What is the best way to lie after a caesarean section? Caesarean section: recovery, consequences. Natural birth after caesarean section
Caesarean section should be performed only in cases where natural childbirth is associated with a high risk to the health and life of the fetus or mother. However, recently the number of elective surgeries has increased. Some time passes, and many women who want to once again experience the happiness of motherhood begin to wonder whether natural childbirth is possible after a cesarean section.
Doctors do not give a clear answer to this question. The second and subsequent births can take place either vaginally or through repeated surgery. Let's consider when a second birth after a cesarean section is allowed, under what conditions a repeat operation is required, and how high the risks of natural childbirth are after several years after a cesarean section.
What you need to know about caesarean section
Despite the fact that, according to statistics, the number of children born as a result of surgery is steadily growing, many women have little knowledge of the indications for surgery and what risks and complications it causes. The first caesarean section is performed solely for medical reasons. A pregnant woman's desire alone is not enough.
The following indications are distinguished:
- the presence of severe chronic diseases (diabetes mellitus, hypertension, cardiovascular pathologies, endocrine diseases);
- malposition;
- multiple pregnancy;
- weakness of labor;
- in severe form;
- premature placental abruption, high risk of fetal hypoxia;
- various genital infections;
- anatomical defects of the uterus and other genital organs.
During a caesarean section, the baby is removed through a cut in the anterior wall of the uterus. In this case, not only an external scar remains on the skin, but also an internal one, on the uterus. It is the presence of a scar that can become an obstacle to further pregnancy and delivery naturally.
Healing of the external scar occurs in a fairly short time, about a week or two after the operation. As for restoring the integrity of the uterine tissue, it takes much more time. Complete healing should take from six months to a year.
Most often it is performed as planned, but a decision may be made to carry it out urgently if there is a threat of uterine rupture, sudden cessation of contractions, or early placental abruption.
Two types of incision are possible: classic (longitudinal) and transverse (incision along the bikini line). The second type of access is more preferable because it is less noticeable and allows for the possibility of giving birth on your own in the future.
Planning for subsequent pregnancies
The most important question in this situation remains: how long after a caesarean section can you give birth. Regardless of whether a woman plans a natural birth or through a repeat operation, the period between childbirth and the next conception should not be less than two years. Such time frames are completely justified: during this time, the uterine scar should heal completely and the integrity of the organ tissue should be restored.
Pregnancy occurring one year after a cesarean section is associated with a very high probability of scar softening. During contractions, the scar may rupture and, accordingly, the death of the child, and sometimes the death of the mother.
In the two to three year period between pregnancies, a woman must approach the issue of contraception very responsibly. Your doctor will help you choose the most optimal means of contraception. The use allows not only to avoid premature pregnancy, but also to restore hormonal levels.
Carrying out abortions at this time is also highly undesirable. Such an intervention always has a negative effect on the condition of the uterus, especially if there is a postoperative scar on it.
When planning a pregnancy 2 years after cesarean section, the patient should consult a doctor to assess the condition of the uterine scar. The following diagnostic methods are used for this:
- Hysterography is an examination of the organ cavity using a special X-ray contrast agent introduced.
- Hysteroscopy is the study of the condition of scar tissue using an endoscope.
If the scar is practically invisible, this allows us to talk about its complete healing and maximum restoration of the body. It is considered wealthy if muscle tissue predominates. In this case, the woman may be allowed to plan a new pregnancy. If the scar is formed by connective tissue, a new pregnancy is contraindicated.
When is self-delivery possible?
As already mentioned, the most optimal period is 2 years after the operation. However, the principle “the later the better” does not work in this situation either. If the period between births is significant, and the second pregnancy occurs after 10 years, natural delivery is unlikely to be acceptable. Considering the mother’s advanced age at that time, a repeat operation will most likely be required.
After the operation, the woman must take an extract from the labor history, which will indicate the reasons for the surgical delivery, the method of suturing the incision, the suture material used, and other features of the operation. In the future, these indications will be taken into account when deciding on the possibility of vaginal birth.
Spontaneous childbirth after cesarean section is possible in the following cases:
- presence of a transverse incision of the uterus;
- the previous operation was performed for indications related to the characteristics of the first pregnancy (for example, multiple births, abnormal fetal position, premature placental abruption);
- the postoperative recovery period passed without complications;
- the course of a new pregnancy without severe pathologies;
- satisfactory condition of the uterine scar;
- cephalic presentation of the fetus;
- lack of attachment of the placenta in the area of scar tissue;
- the child's weight is no more than 3.8 kg;
- psychological readiness of the mother for natural childbirth.
Be sure to take into account the consistency of the scar. It is considered as such if its thickness is at least 3 mm.
Repeated spontaneous childbirth has a number of benefits for both mother and baby. They increase the possibility of natural childbirth in the future, allow a woman to return to normal much faster and, do not cause difficulties with breastfeeding, contribute to a faster adaptation of the baby to the outside world.
When self-delivery is not desirable
- In the presence of a narrow pelvis, chronic severe pathologies, increased risk of hypoxia and fetal death. The suture material that was used during the previous operation is taken into account. A positive aspect is the use of modern synthetic materials (vicryl, polyamide).
- If the recovery process was difficult, with an increase in body temperature, the development of an inflammatory process and prolonged contraction of the uterus.
How possible is spontaneous childbirth after 2 caesarean sections?
Doctors usually note that this is unlikely. In this case, the risk of developing various complications is very high, including:
- oxygen starvation of the fetus;
- rupture of the uterine body;
- further development of the adhesive process in the fallopian tubes or ovaries;
- the appearance of a postoperative hernia.
