About one-third of all US births are delivered by a Cesarean section and in the UK it's approximately one-quarter. Are you surprised by those stats? The growth rate of C-sections has rapidly increased over the last few decades and since 1990 reports indicate that the rates have tripled.
Whether you are electing to have a C-section or if it happens as an emergency, you deserve to feel supported and know what to expect once you go home. However, we have discovered that so many women are not prepared for what the C-section recovery process involves. If you've been to an antenatal class, you'll know that they are primarily focused on vaginal deliveries and the consequent recovery. However, C-sections are more invasive and often entail a longer road to recovery. As they are becoming increasingly common we need to prepare women for what's to come. And this all begs the question, why aren't C-sections discussed more often.
We think the stigma that continues to shroud C-sections limits the conversation around the topic. At the end of the day, the best way to give birth is the way where both mom and baby are as healthy and happy as possible. Sometimes that is a vaginal, natural birth. Sometimes it involves an epidural. Sometimes it involves a C-section. Every pregnancy, every baby, and every female body is different, and that leads to so many different birth stories. At Baby2Body, we're here to meet you exactly where you are, and if you've had a C-section or have one planned we want you to feel as prepared for what to expect when you go home.
From poling our audience, we've discovered that most of the key recovery aspects (such as not lifting and not driving) are known, but it's the smaller anecdotal points from personal experience that are not publicly shared. For women having a first-time C-section, those anecdotes can go a long way in helping with preparedness and confidence in going home with baby.
So we've pulled together some facts and feedback from our audience on things you may not know about C-Section Recovery, but absolutely should.
1. There will be blood
Although you haven't had a vaginal delivery you will still experience bleeding after birth. Many women are often surprised by this. It can be less bleeding with a planned C-Section but if you labored and then experienced an emergency Cesarean you can bleed just as much as with a vaginal delivery.
2. It's going to feel frustrating at times
After a C-section, new mothers often struggle with stress, they must deal with caring for their newborn alongside caring for the painful incision scar and being far less mobile than if they'd had a vaginal delivery. It can make things as simple as getting out of bed very difficult and this frustration added to fluctuating postpartum hormones can be challenging to manage. Being aware of how limited your mobility will be in those first few weeks can help you prepare ahead of time, and get the support you need from your partner, family, or close friends.
3. You might need help feeding baby
Whether you are doing breast or bottle, feeding your baby is a whole lot harder after a C-Section. You will require much more support to lift your baby, and even getting up from a chair is surprisingly hard and a little painful. Remember, the muscles that support your abdomen were separated during your C-section, so you won't have that abdominal strength to support you. Getting your partner or other family involved is going to be critical to your physical and emotional wellbeing.
4. Trapped gas is really common (and painful)
This is one side effect that isn't talked about enough, but gas pains after a c section can be excruciating. They will pass within about a week but it can feel like you have a huge amount of air moving around your middle like a big balloon while everything settles back down after the interference of surgery.
5. You may experience numbness
Loss of feeling near the incision is a side effect that many women experience after a C-Section. It's because small nerves are severed during surgery and it takes time for them to regrow, usually within several months but it can take longer. It's a strange feeling but one that should pass. However, if you are still experiencing persistent numbness months after your operation then you should seek advice from your healthcare professional.
6. You want to be careful when coughing, sneezing, or laughing
You will find any of the above difficult and painful in the first few days after your C-Section, as these daily actions use your abdominal muscles (that have been split open) and will make you feel like you are straining your incision wound. It's not a pleasant sensation, but you can help by having a pillow or rolled-up towel nearby so if you feel like you might sneeze or cough then hold the pillow firmly on your scar area to support it as you do so.
7. You should know about "The Shelf"
Sometimes referred to as the pooch, this is where the skin above your C-Section scar hangs over creating a "shelf". You will notice it while your tummy returns to normal after birth but some women continue to have it long after birth. The skin around the scar is often pulled much tighter than the looser skin above it which is why the shelf can occur.
8. Your scar can look uneven
While you might imagine you're going to have a central and symmetrical scar, this is not always the case. It can be cut higher on one side compared to the other and the scar tissue can be thicker in places. It depends on how your baby was lying and how the scar was closed at the time of surgery. In general, a C-section scar will fade and look much better within 2 weeks, but full healing can take up to 3 months. If you do have thicker areas of scar tissue that bother you then it could be worthwhile seeking help from a scar massage specialist.
9. There can be long-term side effects
Some women do experience symptoms related to their C-section scar long after the operation. Some women feel pain, restriction, or a pulling sensation on or around their scar months or even years after surgery. This is normally due to the build-up of scar tissue which can stick to muscles or even organs and cause pain. Sometimes that scar tissue pain can present as hip or lower back pain, shoulder pain or tension, headaches, or painful periods. If you are experiencing pain long after your C-Section we always advise you to seek advice; and similar to the suggestion above, you may want to seek a specialist in C-Section massage, which can help alleviate these problems.
Do you have more questions about C-section recovery? If you've had a C-section, what do you wish you were told beforehand to help you feel more prepared? Let us know in the comments below!
Having a C-section, which is also known as a cesarean delivery, is a risk factor for endometriosis. Endometriosis following a C-section remains relatively rare, but it is a potential complication that women should discuss with their doctors.
Endometrial tissue typically lines the uterus. Classic endometriosis occurs when endometrial-like tissue develops outside of the uterus.
This can cause the development of adhesions, or scar tissues. These can grow into large masses, or into bands that form between organs.
When endometriosis causes either inflammation or scar tissue, a person can experience heavy or painful periods, as well as pain between periods.
During pregnancy, a person already living with endometriosis may find that their endometriosis symptoms temporarily get better. This may result from increased levels of progesterone in the body during pregnancy.
However, this may not be true for every person. In some cases, the pain relief may be more related to the absence of a menstrual cycle during pregnancy. Some people may not experience any pain relief during pregnancy.
There is also evidence that endometriosis could develop after a c-section in people who did not have the condition prior to giving birth.
This article discusses endometriosis after a C-section, including how doctors diagnose and treat the condition.
Endometriosis can develop after a C-section when it develops inside the surgery scar, which is known as incisional endometriosis.
Incisional endometriosis is rare. The incidence of the condition is only 0.03-0.45%. However, the authors of a 2017 case report suggest that doctors are encountering more C-section scar-related endometriosis because the number of C-sections is rising.
The number could also be higher because not all people may realize they have endometriosis after having a c-section and may not report it.
When a surgeon performs a c-section, endometrial tissue is cut and can move outside the uterus. Endometrial tissue can implant in the area of the surgical scar.
The endometrial tissue then builds up along the scar, leading to painful adhesions that can affect a person’s fertility or make periods more painful. In addition, a person can experience inflammation, pain, and bleeding from the endometriosis lesions.
Surgery can effectively treat many cases of incisional endometriosis, as it involves removing the inflammatory endometrial tissue.
Incisional endometriosis can cause cyclic pain, swelling, and brown-like leakage at the site of the scar during menstruation. In addition, a person can experience the standard symptoms of endometriosis.
They include:
- severe pain during menstruation
- pain or cramps between periods
- pain during sex
- painful bowel movements
- bleeding between periods
- heavy or clot-filled periods
- trouble getting pregnant
- unexplained stomach pain, diarrhea, or constipation
- bladder pain that resembles a bladder or urinary tract infection
A person experiencing any of these symptoms should see their doctor to rule out endometriosis or another condition that may be causing similar symptoms.
Many people with endometriosis wait years for a diagnosis.
A 2017 study found that the average time between the beginning of symptoms and diagnosis in the United States was 4.4 years. Younger women tended to wait longer than older women for a diagnosis.
However, according to the Endometriosis Foundation of America, there can be as much as a 9-year delay in the diagnosis of endometriosis after the onset of symptoms. In cases of incisional endometriosis, doctors may take longer to diagnose the condition as it is rare and still not widely understood.
Generally, to ensure a prompt and accurate diagnosis, people who suspect they have endometriosis may need to see their gynecologist, specifically ask about endometriosis testing, or seek a second opinion.
