cs2I’m officially 28 weeks into my fourth pregnancy, which means I’m just about 11 weeks away from what will be my fourth cesarean section (yipppeeeeeeee). I’m by no means an expert on c-sections, but I hope to be able to shed a little light on the procedure that many mamas fear, and to ease your mind that if you do have to undergo surgery, it really isn’t necessarily the worst thing ever.

To disclaim: I’ve always been fortunate and had very pleasant experiences with all of my surgeries. Recovery has usually been relatively quick and uneventful (a trend I’m hoping will continue with my fourth!) and the surgery itself has been pretty basic all three times. That being said, I’ve heard stories of surgeries that have been the opposite, and I’ve heard of difficult and challenging recoveries – please know that while people can absolutely have bad experiences, those experiences to be the minority (much like how a minority of vaginal deliveries are much more traumatic and dramatic than others).

What to Expect During the Procedure

Prep for emergency c-sections happens quickly. By this I mean, you go from laboring and contracting to being scrubbed/prepped/and wheeled into the OR in a matter of minutes once the decision to operate has been made. Time is of the essence and it definitely feels that way!

cs1Scheduled c-sections do not. When I was pregnant with our second, I debated between scheduling a second c-section or holding out and attempting a VBAC (remember, I’m the girl with the 10 pound baby? My doctor supported my decision to attempt a VBAC but also warned me I may have been being a little unrealistic). My surgery was scheduled at 39 weeks, 4 days as a “just in case you want to go that route” measure, and when surgery day came – and I was still 0 centimeters dilated, 0% effaced – it looked like another baby of mine was going to make me wait past my due date. I made the decision to go ahead and operate – I knew more than anything I did NOT want to attempt a VBAC and wind up having an emergency c-section again, and I just bit the bullet and went to the OR.

The difference between planned and unplanned c-sections are like night and day! On the day of my surgery I walked myself into the OR, hair done and face made up. Everyone was calm, chatty, casual – there was music playing, and a kind of “party” atmosphere, which was awesome given that we WERE celebrating the birth of a new baby. Given the choice between unplanned or scheduled c-section, I’d take a scheduled one any day! (Also, please be warned that your surgery will not be given higher priority over an emergency c-section. Mine was pushed back because of a failed VBAC that needed the OR first).

The surgery itself is fast. What still surprises me most about surgery is just how quickly they get that baby out of you. With all of my cesareans, my babies were delivered within 20 minutes of the procedure starting; maybe even in less time than that. The rest of your time in the OR is spent getting stitched back together again while you fawn over your new babe.

You WILL get to see your baby immediately. Assuming everything is OK with your baby (no meconium in the amniotic fluid or any other health issues), you’ll get a chance to see him or her as they’re being born and as soon as they’ve cleaned them up for you, much like with a vaginal delivery. You likely won’t get to start nursing until you’re stitched up and in the recovery area, although some hospitals are attempting to let moms nurse from the operating table. From my experience at least, waiting to nurse until we were in recovery really didn’t matter (other than I was itching to cuddle those babies so, so much. At least I had people operating on me to distract me). The babies slept, my husband got to cuddle them, I got to stroke their sweet hands and faces, and was able to begin nursing as soon as we rolled into recovery.

You won’t see any of the surgery. In case that’s a worry of yours, don’t let it be. Barring some weird fluke, you won’t see a thing – there’s a big sheet separating you from the action, and no one is crazy enough to ask if you want a mirror to see what’s happening. If your husband/partner is curious, many doctors will let them poke their heads over as the procedure is happening (for some reason my husband found it incredibly fascinating). Cameras/video cameras are up to the discretion of the doctors and hospital, but we were able to take pictures without any problems.

You’ll be in recovery for a few hours. Immediately following surgery, you’ll be moved to the Recovery Room (also known as a Post Anesthesia Care Unit). You won’t be able to leave until you’re able to move your legs again, which can take an hour or two. It can be a frustrating wait: you’re starving, you just want some peace and quiet, and you really just want to be settled in your room so recovery can really, truly begin. But, try and enjoy this peace! I never did with my first two surgeries. I was always in a rush to try and get movement going again because in both cases, people were at the hospital waiting to see me and our new baby, so I felt pressured to hurry up and recover. The third time I learned my lesson, and asked visitors to hold off until we’re moved into our room for our stay – it gave me the chance to not try and rush the recovery process, but instead to enjoy the quiet moments with just my husband, nurse, and newborn.

What to Expect While Recovering at the Hospital

Lots of visitors. As someone who has never had a vaginal birth, I’m not sure what the visitor parade is like post-delivery, but with a c-section expect a steady, consistent stream of them. Be prepared to have your temperature, blood pressure, scar and stomach checked regularly in the hours following surgery. Your uterus will be checked (and there is NOTHING quite like having someone push on your belly after stomach surgery to make sure your uterus is contracting down, let me tell you), and if you labored prior to surgery you’ll have your perineum checked for tears, bleeding and swelling too. From experience, it seems as if hospitals are trying their best to reduce this parade – but even if you and your babe are sharing a nurse, expect a steady flow of people for the first 24 hours.

The first time you walk will be the worst experience ever. But you’ll have to do it. Often. Six to twelve hours after surgery is typically when you’ll get a visit from your nurses, your catheter will be removed…and you’ll be asked to get up and walk to the bathroom. It will be humiliating, bloody, incredibly painful, slow and stooped. Trust me. It’s like that for all of us. You will be positive that you’ll never walk normally again. You’re pretty sure your guts will fall out as you move around. And you’ll tell yourself you aren’t getting up to walk again because it was so horrible.