If several decades ago women were prohibited from becoming pregnant after two caesarean sections, today such restrictions no longer exist, but it is unlikely that it will be possible to avoid surgery for the third and further births. Each subsequent operation significantly increases the risk of complications.
Preparing for childbirth
When planning a second and subsequent pregnancies, the patient must undergo a test to determine the condition of the scar and readiness to conceive and bear a fetus. It is necessary to treat diseases that may become an obstacle to independent delivery.
A new pregnancy after surgery proceeds without deviations from the norm. A third of pregnant women may be at risk of miscarriage due to thinning of the uterine walls. Regular examination of the uterine scar is necessary, especially during the last weeks before the expected birth. The final decision on the mother’s readiness for normal childbirth is made by the doctor no earlier than the 35th week of gestation.
Hospitalization usually occurs at 37-38 weeks of gestation. There is no consensus regarding the method of initiating labor. As a rule, they are induced artificially during the daytime, so that in case of increased risk, emergency surgery can still be performed.
But this practice has many opponents. In their opinion, any external or artificial interference can only cause harm. The natural course of labor without artificial stimulation of its onset usually takes longer, but is safe for mother and baby. The most optimal solution in this situation is an individual approach to each specific case.
Course of labor
According to statistics, only a third of women decide to have another birth without surgery. This is due to fear of complications and unwillingness to risk the child’s health. Meanwhile, in the absence of negative indications, the second birth after a cesarean section, taken by an experienced gynecologist, is successful.
When making a final decision, attention is paid to how the prenatal period went, the timeliness of water breaking, the normal dynamics of cervical dilation, and the positive condition of the fetus and mother.
During the birth period, the following rules are adhered to:
- They are allowed only in specialized medical institutions.
- The use of uterine stimulants based on prostaglandins (for example, Dinoprostone) is undesirable.
- A woman in labor is prohibited from pushing prematurely.
- When pushing, do not put pressure on the abdominal area.
- Anesthetic procedures are excluded due to the risk of missing the sensation of pain as a symptom of scar destruction.
- The need for constant monitoring of the condition of the uterine scar is taken into account.
- A thorough examination of the uterus after the birth of the baby is necessary.
Feeling the walls of the uterus and the healed suture after the placenta is delivered is necessary in order to completely exclude ruptures. Symptoms of a violation of the integrity of the suture can be a sharp weakness of labor contractions, the appearance of vomiting and nausea, as well as pain in the navel area. Palpation of the uterine cavity is performed under intravenous anesthesia and takes about five minutes.
If these symptoms appear and a sharp deterioration in the health of the mother in labor, emergency surgical intervention is indicated.
The physiological recovery period lasts from 6 to 8 weeks. It passes easier and more harmoniously than the rehabilitation period as a result of a cesarean section. The main advantage is the opportunity to establish full lactation.
Every woman who has given birth by cesarean section must understand that her body has undergone a serious surgical intervention, after which it will take some time for her body to recover.
The main thing to do during the recovery period after a cesarean section is to follow the doctors’ instructions to avoid the occurrence and development of complications.
How is the operation performed?
During a caesarean section, the mother's tissues are cut, right down to the uterus, to safely remove the fetus. For safe operation, in some cases only spinal anesthesia is used. The medication is injected into the epidural region of the spine using a catheter.
With spinal anesthesia, only the lower part of the body is anesthetized - from the lower back to the heels. In this case, immediately after childbirth, the woman in labor is able to independently attach the baby to her breast.
If it is known that a caesarean section will be performed in advance, the operation is called “elective”. Indeed, in some cases, a woman in labor is not able to give birth on her own. Such cases include:
- Complete presentation of placental tissue;
- Some dangerous diseases;
- Features of the location of the child in the uterus;
- Discrepancy between the size of the child and the mother's birth canal and much more.
The operation is prescribed to avoid possible complications for both the child and the mother herself. Also, a caesarean section is performed when complications arise during natural childbirth and the woman in labor is unable to cope on her own. This operation is called an “emergency caesarean section” and is performed using slightly different methods, unlike a planned one.
Consequences and complications
Despite the high level of development of medicine, various complications after surgery occur in almost 35% of women in labor. In the first place, in terms of complications that arise, it is worth highlighting various inflammations. The location and severity are difficult to predict; they are individual in each individual case.
Among the main causes of complications, it is worth highlighting infections and some mistakes that were made during a caesarean section.
Women in labor are most often concerned about:
- Infections arising in wounds;
- Endometritis;
- Inflammation of the sutures;
- Unpleasant discharge from the birth canal;
- Sepsis;
- Peritonitis.
These complications bring discomfort to a woman’s life, but with timely treatment they will be quickly eliminated. But it is also worth highlighting a group of diseases that can lead to death, infertility, and constant pain:
- Inflammation of the appendages;
- Inflammation of the inner layer of uterine tissue;
- Inflammation of the tissue near the uterus.
To avoid the occurrence of these diseases, it is necessary to provide the woman in labor with the necessary care and regular examinations from doctors.
The first days after the operation
The first days after a cesarean section, a woman must spend in bed, restoring her strength after the operation. After all, even the simplest operations, which previously went unnoticed, will take away physical strength.
Women in labor spend the first day in the intensive care ward, under the supervision of nurses. Temperature, blood pressure and pulse are checked regularly. At the same time, the intensity of vaginal discharge and uterine contractions is checked. Particular attention is paid to the seam, on which the bandages are changed every few hours, and the condition of the seam itself is checked. To avoid stretching, the woman in labor remains in bed for the first day.
During the operation, painkillers are used; the woman should not even sit on the bed for the first 15 hours. It will be possible to get up only after three days under the strict supervision of medical personnel.
