Your Physical and Emotional Recovery
- What to Expect in the First Days after a Cesarean
- Music Decreases Pain
- Reach Out: Get help from family, friends, and ICAN
- My Interview with Dr. Pamela Morrison: Tips for Your Physical Recovery
What to Expect in the First Days after a Cesarean
Some women recover quickly from a cesarean birth. For others, the physical recovery is longer and more arduous. This is true for vaginal births as well. Some bounce back almost immediately while for others, it can seem like ages until they feel like themselves again.
After a cesarean, day two is usually the most challenging physically, with each day getting better after that, even if incrementally. Nevertheless, on day two, you will be up and about (even if you are moving slowly), eating food, and using the bathroom.
For many women the day their mature milk comes in is a highly emotional day. This might be day three, four, or even five. Expect lots of weeping and welcome to the sisterhood. For many women, no matter the course of labor, the onset of mature milk sets off a few days to a few weeks of a very tender-hearted state when the injustices of the world are keenly felt. Following a cesarean, feelings about the birth are likely to be bouncing around as well. The key here is not to go solo with your thoughts and feelings. Reach out. Ask for compassionate listening from the people in your life who love you. Isolation compounds the difficulty. Find a moms talk group or a therapist. Get to an cesarean support meeting. You will move through this, but it might take time. If you find yourself hopeless, apathetic, angry, overwhelmed by grief, or unable to manage the basics of caring for your baby, this might be post partum depression and you should seek professional support. For more on the emotional recovery, please see If You Have Already Had Your Baby and are Looking for Support.
The First 24 Hours with Baby
“I would suggest that if at all possible, a woman have a one-on-one support person to remain with her for at least the first 24 hours. So many women I have spoken with have grieved over not being able to lift and hold their babies in the immediate time after surgery. I know I could not get out of bed without assistance, and I certainly couldn’t lift my baby from the bassinet. Getting to the bathroom only three feet away seemed an almost insurmountable task. Nurses are busy, and hospitals don’t always allow women to keep their babies in bed with them. I fully attribute the good onset of breastfeeding my son to the fact that my sister was able to remain with me overnight immediately after my surgery. She lifted him for me. She helped me hold him and get him latched on and off all through the night. I had a shared room, and my husband was forced to leave at midnight, but female accompaniment was allowed. Also, I don’t know what I would have done without my giant elastic abdominal support band. I felt like it was the only thing keeping me together at times! I highly recommend them.” Suzanne Chesney
Music Decreases Pain
Research shows music to decrease the perception of pain. Play music during the recovery period! Bring your music into the hospital. Studies suggest that music can interfere with pain signals even before they reach the brain — at the level of the spinal cord. Fascinating!(i)
Reach Out: Get help from family, friends, and ICAN
Call on your people! You are caring for a newborn and simultaneously recovering from a surgery. Don’t go it alone. Invite family and friends to help in the early days and weeks. Hire a post partum doula, if possible.
Seek breastfeeding support from La Leche League International (LLLI) or a lactation consultant. Find a moms talk group and by all means get to an International Cesarean Awareness Network (ICAN) meeting. ICAN is an online and in-person support network of women who have birthed by cesarean. ICAN is an excellent resource! It is difficult to overstate the importance of connecting with other women during this time.
“At ICAN, I don’t have to explain or justify myself. I can just come to a meeting and be sad or confused or angry and know people will understand and love me. That alone can be incredibly healing.” Natalie Short, ICAN Member
My Interview with Dr. Pamela Morrison: Tips for Your Physical Recovery
I recently spoke with Dr. Pamela Morrison, DPT, BCB-PMD, IMTC, IF, a specialist in Women’s Health Physical Therapy and Pelvic Pain. I often refer women to her and they find endlessly insightful support.
Mary Esther: Hi Pamela. Thanks for taking the time to talk today. In terms of recovering from a cesarean from a physical standpoint, what would be helpful for women to know?
