c section follow up visit

Your Postpartum Check-up After Cesarean

After a cesarean delivery, it is important for mothers to have follow up care after discharge from the hospital.  Because a cesarean section is a surgical procedure, their care needs differ from those of mothers who deliver vaginally.  Prior to leaving the hospital, your nurses will remind you to schedule a postpartum check-up with your doctor.  This visit should occur  within two to four weeks of an uncomplicated  cesarean birth.  It is very important to keep your appointment so that any problems are detected and promptly addressed.   This check-up is to make sure your incision is healing well, and to assess your overall health.

At the first postpartum visit , your doctor will:

• Check to make sure your uterus is returning to its normal size
• Assess the healing of your incision
• Discuss pain management
• Discuss birth control options
• Screen for postpartum depression
• Ask how well you are adjusting to the many new changes in your life
• Ask about your support system as you recover and while caring for your baby
• Address any breastfeeding challenges
• Discuss ongoing management of any other health conditions (i.e. high blood pressure, thyroid problems).

During the visit, your doctor will do a pelvic and breast exam.  Your incision will be checked for any signs of infection, and to make sure it is healing properly.  Your blood pressure and weight will be recorded as well.  If there was a significant blood loss during the surgery, your doctor may order blood tests.

Depending on your health status, your doctor will determine the frequency of follow up visits .  For example, if your blood pressure is high, you may be asked to come in for blood pressure checks every few days until it has improved or is better controlled with medication.  If you develop a wound infection, you may need a follow up visit after completing a course of antibiotics.  For most women, however, the next visit will occur within one to three months.

Your first postpartum visit is a good time to ask questions.  It is a good idea to prepare a question list to bring with you to the appointment.  Here are some commonly asked questions:

• Has my incision healed as expected? • Can I try a vaginal birth next time? • How can I get relief from my hemorrhoids, varicose veins, or incisional pain? • What is the best type of birth control for me? • When can I drive? • When can I go back to work?

If you frequently feel sad or “down,” are unsure about which method of birth control to choose, or have difficulty caring for your newborn, discuss these concerns with your doctor.

Try to make the most of your first postpartum visit.   If possible, as your partner, a family member, or a baby-sitter take care of your baby during this visit.  By doing so,  you won’t feel “rushed,”  and receive answers to all of your questions.  It may also be nice to bring a picture of your beautiful new baby for your doctor can keep.

More About Self Care After Cesarean Birth

Introduction to Self-care After Cesarean Birth Preventive Self Care Perineal Care Physical Changes and Healing Vaginal Birth After Cesarean (VBAC) Breast Care Activities and Healthy Exercise Nutrition and Diet Family Planning and Birth Control Normal “Baby Blues” or Postpartum Depression Your Postpartum Check-Up Get as Much Rest as You Can When to Call Your Doctor

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Your postpartum checkups

A postpartum checkup is an important part of your medical care after you have a baby.

Postpartum care is important because new moms are at risk of serious and sometimes life-threatening health complications., get a complete postpartum checkup no later than 12 weeks after giving birth. during your visit, your provider will check to make sure you’re recovering well from labor and birth., if you had pregnancy complications or you have a chronic health condition, you may need extra postpartum checkups..

What is a postpartum checkup and why is it important?

A postpartum checkup is a medical checkup you get after having a baby to make sure you’re recovering well from labor and birth . In the United States, too many women experience serious and life-threatening health complications in the days and weeks after giving birth. Research shows that almost 40 percent of new moms miss their postpartum checkup. Even if you’re feeling fine, it’s important that you go to all your postpartum checkups. This allows you to share any concerns you have with your care team and allows them to look for warning signs of serious health problems, which can cause long-term health issues and even death, and provide treatment.

If you experienced a miscarriage , stillbirth , or your baby died , a postpartum checkup is especially important. A postpartum checkup may help your health care provider or other member of your care team, such as a genetic counselor, learn more about what happened and see if you may be at risk for the same condition in another pregnancy. A genetic counselor is a person who is trained to help you understand about genes, birth defects and other medical conditions that run in families, and how they can affect your health and your baby’s health.

What’s changed in postpartum care guidelines?

The American College of Obstetricians and Gynecologists (also called ACOG) has released new guidelines calling for changes to improve postpartum care for women. They now encourage that postpartum care be an ongoing process, rather than a one-time checkup and now recommend that all new moms: 

• Have contact with their health care provider within 3 weeks of giving birth
• Get ongoing medical care throughout the postpartum period, as needed
• Have a complete and full medical checkup no later than 12 weeks after giving birth

Many of the discomforts and body changes women have in the weeks after giving birth are normal. But sometimes they’re warning signs or symptoms of a health problem that needs treatment. Seeing your provider sooner and more often can help you and your provider spot these signs and symptoms and may help prevent serious medical problems. Your postpartum care should meet your personal needs so you get the best medical care and support.

What is a postpartum care plan?

A postpartum care plan is a plan that you and your health care provider make together. It helps you prepare for your medical care after giving birth. It’s best to make a postpartum care plan during pregnancy or at one of your prenatal care checkups. But if you didn’t get a chance to, it’s never too late. Your postpartum care plan should include:

• Contact information for your health care provider. How do you get in touch with your provider if you’re worried or have questions?
• The dates of all your postpartum checkups. Get in touch with your provider within 3 weeks of giving birth and schedule a complete checkup within 12 weeks of giving birth. Talk with your provider to make sure this timing is right for you. Find out if your health insurance plan covers all your postpartum checkups. Look at the company’s website or call the number on your insurance card.
• Health conditions or pregnancy complications that need treatment after you have your baby. Your provider can help you manage these conditions or may want to refer you to other providers who specialize in treating certain conditions.
• Common physical and emotional changes after pregnancy. What can you expect after giving birth? What’s normal and how do you know when something’s more serious? What are signs and symptoms of serious health conditions to look for after giving birth?
• Postpartum depression (also called PPD) and other mental health conditions after pregnancy. PPD is a kind of depression that some women get after having a baby. It’s strong feelings of sadness, anxiety (worry) and tiredness that last for a long time after giving birth. PPD is a medical condition that needs treatment to get better.
• Your reproductive life plan , including birth control. A reproductive life plan helps you think about if and when you want to have more children. For most women, it's best to wait at least 18 months (1½ years) between giving birth and getting pregnant again. Too little time between pregnancies increases your risk of preterm birth (birth before 37 weeks of pregnancy). Talk to your provider about the best birth control options for you. If you want to wait more than 18 months before getting pregnant again, talk to your provider about long-term reversible contraception, such as IUDs and implants. These types of birth control last for several years but can be stopped when you’re ready to get pregnant again.

What happens at a postpartum checkup?

Here’s what to expect at your postpartum checkup:

Physical exam

• Your provider checks your blood pressure, weight, breasts and belly. If you had a cesarean birth (also called c-section), your provider may want to see you about 2 weeks after you give birth to check on your c-section incision (cut to ensure you’re healing well and without any problems .
• You get a pelvic exam. Your provider checks your vagina (birth canal), uterus (womb) and cervix. If you had an episiotomy or a tear during birth, your provider checks to see that it’s healed. An episiotomy is a cut made at the opening of the vagina to help let the baby out. Your provider can tell you when it’s safe to have sex again.
• Your provider checks on any health conditions, like diabetes and high blood pressure , you had during pregnancy. For example, if you had gestational diabetes , your provider may give you a blood glucose test to check your blood sugar. If your provider prescribes any medication and you’re breastfeeding, be sure to tell your provider at your visit since some medicines can affect your breast milk.  
• Your provider makes sure your vaccinations are up to date, including vaccinations for flu and pertussis. By getting vaccinated, you can help keep from getting sick and passing an illness to your baby.

Problems you had during pregnancy, labor and birth that may affect your health after pregnancy. This is the time to talk about how you may be able to prevent problems in future pregnancies, even if you’re not thinking about having another baby now. For example, if you had a preterm birth, you’re at higher risk for having another preterm birth in the future. Talk to your provider about what you can do to reduce risk of preterm birth and other complications in your next pregnancy. Even if you don’t plan to have more children, ask your provider if any problems you had during pregnancy may affect your health later in life.  For example, if you had a preterm birth, gestational diabetes, gestational hypertension (high blood pressure) or a condition called preeclampsia , you may be at increased risk of cardiovascular disease (also called heart disease) in the long-term. Heart disease affects the heart and blood vessels and can lead to serious problems, like heart attack or stroke.

Feelings about being a new mom. Tell your provider about how things are going. It’s normal to feel tired and stressed in the weeks after birth. You may have questions about breastfeeding and caring for your baby. Tell your provider if you have feelings of sadness or worry that last for a long time—these can be signs of PPD.

What is a postpartum care team?

A postpartum care team is a group health care providers and other postpartum care experts who help you get medical care and support after you give birth. Members of your postpartum care team can include:

• Your prenatal care provider. 
• Your baby’s health care provider.
• A case manager or coordinator, such as a social worker.
• A doula or other perinatal birth worker.
• Lactation specialist or breastfeeding counselor.
• A licensed mental health counselor or mental health care provider.
• Health care providers who treat women with pregnancy complications or chronic health conditions.

If you have a chronic health condition, you may need to see other providers after pregnancy to treat those conditions. Chronic health conditions include:

• High blood pressure (also called hypertension) .  Uncontrolled high blood pressure can lead to heart, disease, kidney disease and stroke.
• Obesity . If you have an excess amount of body fat and your body mass index (also called BMI) was 30.0 or higher before pregnancy, you’re considered to have obesity. BMI is a measure of body fat based on your height and weight. To find out your BMI, go to www.cdc.gov/bmi . 
• Preexisting diabetes (type 1 or type 2 diabetes) . Uncontrolled diabetes can damage organs in your body, including blood vessels, nerves, eyes and kidneys.
• Thyroid conditions . The thyroid is a gland in your neck that makes hormones that help your body store and use energy from food. If it makes too little or too much of these hormones, you can have health problems.
• Kidney disease . If you have chronic kidney disease (also called CKD), your kidneys can’t filter blood like they should. This can cause waste to build up in your body. Untreated kidney disease can lead to kidney failure.
• Mood disorders . A mood disorder is a mental health condition that affects your emotions and needs treatment to get better. Depression (also called major depression or clinical depression) is an example of a mood disorder. It can cause feelings of sadness, and a loss of interest in things you like to do .

Last reviewed: September, 2023

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Your Pregnancy Matters

Beyond the six-week postpartum checkup: How health care after pregnancy is evolving

July 10, 2018

For many years, the six-week postpartum exam has been considered little more than a clearance for women to resume their pre-pregnancy lifestyles. Even after cesarean section (C-section), which is a major surgery, the six-week checkup carried a “see ya later” tone – you’ve recovered, so enjoy your baby and come back next year for your well-woman exam. 

However, the American Congress of Obstetricians and Gynecologists (ACOG) suggests that doctors and patients start thinking about postpartum care as an integral piece of medical care. ACOG’s Committee Opinion No. 736 from May 2018 emphasizes a topic I’ve addressed many times on this blog: Postpartum care is very important for women’s long-term health, and it is evolving.

The weeks after pregnancy should be viewed as a critical stage in a woman’s long-term health and an opportunity to promote and support overall healthy living. Rather than having women wait until the six-week checkup for postpartum care, the new guidelines suggest a cascade approach, with incremental visits based on a woman’s health. 

Whole-patient care after pregnancy

ACOG suggests that most patients begin postpartum care with a visit to an Ob/Gyn two to three weeks after delivery to follow up on physical recovery, emotional health, and any special needs that arose during pregnancy. Women who had  preeclampsia  (high blood pressure during pregnancy) might need a visit 72 hours to a week after leaving the hospital to reduce the risk of serious health complications. 

Then, around 12 weeks postpartum, ACOG suggests that patients have a comprehensive visit with an Ob/Gyn, including a physical exam and a discussion that extends deeper to include emotional wellness and future health considerations. Some of these discussion topics include:

● Care plans for ongoing conditions, such as hypertension or diabetes

● Connection with a primary care doctor

● Family planning, such as  birth control  and how long to wait between pregnancies

● Infant care, including feeding and how the patient is adjusting to motherhood

●  Mental health  in the weeks and months after delivery

● Self-care after pregnancy loss

● Sexuality and relationships at home

● Substance abuse, including  tobacco , alcohol, and other drugs

● Immunization status

Related reading:  The ‘fourth trimester’: Why women need health care after delivery

"Postpartum care is very important for women’s long-term health, and it is evolving." –Robyn Horsager-Boehrer, M.D.

Barriers to postpartum care

It’s important to note that as many as  40 percent of women do not have a postpartum visit . Some might think they don’t need care because they feel fine, while others are not connected to a health system or Ob/Gyn – for example, if a patient’s insurance healthcare coverage ended soon after they had their baby or they never had a relationship with a provider before delivery. Furthermore, some patients are compelled to put their baby’s health needs before their own. 

Many women also face geographic barriers to health care access. Getting to the Ob/Gyn can be inconvenient for women who live in rural areas or rely on public transportation. The ACOG opinion presents an opportunity for doctors and health systems to help patients overcome barriers. Postpartum care has growing potential for:

● Home visits

●  Telemedicine , such as video calls

● Phone calls or text messages for follow-up questions and depression screening

Additionally, not every patient has insurance coverage for a 12-week visit. As such, patients and doctors might consider advocating for changes at an insurance carrier level, such as Medicaid coverage; perhaps including the 12-week visit in the “package cost” of delivery; or considering it a standalone visit with a copay, which could be conducted by a primary care doctor who is well-versed in women’s health.

The notion that the postpartum visit signals the end of a patient/doctor relationship has become antiquated. Instead, postpartum care should be treated as an opportunity to optimize a woman’s health for years to come. The earlier we can have these discussions, the more we can empower women to seek care after their babies are born.

Stay on top of health care news.  Subscribe to our blog today.

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INTRODUCTION

A cesarean birth (also called a cesarean section or surgical birth) is a surgical procedure used to deliver a baby ( figure 1 ). Regional (or rarely general) anesthesia (spinal or epidural) is given to prevent pain, a vertical or horizontal ("bikini line") incision is made in the skin of the lower abdomen, and then the underlying tissues are dissected to expose the uterus. An incision is made in the uterus to allow removal of the baby and placenta. Other procedures, such as tubal ligation (a permanent birth control procedure), may also be performed during cesarean birth. (See "Patient education: Permanent birth control for females (Beyond the Basics)" .)

Some cesarean births are planned and scheduled before the onset of labor because of maternal or fetal conditions that warrant cesarean birth, while others are unplanned and performed during labor because of maternal or fetal problems that arise at that time. More than 30 percent of births in the United States occur by cesarean.

REASONS FOR CESAREAN BIRTH

Some women who intend to give birth vaginally will eventually require cesarean birth. The following list describes some (not all) reasons cesarean might be needed:

● Labor is not progressing as it should. This may occur if the contractions are too weak, the baby is too big, the pelvis is too small, or the baby is in an abnormal position. If a woman's labor does not progress normally, in many cases, she will be given a medication (Pitocin/oxytocin) to be sure that contractions are adequate for several hours. If labor still does not progress after several hours, a cesarean birth may be recommended.

● The baby's heart rate suggests that it is not tolerating labor well.

● Heavy vaginal bleeding. This can occur if the placenta separates from the uterus before the baby is born (called a placental abruption).

● A medical emergency threatens the life of the mother or baby. (See 'Emergency cesarean birth' below.)

PLANNING CESAREAN BIRTH

A planned cesarean birth is one that is recommended because of the increased risk(s) of a vaginal birth to the mother or infant. Cesarean births that are done because the woman wants, but does not require, a cesarean birth are called "maternal request" cesarean births. (See 'Cesarean birth on maternal request' below.)

There are a number of medical and obstetric circumstances where a health care provider might recommend scheduling a cesarean birth in advance. Some (not all) of these circumstances are listed below:

● The baby is in a transverse (sideways) or breech position (buttocks first).

● The placenta is covering the cervix (called placenta previa; cesarean is always recommended for women with placenta previa).

● The mother has had a previous cesarean birth or other surgery in which the uterus was cut open. A vaginal birth is possible after cesarean birth in some, but not all cases. (See 'Future births' below.)

● There is some mechanical obstruction that might prevent or complicate vaginal birth, such as large fibroids or a pelvic fracture.

● The baby is unusually large, especially if the mother has diabetes. (See "Patient education: Care during pregnancy for patients with type 1 or 2 diabetes (Beyond the Basics)" .)

● The mother has an active infection, such as herpes or HIV, that could be transmitted to the baby during vaginal birth. (See "Patient education: Genital herpes (Beyond the Basics)" and "Patient education: HIV and pregnancy (Beyond the Basics)" .)

● The birth involves multiple gestation (twins, triplets, or more).

● The woman has cervical cancer.

● The baby has an increased risk of bleeding.

There is some controversy about the preferred route of birth in certain situations. These include some congenital anomalies, such as spina bifida and abdominal wall defects, and some maternal medical problems.

One of the most important factors in scheduling a cesarean birth is making certain that the baby is ready to be born. In general, repeat cesarean births in otherwise uncomplicated singleton pregnancies are not scheduled before the 39 th week of pregnancy. There are other situations where the cesarean is scheduled before 39 weeks.

Most women will meet with an anesthesiologist before planned surgery to discuss the various types of anesthesia available and the risks and benefits of each. Instructions about how to prepare for surgery will also be given, including the need to avoid all food and drinks for at least two and often for several hours before the surgery.

Advantages of planned cesarean  —  The advantages of a planned cesarean birth include:

● It allows parents to know exactly when the baby will be born, which makes issues related to work, childcare, and help at home easier to address.

● It minimizes some of the possible complications and risks to the mother and baby from labor.

● It helps ensure that a pregnant woman's obstetrician will be available for the birth.

● It may offer a more controlled and relaxed atmosphere, with fewer unknowns such as how long labor and birth will last.

The benefits of planned cesarean birth must be weighed against the risks. Cesarean birth is a major surgery, and has associated risks.

Maternal risks  —  Because cesarean birth involves major surgery and anesthesia, there are some disadvantages compared with vaginal birth.

● Cesarean birth is associated with a higher rate of injury to abdominal organs (bladder, bowel, blood vessels), infections (wound, uterus, urinary tract), and thromboembolic (blood clotting) complications than vaginal birth.

● Cesarean surgery can interfere with mother-baby interaction in the birthing room.

● Recovery takes longer than with vaginal birth.

● Cesarean birth is associated with a higher risk that the placenta will attach to the uterus abnormally in subsequent pregnancies, which can lead to serious complications.

● Cutting the uterus to deliver the baby weakens the uterus, increasing the risk of uterine rupture in future pregnancy. This risk is small and depends upon the type of uterine incision.

Infant risks  —  There are few risks of cesarean birth for the baby.

● One risk is birth trauma, which is rare.

● Temporary respiratory problems are more common after cesarean birth because the baby is not squeezed through the mother's birth canal. This reduces the reabsorption of fluid in the baby's lungs.

● The baby is not exposed to the normal bacteria in the mother's vagina, which may be important because exposure to this bacteria appears to be beneficial in several ways.

Potential complications  —  The most common complications related to cesarean birth include infection, hemorrhage (excessive bleeding), injury to pelvic organs, and blood clots.

● Infection – The risk of postoperative uterine infection (endometritis) varies according to several factors, such as whether labor had started and whether the fetal membranes have ruptured. Endometritis is treated with antibiotics.

Wound infection, if it occurs, usually develops four to seven days after surgery, but sometimes appears during the first day or two. In addition to antibiotics, wound infections are sometimes treated by opening the wound to allow drainage and removing infected tissue if needed.

● Hemorrhage – One to two percent of all women having cesarean births require a blood transfusion because of hemorrhage (excessive bleeding). Hemorrhage usually responds to medications that cause the uterus to contract or procedures to stop the bleeding. In rare cases, when all other measures fail to stop bleeding, a hysterectomy (surgical removal of the uterus) may be required.

● Injury to pelvic organs – Injuries to the bladder or intestinal tract occur in approximately one percent of cesarean births.

● Blood clots – Women are at increased risk of developing blood clots in the legs (deep vein thrombosis or DVT) or the lungs (pulmonary embolus) during pregnancy and especially the postpartum period. This risk is further increased after cesarean birth. The risk can be reduced by using a device that gently squeezes the legs during and after surgery, called an intermittent compression device. Women at high risk of DVT may be given an anticoagulant (blood thinning) medication to reduce the risk of blood clots.

CESAREAN BIRTH ON MATERNAL REQUEST

The concept of requesting a cesarean birth is relatively recent. In the United States and most Western countries, pregnant women have the right to make choices regarding treatment, including how they will give birth.

A woman who wants to request a cesarean birth should discuss this decision with the health care provider, who can provide information about each route of birth and can help to relieve common fears about pain during childbirth, the expected process of labor, as well as the woman's right to determine the route of birth. (See 'Maternal risks' above.)

Regardless of a woman's decision, it is possible to reconsider the decision at any time based upon a change in circumstances.

EMERGENCY CESAREAN BIRTH

In some cases, cesarean birth is performed as an emergency surgery during labor. Time may be of the essence, depending on the situation. Cesarean births performed due to concerns about the mother's or baby's health are generally started as quickly as possible.

By contrast, if a cesarean is performed because labor has not progressed normally or for other, less serious concerns about the baby's well-being, the surgery is usually begun within 30 to 60 minutes.

If an epidural was placed before the attempted vaginal birth, it usually can be used to administer anesthesia for the cesarean birth (a larger dose is necessary for cesarean versus vaginal birth). Otherwise, spinal anesthesia (or rarely general anesthesia) is given. (See 'Anesthesia' below.)

After being admitted to the hospital for a planned cesarean birth, a woman may be given an oral dose of an antacid to reduce the acidity of the stomach contents. Another medication may be given to reduce the secretions in the mouth and nose. An intravenous (IV) line will be placed into the hand or arm, and an electrolyte solution will be infused. An antibiotic will be given through the IV to help prevent a postoperative infection. Monitors will be placed to keep track of blood pressure, fetal heart rate, and maternal blood oxygen levels.

Anesthesia  —  The woman is usually accompanied to an operating room before anesthesia is administered. A partner can usually stay with her in the operating room.

There are two types of anesthesia used during cesarean birth: regional and less commonly, general. For a planned cesarean birth, regional anesthesia is usually performed. Meeting with the anesthesiologist allows the woman to ask specific questions about anesthesia, and allows the anesthesiologist to identify any medical problems that might affect the type of anesthesia that is recommended.

With epidural and spinal regional anesthesia, the anesthetic is injected near the spine, which numbs the abdomen and legs to allow the surgery to be pain-free while allowing the mother to be awake.

General anesthesia, now infrequently used for cesarean, induces unconsciousness. This means that the mother will not be awake or aware during the procedure. After the anesthesia is given, the woman will fall asleep within 10 to 20 seconds and a tube will be placed in the throat to assist with breathing. General anesthesia carries a greater risk of complications than epidural or regional anesthesia because of the need for an endotracheal (breathing) tube and because drugs given to the mother affect the baby.

Women who have general anesthesia will not be awake during the cesarean birth. Regional anesthesia is generally preferred because it allows the mother to remain awake during the procedure, enjoy support from staff and her partner, experience the birth, and have immediate contact with the baby. It is usually safer than general anesthesia.

After the anesthesia is given, a catheter is placed in the bladder to allow urine to drain out during the surgery and reduce the chance of injury to the bladder. The catheter is usually removed within 24 hours after the procedure.

Skin incision  —  There are two basic types of incision: horizontal (transverse or "bikini line") and vertical (midline). Most women have a transverse skin incision, which is made 1 to 2 inches above the pubic hair line. The advantages of this type of incision include less postoperative pain, more rapid healing, and a lower chance that the wound will separate during healing.

Less commonly, the woman will have a vertical ("up and down") skin incision in the midline of the abdomen. The advantages of this type of incision include a slightly more rapid access to the uterus (eg, if the baby is in distress or if the woman is bleeding excessively).

Uterine incision  —  The uterine incision can also be either transverse or vertical. The type of incision depends upon several factors, including the position and size of the baby, the location of the placenta, and the presence and location of any fibroids. The main consideration is that the incision must be large enough to allow birth of the baby without causing trauma.

The most common uterine incision is transverse. However, a vertical incision may be required if the baby is breech or sideways, if the placenta is in the lower front of the uterus, or if there are other abnormalities of the uterus.

After opening the uterus, the baby is usually removed within seconds. After the baby is born, the umbilical cord is clamped and cut and the placenta is removed. The uterus is then closed. The abdominal skin is usually closed with absorbable sutures (ie, absorbed by the body so they do not need to be removed).

After the mother and baby are stable, she and her partner may hold the baby.

POSTOPERATIVE CARE

After surgery is completed, the woman will be monitored in a recovery area. Pain medication is given, initially through the IV line, and later with oral medications.

When the effects of anesthesia have worn off, generally within one to three hours after surgery, the woman is transferred to a postpartum room and encouraged to move around and begin to drink fluids and eat food.

Breastfeeding can usually begin any time after the birth. A pediatrician will examine the baby within the first 24 hours of the delivery. Most women are able to go home within a few days after giving birth. (See "Patient education: Deciding to breastfeed (Beyond the Basics)" .)

The abdominal incision will heal over the next few weeks. During this time, there may be mild cramping, light bleeding or vaginal discharge, incisional pain, and numbness in the skin around the incision site. Most women will feel well by six weeks postpartum, but numbness around the incision and occasional aches and pains can last for several months.

After going home, the woman should notify the health care provider if she develops a fever (temperature greater than 100.4°F [38°C]), if pain or bleeding worsens, or if there are other concerns (eg, severe headache, abdominal pain, difficulty breathing).

FUTURE BIRTHS

Previously, obstetricians recommended that all women who had a cesarean birth have the same for all future birth. However, this is no longer the case. Many women in the United States who have had one low transverse cesarean birth choose to have a repeat cesarean birth, although these women could try to have a vaginal birth with the next pregnancy. Between 60 and 80 percent of women who try to give birth vaginally after a C-section are successful in giving birth vaginally. However, women who have a vaginal birth after cesarean (VBAC) have a less than 1 percent chance that the uterus will rupture during labor or birth, which could affect the baby's health [ 1 ].

WHERE TO GET MORE INFORMATION

Your health care provider is the best source of information for questions and concerns related to your medical problem.

This article will be updated as needed on our web site ( www.uptodate.com/patients ). Related topics for patients, as well as selected articles written for health care professionals, are also available. Some of the most relevant are listed below.

Patient level information  —  UpToDate offers two types of patient education materials.

The Basics  —  The Basics patient education pieces answer the four or five key questions a patient might have about a given condition. These articles are best for patients who want a general overview and who prefer short, easy-to-read materials.

Patient education: Cesarean birth (The Basics) Patient education: Anesthesia for cesarean birth (The Basics) Patient education: When your baby is overdue (The Basics) Patient education: Care during pregnancy for people with type 1 or type 2 diabetes (The Basics) Patient education: Labor and childbirth (The Basics) Patient education: Postpartum hemorrhage (The Basics) Patient education: Placenta previa (The Basics) Patient education: Shoulder dystocia (The Basics) Patient education: Vaginal birth after a cesarean (The Basics) Patient education: Having twins (The Basics) Patient education: Spina bifida (The Basics) Patient education: Breech pregnancy (The Basics)

Beyond the Basics  —  Beyond the Basics patient education pieces are longer, more sophisticated, and more detailed. These articles are best for patients who want in-depth information and are comfortable with some medical jargon.

Patient education: Permanent birth control for females (Beyond the Basics) Patient education: Care during pregnancy for patients with type 1 or 2 diabetes (Beyond the Basics) Patient education: Genital herpes (Beyond the Basics) Patient education: HIV and pregnancy (Beyond the Basics) Patient education: Deciding to breastfeed (Beyond the Basics)

Professional level information  —  Professional level articles are designed to keep doctors and other health professionals up-to-date on the latest medical findings. These articles are thorough, long, and complex, and they contain multiple references to the research on which they are based. Professional level articles are best for people who are comfortable with a lot of medical terminology and who want to read the same materials their doctors are reading.

Anesthesia for cesarean delivery Cesarean birth: Overview of issues for patients with obesity Cesarean birth on patient request Cervical ripening and induction of labor after a prior cesarean birth Repeat cesarean birth

The following organizations also provide reliable health information.

● National Library of Medicine

( https://medlineplus.gov/ency/article/002911.htm , available in Spanish)

● The American College of Obstetricians and Gynecologists

( www.acog.org/Patients )

• ACOG Practice Bulletin #54: vaginal birth after previous cesarean. Obstet Gynecol 2004; 104:203.
• Berghella V, Baxter JK, Chauhan SP. Evidence-based surgery for cesarean delivery. Am J Obstet Gynecol 2005; 193:1607.
• James D. Caesarean section for fetal distress. BMJ 2001; 322:1316.
• American College of Obstetricians and Gynecologists. ACOG Committee Opinion No. 394, December 2007. Cesarean delivery on maternal request. Obstet Gynecol 2007; 110:1501.
• Minkoff H, Powderly KR, Chervenak F, McCullough LB. Ethical dimensions of elective primary cesarean delivery. Obstet Gynecol 2004; 103:387.

• Health & Wellness

What to Expect at Your Postpartum Checkups

During pregnancy, you likely got used to seeing your OB or midwife fairly often, especially as you neared your due date. Consistent visits are a standard part of prenatal care to ensure everything is progressing smoothly and that you and baby are healthy. So what happens now that baby is born? In the past, prenatal care has been far more thorough than postpartum care, but in recent years experts have called for a change. Giving birth is no small feat—it takes both a physical and emotional toll, and new moms need medical care and support, starting with their first postpartum checkup. Here, we talked to two experts to lay out everything you need to know about postpartum checkups, from when to expect them to how to prepare.

What Is a Postpartum Checkup?

Postpartum checkups are the visits to your OB or midwife that you’ll have after giving birth—and they’re just as important as your prenatal visits, as the first few weeks after delivery are a time of major transition for both you and baby.

During these checkups, your doctor will want to make sure you’re adapting well emotionally and recovering well physically. “Issues with blood pressure, infections, breastfeeding issues and hormonal imbalances can all happen postpartum,” says Rebekah Mustaleski , a certified professional midwife and compression director with Motif Medical . “It’s often hard to recognize the subtle differences that signal some of these issues because a new parent is consumed with caring for their newborn. It’s essential to be seen by your doctor or midwife so that they can do an assessment and make sure that your postpartum recovery is going smoothly.”

When Do Postpartum Checkups Happen?

It used to be that you’d have one postpartum checkup, typically six weeks after giving birth or sooner if you delivered via c-section. However, in recent years, experts have called for postpartum checkups to happen sooner and more frequently. The American College of Obstetricians and Gynecologists (ACOG) now recommends that postpartum care start no later than within the first three weeks after birth and should be followed by ongoing care as needed. “To optimize the health of women and infants, postpartum care should become an ongoing process, rather than a single encounter, with services and support tailored to each woman’s individual needs,” the guidance reads. Plus, the ACOG states women should receive a comprehensive postpartum checkup that includes “a full assessment of physical, social and psychological well-being” no later than 12 weeks postpartum.

According to Mustaleski, most providers schedule postpartum checkups the day after birth (where they’ll come see you bedside as you recover), two to three weeks postpartum and then again at six to eight weeks postpartum.

What Happens During Postpartum Checkups?

The postpartum checkups are a time to discuss how you’re healing and adapting to motherhood. During the visit, your doctor will check on several aspects of your physical and emotional recovery. According to the ACOG, it will also cover infant care and feeding, family planning, sleep and fatigue, chronic disease management and health maintenance.

“I usually talk to my patients about how the pregnancy and delivery went," says Laura Riley , MD, department chair of obstetrics and gynecology at Weill Cornell Medicine. She also asks how infant feeding is going, whether Mom has any questions about returning to work and when is a good time to resume exercise…

Postpartum checkups: Physical recovery

During the physical checkup, your doctor or midwife will check your vitals, assess your weight and take your blood pressure. According to Mustaleski and Riley, they’ll also:

• Check your breasts for lumps and abnormal discharge
• If you’re breastfeeding, make sure your ducts aren’t clogged and you don’t have an infection
• Look at your abdomen for returning muscle tone
• Do a pelvic exam to see if your uterus is returning to its normal pre-pregnancy size and that the cervix is closed
• For c-section deliveries, make sure the incision is healing well and has no signs of infection
• Check how well any episiotomy or laceration has healed
• Administer any lab tests they think are necessary (such as a blood count if you lost a lot of blood during birth)
• Ask about your postpartum bleeding
• Ask about your pelvic floor recovery and refer you to a pelvic floor physical therapist, if needed If you’re having excessive pain, bleeding or problems with an incision, definitely tell your doctor, Riley says.

Postpartum checkups: Family planning

Another big item to cover during your postpartum checkups is birth control options . According to Riley, risk of complications in any subsequent pregnancy goes down if you wait at least 12 months after giving birth to conceive again. (The ACOG recommends ideally waiting at least 18 months.) Just because you’re breastfeeding and not menstruating yet doesn’t mean you can’t get pregnant . (After all, you ovulate before your first postpartum period arrives!) Your provider should discuss when you can safely start having sex again and talk you through your family planning options.

“It may seem like it’s too soon for that discussion, but some people do show up to their six-week postpartum appointment and find out they’re pregnant again!” Mustaleski explains, adding, “At your six- to eight-week postpartum appointment, many providers will do a Pap smear, if you’re due to have one done.”

Postpartum checkups: Emotional recovery

While physical recovery is certainly important, your doctor will also want to check in on how you’re coping with the transition to motherhood. During the visit, expect to answer questions about your mood, sleeping patterns and other aspects of your emotional well-being.

One big thing providers look for are signs of postpartum depression , which up to 15 percent of women experience, according to the American Pregnancy Association . The most common assessment is the Edinburgh Postnatal Depression Scale. “It’s a series of 10 questions that gives your doctor or midwife an overview of how you’re doing emotionally over the last seven days,” Mustaleski says. “If your score indicates that you’re experiencing postpartum depression, your doctor or midwife will discuss treatment options with you to help you start feeling your best as soon as possible.”

How to Prepare for a Postpartum Checkup

When you’re exhausted and sore, getting yourself out of the house for a postpartum checkup may seem daunting—but remember, these critical visits are set up to ensure your health and well-being.

Since this post-pregnancy stuff is completely new to you—the aches, the pains, the emotions—be sure to track and flag any symptoms you’re worried about, and write down all your questions beforehand. “Most new parents are functioning on minimal sleep, so attempting to recall your questions in the moment is difficult,” Mustaleski says. Her advice? Start a list on your phone that you can easily bring with you to the appointment. Your questions might touch on the topics mentioned above, plus:

• How your delivery went
• Baby’s safety
• Physical activity and exercise goals
• Breastfeeding or formula-feeding
• Returning to pre-pregnancy activities
• Body changes or new pains (pay attention to worsening pressure in your vagina, difficulty with bowel movement and inability to fully empty your bladder, Mustaleski says)

Make sure to also note any additional support you feel you need, such as a lactation consultant, pelvic floor therapist, mental health therapist or other professional.

As you prepare for a postpartum checkup, remember to also plan for childcare. Due to COVID-19, some offices may not be allowing baby to come with you. It’s always best to call ahead and ask about the office’s policies. “Many midwives will do a well-baby check up at the same time as your postpartum visit, so you can also ask if that is an option with your provider,” Mustaleski says. If you do end up bringing baby to the appointment, remember to pack a change of clothes, diapers, wipes, burp cloths, pacifiers (if baby is using them) and an extra bottle if baby’s not breastfeeding.

Postpartum checkups can be a lot to take in, but they’re ultimately designed to support you. Come prepared with any and all questions! “The postpartum is a time of in-between—you aren’t pregnant anymore, but you aren’t back to your everyday life,” Mustaleski says. “If you have questions about what is okay or safe for you to do during that transition, ask your provider to give you guidance on how to safely help your body recover.”

About the experts:

Laura Riley , MD, is a board-certified obstetrician who specializes in high risk pregnancies. She serves as the department chair of obstetrics and gynecology at Weill Cornell Medicine , as well as the obstetrician and gynecologist-in-chief at NewYork-Presbyterian/Weill Cornell Medical Center, based in New York City. She received her medical degree and completed her residency at the University of Pittsburgh School of Medicine.

Rebekah Mustaleski , CPM-TN, IBCLC, is a certified professional midwife specializing in evidence-based maternity care. She cofounded Roots & Wings Midwifery in Knoxville, Tennessee. Mustaleski received her bachelor’s degree in psychology from Centre College and worked as a doula and birth photographer prior to establishing Roots & Wings.

Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such. You should always consult with a qualified physician or health professional about your specific circumstances.

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C-section recovery: Timeline, aftercare tips, and expectations

C-section recovery time varies, but there are week-by-week milestones to look forward to. Find out how you'll feel after a C-section, and what to expect. 

Week-by-week C-section recovery timeline

C-section recovery tips, when to call the doctor after a c-section.

After a C-section , you'll probably feel both delighted and overwhelmed by the new baby in your arms. You'll also be recovering from major abdominal surgery while dealing with typical postpartum issues such as engorged breasts , mood swings, and postpartum bleeding .

C-section patients typically stay in the hospital for two to four days before going home. But your full recovery will be measured in weeks, not days. Be patient and gentle with yourself as you transition into motherhood and recover from surgery. You'll be able to do some things quickly, like breastfeeding and walking. Other activities, like moderate exercise , may not be possible for six to eight weeks after the surgery.

Day of a C-section

• Whether you had a scheduled or unscheduled C-section, you should be able hold your baby right away. Some moms even feel up to having skin-to-skin contact in the operating room as the doctor is finishing the surgery.
• Breastfeeding (if you're planning to) is encouraged shortly after delivery. Most C-section moms start breastfeeding in the recovery room.
• It's normal to feel groggy immediately after delivery and in the first few hours after your surgery, especially if you had a long labor leading up to your cesarean section.
• You'll receive IV fluids until you can eat and drink. You'll probably have a light meal and drink within six to eight hours. By the next morning, you'll likely be back to your normal diet.
• Most women have either an epidural or spinal medication given for their anesthesia. In addition to the anesthetic that makes you comfortable for the surgery, your anesthesiologist will probably give you a long-acting medication that will keep you comfortable for 18 to 24 hours following the C-section. (Women who have general anesthesia don't receive this medication, and so will require more IV narcotics for pain management.)
• With the assistance of your nurse, it's a good idea to get out of bed and walk around a bit within 12 hours. This will help you recover more quickly and decrease the risk of blood clots. It also helps with postpartum constipation , which is common.

One day after a C-section

• Your incision will be sore, and your pain may increase as your anesthesia wears off. You'll receive pain medication as needed. Toradol is a non-narcotic medication that's given 24 to 48 hours after surgery through your IV. It's an anti-inflammatory medication that will help with both pain and healing.
• When your IV is removed, your provider will recommend oral pain medication, such as ibuprofen or acetaminophen (Tylenol), as needed. These medications are safe to take while breastfeeding . If these options don't provide enough pain control, talk to your care team about adding a stronger, opioid medication.
• If you have a bandage over your incision, it may be removed today or tomorrow. Steri-Strips (small, sticky bandages) will be used in its place. Some surgeons use surgical glue to close the incision, so there are no bandages.
• Your Foley catheter (in your bladder) will be removed 18 to 24 hours after your surgery. (Your sensation of the need to pee usually returns within six hours. In some instances, your bladder needs more time to recover and the catheter needs to be replaced for another day.)
• You'll probably have some postpartum cramping , called afterpains (especially during breastfeeding), as your uterus returns to its normal size. This occurs for all women after delivery ( vaginal birth or cesarean), and is unfortunately worse the more deliveries you've had.
• You may also have constipation and gas pains, and they may be severe – sometimes even worse than your surgical pains. Ask your provider about anti-gas medication and a stool softener, to get things moving and make it easier when you do have a first postpartum poop . Research also shows that a little coffee, starting the day after a C-section, can help.
• Your vaginal blood flow (called lochia) should be slowing, but you'll have some bleeding and/or discharge for four to six weeks. Women who deliver via C-section tend to have much less vaginal bleeding (that lasts for less time) compared to women who deliver vaginally.
• It's okay to take a shower today! The soapy water will be good for cleansing your incision, but don't scrub it. Rinse and fully dry the incision, especially if you have flesh that falls over it, as this can trap moisture, water, and sweat. Pat the incision completely dry with a clean towel and/or use a hair dryer on a low heat setting.

Two days after a C-section

• Your pain should be decreasing, but your incision will still be tender for weeks. It's normal for it to feel tingly and numb, too.
• You're eating more solid foods now (or maybe you worked your way up to them yesterday) and getting back to your normal diet. It's okay to not have had a bowel movement, but hopefully you've at least passed gas by now. Continue with your stool softeners, at least until your bowel movements are soft and regular.
• If you have staples over your incision, your healthcare provider will remove them before you go home. (Stitches will dissolve on their own.)
• You should be able to lift your baby now.

One week after a C-section

• Your stitches will start to dissolve about one to two weeks after the surgery. They're under your skin, so you won't see them, and they don't need to be removed. If you have Steri-Strips covering the incision, keep them on for about 10 to 14 days, and then you can peel them off.
• Any gas pains should be over by now, as your bowels are back to functioning normally. You may need to continue stool softeners for up to four to six weeks, so keep a bottle on hand.
• You probably don't need to take pain medication anymore. (Some women don't need any after the first few days.)

Two weeks after a C-section

• You're probably feeling much better! You might enjoy some light exercise such as yoga or walking. But don't push your body too hard, as you're still recovering.
• You may be able to drive a car now, as long as you're not taking narcotic pain medication or still feeling weak. Make sure to wear your seat belt.
• You can peel off any remaining Steri-Strips. If you have surgical glue, you can use a warm wash cloth to scrub the remaining glue off your skin.
• Doctors have different recommendations to address scarring, so ask your doctor what they suggest. Read our article on C-section scars for a good overview.

Four weeks after a C-section

Your abdomen should be healed by now, and your bleeding has tapered off. Any tenderness may be gone. You're probably moving more comfortably and are able to be more active.

Six weeks to eight weeks after a C-section

• Your uterus is contracted to its normal size. (Your abdominal muscles are still weak, though, so your postpartum belly will likely still look bigger.)
• You can probably resume most of your regular activities: sex (talk with your provider about contraception); all types of exercise; baths; and even returning to work , if that's in your plan.

Two-plus months after a C-section

After two months, your body should be fully healed and recovered from your delivery, so if you're still having any concerning symptoms, reach out to your doctor.

"This does not mean, by any means, that you're back to the same person you were prior to your pregnancy," says Shannon Smith Opens a new window , an ob-gyn at Brigham Faulkner Ob/Gyn Associates in Boston. "Our bodies will unavoidably change from both carrying a pregnancy and from whatever type of delivery we have that brings our little ones into the world."

You may still have some tingling and numbness around your incision. This can take months to years to go away, as the little nerves in the skin take a long time to heal. There's nothing to do to expedite the process, but it's perfectly normal.

Many postpartum women experience abdominal diastasis (a vertical bulge in the abdomen) and pelvic floor dysfunction . This is the time to reach out to a pelvic floor physical therapist to help aid your recovery. (Your healthcare provider may be able to refer you to one, or you can use The Academy of the American Physical Therapy Association's PT Locator Opens a new window tool to help find a therapist in your area.)

Finally, with all the changes that occur in your body after delivery, don't forget the effects on your mental health. If you have any concerns at any point during your recovery, reach out to your provider.

Read more about the baby blues and postpartum depression .

Here's what to do once you get home to help speed your healing and C-section recovery time:

• Ask for help. You'll need help once you get home. Ask for support from your partner, parents, in-laws, and friends – or hire paid help if you can. Give people concrete jobs so they can best support you. It's important that you get rest while you're healing and caring for your newborn . Limit visitors, and prioritize those who will provide practical help, such as making meals, doing dishes, and doing laundry.
• Manage your pain. You'll likely be given prescriptions for more painkillers and a stool softener before you leave the hospital. And for incision pain, your doctor may prescribe a lidocaine patch. To reduce your need for prescription painkillers, take over-the-counter medications such as ibuprofen or acetaminophen around the clock. Some women need prescription painkillers for up to a week after surgery, gradually transitioning to only over-the-counter pain relievers. Most pain-relief medications are safe for breastfeeding moms, but ask your doctor if you have questions. You may also find that a heating pad or an ice pack helps relieve pain.
• Choose a breastfeeding position that doesn't put pressure on your incision. The football hold and side-lying position are two good options. A firm breastfeeding pillow can also help avoid incision pain.
• Avoid constipation: There are many reasons for constipation after a C-section, including the effects of pain medication and being less active. Make sure to take your stool softener and drink plenty of fluids. If you're breastfeeding or pumping, get in the habit of drinking a full glass of water each time you sit down to breastfeed or pump.
• Walk. Walking promotes healing and helps prevent complications such as blood clots. Start slowly and increase your activity gradually. In six weeks, you'll be able to start exercising moderately – but wait until your caregiver gives you the go-ahead.
• Consider an abdominal binder: Some experts recommend wearing a belly wrap , called an abdominal binder, to help reduce pain immediately following a C-section. These binders are available at drugstores and online and are often provided by hospitals. They stabilize the area around your incision to reduce pain with movement. Talk with your provider or hospital staff if you have questions about how to use one.
• Don't overdo it: Avoid strenuous tasks or lifting anything heavier than your baby in their carrier for up to six weeks. Stairs are safe and pose no danger to your incision, but if they bother you, try to keep going up and down to a minimum. Keep in mind that some things that are usually easy for you might now be difficult. Listen to your body and stop if something feels uncomfortable.
• Eat well: Good, nutritious food – including plenty of fruits, vegetables, and whole grains – will help you heal and avoid constipation. Continue to take your prenatal vitamin , as well as iron supplements if your caregiver recommends them.
• Hold off on sex and tampons: To prevent infection, don't put anything in your vagina until you get the go-ahead from your provider. Once you get the okay on sex, you'll need to have a plan for contraception.
• Avoid baths and swimming at first: Also to prevent infection, don't submerge yourself in water (in the bathtub, a hot tub, or a swimming pool, for example) until you have the okay from your caregiver, usually in about six weeks.
• Go slow on driving: Don't drive if you're taking prescription pain medication. You'll be ready to drive when you're done taking prescription painkillers and when you don't experience pain from the motions of driving (turning to check your blind spot, stepping on the brake pedal, and steering, for example). Ask your doctor for guidelines, but most C-section moms are ready to drive by week two or three post-surgery.
• Wait on going back to work: Typically, it takes six to eight weeks or more for moms to be ready to return to work after a C-section. If you have maternity leave, take full advantage of it. Give yourself time to physically and emotionally heal. Talk to your doctor about specific concerns and familiarize yourself with state laws regarding maternity leave and breastfeeding at work .

You may see your doctor for an incision check one to two weeks after leaving the hospital, and you'll have a complete postpartum checkup around six weeks after delivery. In the meantime, call your caregiver if you have signs of an infection , including:

• Warmth, redness, swelling, draining, or oozing at the incision site
• Worsening pain or sudden onset of abdominal pain
• Any fever (even if your incision looks fine) or chills
• Foul-smelling vaginal discharge
• Pain or burning when urinating, the urge to pee frequently when not a lot comes out, or urine that is dark and scanty or bloody

Also call your provider immediately if you have:

• Heavy bleeding (if you soak two pads an hour for two hours straight, for example)
• Pain that's not controlled with your pain medication
• Severe or persistent pain or tenderness and warmth in one area of your leg, or one leg that's more swollen than the other
• Pain in one or both breasts, especially if accompanied by a fever or flu-like symptoms
• Trouble breathing or chest pain
• Severe headache that doesn't respond to pain medication or comes back immediately after the medication wears off
• Swelling in your hands, face, or eyes, or sudden weight gain (more than two pounds in a week)
• Vision changes (blurriness, seeing flashing lights or spots, sensitivity to light)
• Flu-like body aches and pains
• Thoughts of hurting yourself or your baby, or if you feel incapable of caring for your newborn

For more information on possible medical problems in the weeks after delivery, see our article on postpartum warning signs .

Learn more:

• Your most common postpartum recovery questions, answered
• Postpartum fatigue
• When will I get my first period after birth?
• The healthy way to lose weight after pregnancy

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C-section scars, healing, and incision care

Postpartum swelling (edema)

When can I start working out after a c-section?

What to know about diastasis recti

BabyCenter's editorial team is committed to providing the most helpful and trustworthy pregnancy and parenting information in the world. When creating and updating content, we rely on credible sources: respected health organizations, professional groups of doctors and other experts, and published studies in peer-reviewed journals. We believe you should always know the source of the information you're seeing. Learn more about our editorial and medical review policies .

ACOG. 2022. Cesarean birth. The American College of Obstetricians and Gynecologists. https://www.acog.org/womens-health/faqs/cesarean-birth Opens a new window [Accessed March 2023]

ACOG. 2021. Optimizing postpartum care. Committee Opinion Number 736. The American College of Obstetricians and Gynecologists. https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2018/05/optimizing-postpartum-care Opens a new window [Accessed March 2023]

ACOG. 2022. Postpartum pain management. The American College of Obstetricians and Gynecologists. https://www.acog.org/womens-health/faqs/postpartum-pain-management Opens a new window [Accessed March 2023]

March of Dimes. 2018. Having a c-section. https://www.marchofdimes.org/find-support/topics/birth/having-c-section Opens a new window [Accessed March 2023]

Mayo Clinic. 2020. C-section recovery: What to expect. https://www.mayoclinic.org/healthy-lifestyle/labor-and-delivery/in-depth/c-section-recovery/art-20047310 Opens a new window [Accessed March 2023]

MedlinePlus. 2022. After a c-section – in the hospital. https://medlineplus.gov/ency/patientinstructions/000620.htm Opens a new window [Accessed March 2023]

MedlinePlus. 2022. Going home after a c-section. U.S. National Library of Medicine. https://medlineplus.gov/ency/patientinstructions/000624.htm Opens a new window [Accessed March 2023]

Nemours. 2022. Cesarean sections (C-Sections). KidsHealth. https://kidshealth.org/en/parents/c-sections.html Opens a new window [Accessed March 2023]

Zamanabadi MN et al. 2021. Effect of caffeine on postoperative bowel movement and defecation after cesarean section. Annals of Medicine & Surgery 68. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8358636/ Opens a new window [Accessed March 2023]

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What to Expect at Your Postpartum Exams

In the weeks after having a baby, you'll need another exam. Here's what to expect and why your first postpartum checkup is just as important as your newborn's.

When Should I Schedule Postpartum Exams?

What happens at your postpartum checkup, getting back to normal after birth, what to ask during postpartum exams, reasons to get to the doctor earlier.

After spending nine months in and out of doctors' offices, ultrasound rooms, and, finally, the hospital, you may be sick of donning that ubiquitous blue gown. But experts agree you definitely shouldn't miss your postpartum checkups . While giving birth may be a normal process, some people may experience a few health aftershocks , physical and/or mental , and it's important that they be examined and treated promptly.

"Now that you have a baby to take care of, you need to take even better care of yourself," says Judith Reichman, MD, a gynecologist at Cedars-Sinai Medical Center in Los Angeles and the author of Relax, This Won't Hurt: Painless Answers to Women's Most Pressing Health Questions .

The consequences of skipping your postpartum appointments can be serious: incomplete healing, an unintended pregnancy , an overlooked infection, undiagnosed postpartum depression , and more. Taking the time to keep these appointments can pay off in many ways, physically and emotionally.

In the past, people usually had a four-week or six-week postpartum exam, but the American College of Obstetricians and Gynecologists (ACOG) updated their guidance in recent years. The organization now recommends appointments be conducted within the first three weeks postpartum instead. "This initial assessment should be followed up with ongoing care as needed, concluding with a comprehensive postpartum visit no later than 12 weeks after birth," the ACOG notes.

Still, the comprehensive exam (recommended before 12 weeks) resembles the previous six-week postpartum exam. You should also call or visit your doctor for any concerning postpartum symptoms, no matter when they appear.

Your postpartum exam will be conducted by your OB or midwife . As your checkup includes an internal examination, you might prefer to ask someone else to watch your baby—but most practitioners are accommodating and welcome babies into the exam room.

Your medical practitioner will be looking at the following items, but remember that every doctor and patient is different.

1. Your Incision

If you had an episiotomy or tear during vaginal delivery , "checking that incision is the first thing on your doctor's list," says Siobhan Dolan, MD, assistant medical director of the March of Dimes in White Plains, New York, as it can lead to pain and other problems postpartum. They will observe your outside genitalia to ensure you're healing well and will also use a speculum to check internally.

Most incision problems occur within 10 days of giving birth, according to Tekoa King, a certified nurse-midwife in San Francisco. If at any time postpartum you notice unusual redness, pain, or fluid coming from an incision, contact your doctor—no need to wait until a scheduled appointment.

Note that, if you've had a C-section , you'll probably have a preliminary incision checkup at around two weeks and another at six weeks.

2. Your Uterus, Ovaries, and Cervix

Expect yet another pelvic exam, but this one has a twist—your doctor is making sure that your reproductive organs are returning to their pre-pregnancy state (amazingly, your uterus will shrink back to the size of a fist). They'll also check your uterus for tenderness and other signs of infection. And since this checkup counts as your annual exam, your doctor will feel your ovaries for growths and perform a Pap smear to check for abnormal cervical cells.

3. Your Breasts

Your breasts go through many changes during pregnancy and after delivery; it's important for your doctor to keep track of what's normal (like engorgement ) and what isn't. First, your doctor will give your breasts a thorough exam for blocked milk ducts, which feel like little knots.

According to Dr. Dolan, these can develop into mastitis , an infection that occurs when bacteria gets trapped in a milk duct. If you have it, the area around the infection becomes red and hot, and you may also develop flu-like symptoms, such as a fever and body aches. Mastitis can occur any time postpartum, so report any breast pain to your doctor or midwife. An antibiotic that's safe for nursing parents can clear up the infection. Your doctor will also check your breasts for lumps or masses.

4. Your General Health

As you've probably surmised, pregnancy affects just about every body function you can think of, which is why it's important to get an overall health check. Much of this exam is just like a regular physical: Your doctor checks your weight and blood pressure, and may even take your pulse or listen to your chest. They'll also run any necessary tests, such as blood work if they're worried about anemia .

From there, the exam addresses more specific postpartum concerns. Your doctor will ask if you're still taking your prenatal vitamins ; if you're nursing, it's especially important that you replenish your body with calcium, iron, and other vital nutrients.

Next on the list are your bladder and intestines. Pregnancy and delivery can really take their toll on these organs, even if you've been religious about your Kegel exercises , so your health care provider will ask whether or not you've had any leaking urine, extreme bowel urgency, or bothersome constipation, or pelvic floor prolapse .

"It's also important that your doctor manually check your thyroid, a butterfly-shaped gland in your neck that is very active in producing hormones during pregnancy, to make sure it's a normal size," according to midwife King. If it's oversized, it might not be working properly, and you may need some blood work to determine if you need medication.

Those with special health conditions during pregnancy will likely need follow-up care. For example, if you had gestational diabetes , your doctor may check your blood sugar and suggest continued drug treatment or a diet regimen if the problem continues.

Finally, your doctor will make sure you're up-to-date on all recommended vaccinations .

5. Your Mental Health

Assessing your emotional welfare at a postpartum checkup is just as vital as checking your physical health, experts say. "It's important for everyone's well-being to talk about how [parenthood] is going," says Dr. Dolan.

If you're feeling overwhelmed, your doctor may be able to put you in touch with postpartum helpers, such as doulas or baby nurses.

You may also undergo screening for postpartum depression . "It's one of the most important things to look for at this checkup, and it's a common problem," says King.

Up to one in eight birthing parents may experience depression in the postpartum period , according to the Centers for Disease Control and Prevention (CDC) . It's important to discuss any symptoms with your doctor, including feelings of anxiety, sadness, numbness, postpartum psychosis , or anger . But the FDA recently approved medication that can help treat postpartum depression symptoms.

6. Family Planning

Another conversation topic will be your postpartum period and contraception . "One of the most important parts of this checkup is family planning. It's possible to become pregnant right after coming home from the hospital," says Margaret Comerford Freda, a registered nurse and certified health-education specialist at Albert Einstein College of Medicine in New York City.

You may want to change birth control methods entirely; what worked for you before may not fit your new life. If you used to take the birth control pill, for example, you may decide to try an IUD because taking medicine may now be the last thing you want to remember each day. Also, barrier methods of birth control, such as a diaphragm, need to be checked for fit since your cervix may have changed size after pregnancy.

If all is well with your health and well-being, your doctor will likely give the all-clear to resume normal activities, which might include exercising, driving, and lifting heavy objects. The timeline for these activities usually differs for vaginal births and C-sections.

Your provider will also tell you when it's safe to start having sex again . Most experts advise against putting anything inside the vagina for a few weeks after C-section or vaginal delivery. In the past, most people got the green light to resume sexual activity at the six-week postpartum mark, assuming everything was healing well. However, many doctors now advise people to take it slow but go with their own comfort level and judgment to know when they're ready to have sex again.

Before you leave your doctor's office, take the opportunity to ask any lingering questions about your body, mind, or life as a new parent. Getting the answers you need will make the transition to life with a baby much smoother.

The topics you'll want to discuss will be personal to you, but you may consider bringing up the following questions:

• Do you have a reference for a lactation consultant? (Depending on your needs, you might ask for recommendations for a mental health specialist, pelvic floor therapist, etc.)
• How can I manage my postpartum symptoms?
• Is my tenderness, bleeding, or discomfort normal?
• What supplements should I be taking now?
• Should I be checked for diastasis recti ?
• When can I return to certain prepregnancy activities?
• Do I need any vaccinations?
• Should I make changes to my postpartum diet or exercise plan?
• Clarifications about your labor and delivery experience
• Questions about caring for your baby, including feeding and sleeping needs

You don't want to wait until your scheduled postpartum checkup to report any of the following:

• Fever above 100.4° F
• Nausea and vomiting
• Pain or burning during urination
• Bleeding that increases or is heavier than a normal menstrual period
• Severe pain in your lower abdomen
• Pain, swelling or tenderness in your legs
• Red streaks on your breasts or painful new lumps
• Redness, discharge or pain from an episiotomy , perineal tear , or abdominal incision that doesn't subside or that worsens
• Foul-smelling vaginal discharge
• Severe depression

Characteristics of Women without a Postpartum Checkup among PRAMS Participants, 2009–2011 . Maternal and Child Health Journal , 2019

Physical Health, Breastfeeding Problems and Maternal Mood in the Early Postpartum: A Prospective Cohort Study .  Archives of Women’s Mental Health , 2018

Social Support, Postpartum Depression, and Professional Assistance: A Survey of Mothers in the Midwestern United States .  The Journal of Perinatal Education , 2015

Optimizing Postpartum Care . American College of Obstetricians and Gynecologists, 2021

What to Expect at a Postpartum Checkup—And Why the Visit Matters . American College of Obstetricians and Gynecologists: Expert View , 2022

Comparison of the Effects of Episiotomy and No Episiotomy on Pain, Urinary Incontinence, and Sexual Function 3 Months Postpartum: A Prospective Follow-up Study .  International Journal of Nursing Studies , 2011

Pelvic Examination at the 6-Week Postpartum Visit After Cesarean Birth . Journal of Midwifery & Women’s Health , 2016

Vitamin D and Calcium Supplementation in Nursing Homes—A Quality Improvement Study .  Nutrients , 2022

Postpartum Depression .  StatPearls , 2022

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Your Postpartum Checkups

Medical review policy, latest update:.

Added FAQs to the article with updates to sourcing and check on text for #BumpDay 2023.

What is a postpartum checkup?

When is my first postpartum checkup, is there still a six-week postpartum checkup, read this next, how to prepare for your postpartum checkups, can i bring my baby to my postpartum checkups, what happens at my postpartum checkup, give you an annual exam, examine your post-pregnancy body, make sure no serious health issues have cropped up since you delivered, get the go-ahead of when to start working out again and go back to normal activities, discuss your mental health and how you're feeling, talk about resuming sex after baby and get you back on birth control, chat about any future baby plans (if applicable).

Remember: Your health is important, and taking good care of yourself helps you take good care of your baby. That's why it's necessary to schedule and attend your postpartum doctor's appointments. An added bonus? You'll probably feel better and more reassured after the visit with your practitioner too.

Postpartum Checkup FAQs

How many postpartum checkups do you need, what does a postpartum checkup consist of, what happens if i miss my postpartum checkup, do they test urine at postpartum checkup, updates history, go to your baby's age, trending on what to expect, the covid-19 vaccine for infants, toddlers and young children, how to create a night shift system when you have a newborn, ⚠️ you can't see this cool content because you have ad block enabled., when do babies start laughing, baby-led weaning, what happens in the ‘4th trimester’ (and is it a real thing).

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• Labor and delivery, postpartum care

C-section recovery: What to expect

Pregnancy and delivery cause major changes in the body. From abdominal pain to shifting moods, learn what's involved in recovery from a C-section.

If you're planning to have a cesarean delivery — also called a C-section — or you want to be ready in case you need one, you might have questions about recovery. How much pain will there be? What breastfeeding positions might work best? Understand how to take care of yourself and your baby after a C-section.

Treat your C-section wound with care

After a C-section, pain and tiredness are common. To help with healing:

• Get enough rest. It's important to keep moving after a C-section, but you also need to get enough rest. If family and friends can help you with daily tasks, let them. Rest when your baby sleeps. For the first couple of weeks, don't lift anything heavier than 10 to 15 pounds.
• Seek pain relief. Your healthcare professional might suggest ibuprofen (Advil, Motrin IB, others), acetaminophen (Tylenol, others) or other medicines to relieve pain. Most pain relief medicines are safe to take while breastfeeding.

Look for signs of infection

Check your C-section wound for signs of infection. A member of your healthcare team likely will tell you how to care for the wound before you leave the hospital. Contact your healthcare professional if your wound is red, swollen or leaking fluid. Also seek care if you get a fever or if the area around the wound changes color. It may be red, purple or brown, depending on your skin color.

Try different breastfeeding positions

You can begin breastfeeding soon after a C-section. You might start in the delivery room. Breastfeeding positions that work well after you've had a C-section include:

• Football hold. Put a pillow along your side and use a chair with broad, low arms. Hold your baby at your side, with your elbow bent. With your open hand, support your baby's head. Face the baby toward your breast. Your baby's back will rest on the pillow and your forearm. Support your breast in a C-shaped hold with your other hand.
• Side-lying hold. You and your baby lie on your sides. Your baby faces your breast. Support your baby with one hand. With the other hand, grasp your breast and touch your nipple to your baby's lips. Once your baby latches on to breastfeed, use one arm or a pillow to support your own head. Use your other arm to help support the baby.

For support or information about breastfeeding, contact a person who specializes in breastfeeding, called a lactation consultant. Ask your healthcare professional to suggest someone.

Manage other symptoms

While you're healing from a C-section, you're also healing from pregnancy. Here's what to expect:

• Vaginal discharge. After delivery, a mix of blood, mucus and tissue from the uterus comes out of the vagina. This is called discharge. The discharge changes color and lessens over 4 to 6 weeks after a baby is born. It starts bright red, then turns darker red. After that, it usually turns yellow or white. The discharge then slows and becomes watery until it stops.
• Contractions. For a few days after a C-section, you might feel contractions. They are sometimes called afterpains. These contractions often feel like menstrual cramps. They help keep you from bleeding too much because they put pressure on the blood vessels in the uterus. Afterpains are common during breastfeeding. Your healthcare professional might suggest a pain reliever that you can buy without a prescription. They include acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin IB, others).

Sore breasts. A few days after giving birth, you might have full, firm, sore breasts. That's because your breast tissue overfills with milk, blood and other fluids. This condition is called engorgement. Breastfeed your baby often on both breasts to help keep them from overfilling.

If your breasts are engorged, your baby might have trouble attaching for breastfeeding. To help your baby latch on, you can use your hand or a breast pump to let out some breast milk before feeding your baby. That process is called expressing.

To ease sore breasts, put warm washcloths on them or take a warm shower before breastfeeding or expressing. That can make it easier for the milk to flow. Between feedings, put cold washcloths on your breasts. Pain relievers you can buy without a prescription might help too.

If you're not breastfeeding, wear a bra that supports your breasts, such as a sports bra. Don't pump your breasts or express the milk. That causes your breasts to make more milk. Putting ice packs on your breasts can ease discomfort. Pain relievers available without a prescription also can be helpful.

Hair loss and skin changes. During pregnancy, higher hormone levels mean your hair grows faster than it sheds. The result is more hair on your head. But for up to five months after giving birth, you lose more hair than you grow. This hair loss stops over time.

Stretch marks won't go away after delivery. But in time, they'll fade. Expect any skin that got darker during pregnancy, such as dark patches on your face, to fade slowly too.

• Mood changes. Childbirth can trigger a lot of feelings. Many people have a period of feeling down or anxious after giving birth, sometimes called the baby blues. Symptoms include mood swings, crying spells, anxiety and trouble sleeping. These feelings often go away within two weeks. In the meantime, take good care of yourself. Share your feelings, and ask your partner, loved ones or friends for help.
• Your symptoms don't go away on their own.
• You have trouble caring for your baby.
• You have a hard time doing daily tasks.
• You think of harming yourself or your baby.

Medicines and counseling often can ease postpartum depression.

Weight loss. It's common to still look pregnant after a C-section. Most people lose about 13 pounds (6 kilograms) during delivery. This loss includes the weight of the baby, placenta and amniotic fluid.

In the days after delivery, you'll lose more weight from leftover fluids. After that, a healthy diet and regular exercise can help you to return to the weight you were before pregnancy.

Postpartum checkups

The American College of Obstetricians and Gynecologists says that postpartum care should be an ongoing process rather than a single visit after your delivery. Check in with your healthcare professional by phone or in person within 2 to 3 weeks after delivery to talk about any issues you've had since giving birth.

Within 6 to12 weeks after delivery, see your healthcare professional for a complete postpartum exam. During this visit, your healthcare professional does a physical exam and checks your belly, vagina, cervix and uterus to see how well you're healing.

Things to talk about at this visit include:

• Your mood and emotional well-being.
• How well you're sleeping.
• Other symptoms you might have, such as tiredness.
• Birth control and birth spacing.
• Baby care and feeding.
• When you can start having sex again.
• What you can do about pain with sex or not wanting to have sex.
• How you're adjusting to life with a new baby.

This checkup is a chance for you and your healthcare professional to make sure you're OK. It's also a time to get answers to questions you have about life after giving birth.

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• Landon MB, et al, eds. Postpartum care and long-term health considerations. In: Gabbe's Obstetrics: Normal and Problem Pregnancies. 8th ed. Elsevier; 2021. https://www.clinicalkey.com. Accessed Sept. 6, 2023.
• American College of Obstetricians and Gynecologists. Committee Opinion No. 736: Optimizing postpartum care. Obstetrics & Gynecology. 2018; doi:10.1097/AOG.0000000000002633.
• Berens P. Overview of the postpartum period: Normal physiology and routine maternal care. https://www.uptodate.com/contents/search. Accessed Sept. 6, 2023.
• Ramos D. What to expect at a postpartum checkup — and why the visit matters. American College of Obstetricians and Gynecologists. https://www.acog.org/womens-health/experts-and-stories/the-latest/what-to-expect-at-a-postpartum-checkup-and-why-the-visit-matters. Accessed Sept. 6, 2023.
• FAQs: Postpartum depression. American College of Obstetricians and Gynecologists. https://www.acog.org/Patients/FAQs/Postpartum-Depression. Accessed Sept. 6, 2023.
• Postpartum care. Merck Manual Professional Version. https://www.merckmanuals.com/professional/gynecology-and-obstetrics/postpartum-care-and-associated-disorders/postpartum-care#. Accessed Sept. 7, 2023.
• Berghella V. Cesarean birth: Postoperative care, complications, and term sequelae. https://www.uptodate.com/contents/search. Accessed Sept. 8, 2023.
• Breastfeeding your baby. American College of Obstetricians and Gynecologists. https://www.acog.org/womens-health/infographics/breastfeeding-your-baby-breastfeeding-positions. Accessed Sept. 8, 2023.
• Li L, et al. Breastfeeding after a C-section: A literature review. Midwifery. 2021; doi:10.1016/j.midw.2021.103117.
• Marnach ML (expert opinion). Mayo Clinic. Sept. 11, 2023.

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What Happens During C-Section Recovery?

• First 48 Hours
• Recovery at Home
• Incision, Internal Pain, and Healing
• Postpartum Check-up

Complete C-section recovery can take a few weeks, but you should notice decreased pain after the first few days. A cesarean section (also called a cesarean or C-section) is a major abdominal surgery, and what you do after surgery will influence your recovery. Your overall health and any pregnancy complications, the type of C-section you have, and your physical activity following a C-section all impact healing.

Learn what to expect during C-section recovery and what you can do to promote healing.

Jun / Getty Images

C-Section Recovery: First 48 Hours

The first few days after a C-section are usually the most painful because your incision is fresh. Abdominal surgeries, like cesareans, disrupt internal tissues and muscles. However, a surgeon carefully separates the abdominal muscles instead of cutting them during a C-section.

C-sections recovery is different than other abdominal surgeries because of the myriad changes happening simultaneously in your body. In addition to healing from the surgery, recovery will also involve typical postpartum changes, including:

• Body temperature changes
• Blood pressure fluctuations
• Blood clot development
• Shifting body fluid balances

After a C-section, you'll likely remain in the hospital for three or four days, though complications can extend your stay. During that time, medical staff will monitor you and your baby for signs of postpartum complications and assist you through the healing process.

You may receive medications to help manage blood pressure, post-surgical pain, or postpartum cramping or to prevent infections. If your C-section was planned, your healthcare provider might discuss some specific options for post-op recovery before delivery.

Move Early and Often After C-section

As soon as you can, your healthcare providers will encourage you to get up and move around slowly and carefully to aid in recovery and relieve gas. Ideally, you are up and moving to use the bathroom without a catheter in the first 24 hours after your C-section.

C-Section Recovery: When You Get Home 

You are usually discharged home as soon as your healthcare provider is sure you and your baby are not at risk of any immediate postpartum complications. Still, this doesn't mean that going home after a C-section is easy.

You will undergo typical postpartum body changes, including hormonal shifts and vaginal bleeding . Even after a C-section, expect vaginal bleeding during the first three to four weeks after delivery, with additional discharge possible for up to six weeks. Postpartum bleeding and cramping are part of the involution (shrinking) process as your uterus contracts to its pre-pregnancy size.

During this time, it's important to stay active to prevent blood clots and regain strength. Activity restrictions and incision care after a C-section can complicate the physical and emotional changes after delivery.

Involving your partner, family, and friends in your postpartum life can help you manage the physical and emotional challenges that follow a C-section.

You will be advised not to lift anything heavier than your baby for at least the first few weeks and limit physical activity and housework. Rigorous activity and heavy lifting could cause problems for both your post-op recovery and postpartum healing.

C-Section Recovery Complications

About one-third of all babies in the United States are delivered by C-section. Most of the time, recovery goes smoothly. When you go home, your healthcare provider will advise you to watch for the following symptoms:

• Severe headache
• Sudden pain at the incision site or in the abdomen
• Discharge or discoloration at the incision site
• Foul-smelling vaginal discharge
• Hives or rash
• Blood in your urine
• Heavy vaginal bleeding (soaking through more than one pad per hour)
• Wound opening

Call 911 or visit an emergency department if you develop a high fever (over 103 degrees), shortness of breath, or hives.

You can help reduce your risk of complications by avoiding:

• Heavy lifting
• Soaking in a bath or hot tub
• Strenuous activity or exercise
• Sexual activity

At your postpartum checkup, your healthcare provider will inform you when you can safely resume these activities.

Incision, Internal Pain, and Other Healing in C-Section Recovery 

After a C-section—like other abdominal surgeries—you will need time to recover from the surgical incision, blood loss, and potential nerve damage. C-sections can be performed in a few ways, and healing depends on the surgical method and the reason for the cesarean.

Low transverse : Low transverse or "bikini cut" is a low, horizontal incision offering a less obvious incision after recovery, a less invasive approach, and less trauma to abdominal tissue and muscles. The drawback, however, is that this technique offers a smaller space to deliver the baby and may not be feasible or safe in all deliveries.

Classic incision : A vertical cut in the abdomen to expose the uterus and deliver the baby provides ample space and quick access for safe delivery. It results in a much larger incision that can affect more muscle and tissue than the lower transverse method, leaving a more prominent and noticeable scar after healing .

What Type of C-section Will I Have?

Your healthcare provider will likely use the low transverse technique if you have a planned C-section. However, emergency C-sections (especially those due to fetal distress) often require larger incisions like the classic method to deliver your baby quickly and safely.

Postpartum Check-up in C-Section Recovery

Between 25% and 97% of American mothers attend their postpartum checkups. This visit is essential for everyone postpartum to monitor physical and emotional recovery after childbirth.

Postpartum checkups are crucial after cesarean delivery because there are additional risks of infection or surgical complications.

Expect to return to see your healthcare provider about three weeks after your C-section. If you experience complications after delivery, like significant blood loss or high blood pressure, your healthcare provider will want to see you between two and 10 days after delivery.

You will have an additional postpartum visit around 12 weeks after delivery. During your postpartum healthcare visits, your provider will ask about or check your:

• Incisional pain and healing
• Postpartum bleeding
• Uterus size and location
• Hormone changes
• Sexual health
• Emotional recovery and bonding with your baby
• Breastfeeding

Your healthcare provider may offer certain medications for pain management or to support your recovery. They may suggest antibiotics or additional treatments if you are having difficulty healing or experiencing any problems with your C-section incision.

Incision Care

Some products to help aid incision healing include:

• Medical-grade honey
• Petroleum jelly
• Antibiotic ointments

If you're concerned about scarring, consider scar massage and silicone gel after your incision has healed. Talk to your healthcare provider about supplements or natural remedies before using them postpartum, especially if you are breastfeeding.

Support for Birthing Parents in C-Section Recovery 

C-section recovery and adjusting to a postpartum routine with your new baby can be mentally and physically challenging. Hormone shifts can add emotional strain to the physical healing process, as do the responsibilities of caring for a newborn.

Involving your partner, healthcare provider, family, friends, support groups, or other community resources can help you navigate this period. Some people hire a postpartum doula to help with the transition.

Different insurance companies and public health programs may offer this as well as additional resources during the recovery period. Various organizations provide maternal mental health support .

Don't wait to get help if you experience feelings of hopelessness, despair, severe depression, or think of hurting yourself or your baby. These could be signs of postpartum depression , and help is available.

Self-Care During C-Section Recovery

Take time and make an effort to care for yourself after a C-section; it is important for you and your baby. Good self-care in this stage can help you fare better in future pregnancies, avoid future health issues, and create a healthier and happier environment for you and your baby. Focus on the following areas of self-care:

• Asking for help (so you can take time for yourself)

C-sections are common, but remember, they are still major surgical procedures. The healing process takes time, but adhering to your healthcare provider's recommendations, watching for signs of complications, and resuming light physical activity can support the healing process. Talk to your provider about ways to manage and prevent having to deal with surgical issues alongside life with a newborn.

American College of Obstetricians and Gynecologists. Optimizing postpartum care .

American College of Obstetricians and Gynecologists. Cesarean birth .

Ghaffari P, Vanda R, Aramesh S. et al.  Hospital discharge on the first compared with the second day after a planned cesarean delivery had equivalent maternal postpartum outcomes: A randomized single-blind controlled clinical trial . BMC Pregnancy Childbirth. June 2021;21(466). doi:10.1186/s12884-021-03873-8.

Bollag L, Lim G, Sultan P, et al. Society for obstetric anesthesia and perinatology: consensus statement and recommendations for enhanced recovery after cesarean. Anesthesia & Analgesia. May 2021;132(5):1362-1377. doi:10.1213/ANE.0000000000005257.

American Pregnancy Association. Cesarean after care .

Centers for Disease Control and Prevention. