Cesarean Postnatal Care Tips

Cesarean Postnatal Care Tips

Please note these are general recommendations. They may not be appropriate for everyone.

Immediate Care

Having access to obstetrician-guided early non-constipating pain relief can assist you to move more easily and to feed and care for your baby with minimal pain. Use of pain relief medication should always be guided by your medical practitioner (GP, OBGYN).

Use wound support when coughing e.g. a folded-up towel gently placed over the wound.

Take care when you’re getting out of bed to reduce the strain on your wound:

1. Gently brace abdominals and pelvic floor, and support wound with hand or gentle support such as a folded-up towel.

2. Bend knees up and roll onto side (log roll)

3. Push up with arms whilst dropping legs over the side of the bed

4. Try and attain an upright posture

Scar Care

Watch for signs of infection. These can include redness above and below the scar line, discharge, and pain. It is very common to notice a firm lump at one end of the scar – these are generally caused by the suture knots. These stitches should dissolve by 6 weeks post-delivery.

It is important to achieve a scar that moves well and heals flat. It will take 6-10 weeks for your wound to heal completely. A c-section scar can adhere to the bladder which can make you feel like you need to go to the toilet a lot. Scar adhesions can also irritate surrounding nerves and lead to itching around the anus and even knee pain. Although these symptoms may be uncommon, it is important to have a quality physio assess your scar early to ensure it heals as well as possible. The scar will usually appear purple/red for 6-12 months. Sometimes a scars can remain red for years after surgery. Occasionally laser therapy is required in these instances. You should consult your physio if you have questions about laser for scars. Laser therapy can help finish the healing process and allow the scar to go white in these circumstances however, it is not appropriate for everyone.

It is common to have an area of numbness or itchiness across the scar and surrounding area for up to 12 months post delivery – this is due to healing of any nerves that were cut during the procedure. Ice can help manage itchiness. Sometimes there can be an unpleasant prickling sensation as these nerves regrow. If this is bothersome we recommend discussing it with your GP.

Following delivery the obstetrician will stitch 3-6 layers of closure for the uterus, muscle and skin. As the layers of the scar heal they can sometimes stick together or ‘adhere’. The aim of scar massage is to gently reduce the development of these ‘adhesions’ and allow the scar layers to move freely on each other. Scar massage must not be completed until the scar has fully closed (no oozing or scabbing present). This is usually around 6-8 weeks post-delivery.

Lifting

Post-cesarean delivery it is advised you avoid heavy lifting for the first 6 weeks. Use the weight of your baby as a general guide. As your baby gets heavier you should generally be able to lift heavier items. Be careful with the travel capsule and pram as these items are heavier than they look.

Remember good lifting technique:

● Squat and use your legs to get down to the load keeping your back straight

● Position the weight close to your body

● Engage core and pelvic floor before and during the lift

Driving

There is conflicting advice and guidelines for driving post C-section. Some health professionals suggest 6-8 weeks of no driving. Most women return to driving 2-6 weeks post-delivery. We advise not returning to driving until you feel able and capable and also when your insurance covers you to do so. Some insurance companies will not cover you in the event of an accident for a minimum of 6 weeks following major surgery. You should check with your insurance company if they include a cesarean as major surgery to ensure you are covered when driving.

Possible test of driving suitability:

● Can you walk up and down a flight of stairs with no pain ?

● When sitting in the driver’s seat of a car can you rotate and look over your shoulders to both directions without pain?

Intercourse

It is generally considered safe to return to intercourse one week after cessation of bleeding.

If you are breastfeeding or your oestrogen levels are low the vagina tissues can still be dry and fragile and this can lead to some discomfort. Using a lubricant that is free of parabens and taking your time can help but we would also strongly recommend a postnatal check. An experienced women’s health therapist will be able to tell you if there is any muscle tightness or signs of oestrogen deficiency that might be impacting how comfortable you find intercourse.

We hope you find this general information helpful. We strongly encougage all postnatal women to book in for a Postnatal Check with one of our awesome women’s health physios for advice specific to your situation.