All movements should be done slowly, getting out of bed is done with the help of relatives or nurses. When you first rise, you may experience slight dizziness and weakness throughout the body. Unpleasant symptoms will quickly pass during the recovery period.
First steps
Depending on how the woman in labor behaves, how the rehabilitation period will go depends. When you first try to get out of bed, you must follow some rules:
- Before sitting on the bed, you need to lie on your side and only then sit down with your legs dangling;
- Then you need to lightly move your feet, as if sifting through water;
- When standing up, the feet should rest on the floor and the back should be straight - this way the seam on the stomach will not strain, the woman will feel only a slight tension in the navel area;
- There is no need to rush to go; you need to stand for a while, leaning on a bed, cabinet or person;
- And only then start moving with light, small steps.
It is these instructions that should be followed in the first days after surgery. If you do everything correctly, after just a couple of days, the process of walking will bring less discomfort. You should gradually increase the load every day, but not too much, so that the load on the seam is minimal.
Fighting cough
Some women in labor after a cesarean section are bothered by a cough. To reduce the load on the abdomen, and accordingly the postoperative suture, you need to learn how to cough correctly so as not to strain the sutures.
A cough occurs because when general anesthesia is used, a small amount of mucus accumulates in the lungs. Names this mucus and coughing up after surgery. For the first couple of days, the stitch will become very tense and painful when you cough. To reduce pain, you need to place your palms on your stomach, holding the area with stitches. The best option is to bandage the stomach with a cloth or terry towel. Cough technique:
- Take a deep breath;
- Exhale sharply;
- Keep your stomach pulled in.
If all conventions are followed, the cough will resemble a dog barking.
Intestinal gases and urinary problems - normal or pathological?
It is worth preparing in advance for the fact that after the operation, the woman will have intestinal gases. This is a normal phenomenon, since surgical intervention in the abdominal area slows down the processes of peristalsis.
It is impossible to completely eliminate the formation of gases in the first days. Refusal of food that causes attacks of flatulence, deep breathing techniques and rocking in a chair will help solve the problem.
Less commonly, women in labor experience problems with the bladder. Difficulty urinating can be caused by a catheter used during a cesarean section. In order to improve the functioning of the genitourinary system, you should try to drink more fluids.
If a simple method does not help, consult a doctor. Using a catheter to empty the bladder of accumulated fluid will relieve some of the pain. The main thing is not to hush up the problem. In the future, consultation with a nephrologist is necessary.
Rules for eating
For the first two days, all nutrients to support the life of the woman in labor are administered intravenously. This is necessary so that all internal organs can rest after the operation. Only pure non-carbonated water is allowed, with a small slice of lemon.
And only on the third day is it possible to consume chicken broth. This nutritious dish will help you quickly gain strength. After a couple of days, liquid porridge, chopped meat, and all liquid foods are allowed. Regardless of the product, its volume should not exceed one hundred grams (milliliters).
Small portions are calculated so as not to strain the gastrointestinal tract. This will speed up recovery after a cesarean section. For the same reasons, food should be easily digestible. Ideally, everything is boiled or steamed. Do not be surprised that the first hard stool forms only after a week.
Features of feeding a baby
If no complications arise in the first days, the woman can safely ask that the baby be brought to her for breastfeeding. The baby will stimulate milk production in the breast.
If for various reasons the baby is not brought in for feeding (for example, if complications arise), the milk must be expressed independently.
When feeding, you need to hold the baby sitting or lying down. Standing makes the seam tense, and the load of a child will only delay rehabilitation. Depending on the severity of the operation, the ban on holding the child standing for a long time may last for six months.
When feeding, it is better not to sit upright, but to lean your back on several pillows. At this moment, relatives or medical personnel should be nearby. They will take the baby so the woman can go back to bed.
Taking care of the seam
As after any other operation, it is necessary to take care of the stitches during the rehabilitation period. The first days of care consist of daily treatment of the wound. The dressing is changed five times a day. You can shower only after the stitches have been removed. But even when taking a shower, you should forget about the washcloth, despite the fact that the scar has already formed. The tissue on the scar is still very delicate, so you shouldn’t work on it too much.
After a cesarean section, the stitches will hurt for several days. To cope with pain, the doctor prescribes painkillers in each individual case. Over time, the pain becomes less and less, the dose of the drug decreases. Bandages are needed to support the abdomen. For at least two months, women who have undergone surgery should not understand things whose weight exceeds two kilograms.
According to statistics, today every fifth woman preparing for motherhood gives birth by caesarean section. At the same time, there is a persistent increase in operative delivery both in Russia and abroad. Caesarean section is an abdominal operation under anesthesia. With this method of delivery, the baby completely bypasses the birth canal and is removed from the mother's body through an incision in the lower abdomen. Like any other surgical intervention, a caesarean section entails a long and painful recovery.
Recovery of the body after cesarean section
The first day of labor is spent under the constant supervision of medical staff in the intensive care ward (ICU). To prevent complications, a number of measures are taken:
- taking the main indicators of the mother’s condition (measuring temperature, blood pressure, pulse),
- correction of blood loss using medications and other methods (medicines that increase uterine tone, blood transfusions, blood replacement drugs),
- prescription of broad-spectrum antibiotics,
- pain relief with drugs combined with breastfeeding,
- urinary catheter control,
- restoration of intestinal motility of the mother in labor,
- postoperative suture care (treatment with antiseptic solutions, changing dressings),
- general monitoring of the mother’s condition and well-being and assistance to her.
