Unplanned Cesarian section births are like the Spanish Inquisition: no one expects them. That should be a given, since they’re called “unplanned,” so maybe I should qualify that to say that no one expects that it will happen to you. I certainly didn’t, because I was prepared. (Hah! Myth number one of childbirth). I went to the childbirth classes, I read lots of books, and I thought I was pretty educated on how to avoid a c-section. But I also didn’t plan to have gestational diabetes or a prolonged induction. So after five days and five even longer nights of induction, including 21 hours of labor, Miri was finally born via an unplanned c-section. In all of my preparation, research, and reading, I had skipped over the chapters on c-sections and tuned out in the classes. I was slightly more prepared than the average person simply because I’m a nurse, I vaguely remembered some from my OB rotation in nursing school, and I’d even witnessed a c-section as a nursing student. But of course there was a lot I wasn’t prepared for and wasn’t even expecting, so hopefully this will help you be a bit more prepared than I was. And if you’re pregnant and skimming over this because a c-section won’t happen to you, bear in mind that one out of three babies are born via c-section in the US. So even if you’re not going to have one, the chances that your friend/sister/cousin will are pretty high, so at least read this so you can help them out.
1. Even if your epidural is amazing, you will feel stuff. A lot of weird stuff. The epidural blocks pain receptors, but doesn’t block pressure or pulling sensations. You will feel them pulling on your insides, jiggling stuff around, and a lot of pressure and pulling as they get the baby out. It’s not exactly painful or uncomfortable, but it sure is weird. If your partner is sitting near your head, he or she will see your body jiggling a little as they push and pull your innards apart, and that might skeeve them out a little. Then, as they actually pull the baby out of you, there will be a LOT of pushing and pulling, and many women feel nauseous as this happens. Tell your anesthesiologist (the masked guy near your head who is not your husband) whatever you feel, whether it’s pain, nausea, shortness of breath, because he can give you lots of good drugs for whatever it is.
2. Prepare your partner. Your partner may claim to not be squeamish, but unless he is an OB himself, I can guarantee he’s going to feel at least a little uncomfortable at times. Warn him NOT to look over the blue curtain. They will hold the baby up for him to see, when it’s time. If starts feeling, um, unwell, he should say, “I don’t feel well,” and if he REALLY feels unwell he should just sit on the floor. Trust me, the anesthesiologist and the team has seen it all before and the very last thing they want is a dad passed out on the floor. A glance over the blue curtain at the wrong moment could be traumatizing for Dad….which brings me to #3…
3. They will be taking more than a baby out of you. Once the baby and the placenta are born, the surgeon will likely lift your entire uterus out of your abdomen, set it gently on your belly and stitch it up. (They put it back of course!) This allows them to see the entire incision and inspect the organ, but it may also traumatize an unsuspecting Dad who glances over the curtain at the wrong time, not expecting to see his wife’s organs outside of her body. This is something you can ask the OB ahead of time if you have a chance, I’m not sure that surgeons always take the uterus out to stitch it up but where I delivered it was standard practice.
4. There will be swelling. Oh, the swelling. You thought you had puffy feet and ankles before giving birth? Hah, that was nothing. This is one pregnancy symptom that does not go away right after delivery, and in fact it will get much worse. This was the number one thing I was LEAST expecting, and it was actually more bothersome and uncomfortable than my incisional or abdominal pain during the first week of recovery. As my husband so succinctly put it, “You looked like you had a fat suit on, from the waist down.” He was at least smart enough to tell me that after the swelling had gone down, and I was not as much of an emotionally labile wreck. My feet and legs swelled all the way up to my thighs, I could barely bend my cankles, and could not lift my own legs onto the bed or the ottoman without using my hands or help from someone else. I couldn’t be on my feet for more than a few minutes without feeling even more uncomfortable, and walking was rather difficult. Forget trying to wear anything except very loose yoga pants and flip flops many sizes too big. There isn’t much you can to do prevent this, it happens for many reasons. There is a normal fluid shift that happens after having a baby…all that extra fluid has to go somewhere, and gravity wins so it goes south. Plus if you deliver in a hospital you likely received many liters of IV fluid during the course of your labor, more if you had an epidural. I was in the hospital for many days prior to delivering, so I probably got a lot more fluid than the average laboring mom, so hopefully your swelling won’t be as bad as mine. But trust, it will suck. Though it seems counter-intuitive, the best thing you can do for this is drink lots of water to help flush it out and stay hydrated. Keep your feet elevated as much as possible, even on pillows when you’re in bed. I could see my knees again about 10 days post-partum, and by two weeks finally some definition in the shape of my feet again.
5. There’s a reason hospital beds are adjustable. You’ve been happily adjusting the head and the leg height on your hospital bed for a couple of nights, and probably complaining about how uncomfortable it is. BUT the one saving grace is that it keeps your head elevated. The first time you get to lay in your own bed when you get home, you will realize how important this was, because you will realize you can’t comfortably lay down flat. At least I couldn’t, which resulted in a flood of tears within hours of getting home from the hospital. Wedge pillows can be a lifesaver, or just try to prop yourself up on a lot of pillows. Which brings me to #6…
6. There will be tears. So many tears. This isn’t unique to a c-section delivery, I just thought I’d throw it in there. Between the hormonal changes, exhaustion, pain, and the realization that you just became someone’s MOM, you will cry a lot. You won’t necessarily be sad, or even upset (I cried every time someone told me Miri was cute), and the tears may not be proportional to how upset you are, but they will flow. And once they start, you won’t be able to stop it. It’s all completely normal. Just be sure to warn your partner so they don’t freak out.
7. Be kind to your bowels. Things are going to slow down, wayyyy down. The hospital will give you stool softeners, TAKE THEM. Stay on schedule with them. Drink you morning coffee, eat a lot of melon, drink tons of water. Trust me on this. And if things just aren’t moving, tell your doctor, don’t wait too long!
The best advice on recovery was from my OB, who told me “Act like you have the flu for two weeks.” She tells patients who had a vaginal delivery to rest as if they have a cold for two weeks, and C-section patients to rest as if they have the flu. That means no going out if you don’t have to, let someone else do the laundry, dishes, etc. And be sure your partner hears that advice!