anesthesia may be required, which would mean you’d be in a sleep-like state for the delivery. Again, this is reserved for rare cases when there isn’t time to place the regional anesthesia and is only done when it’s in your and your baby’s best interests.

What will it feel like?

Before surgery, a curtain is drawn between your upper and lower body to help you stay relaxed. Your partner can sit behind this curtain at the head of your bed while you await your little one’s arrival. You’ll also have an anesthesia provider right there with you whose sole purpose is to make sure you are okay. They can answer your questions and help treat uncomfortable symptoms (like nausea) should they arise. Once your surgeon has made sure you’re completely numb, they’ll make a horizontal or vertical incision in your lower abdomen and then another in your uterus to deliver your baby. Next, they’ll cut the umbilical cord and remove the placenta. Then your medical team will stitch you back up. The entire process is usually done in about an hour. 

Will I really feel nothing?

The anesthesia will ensure there’s no pain at all. However, there may be other sensations. Some women report feeling tugging, pressure, or shortness of breath as their doctor presses on their uterus and eases the baby out. It’s also possible to experience light shaking or shivering, which can be a side effect of a spinal block and is no cause to worry. 

None of these sensations should hurt; however, they might feel strange or even frightening. Using a breath technique or relaxation practice can help you through it, as can leaning on your support person. Keep your doctor and anesthesiologist informed about how you feel so they can ensure you remain as comfortable as possible. 

What happens with my baby?

Just like with vaginal delivery, unless there is an immediate medical need, you’ll be able to see your baby right away. As long as you’re feeling well enough, after the umbilical cord is cut and your baby is dried gently, they can be placed on your bare chest for skin-to-skin contact. Depending on your hospital and how you’re feeling, you may even be able to try breastfeeding in the operating room or recovery area. If you’re not up for having baby on your chest, you can have your partner hold baby cheek to cheek with you to get that skin to skin contact and feel the soothing presence of your baby near to you.

How will I feel after?

After birth of any type, you’ll probably feel sore, elated, and exhausted. However, a C-section is a major surgery, so the healing timeline may be longer than with vaginal birth, and you will likely be in the hospital for an extra day or two. 

In the hours after birth, you will receive pain medication to help you remain comfortable as the anesthesia wears off. You can spend time skin to skin with baby, start to breastfeed, and check out all their little fingers and toes. You may also feel really sleepy so this might be a good time for your partner to do some bonding while you rest.

When can I eat?

At this point you’ll be able to slowly start to eat some ice chips and drink some fluids. Once you’re feeling well enough, you’ll be encouraged to drink plenty of fluids and eat your first meal. Usually the day of your C-section or the morning after (depending on what time of day your surgery was), you’ll get up to walk around with the help of your nurse. You’ll gradually get better at this and will be encouraged to get up several times a day, which will help prevent constipation and reduce the risk of blood clots in your lower extremities.

In the days following the birth, your care team will keep a close eye on your incision to watch for bleeding or any signs of infection. During this time, you’ll most likely experience cramping in your uterus and vaginal bleeding as you would after a vaginal birth.

The first weeks

Over the first few weeks of recovery, it’s important to rest as much as possible and avoid lifting anything heavier than your baby. So get ready for plenty of snuggling and cuddling as you heal. Expect that movement may be uncomfortable and deep bending is off the table until usually four to six weeks after delivery. It is still important to continue doing several short walks a day, which over time you’ll be able to slowly increase in length. The physical limitations can be extremely challenging and frustrating as a new parent, so lean on your support system wherever possible. Full recovery typically takes about six weeks, so it may make sense to consider how you would handle this recovery period now, just in case. 

You’ve got this

(And we’ve got you.) Ovia’s goal is to help you have your healthiest pregnancy and most empowered birth experience. Part of that is feeling ready to make decisions with your healthcare provider that prioritize your and your baby’s safety and wellbeing. This information is meant to help you feel prepared and reassure you that birth can still be beautiful, even when it doesn’t go exactly as planned. 

Reviewed by the Ovia Health Clinical Team

Read more

• C-section incision area
• Mental health postpartum

Sources

• “Births – Method of Delivery.” National Center for Health Statistics. Centers for Disease Control and Prevention. March 2, 2021. https://www.cdc.gov/nchs/fastats/delivery.html
• “C-section.” Mayo Clinic. Mayo Clinic. June 12, 2020. https://www.mayoclinic.org/tests-procedures/c-section/about/pac-20393655
• “Pain Management for C-Sections.” Yale Medicine. Yale Medicine. https://www.yalemedicine.org/conditions/anesthesia-for-c-section
• “Cesarean Birth FAQs.” Acog.org. The American College of Obstetricians and Gynecologists. 2021. https://www.acog.org/womens-health/faqs/cesarean-birth