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Key takeaways

• Expect to stay in hospital for at least 1 day after your caesarean.
• Manage pain, care for your wound, and move gently to aid recovery.
• Gradually increase activity at home, avoiding heavy lifting or driving initially.
• Understand your body's healing, including scar care and pelvic floor exercises.

What to expect in the first few days

If your caesarean was planned and straightforward, you may be able to go home as early as 24 hours after birth. If it was an emergency procedure, there were any complications, or you have other healthcare issues you may need to stay in hospital longer.

You will be offered medication to help with pain. You can eat and drink as soon as you feel hungry or thirsty. You will also have regular contact with your baby and can start breastfeeding if you choose to.

Pain management

Most people feel some discomfort for the first few days. Your doctor or midwife will advise you on suitable pain relief. This is usually regular paracetamol and ibuprofen, which are safe to take while breastfeeding. You can continue to take these regularly at home. You may also be given stronger pain relief such as dihydrocodeine to take for a short time. Always take medicines as advised and do not exceed the recommended dose.

Urinary catheter

Before the start of the operation a thin, flexible tube called a catheter, is inserted into your bladder. This usually stays in place for at least 12 hours. This allows urine to drain from your bladder while you recover from surgery. Your midwife will remove the catheter once you are mobile and able to walk safely to the toilet. Removing the catheter may feel uncomfortable, but it is not usually painful.

After the catheter is out, you will be encouraged to drink plenty of fluids. Your midwife may ask you to measure the amount of urine you pass. Tell your midwife if you have any discomfort when you pass urine.

Getting up and moving around

You will be encouraged to get out of bed and move around as soon as possible. Once the anaesthetic has worn off, you can stand and take a short walk. You may feel unsteady the first time you get up, so someone should help you. Your abdomen may feel tender and heavy.

Preventing a blood clot in a deep vein (deep vein thrombosis, or DVT)

Moving around soon after your caesarean helps reduce the risk of blood clots. Other ways to reduce this risk include keeping well hydrated and wearing compression stockings if advised.

Some people may also receive a daily injection of a blood-thinning drug after surgery. Depending on your individual risk factors, you may need these injections for 10 days or up to 6 weeks after birth.

Basic wound care

Your wound will usually be covered with a dressing for at least 24 hours after surgery. Your midwife will advise you on how to care for your wound. You will usually be told to gently clean and dry the wound every day. Wearing loose, comfortable clothing and cotton underwear may help reduce irritation around the wound.

Your first six weeks of recovery at home

You will probably need to take things easy for several weeks after your caesarean. You may need help in the early days at home. Your midwife or health visitor will check on your recovery.

Wound care at home

Your midwife will usually check your wound during your postnatal care. They will remove your dressing if you still have one. Once the dressing is removed, clean and dry your wound gently every day. You can use water and pat the area dry with a clean towel. Keep the wound clean and dry between washes.

Stitch or staple removal

Non-dissolvable stitches or staples are usually taken out by your midwife. This usually happens around 5 to 7 days after your caesarean. This does not usually hurt, but it may feel uncomfortable. If you have dissolvable stitches, they will gradually dissolve on their own over the following weeks.

Managing pain

Your wound may feel sore, bruised, numb, or sensitive for several weeks. You will be advised to take pain relief for as long as you need it, usually for 1 to 2 weeks, and sometimes longer.

Gradually increasing daily activities

Gentle exercise, such as walking, can help your recovery. Increase your activity gradually and listen to your body. Avoid strenuous exercise until you feel comfortable and your pain has settled. For many people, this takes around 6 weeks, although recovery varies from person to person.

You should be able to hold and carry your baby once you are home. However, you may not feel ready to do some activities straight away, including:

• driving
• exercising
• carrying anything heavier than your baby
• having sex

Only restart these activities when you feel able and they are not uncomfortable.

Driving after a caesarean

Before driving you should be able to wear a seatbelt comfortably, perform an emergency stop safely, and make all the necessary movements without pain. Check with your insurance company as requirements may vary. If you are unsure whether you are ready to drive, discuss this with your healthcare professional.

Your bowels after birth

It can take a few hours or days for your bowels to return to their usual pattern after surgery. This can cause trapped wind, bloating, and constipation. If you are taking opioid pain relief such as dihydrocodeine, your midwife or doctor may recommend a laxative to help prevent constipation.

To help prevent or manage constipation:

• Drink 6 to 8 cups of fluid a day.
• Eat regular meals, including fibre-rich foods such as fruits, vegetables, wholemeal bread, and oats.
• Some people find chewing gum, drinking peppermint tea or prune juice helpful.
• Move around as much as you comfortably can.
• Do not ignore the urge to open your bowels.
• Place your feet on a footstool when sitting on the toilet to help you empty your bowels more easily.

Understanding your healing body

Scar healing

The scar is usually a horizontal line just below your bikini line. It is about 10 – 20cm long. It will usually be red and noticeable at first but may fade with time. On darker skin, the scar may fade to a brown or white mark.

You may experience numbness in the area around your wound. Sensation may return over time. Your midwife may suggest massaging your scar once it has fully healed. This can help break up scar tissue and reduce itching.

To massage your scar:

1. Lie on your back.
2. Use a non-perfumed cream or lotion.
3. Make 20 to 30 small circular motions over your scar with your fingertips.
4. Repeat this 2 to 3 times a day.

Separation of your abdominal muscles (diastasis recti)

The two large muscles that run down the middle of your stomach can separate during pregnancy (diastasis recti). Your growing womb pushes these muscles apart, making them longer and weaker. For many people, the gap reduces in the weeks after birth, but it may take longer to fully resolve.

If you are concerned that the gap is still present after a few months, contact your GP or health visitor, as this can sometimes contribute to back pain or core weakness. Your GP can refer you to a physiotherapist for tailored exercises if needed. Gentle core strengthening, pelvic floor exercises, and attention to posture may support recovery over time.

Pelvic floor exercises

Pelvic floor muscles support your womb, bowels, and bladder. Pregnancy and birth put pressure on these muscles. Exercising them helps prevent leaking urine when you cough or sneeze (stress incontinence).

You can start gentle pelvic floor exercises as soon as your catheter has been removed and you feel comfortable. Your midwife or a physiotherapist who specialises in pregnancy and birth can show you how. Everyone can benefit from doing pelvic floor exercises, even after a caesarean. If you are worried about your pelvic floor after your 6 to 8-week postnatal check, speak to your GP.

When to seek medical attention

Contact your midwife, GP, or attend your local maternity unit straight away if you have any of the following symptoms after a caesarean:

• Severe pain, or pain that is getting worse.
• Pain that is not controlled by your pain relief.
• Difficulty or pain when passing urine.
• Heavy vaginal bleeding (soaking a pad in an hour or passing large clots), or bleeding that gets heavier after the first week.
• Vaginal blood or discharge that has an unpleasant smell.
• Your wound becomes more red, painful, swollen, or hot.
• Pus or foul-smelling discharge coming from your wound.
• High temperature (fever) or chills.
• Feeling generally unwell, for example, with nausea, vomiting or diarrhoea
• Cough, chest pain, or shortness of breath.
• Swelling, redness, or pain in one of your lower legs.
• A persistent or severe headache.
• Breast redness, pain, or swelling that is getting worse or not improving after 24 hours, or you develop flu-like symptoms.
• Sudden shortness of breath, severe chest pain, or coughing up blood.