A guide to preparing and healing from a C-section

Whether you meant to have a c-section, or childbirth took an unexpected turn, your recovery will look a little different than that of a vaginal birth. Here are some basic things to consider as you navigate the pre and post-operative world.

Preparing for a C-section:

Not everyone will know ahead of time that the birth will be via c-section, but if you do know, here are some things you can do to prepare:

• Build up your iron stores: Having good iron reserves going into surgery will help with your recovery, improve your ability to breast/chestfeed and improves overall birth outcomes. Remember to look for a full heme iron supplement. (I like Bob's Iron)
  
• Build up your energy reserves: I suggest eating slow cooked soups and stews. If you are not a vegetarian, I highly suggest slow cooker beef stews, chicken/turkey soups, yams, beets and cooked dark green vegetables. Try cooking a big batch of soup or stew, eat half and freeze the rest.
  
• Pelvic floor physiotherapy: If you have coverage or the means to do so, I highly suggest booking a pelvic floor assessment for 6 weeks postpartum. The physiotherapist will be able to assess and give you the green light regarding if your body is ready for exercise, or if you have some internal pelvic floor strengthening still to do. Just because the baby wasn't born out of the vaginal canal doesn't mean your pelvic floor wasn't impacted. Both the pregnancy and the surgery will greatly impact your pelvic floor, and getting a sense of where you have 'landed' 6 weeks postpartum, will let you know what you need to work on before you start working out.

Navigating recovery post C-Section:

• REST!!!!  Other than getting up to pee, maybe an occasional shower and whatever the frequency your healthcare provider says for blood circulation, don't get too active too soon. This is not a time to be hosting, or cleaning, or cooking. If you have other children, have them come to you in your bed. This is when extra care is most needed. This is not a luxury; this is necessary for your full recovery. The government of Canada now offers 5 weeks of separate parental leave (that doesn't affect your leave), so if you have a partner who can, get them to take it!! For those without partners, I suggest seeking the help from a family or friend in your bubble, or hire the care of a postpartum doula. There are postpartum doula services that provide free or discounted services for marginalized and low income families if you don't have someone in your bubble to help. (check out Doula Services Association)
  You will know if you have pushed it too far with activity (like grocery shopping or going for too long of a walk) because your scar will begin to ache and you will get a pulling sensation. for the first 3 months, use you scar as a gage to keep you in check with your level of activity.
  
• Timeline: You are looking at an 8week recovery period minimum. Even if you feel okay, remember to lay low regardless. If you don't feel okay, be gentle with yourself and know that it will get better with time, and seek extra care to help with your recovery.
  
• Lactation consultant: Be warned that milk coming in is often delayed with a c-section. (it usually comes on day 3 postpartum) Lots of skin to skin, circular breast massage, plenty of fluids and nourishing food will help it along. If you are experiencing pain or struggling with breastfeeding, seeking support from a certified lactation consultant can make all the difference. Breastfeeding can be hard and overwhelming, especially if you have a surgical scar to maneuver around. The sooner you get the support, the greater your chance of success and a positive experience.
  
• The scar: Oh the scar. The hospital and your provider will hopefully give you some tips on how to side roll out of bed, and to place a pillow over your belly and hold when you have to cough (yes, it's a thing).  It will likely 'eek' you out and you probably won't want to touch it for a long time. Once you are fully mobile and ready to address it (usually 3months+), acupuncture and gentle manipulation can help with breaking up any scar adhesions that cause pulling and discomfort.
  
• Keep eating nourishing foods: The best food in the immediate postpartum is warm, easily digestible soups and stews. Just like I wrote in the pre-surgery section, if you are not a vegetarian, I highly suggest slow cooker beef stews, chicken soups, yams, beets and cooked dark green vegetables. This allows for maximum nourishment with minimal effort for your digestive system. Smoothies and salads are also okay, but try to favour the warm and cooked foods in these first few days if you can.
  
• You will dread your first bowel movement . Ample water, prunes, apricots and stool softeners are your best friend at this stage.
  
• Your mental health: Mentioning what you are feeling to a close friend, or to your doctor or Midwife at your well baby visit is a great way to find out if what you are experiencing is something that could benefit from a little extra help or if you just need someone to listen as you process everything that you have just experienced.  
  
• Supplements: Remember those supplements you were so diligent with your whole pregnancy?... It’s time to get back on them. Taking a prenatal for at least 6 months postpartum, and longer if breastfeeding, will help ensure you get your vitamin and mineral stores back up to normal, and get you feeling strong and well as fast as possible. Include an omega fish oil with high DHA content, Vitamin D3, your prenatal and a magnesium if constipation is an issue.
  
• If you are struggling with your recovery, or not recovering as fast as you would like, feel free to reach out to see if acupuncture or Chinese herbal medicine can help you with your recovery.

The first month after a csection can be a rollercoaster. Remember that pushing too hard now may slow your recovery in the long run and could lead to messy complications. Take your time, rest, ask for help.

Dr. Emilie Salomons Dr. TCM, FABORM, OBAAM, Doula.