On the second day, if there are no problems or complications, the mother and child are transferred to the postpartum ward. Now the new mother’s activity increases, and all care for the baby falls on her shoulders.
Let's consider what restrictions and difficulties women who give birth by cesarean section encounter.
When can you get up, start walking and sitting?
You can try to get out of bed 6–8 hours after giving birth. The first ascent must be carried out under the supervision of medical staff or relatives. Getting up early helps prevent intestinal problems.
It is necessary to rise very carefully, without haste, so as not to provoke dizziness. First, it’s better to sit for a while with your legs hanging off the bed. Then try to stand up briefly, leaning on the bed with one hand. It is better to hold the stitches with your other hand, this will reduce pain.
With each subsequent rise, you need to increase the time you stay on your feet and try to take steps. If there are no complications on the second day, women in labor should move independently to provide care for their children. A postoperative bandage will be a good helper for mom. It must be purchased in advance at the pharmacy and brought with you to the maternity hospital. The main thing is not to abuse wearing the bandage, use it no longer than three hours in a row and only in a standing position and while walking.
The best way to restore a mother's strength after a cesarean section is proper sleep. Therefore, you need to rest as much as possible while lying in bed. The first two days are accompanied by severe pain in the incision area, so it is better to avoid prolonged sitting, for example, while eating. It is possible to sit fully after surgery only 3–4 days after birth.
How much weight can you lift?
In this matter, much depends on how the birth went and how the mother is feeling. Doctors recommend that women lift no more than two kilograms in the first months after surgery. But the harsh realities are such that a young mother has to take care of her baby almost 24 hours a day, so such restrictions are simply impossible. If the mother’s condition allows her to carry the child in her arms painlessly and without difficulty, then let the baby be the only burden for the mother for the next couple of months.
In this case, the acceptable weight for lifting after a cesarean section is 3–5 kg for 2–3 months.
Acceptable severity after cesarean section - the weight of the child
When can you lie on your stomach and side?
Doctors' opinions differ on this issue. Some believe that lying on your stomach helps the uterus contract faster, and this is true. But for women in labor with a painful suture on the abdomen, this can be extremely problematic. Therefore, it is advised to try lying on your stomach no earlier than 2 days after birth. This should be done very carefully. In case of the slightest pain, it is better to stop these attempts for a while, but do not quit.
Almost immediately after the operation, you can and should lie on your side and turn from one to the other. This will help restore intestinal motility and reduce the risk of adhesions.
After childbirth, it will be advisable to perform simple exercises in the absence of general contraindications:
- perform head rotations,
- gently bend and straighten your legs,
- make circular movements with your hands,
- rotate the feet and hands,
- strain and relax your buttocks to strengthen them,
- use the Kegel method (from 3 days after birth).
Table: list of exercises allowed in the early postoperative period
| №
exercises | Starting position (I.P.) | Progress of the exercise | Note |
| 1. | Lying on your back, arms at your sides |
| Breathe deeply |
| 2. | Lying on your back, arms at your sides |
| Breathing is uniform |
| 3. | Lying on your back, arms at your sides |
|
|
| 4. | Lying on your back, arms at your sides |
| Breathing is uniform |
| 5. | Lying on your back, hands behind your head |
|
|
When can you shower and bathe?
If you perform such simple gymnastics from the first day, you can avoid many complications and health problems. The uterus will contract faster and the intestines will begin to work; the former shape and size will return faster.
It is strictly forbidden to wet the seam until it has healed. You can limit yourself to rubbing and washing. You will be able to take a shower no earlier than a week after giving birth. You cannot rub your stomach with a washcloth for two weeks.
You will have to forget about a hot bath for at least 6-10 weeks, until the lochia (bloody discharge from the uterus after childbirth) ends.
Failure to comply with restrictions in water procedures is fraught with:
- deterioration of scar tissue on the abdomen,
- slowing down the healing process of sutures,
- suppuration,
- increased blood circulation and, as a result, intense bleeding,
- inflammation of the uterus due to the penetration of bacteria and microbes from tap water.
- thoroughly wash the bathtub with safe, proven products,
- observe the temperature regime (not higher than 40–42 degrees),
- use high-quality natural soap,
- exclude aromatic oils, foam and salt,
- periodically take a bath with herbal decoctions (chamomile),
- start with 5 minutes and each time increase the time spent in hot water.
How to breastfeed
It is extremely important for a child to receive colostrum on the first day of life in order to start the digestive system and adapt to existence outside of the mother. Nurses should advise women on feeding positions that are comfortable for both them and their babies. In the first days, feeding is possible only in a side lying position.
- lie down on your side
- place a pillow under your knees to prevent you from sliding down the bed,
- use a second pillow to protect your stomach from the baby’s push,
- hold the baby's head
- Make sure that the baby's head and body are in the same plane.
In the future, you can feed while sitting. Use a pillow to raise your baby to chest level and protect your incision.
The “cradle” feeding position is very comfortable after a caesarean section.
It is imperative to avoid positions that place pressure on the painful abdomen. The “In the cradle” and “Under the arm” poses are very convenient to use.
The “Underarm” feeding position will help not strain the mother’s stomach.
When can you get pregnant again?
Any childbirth is a huge stress for a woman’s body. Therefore, before subjecting it to such tests again, you must wait at least 2-3 years. Everything is individual. And only an experienced obstetrician-gynecologist, after a complete examination of the mother’s health, can “give the go-ahead” for a second pregnancy and childbirth.
You can get pregnant after a cesarean section just as quickly as after a natural birth, so you need to think about a contraceptive method before resuming sexual activity.
Read more about pregnancy after cesarean in the article -.