But you will, again and again, because ambulating (fancy hospital term for “walking”) helps with the recovery process and is necessary. Just keep in your mind that you WILL walk normally and without pain again – much more quickly than you can imagine! – so slowly but surely push yourself ever-so-gently to that point.

Food and drink may be hard to come by at first. It seems a little unfair; you’re not supposed to eat for 12 hours prior to surgery (in the case of a planned c-section), and you only get liquids when you’re laboring prior to an emergency c-section…yet post-op, you have to continue to starve for at least a few hours. Some doctors will allow you to resume a normal diet relatively quickly, while others prefer you have only liquids until you’re 24 hours post-op. When you are able to eat and drink normally again, make wise decisions – skip any bubbly or gas-inducing foods to avoid seriously upsetting your belly.

You’ll feel incredibly gross. Aside from having all of the normal postpartum issues like painfully engorged breasts, tender (maybe even cracked, bleeding or bruised) nipples, cramps, and maybe a tear or swelling down there if you labored, you’ll also have the added joy of a big incision to care for and worry about, covered in medical tape and staples. And, a fun little fact no one mentions after surgery – you’ll be bloated and gassy thanks to all of the air getting into your insides during surgery. Sleep that first night is ROUGH. A tip? Lay on your side with your feet higher than your head to help relieve gas pains, and know you’ll sleep better in a few more nights.

Bring comfortable clothes. Same as when you have a vaginal delivery, pack clothes in your hospital bag that are loose, comfortable and easy to nurse in. The biggest challenge for c-section moms in recovery is finding bottoms to wear that don’t rub all over their scar – they may not be super stylish, but look for clothes with a higher waist or ones with a fold-down waistband that can rest on the scar without rubbing any stitching into it.

What to Expect at Home

Take it easy. Most women are discharged 2 – 4 days post-surgery. In those early days, recovery recommendations vary, but the gist is all the same – take it easy. Don’t do any crazy heavy lifting. Don’t go for super long walks pushing the stroller. Limit how many times you’re climbing up and down the stairs. Some doctors advise you not drive in the beginning because the twisting motion involved with looking in reverse can agitate your belly. Despite what I said about how painful that first walk is, you WILL start to feel human relatively quickly and may easily convince yourself that you’re back to normal and can handle day-to-day life. I say to you: don’t push it. Fight that feeling. You may end up doing more harm than good! So for at least a few weeks, try and take it easier than usual. Remember, as common as a c-section may be, it IS still surgery.

Prep your house. In our house, our master bedroom is downstairs (where the newborn sleeps initially), but the nursery (with all of the baby’s clothes and gear) is upstairs. Because our first surgery wasn’t planned, my poor husband made about 5189016927907 trips up and down the stairs getting stuff I needed. Before our second surgery, I wised up and prepped our downstairs with the stuff we’d need – clothes, plenty of diapers and wipes, all of my nursing gear, etc. If you have a higher bed, you might want to consider putting a stool next to it to help you getting in and out. Before you leave the hospital, be sure to grab a bunch of pads and those awesome mesh underwear, and most importantly – leave with a prescription for pain medicine. You might end up not filling it, but it’s better to have it than to not! Dulcolax is also a c-section mom’s best friend, so make sure you have some on hand just in case.

Stay in loose, comfy clothes. You’re still going to be bloated even after a c-section, so be sure you have some nice, comfy clothes to wear in those early weeks. Your scar will stop hurting and itching after a few days, but you’ll still want to avoid waistbands that rub against it for a little while longer. Invest in some loose, comfortable granny panties to wear (again, to avoid rubbing your scar).

Get some help. The hardest part about recovering from my third c-section was having to juggle being postpartum, caring for a newborn, recovering AND caring for our then 21-month-old and 3 1/2 year old. They didn’t understand that I couldn’t lift them up or was moving a bit slower than usual. Thankfully my husband was able to take a few weeks off from work in order to help in the beginning; how was I supposed to put my younger guy in his crib for naps if I couldn’t lift anything over 10 pounds?? Have a plan of how you’re going to handle childcare (if needed) before you head into surgery. Get help if you have to. Make sure there are plenty of toys, books and activities you can do together that don’t involve a lot of physicality. Don’t be afraid to turn on a movie or a short TV show if you need a little bit of time with your feet up too.

Medical tape is a pain to scrub off. I learned by my third surgery – through lots of trial and error and scrubbing – that mineral oil is an awesome medical tape adhesive remover – and  this makeup remover from Target that I had on hand worked really well.

Your scar WILL fade. Initially your scar – which is remarkably tiny given the fact they took, you know, a BABY OUT OF IT – will be red. After a few weeks it will begin to shrink and fade, and after a year, it will just look like a small scar. It’s incredible how fast it will heal, but before you get comfortable with it, sometimes it helps to hold a pillow to it when you’re sneezing or coughing. After a few weeks you’ll likely forget it’s there (hopefully, if recovery is going well!) and while you may experience numbness from time to time, it will heal like any other scar would.

REMEMBER: at the end of the day, your goal is a healthy baby – if surgery is what it takes to get you there, it’s not the end of the world. It may feel like you’re never going to walk normally, sneeze or belly laugh again, but you will – and likely much faster than you can even imagine. Take it easy and keep in mind that while recovery is primarily physical, it’s also very mental – just tell yourself “this too shall pass” and before you know it you’ll be running around like the super mom you were before you headed into the OR.

Just don’t forget the Dulcolax.

Hey cesarean mamas – anything else we should add to our list??