There are different reasons why a pregnant woman may undergo a cesarean section procedure, commonly referred to as C-section. For some, it’s a health matter. Others select to have a C-section. In still other cases, women plan for a vaginal delivery but complications during labor require surgeons to become involved. No matter the situation, there are certain steps women can take before and after to optimize the procedure and subsequent recovery. Dr. Drue Webb, Family Medicine and Obstetrics Physician at Pullman Regional Hospital's Family Medicine Residency Center, shares important information for moms-to-be.
What Happens During a C-Section?
A C-section is a major surgery; it involves surgically opening up the abdomen to access the uterus in order to remove the baby. In doing so, surgeons need to go through various layers of muscle and other tissue. Surgeons also need to be extremely cautious, as they are operating very near to organs such as the bowel, bladder, and uterus.
“All of those things increase risks that can be associated with the surgery and elevate it to a ‘major’ surgery level. It also will require more recovery time because it is an open surgery,” states Dr. Webb.
What Does Recovery Look Like?
With a routine C-section, most women will remain in the hospital two or three days post-surgery. In comparison, women who delivery vaginally are typically discharged after only one or two days At-home recovery also differs. Women who have a vaginal delivery generally resume their usual activities within about a week or two. With C-sections, this recovery time often lasts up to four weeks.
“In the hospital, we always encourage women to get up and walk around. That can help with the pain management aspect. It's kind of like a sore muscle after working out. If you stay too still, it actually gets more painful,” explains Dr. Webb. “So, we encourage early ambulation in the hospital and on discharge, but we want them to be careful about how much they're lifting.”
Most experts warn that if women are lifting more than the baby’s weight, they are at risk for interfering with the healing of the incision site. Some surgeons will recommend patients not lift more than 13 to 20 pounds for at least two weeks, but others give recommendations up to four to six weeks. “In some of the data we've seen, that's when you start to completely heal on that internal incision,” adds Dr. Webb.
It’s important to keep the incision area clean and dry. If it’s too moist, it can disrupt healing. Dr. Webb notes that regular soap and water are recommended as a cleaning agent.
Additional Considerations Surrounding C-Sections
If a C-section is scheduled, that typically occurs at about 39 weeks. Dr. Webb urges women to participate in standard prenatal care in order to optimize recovery and reduce risks. For example, maintaining a healthy pregnancy weight, staying active, and adhering to prenatal appointments and recommendations.
Some women wish to have a vaginal delivery after they’ve already had a C-section, and that is possible. Dr. Webb shares there are some considerations and concerns that need to be addressed, though.
“There are risks if you vaginally deliver after a C-section, so surgeons will need to assess that and see where they think you're at in terms of risk factors. The other aspect is that because of the higher risk associated with a vaginal delivery after C-section, not all hospitals are covered for those types of deliveries. At Pullman Regional Hospital, we don't do vaginal deliveries after C-sections. So, those women would go to Spokane or a larger hospital that is able to do those deliveries.”
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