Every woman will be able to choose the method of contraception that is suitable for her
- intrauterine device (IUD) - allowed from 7 weeks after surgery in the absence of contraindications,
- barrier contraceptives (condoms, caps, diaphragms) - acceptable after the cessation of lochia,
- spermicides (in the form of suppositories, tablets, creams) - chemicals that destroy sperm,
- injection contraceptives (combined and containing only progestogens) - recommended from the moment the menstrual cycle resumes,
- voluntary sterilization by surgery.
Use contraception responsibly after a cesarean section. After all, pregnancy that occurs before two years after surgery is very dangerous for the health and life of a woman.
Recovery after caesarean section with spinal anesthesia
A cesarean section is always performed under anesthesia: general or local.
For pain relief, epidural or spinal anesthesia, in which the woman in labor is conscious, has recently become more and more often chosen. This allows the mother to see the birth of the child with her own eyes, hear his first cry and almost immediately try to attach him to the breast.
During a caesarean section under spinal anesthesia, the mother in labor can immediately see her baby and even hold him
The advantages of spinal anesthesia are:
- effectiveness (100% pain relief),
- no risk for the child (if the dose is correctly calculated and administered),
- non-toxic effect on the mother's body,
- ease of implementation,
- minimal complications after surgery.
But individual reactions to drugs are always possible. Thus, many women who have gone through childbirth with spinal anesthesia report the following symptoms:
- severe dizziness and headaches,
- drop in blood pressure,
- loss of feeling in legs,
- yeast attacks,
- raw pain in the back, in the injection area,
- shortness of breath and difficulty breathing,
- vomit,
- numbness.
If a woman experiences such symptoms after spinal anesthesia, doctors recommend bed rest for the first day, without getting out of bed.
Recovery will be faster and more successful if the young mother, even while lying in bed, does:
- turns from side to side,
- simple exercises for arms and legs,
- breathing exercises.
Restoring the monthly cycle after cesarean section
For 6–10 weeks after the birth of a child, a young mother secretes lochia; they have nothing to do with menstruation.
In terms of restoring the menstrual cycle, childbirth by caesarean section is no different from natural birth. The arrival of menstruation is influenced by completely different factors:
- age, health and lifestyle of a woman,
- the course of pregnancy, its features and problems,
- breast-feeding.
Lactation can be called the driving force behind the restoration of menstruation. It is the duration of breastfeeding and its frequency that determines how quickly the cycle will resume.
Women who are breastfeeding get their periods 6–12 months after giving birth.
If artificial feeding, then the restoration of the cycle can be expected after 2-3 months.
Restoring the menstrual cycle after childbirth occurs differently for all women.
It is imperative to consult a gynecologist if there is no menstruation for more than a year after the birth of the child, in order to rule out inflammation and other problems.
Restoring your figure after caesarean section
Every young woman dreams of quickly gaining a beautiful figure after giving birth to a child. It will be easier to return to your former shape after childbirth if you follow a number of recommendations:
- getting up early after surgery,
- physical activity during the day,
- good sleep (only possible with the help of relatives),
- proper nutrition,
- playing sports (within the permitted time limits).
Nutritional Features
In the maternity hospital, the medical staff is responsible for the mother’s food, so following the diet will not be so difficult. It is very important to adhere to proper nutrition at home. This will be beneficial not only for the figure of the young mother, but also for the health of her baby if the child is breastfed.
To return to normal after surgery and provide the baby with milk, the mother must:
- eat a balanced diet,
- consume only high-quality natural products,
- exclude carbonated drinks and fast food,
- drink enough water.
Any diet aimed at losing weight is contraindicated for breastfeeding women.
Table: approximate daily set of products for a nursing mother
| Product name | Quantity | Unit | Note |
| Milk | 200 | ml |
|
| Kefir (ryazhenka, yogurt) | 300 | ml |
|
| Cottage cheese (yogurt) | 80 | G |
|
| Cheese | 10–20 | G |
|
| Oil | 20 | G |
|
| Cereals (including pasta) | 60 | G |
|
| Meat (chicken, turkey, pork, beef, etc.) | 150–200 | G |
|
| Potato | 150–200 | G |
|
| Vegetables and greens | 500 | G |
|
| Fruits and berries | 300 | G |
|
| Juices, compotes, jelly | 200 | ml |
|
Table: Dr. Horvath's diet
A woman who has chosen artificial feeding can be offered Dr. Horvath's diet to lose weight. The advantage of this diet is the gradual reduction of extra pounds, which means a lasting effect.
| Diet day | First breakfast | Lunch | Dinner | Afternoon snack | Dinner |
| 1 |
| 1 small apple |
|
|
|
| 2 |
|
| Coffee with milk (100 ml) with sweetener |
|
|
| 3 |
| Small citrus |
| A glass of tomato juice |
|
| 4 |
| Small citrus |
| Large apple |
|
| 5 |
| 100 g berries or fruits |
| A glass of kefir |
|
| 6 |
| Salad of 2 carrots with vegetable oil |
| 50 g radish |
|
| 7 |
| A glass of milk or kefir |
|
|
|
Physical activity in the first two months
The first time after childbirth, the best physical activity, along with caring for the baby, is walking. It doesn’t matter where exactly you walk - at home around the apartment or in the park with a stroller. The main thing is to do it systematically and with pleasure. Don't be afraid that the seams will come apart. A postpartum bandage will help prevent this, as it reduces the load on the painful suture.
A postpartum bandage will be a good helper for a woman after a caesarean section.
It is better to delegate some of the housework to relatives, for example, washing floors or hand washing something large. Avoid lifting anything heavy (other than a child) and putting stress on the rumen.
