After your caesarean

If your birth was by caesarean you will very likely have spent a little extra time in hospital before being discharged. You will have probably been getting plenty of pain relief over the first few days and hopefully will be feeling confident about mobilising and feeding issues by the time you leave hospital. So what next?
Pain relief:You are very likely to still be needing some regular pain relief after you leave hospital. You should use enough pain relief in order to get through the day without significant pain. Your need for pain relief will obviously diminish as the days and weeks go by. Pain relief needs vary widely from woman to woman & there is no strict rule about how long to take these medications for. You will usually only require over the counter medications for pain relief. Paracetamol and Paracetamol + codeine are good simple options. These can be combined with anti-inflammatory medications such as Nurofen or Voltaren as needed. Pain should generally not increase after discharge from hospital. If this occurs you should seek advice.
The wound: No special wound care is usually required. There is a dissolving stitch under the skin. The wound does not need to remain covered and can simply be washed with soap and water. If you notice increasing redness, swelling or pain around the incision you should seek advice. There is no need to put anything on the scar to facilitate healing, although when it is comfortable to do so, gentle massage of the scar with Vitamin E cream or similar may help to improve the appearance of the scar in the longer term. It is very common to have areas of numbness around the scar, these will usually be temporary.
Vaginal bleeding: Tends to be very similar to the bleeding following vaginal delivery. Duration and amount can vary widely. It is not unusual to pass the occasional clot. Average duration is about 4 weeks but anything between 2 and 6 weeks is normal.
Daily activities: The caesarean incision is fundamentally quite a strong incision which usually heals very well. You should avoid heavy lifting and strenuous activity for the first 6 weeks. Most daily activities are fine within those guidelines. As a reasonable guide, if something causes significant pain, you are not ready to do it yet.
Driving: There is no good evidence on which to base a recommendation on in this area. The concern about driving is your ability to react quickly and decisively in an emergency. In my view most women are ready to drive at about 3 weeks after an uncomplicated caesarean. A good way to assess your readiness to drive is to sit in the driver’s seat of your car with the seatbelt on and stomp on the brake as hard as you can (no you won’t break the pedal!). When you can do this reasonably comfortably then you can drive.
Exercise: Take things pretty gently for the first 6 weeks. Walking, stationary cycling and any other gentle exercises as recommended by the hospital physiotherapist are a good start. Remember work within the limits of comfort. The 6 week check up is a good time to discuss further progress.
Sexual intercourse: You are very likely to feel tired and uncomfortable for at least the first few weeks after your caesarean. Sex may well be the last thing on your mind. However it is perfectly OK to resume having sex whenever you feel ready to do so.

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