Usually, doctors take a complete medical history and perform a pelvic exam before testing. A person may then need to undergo several tests to get an accurate diagnosis.
A doctor may be able to feel adhesions or endometrial growths during an exam, though this is uncommon. If a person experiences unusual pain during a pelvic exam, this may also be a sign of endometriosis.
If a pelvic exam causes a doctor to suspect endometriosis, other tests can confirm the diagnosis. These include:
- Pelvic ultrasound: During this procedure, a doctor uses sound waves to view the uterus and surrounding organs. They may insert a small transducer into the vagina to get a better look or use the transducer only on the outside of the abdomen.
- Biopsy: A doctor may use a needle to remove a small section of endometrial tissue. Testing this sample can help rule out other issues, such as cancerous growths.
- Exploratory surgery: Surgery like laparoscopy is the only way a doctor can definitely diagnose endometriosis in the abdominal wall. However, it is possible to diagnose incisional endometriosis with ultrasound, MRI, and typically by making a new incision at the old incision site and removing the tissue. A pathologist then examines the tissue to confirm the condition.
Endometriosis is a chronic illness with no cure. In cases of endometriosis after a c-section, surgery to remove the endometriosis is the most likely treatment. This is also more likely if a person wants to conceive again.
For endometriosis in general, surgery is not always the first treatment choice. There are other treatments that can manage symptoms that could benefit some people depending on their specific symptoms. Some treatments may also prevent endometriosis from getting worse. A doctor may recommend:
- over-the-counter or prescription pain medication.
- alternative pain management techniques such as acupuncture or massage therapy
- Hormonal birth control pills contain progesterone, which is a hormone that can help prevent endometrial tissue from growing. Learn more about birth control for endometriosis.
- Hormonal contraceptives that do not contain progesterone such as gonadotropin-releasing hormone (GnRH) agonists or antagonists.
In severe cases, people who do not want to become pregnant may choose a hysterectomy, which is surgery to remove the uterus. This may also include a bilateral salpingo-oophorectomy (BSO), in which the surgeon also removes the ovaries.
Learn about the new guidelines for endometriosis diagnosis and treatment.
Endometriosis is a chronic condition, but surgical and medical treatment can help manage the symptoms.
People who have used medication, such as progesterone, to control endometriosis often experience symptoms after stopping the treatment.
Even among people who have undergone surgery, endometriosis may come back. Treatment with progesterone or with GnRH agonists and antagonists may reduce the risk of recurrence or slow new growth.
A hysterectomy on its own can greatly reduce the risk of recurrence. Research from 2020 found that the proportion of women living with endometriosis who experienced pain went down by 28% after a hysterectomy
However, earlier research found that 62% of participants experienced endometriosis symptoms even after undergoing hysterectomies but keeping their ovaries. This means that in some cases, a person may need to have their ovaries removed as well.
The removal of ovaries, however, also comes with its own health risks. A person should make a decision on whether they need surgery and what kind of surgery is best in consultation with their doctor.
Incisional endometriosis can cause pain and discomfort. But the condition is so rare, that there is not enough data to indicate whether it is dangerous. In extremely rare cases, the condition could become malignant, which means cancerous.
Why does my c-section scar hurt years later?
A person should not experience pain in the area of their scar years after a C-section. If they are experiencing pain, they may wish to rule out endometriosis or other conditions such as a hernia.
Learn more about hernias after a C-section.
Can a hard lump in the stomach after a C-section indicate endometriosis?
According to research, a lump in the c-section scar area could indicate endometriosis. It is likely to be chronically painful, but the pain may come and go in cycles.
What is post-partum endometritis?
Post-partum endometritis is a different condition than endometriosis, although both occur after pregnancy and delivery. When a person is pregnant, bacteria can reach the lining of the uterus and cause an infection. This can occur during vaginal delivery, but also during pregnancy through pelvic examinations, for example. The condition typically develops after delivery, which can be vaginal or via c-section. It affects up to 27% of caesarian births.