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Cesarean section, also popularly called a C-section is one of the commonest surgical procedures being performed in obstetric units all over the world today. Over the years with the advent of modern surgical techniques and expertise it has come to be one of the safest surgical procedures ensuring good maternal outcome. The postpartum journey may differ a bit depending on whether a mother undergoes a normal (vaginal) delivery or a c-section. If you have been through or are planning a cesarean section to deliver your baby here are some points to ensure good healing and smooth recovery in postpartum phase.


Immediate post-op recovery- Typically after a cesarean section (which is usually done under regional anesthesia except in rare cases) the mother is kept under observation for 1-1.5 hours. Breast-feeding is initiated as early as possible to establish lactation and ensure good bonding. As the effect of regional anesthesia wears off by 2-3 hours patient is encouraged to move her limbs. Adequate analgesia is given to help tide over the surgical site pain. Clear liquids are initiated by 6-8 hours and once the mother is comfortable, she is started on a soft diet by 12 hours post-surgery. An indwelling urinary catheter is removed by 8-10 hours post-surgery and she is encouraged to void urine. She is also advised to ambulate and take short walks after 24 hours to prevent clot formation in the lower limbs.


The recovery and care on the 2nd day post operative day in hospital concentrates on helping the mother resume normal dietary intake, lactation, and mobility. A lactation counselor ensures that good latching is established and guides the mother about different postures for breast feeding. Antibiotics and analgesics are continued to prevent wound infection and provide pain relief. The physiotherapist teaches the mother about postpartum exercises that she can practice at home for good healing. Counseling is done by a dietician to advise about the best nutrition that can be given to the mother at home. The most important component of postpartum recovery is to provide good emotional support to the mother and allay the anxieties associated with baby care, lactation, and physical recovery in this new phase. Once the mother is able to do all this, her physical condition is verified, wound is checked, and she is usually discharged and sent home in 2- 3 days.


We usually advise new mothers to stay warm, well hydrated and consume a high calorie diet rich in galactagogues that help promote lactation at home. Avoid foods that are too spicy, salty, and cold. Fluid intake of 2-3 litres a day is necessary for good hydration and lactation. Sleep is most essential to give rest for the mother in this phase. It is normal to have bleeding for a few days post-delivery and it usually stops on its own. The wound is usually covered with a simple waterproof dressing so mothers are encouraged to have a bath everyday and keep themselves clean and dry.


Post discharge the follow up with the doctor is scheduled on 5th-7th post op day. After enquiring about the well-being of the mother, the wound dressing is removed and may be left open if healed well. Most of the times, the sutures in the skin are self-absorbable and hence suture removal is not necessary. Sometimes an antiseptic ointment may be prescribed for application to prevent wound infection. The mother is further advised to take rest, relax and allow her body to recover in the next few weeks. Iron and calcium supplements are restarted and continued till 3-6 months.


At home, with good support from her partner and family members, the mother can recover slowly and come back to her normal self by the end of 6 weeks. Commonly encountered problems in this phase are-


- Pain - adequate pain relief measures such as oral analgesics, warm packs may be used.
- Sore nipples- encourage to keep nipple area moist and use a good nipple care cream in between feeds.
- Insufficient breast milk production- can be overcome with good hydration, rooming in with the baby, kangaroo mother care and including galactagogues in the mother’s diet (such as pepper, ghee, garlic, dil, oats)
- Wound care- advise the mother to wash the wound daily with soap and water and keep the area clean
- Perineal hygiene- it is important to prevent wound contamination hence mother is advised to use a clean sanitary pad for bleeding and change it often to prevent infection.
- Lack of sleep- is a known problem in the postpartum phase and hence the old adage- “sleep when the baby sleeps”
- Constipation- can be overcome by increasing water intake, consuming a fibre rich using stool softener medications
- Postpartum blues- has to be looked out for and good emotional support has to be given by the family


With time the mother is more confident and can take care of herself and her baby. Her body undergoes changes, and she is able to feel like her old “self” by 8-10 weeks. Though we allow normal mobility and physical activity, exercises such as a brisk walk may be resumed by 6-8 weeks. After the 3rd month she can be encouraged to restart her fitness journey and do active exercises such as swimming, running, cycling or even lift weights at the gym. Sexual activity can be resumed once the mother is ready anytime after 6 weeks. However, use of contraception is essential (especially if periods start) to avoid accidental conception and ensure good spacing between pregnancies.


Despite the volume of content available online and offline to read and understand about c- section and its recovery, it almost always poses a challenge in the most unique ways possible. The happiness of the birth of the child may be disturbed by phases of pain, difficulty in lactation, lack of sleep, low moods and blues or simply put – difficulty to adjust to the new ways of life. In order to make it a tad bit smoother our advice to new mothers would be to-


- go into the new phase without too much planning- embrace the days as they come,
-give good rest to your body to recover completely,
-take all the help you need from your partner and family members,
-voice out your feelings for emotional support,
-enjoy the small moments with your baby
-avoid reading or researching too much online and simply enjoy the quiet moments as a family
-know the warning signs in postpartum phase such as- fever, excessive vaginal bleeding, foul smelling vaginal discharge, pus discharge from wound, breast congestion etc and see your doctor immediately if you experience any of these


However long the nights may be, however tired and helpless you may feel, it is a journey that makes you strong and resilient and teaches the wonders your body can do in creating a beautiful human being. So my advise to all the new mothers out there would be embrace the phase of recovery, rest and respect your body and allow it to heal completely so that your motherhood journey is a smooth, comfortable and memorable one.

(Dr. Sahana K P , MBBS , MS (OBG) FMAS, PGDMFM (Germany), Consultant - Obstetrics and Gynaecology, Apollo Hospital, Sheshadripuram , Bengaluru)