Pamela: Keep the scar mobile! We don’t want adhesions for a few reasons. First of all, we want to avoid restrictions with the bladder and lower abdominal muscles. Tension here can also form a pooch whereby the abdominal tissue starts to lie in front and over the scar creating a false looking “muffin top”. Secondly, we want to avoid scar sensitivity and pain. Performing scar massage and having it assessed by a physical therapist can really help avoid future issues. Keep the scar mobile!
Mary Esther: When would be a good time for a woman to begin massaging her scar?
Pamela: I would suggest that once the scar is closed and a woman gets clearance from her doctor, she can use coconut oil, cocoa butter, or vitamin e oil and massage the scar. Doing this also limits abdominal swelling that we often we see after a cesarean.
Mary Esther: What else might be good to keep in mind following a cesarean?
Pamela: Well, I’d suggest that any woman should get assessed for Diastasis Recti. The abdominal muscles often pull apart during pregnancy and form a gap along the center of the abdominals called the linea alba. Another thing not many know is that it possible to have a nerve adhesion because of the scar that can affect the groin, hips, mons pubis, clitoris, perineum, bladder and or pelvic floor region. If a woman is having painful intercourse after a cesarean, she can see a physical therapist who works with pelvic floor and pelvic pain disorders.
Mary Esther: Is there anything else you can suggest?
Pamela: You know, with any pregnancy, organs get pushed upwards and can be malpositioned after the birth. This is true with a cesarean too and visceral mobilization can improve the function of organs and limit swelling. It improves the physiology of the organs and can facilitate lymphatic drainage.
Mary Esther: Can you explain what visceral mobilization means? Massaging the belly? Is this something women can do on their own, or is it a good idea to see someone for help with this?
Pamela: Visceral mobilization is when the therapist uses advanced manual therapies to re-instate the normal mobility and motility of an organ. This improves or corrects the physiology of the organ. Massaging the belly can be very helpful in improving blood flow, decreasing bloating, and helping the mother’s pelvis recover from labor and delivery and surgery. Patients can be instructed in self abdominal massage and can also learn some basic visceral mobilization techniques from a skilled provider.
Mary Esther: How do you feel about abdominal binders?
Pamela: Many of my patients do very well with them following a cesarean. They work like an ace bandage on a sore ankle to control swelling. I have had a few women who haven’t liked them because of poor fit or feeling very constricted. But generally, I think they are a good idea to provide the post-partum women with needed abdominal support given the discomfort from the surgery and also help them complete some of the tasks of activities of daily living with less pain initially. Once the swelling is down and the abdominal muscles are more reactive and contracting, the patient can reduce the wear time and eventually eliminate the binder. Following the guidelines of the provider is important.
Mary Esther: Thanks so much for your time, Pam! Very helpful.
Dr. Pamela Morrison: For more than 20 years, Dr. Morrison Wiles has been practicing in the areas of orthopedics and sports medicine, and pelvic health issues. She earned a BA in biology, psychology, and completed the program in athletic training at the University of Stony Brook, New York in 1991. Dr. Morrison Wiles achieved a BS in physical therapy in 1993 from Downstate Medical Center in New York, as well as an advanced master’s degree in orthopedic physical therapy from Touro College, New York in 1999. Dr. Morrison Wiles has completed all courses given by the Institute of Physical Arts on functional manual therapy re-education and mobilization techniques. Certified as a specialist in pelvic muscle dysfunction biofeedback, she has also completed training in real-time ultrasound imaging for lumbar and pelvic dysfunction. She has completed a Doctorate in Physical Therapy at Touro College in 2006 with research completed in physical therapy evaluative findings in patients with vulvar pain.
Contact Dr. Morrison:
(i) Bernatzky G, Presch M, Anderson M, Panksepp J., “Emotional foundations of music as a non-pharmacological pain management tool in modern medicine,” Neuroscience and Biobehavioral Review. 35(1) (2011): 989-99
Cepeda MS, Carr DB, Lau J, Alvarez H., “Music for pain relief,” Cochrane Database of Systematic Reviews. Apr 19(2):CD004843 (2006):418-27