Playing sports from the third month
After a caesarean section, you need to take care of your belly. You can pump up your abs no earlier than six weeks after giving birth and with the permission of your doctor. He will examine your seam and recommend loads.
To restore your abdominal muscles, you should start with the simplest exercises.
Table: set of exercises from the third month after cesarean section
| № exercises | Starting position (I.P.) | Progress of the exercise | Note |
| 1 |
|
| Repeat 5 times |
| 2 |
|
| Repeat 5–10 times depending on how you feel |
| 3 |
| Leg movements simulating cycling |
|
| 4 |
|
|
|
For young mothers with a scar on the uterus, Pilates and water aerobics classes will be useful, where the load on the stomach and abdominal muscles is minimized.
Pilates classes will have a beneficial effect on a woman’s recovery after a caesarean section
Six months after giving birth, you can begin more active training aimed at reducing your belly fat.
Video: a simple way to remove belly fat after a caesarean section
Care after caesarean section
As a result of the operation, a woman is left with a scar on her abdomen for a long time, which must be carefully cared for to avoid suppuration of the tissue. A week after surgery, take a shower every day, but do not rub the seam with a washcloth. Afterwards, treat as prescribed by your attending physician.
Ointments (Contractubex, Solcoseryl) will help remove an unsightly scar.
Video: postoperative suture hygiene
It is quite possible to recover after a cesarean section in a short time if you take this issue seriously. First of all, you should listen to the advice of your attending physicians, observe the restrictions of the postoperative period, and gradually load the body without overtiring it. Physical activity combined with a healthy diet will quickly return a woman’s health and figure to its previous state.
In modern obstetrics, cesarean section is the most frequently performed delivery operation. It is done under general or regional anesthesia (spinal or epidural anesthesia - with these types of anesthesia, the anesthetic is injected into the spinal canal at the lumbar level). During this anesthesia, only the lower part of the body is anesthetized. The expectant mother is conscious during the operation and can hear and see her baby immediately after birth. After the baby is removed, the woman is often given medication to help her sleep for the remainder of the operation. In this case, surgery is easier to tolerate. Awakening occurs on the operating table. In this case, as a rule, the woman feels good and does not feel weak or faint. And when general anesthesia is used, the woman comes to her senses within 30–60 minutes after the operation.
It doesn't hurt at all
Before the operation, the woman is given a catheter into her bladder, as well as a catheter (thin tube) into a vein in her arm. The catheter from the bladder is usually removed at the end of the first day; this procedure is completely painless. The catheter is in the vein of the elbow until there is a need for intravenous administration of drugs.
The first day after caesarean section - intensive care ward
After the operation, the woman is transferred to the intensive care ward, where she is under the supervision of medical staff. The ward is equipped with equipment that makes it possible to constantly monitor the condition of the young mother, and, most importantly, her well-being is monitored by an obstetrician-gynecologist and an anesthesiologist-resuscitator.
After the operation is completed, an ice pack is applied to the lower abdomen for 1.5–2 hours in order to prevent bleeding and the formation of postoperative hematomas (hemorrhages), improve uterine contraction, and relieve postoperative tissue swelling.
2–3 hours after the operation, the woman needs to begin to move her arms and legs, and turn around in bed. You are allowed to sit down and walk around the ward 5–6 hours after the operation.
After a caesarean section, a woman is given a number of medications:
- intravenous fluids are administered to replenish blood loss and restore water and electrolyte balance. After surgery, as a rule, an intravenous catheter (a tube inserted into the cubital vein) remains. Liquid flows through this catheter using a dropper. If the cesarean section operation was completed without complications, the drip remains in place for 2–3 hours;
- Narcotic analgesics are prescribed, since the pain in the suture area can be quite severe. These drugs are administered 1–2 times a day for the first 2–3 days, and then gradually withdrawn. They provide the necessary degree of pain relief;
- uterine contracting agents (oxytocin) are administered intravenously into a dropper or intramuscularly 2 times a day;
- prevention of infectious postoperative complications after cesarean section is carried out using antibacterial drugs. The first dose of antibiotic is administered intravenously immediately after ligation of the umbilical cord and again 6–12 hours later during the first day after surgery. If a woman belongs to a high-risk group for the development of infectious and inflammatory complications after cesarean section (for example, if genitourinary tract infections were detected during pregnancy, more than 12 hours have passed from the moment of rupture of water before surgery, etc.), the introduction of antibacterial drugs continue for 5–7 days. If the operation was planned and passed without complications, then a single administration of antibiotics during the operation is possible. In any case, the use of antibiotics during and after surgery, as a rule, does not affect the ability to breastfeed. If it is necessary to use antibacterial drugs that are incompatible with breastfeeding, the doctor will definitely tell the young mother about this and explain how to behave in order to maintain the possibility of feeding the baby with breast milk after treatment.
On the first day after cesarean section, therapy is carried out aimed at restoring intestinal function. To do this, stimulants of intestinal contractility (potassium preparations, etc.) must be added to the administered solutions. At the end of the first - beginning of the second day after surgery, a cleansing enema is prescribed to activate the intestines.
On the day after a cesarean section, you are only allowed to drink and not eat. This restriction is necessary in order to minimize the load on the gastrointestinal tract. You can drink water with lemon juice or still mineral water.
In the early postoperative period, the formation of blood clots in the vessels of the lower extremities is prevented: medications are administered to prevent the formation of blood clots, leg bandaging before surgery or the use of special compression stockings is recommended - this measure improves venous outflow from the legs, helping the movement of blood through the veins. It is advisable to wear elastic bandages or stockings for at least seven days after childbirth.
If the operation went well, the mother and baby have no complications, then for the first time the baby can be brought to the intensive care ward for feeding, however, in most maternity hospitals this is not accepted, and more often the baby is brought to the mother in the postpartum ward.
After caesarean section: postpartum ward
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At the end of the first - on the second day after a cesarean section, the woman is transferred to a regular ward of the postpartum department. She is allowed to sit down and walk around the ward. Also on the 2nd day, the administration of infusion solutions continues. In the case of using medications that can have a negative effect on the newborn, breastfeeding is recommended to begin later, after their effect has worn off.
Within 6–7 days, the attending physician examines the postoperative suture, and the nurse bandages it once a day and treats it with antiseptic solutions. The sutures are usually removed 5–7 days after surgery.
To assess the condition, the young mother is prescribed various blood tests. On the 5th–6th day after the operation, an ultrasound examination of the pelvic organs is performed, which allows one to judge the size of the uterus, the condition of postoperative sutures, the presence of hematomas, blood clots, the size and contents of the uterine cavity.
After childbirth, the uterus is an extensive wound. The healing process is accompanied by the presence of discharge from the genital tract - lochia. After a cesarean section, just as after a natural birth, the lochia first comes out bloody, then bloody (brownish-pink) and will be released for 6-8 weeks after birth. A woman is recommended to toilet her external genitalia after each urination or defecation, and change a sanitary pad every 2-4 hours.
Features of nutrition after cesarean
The load on the gastrointestinal tract in the postoperative period should be increased gradually. On the second day, you can eat boiled meat, porridge, low-fat broth, and drink sweet tea. Starting from the third day, the mother can afford more nutritious nutrition, taking into account breastfeeding.
Belly support after cesarean
Immediately after transfer to the postpartum ward, you can start wearing a postoperative bandage. It is worn over an aseptic dressing. A postoperative bandage fixes the sutures, abdominal muscles, reduces pain in the suture area and the likelihood of hernias. The bandage must be worn for 2 months after surgery.
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Breastfeeding after caesarean section
Breastfeeding is allowed depending on the traditions of the institution, the condition of the mother and child on the 1st–3rd day after surgery. The formation of lactation after a cesarean section is almost no different from that in women who gave birth naturally. If the operation was planned (performed before the development of spontaneous labor), then milk may come not on the 3-4th, but on the 4-5th day, but colostrum begins to be released immediately after the operation.
It is most convenient to feed the baby lying on his side in the first days after a cesarean section. In this position, the postoperative suture will be subject to the least impact. In the future, it is possible to feed the baby while sitting or standing.
In the normal course of the postoperative period, the mother is discharged from the maternity hospital on the 6th–7th day.
After returning home
10–12 days after discharge from the maternity hospital, it is advisable to visit an obstetrician-gynecologist at the antenatal clinic to make sure that recovery after surgery is proceeding normally.
Final recovery after caesarean section
Final healing of the postoperative wound on the uterus and scar formation occur within 8 weeks after birth. During this time, it is recommended to visit your obstetrician-gynecologist again. In this case, it is imperative to do a control ultrasound examination of the pelvic organs to check the condition of the uterine cavity and postoperative scar.
Menstruation after a cesarean section is restored in the same way as after a natural birth. If a woman is breastfeeding, then menstruation returns 6-12 months after birth, in cases where the child is bottle-fed - usually 8 weeks after birth.
When resuming sexual relations, it is necessary to use contraceptives, which your doctor will help you choose. An abortion performed within 1–2 years after surgery significantly worsens the prognosis of subsequent pregnancies. It is believed that the scar on the uterus reaches its optimal state (complete restoration of the muscle layer) 2–3 years after surgery. It is after this period of time that it is recommended to plan a subsequent pregnancy.
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- After cesarean section, sexual rest is recommended for 2 months after surgery.
- For 2 months after surgery, it is not advisable to lift weights exceeding 3–4 kg (the weight of the child).
- Be sure to follow the rules of personal hygiene: it is advisable to take a shower at least 2 times a day, and do not rub the seam area with a washcloth. After a shower, once a day it is recommended to treat the area of the postoperative scar with antiseptic solutions (diamond green, 70% ethyl alcohol solution). After treatment, a disposable antiseptic bandage is applied to the suture area to prevent friction of the suture on clothing. After the crusts have completely disappeared (on average 10–14 days after surgery) in the area of the postoperative suture, the bandage may not be applied in the future.
- The menu of a woman who has undergone a cesarean section and is breastfeeding should include a sufficient amount of proteins, since they are the main building material for the synthesis of immune factors and hemoglobin. Proteins are also found in large quantities in breast milk. A lot of protein is found in meat, fish, cottage cheese, milk, and cheese. In this case, meat and fish should be lean, boiled or steamed. The cheese should be mild.
- For 2 months after surgery, you should not exercise your abdominal muscles, as there is a risk of sutures coming apart. But after 1 month you can begin light physical exercises aimed at restoring the overall tone of the body. To begin with, you can study for 15–20 minutes, then increase the study time to 40 minutes a day.
Breathing exercises
Already 2 hours after the operation, breathing exercises can be performed, aimed primarily at preventing congestion and inflammatory complications in the lungs, which can arise due to the fact that the woman has been in a lying position for a relatively long period. These exercises are especially relevant during general anesthesia, when a tube is inserted into the respiratory tract, it irritates the respiratory tract, and an increased amount of mucus is formed in them, which is a breeding ground for pathogenic microbes. Breathing exercises are performed by a nurse. It consists of combining the phases of breathing (inhalation and exhalation) with a certain frequency. You can also use balloon inflation for this purpose.
How to make sure that you can return to normal sex life?
Doctors are confident that if there are no complications, then sexual activity can begin as soon as the bleeding after the operation (lochia) has stopped, and there are no problems with the sutures. In order to verify this, you need to perform an ultrasound. This procedure shows how strong the stitches are and whether they will come apart during sex.
Even if a woman feels that she is ready to resume sexual activity and has a desire, consultation and permission from a doctor are necessary. Only a specialist will be able to determine how the postoperative suture is healing.
Besides the stitches, the fact is that after the placenta separates from the uterus, an open wound is formed. We must not allow it to become infected. Therefore, any tampons are excluded, as is sexual activity. Until the wound heals completely.
Statistics
After cesarean section, sexual activity begins no earlier than a month later. According to statistics, the bodies of 10 percent of women after surgery fully recover within four weeks. And from a physiological point of view, you can already begin to be sexually active again. Another 10% of women, due to the individual characteristics of the body and complications, cannot be rehabilitated even after 8 weeks. The remaining 80% recover after cesarean in a period of 1.5 to 2 months.
Physiological side
After a cesarean section, a woman needs to listen to her body. Before resuming sexual activity, you need to wait until the bleeding stops. After this, do an ultrasound and consult a doctor.
At first it is necessary to use contraceptives. But during the lactation period, birth control pills are most often contraindicated, and the IUD can only be inserted six months after surgery. The best options are condoms or vaginal suppositories.
The onset of sexual activity after cesarean section should be gentle. The man must move very carefully, smoothly, to avoid damaging the recently healed stitches. In the first months, sharp, rough movements, pressure and deep penetrations are excluded. For six months, only classic poses are recommended.
During the first intimate relationship after surgery, a woman may feel discomfort. Pain often appears after a caesarean section. But these feelings will pass over time. Ligaments, muscles and tissues of the body will stretch and become toned. This takes time.
Some ardent couples, in the very first months after resuming sexual life, try to replace classic poses with others. This should not be allowed, since penetration of fingers and even tongue can introduce bacteria into the body. Another danger is if the woman reacts violently. In this case, the tension may cause the seams that have not yet strengthened to separate.
According to scientists, during breastfeeding a woman produces hormones similar to those produced during sex. This often explains the reluctance to resume sexual activity. And this happens most often after a cesarean section.
After cesarean section, sex life fades into the background for women. The thing is that a woman in labor is not adapted to a quick return to sex. The partner will have to be patient, since prolactin (the maternal hormone) forces the woman to focus only on the newborn. The body is very “busy” at this time. He is engaged in feeding the offspring. At the same time, sexual desire is not perceived by him as parallel and is considered less important. This condition goes away after some time.
At first after surgery, a woman may not always experience orgasm. For some, it takes about a year to experience the same pleasure again. But 40 percent of women note that after a while they began to experience orgasm twice as often.
Psychological side
At first, when sexual activity resumes after cesarean section, a woman often experiences fear of sex. Fatigue, worries about the child, sleepless nights, and depression are largely to blame. Most often, the first time after resuming sexual life, it will not give the same pleasure as before.
In such a situation, a woman needs to talk to her partner and tell her about her fears. And the man must be patient and not only support her morally, but also help with household chores and let her get enough sleep if possible.
A woman often feels unattractive. After childbirth, the stomach and chest sag greatly. Excess weight often gets in the way. But this can only be corrected over time. During this period, a man needs to be more attentive to his soul mate. Over time, the desire will return. To “stimulate”, doctors often recommend romantic dates or watching erotic films together.
Pain after caesarean section during sex
After a cesarean section, pain may occur during sex. Moreover, their localization most often changes. They can also appear in the vagina. The thing is that the hormonal process of contraction of the uterus and vagina starts, but it was not subject to deformation. Discomfort during sex is experienced due to excessive contraction.
Sexual activity after a caesarean section in the absence of lubrication can cause severe pain to the woman. Often the reason is psychological constraint. In such cases, you can use special hygienic gels or lubricants. If during sex there is a sharp pain or discharge begins, you should immediately consult a doctor.
Do's and don'ts after cesarean section
You cannot begin sexual activity if your partners have sexually transmitted infections or inflammations. And also if the lochia has healed and the sutures continue to bleed. Before starting sexual activity after surgery, the partner must undergo a full examination. Anal sex and heavy lifting are strictly prohibited.
What can you do after a caesarean section? It is necessary to use contraceptives to avoid pregnancy, since the next one can be planned only after two years. Over time, you can start choosing a pose. This must be done very carefully and gradually. The most successful will be those in which the woman herself can control her own movements. Most often this is the “on top” position.
Recovery after cesarean
During the first period of recovery after cesarean section, the woman is prescribed bed rest. She should lie in bed from 3 to 12 hours. You need to get up carefully, without sudden movements, slowly and preferably gradually. It's best in someone's presence. You can start sitting up only on the third day after cesarean section.
If the operation was performed under general anesthesia and gurgling and wheezing are felt in the chest, you need to cough to get rid of the mucus accumulated in the lungs. Rocking in a chair, deep breathing and eliminating any foods that can make you gassy and carbonated drinks from your diet will help you cope with gas.
If constipation begins, physical activity (but moderate), dried fruits and vegetables help to normalize stool. All of the above can be reflected in the psychological background of a woman. And during this period it turns out to be reduced.
During the recovery period after a caesarean section, lubrication is often poorly produced. In this case, active petting helps a lot. You can use aphrodisiacs or incense. To minimize stress on the abdomen and hips in the first months, it is best to use the “back” or “missionary” position. You can try others gradually, but at the same time pay attention so that pressure on the vagina does not cause pain.
