11 Things No One Tells You About C-sections
February 27, 2020
Chances are, if you’ve scheduled a c-section, you’ve done your homework. You know what a c-section entails and what your options might be to make it more comfortable. Maybe you even viewed some videos online and curated your music playlist. But Bumpies who’ve had a c-section tell us that, despite painstaking preparation, a slew of things still caught them by surprise.
“Because they get a little bundle at the end, people sometimes forget that this is still a major surgery,” says New York-based ob-gyn Kameelah Phillips, MD—and as a result, they also don’t realize the big and small things that often happen when you undergo this type of procedure. So we’ve asked OBs, as well as moms who’ve been there, to give you a no-holds-barred heads-up about the unexpected truths of a c-section delivery and recovery.
If you have a spinal block, your body might experience spasms—a common reaction to the medication. It may feel strange, but “it’s nothing excessive,” says Carolyn Eskridge, MD, an ob-gyn with Atrium Health Eastover OB/GYN in Charlotte, North Carolina. It’s more of a “light shiver,” she explains, and it should go away as the anesthesia wears off.
Your cesarean won’t hurt a bit, thanks to the anesthesia you’ll be given—but you’ll still have some sensation. “The goal of anesthesia is to take away pain, sharpness and pinching,” Phillips says. “But you’ll still feel touch.” You might feel a pushing and tugging sensation as your doctor eases baby out of the belly, especially if your little one has been curling up near your rib cage. Some doctors, like Phillips, like to let their patients know beforehand. “What the mom is feeling is my body weight maneuvering the baby out,” she says.
While it’s natural to think you feel cold because the room is cold (after all, operating room temperatures are typically low to keep things sterile), Eskridge says doctors actually raise the temperature for c-sections in order to accommodate the new arrival. So the real reason why you might feel cold is that you’ve been numb from the waist down, half-naked and lying still for 30 minutes—and it only feels colder when doctors remove your surgical drapes at the end of surgery, Phillips notes. Don’t feel shy about speaking up; often, you can get warm blankets to cover you up.
Well, sort of. Actually, your legs will be fitted into contraptions called sequential compression devices (SCDs), which inflate and deflate to improve circulation and prevent blood clots. So it might kind of feel like a massage. SCDs are often slipped on before surgery, and they stay on for much of your stay except when you’re taking a walk, which is another good way to stave off clots and keep your blood flowing.
New mom Lori was surprised that business was being done down there in the middle of the night after her c-section. But the truth is, even though it wasn’t baby’s exit route, your vagina is still an important part of your recovery. Basically, the “vaginal car wash,” as Lori jokingly calls it, is a post-delivery peri-bottle rinse and dry-cloth pat down to clean up any blood leaking after the surgery (more on that below). If your labor started out vaginally but switched to a c-section partway, you may experience more bleeding and, therefore, require more cleansing. In this case, a small sponge may be inserted to clean the inside of your vagina. This “helps minimize the risk of infection,” says Phillips.
You won’t have as much postpartum bleeding as with a vaginal delivery (since the vaginal cavity is wiped clean at the time of your surgery), but bleeding will still happen. “I was surprised,” says Bump user BChenier. “I figured since the baby didn’t come out vaginally, I wouldn’t bleed (boy, was I wrong).” “It’s the way the uterus cleans itself out after delivery, and it’s completely normal,” Phillips says. Your uterine wall is healing itself after the placenta has detached. Your blood vessels are responding to hormone fluctuations. That thick lining that grew to support baby throughout your pregnancy is shedding. Don’t worry, though—any bleeding should last only up to six weeks.
Pooping can be a problem post c-section, since it’s tough to push when your abdomen is tender and sore. “Even though we don’t cut abdominal muscles, it’s still engaging your core, which is weak,” Phillips explains. Plus, it’s hard not to think that pushing will bust your abdominal stitches (though that’s not going to happen, Phillips assures, even if it feels as if everything is opening up). That’s why she highly recommends taking stool softeners after delivery, which will help ease you back into your routine. Of course, drinking lots of water and walking around as soon as you can after the c-section will greatly ease the poop situation too.
When your bowels become sluggish after surgery, gas can press on the diaphragm, trigger a nerve and extend the pain to the shoulders. Phillips says people primarily feel a sharp, shooting sensation on the right side. To combat this, your nurse will probably offer you anti-gas meds and encourage you to walk around as soon as possible post-surgery (usually after a day). Another cause for shoulder aches, adds Eskridge, is something called “referred pain”—pain that arises from one part of the body (in this case, the uterus) but is felt in another. Whatever the cause, your shoulder should feel better in a day or so.
“I came home and had a coughing fit one afternoon, and OMG it hurt like the dickens!” says Bumpie BOGOhokie06. Eskridge, who underwent two c-sections of her own, experienced the same thing—and offers some useful advice: “Splinting (holding a pillow against the abdomen over the incision) is very helpful in preventing pain with coughs, sneezes and laughing,” she says. Keep a pillow handy in all rooms and when you’re riding in a car. Belly bands or other compression garments can also help support your abs, since applying pressure to your muscles after they’ve been cut will help combat the pain that comes from muscle contractions. Expect the worst pain in the week following delivery, after which it will gradually subside over the course of a few more weeks.
Some moms admit they didn’t realize just how prominent their c-section scar would be. (It may be horizontal or vertical, and it usually sits right above your pubic hairline.) “I felt totally disfigured,” Lori says of her c-section scar. “But over time, it faded and flattened out a lot, and now I actually love it. It’s my mommy battle scar!” Don’t put anything on your scar for six weeks, otherwise you risk infection. Just let it heal. After that, if you want the scar to fade faster, Eskridge suggests trying scar-fading ointments, though the scar might not disappear completely. Regardless of how effective they are, Phillips points out that it’s hard for most women to apply them consistently when they have a new baby. “You’re gonna heal the way you’re gonna heal,” she says, “and it’s okay.”
Yes, you just had major surgery, and yes, you need to rest and recover. But getting up and hobbling around as soon as humanly possible is a good idea. (Most doctors recommend the day after your surgery, but of course, wait until yours gives you the green light.) “Once the spinal wears off and movement is back in the lower extremities, it’s safe to walk around,” Eskridge says. “It gets the bowels working again and can prevent a lot of gas pain.” It also helps prevent blood clots. Phillips advises making a point to get out of bed every few hours. “Take yourself to the bathroom instead of using a bedpan and walk up and down the hallway with support,” she says. “Push yourself, within reason.”
Updated February 2020
Kameelah Phillips , MD, is a New York City-based ob-gyn affiliated with Lenox Hill Hospital. She received her medical degree from Keck School of Medicine of USC and has been practicing for over a decade.
Carolyn Eskridge, MD, is an ob-gyn with Atrium Health Eastover OB/GYN in Charlotte, North Carolina. She earned her medical degree from Louisiana State University in 1992.
Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such. You should always consult with a qualified physician or health professional about your specific circumstances.
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