Postpartum Instructions After a Cesarean

GENERAL ACTIVITY

You will generally spend 3-4 nights in the hospital. We urge you to have someone who can sleep over in your room with you. This person can be very helpful in case the nurses are busy. Just having someone close by to hand you something, get you some water, help you up to the restroom, or to call the nurse for you can make a big difference in your recovery.

For the first week after going home, you should be on restrictions. Basically, no housework, no chores, no exertion and no heavy lifting. Mainly focus on mom and baby responsibilities and ask for help with everything else!

Try to rest as much as possible, for example take a nap two or even three times a day for the first few days. Try to sleep when the baby sleeps. The more rest that you get this first week, the easier the rest of your recovery will be.

Your amount of activity can gradually increase, but try to avoid getting overly tired. Household activities should be resumed gradually, beginning with the easiest, and later adding the more difficult tasks. You should expect to be able to do almost all of your activities within 3-4 weeks.

Avoid driving for about 1-2 weeks, and do not drive if you are still taking pain medication. Being a passenger is okay. Do not begin driving until you feel that your reflexes are normal, and you can make fast or sudden movements without hesitation.

DIET AND VITAMINS

In general, you may eat whatever you wish. Breastfeeding mothers tend to avoid spicy or odorous food such as garlic, onion, pepper, etc. You still need 3-4 servings per day of dairy or calcium supplementation. High fiber is helpful to maintain bowel regularity. Prenatal vitamins should still be taken once daily. We also advise a daily stool softener until bowel movements are regular and normal.

PAIN RELIEF

In the Hospital

The first 24 hours, pain relief is likely not an issue because you have probably been given a medicine called Duramorph, a long-lasting form of morphine. If you have pain, we can give you a medicine called Toradol, an injectable drug similar to Advil but very effective.

Starting 1 day after the C/S, we offer oral pain medication, either Percocet or Vicodin. We advise Percocet initially, maybe for 1 or 2 more days. It is pretty strong.  By the third day, you can try switching to Vicodin to see how well you tolerate this, because we often send patients home with a prescription for this.

After Discharge

You will be given a prescription for pain medication at discharge. Tylenol or Motrin may also be taken for pain relief.
By 1-2 weeks, you may no longer need it. There will be discomfort in the area of the incision for a while but usually of a mild degree by the third or fourth week after surgery. Occasionally, numbness around the incision may persist for many months.

HYGIENE

You may wash your hair and shower as usual, but tub bathing should wait until after the 6 week checkup but do not douche, use tampons or resume intercourse before your SIX-WEEK postpartum visit.

Keep the wound dry after bathing by gently blotting with a towel, using a blow dryer on light settings, or by air-drying. Call the office if you notice drainage, separation or redness around the incision. 

VAGINAL BLEEDING/DISCHARGE

Some vaginal discharge or bleeding (“lochia”-initially red, later on pink to brown) will usually last for 3-5 weeks after giving birth, and occasionally longer. There is usually less lochia after cesarean birth than after vaginal. Use pads only, not tampons. With excessive activity the lochia may return to a redder color for a few days.

The return of menses is variable. If you are nursing, you may not have any menses throughout the nursing period, or you may have random spotting. The 1st period may be from 6-8 weeks after cessation of nursing. On the other hand, you can have regular menses even while still breast-feeding.

If you are not nursing, the first period may be from 6-8 weeks after delivery. The first period can be unusually heavy with clots, and it may take a few months for regular menses to resume.

HEMORRHOIDS AND CONSTIPATION

Constipation is common postpartum, particularly while nursing (due to fluid losses). Please follow the same advice given during pregnancy. Prevention is the key. Drink plenty of water throughout the day. Have a good daily intake of fiber (fruits, vegetables and bran). For constipation, you can try prune juice, Metamucil or Citrucel (adds bulk), Colace (a mild laxative), or MOM (Milk of Magnesia). For hemorrhoids, we recommend fiber and bulk supplements to help produce soft stools (bran, bran and more bran), sitz baths at home, Preparation H or Anusol (with or without hydrocortisone), or Tucks pads.

EXERCISE

Don’t expect to begin regular exercise for 6-8 weeks. Walking is good for you, but be careful not to overdo it. Some stretching and exercises that avoid the abdominal area may be initiated 2-4 weeks after the operation. Actual sit-ups or other direct abdominal exercises should wait until at least 2 months after C/S.

CARE AFTER CIRCUMCISION

The penis will be wrapped with Vaseline gauze. There will be a small amount of dark blood on the gauze – this is normal and expected. You should remove the gauze in about 48 hours. Apply a little Vaseline or A&D ointment first, and the gauze will easily slide off. It is okay if the gauze falls off before 48 hours. After the gauze is removed, the tip of the penis usually looks a bit red and swollen with some white or yellow secretions on it. For the next 2 weeks, apply Vaseline or A&D ointment liberally to the tip whenever you change the diaper. When the tip looks pink like normal skin, the area is fully healed, usually about 2 weeks after the procedure is done.

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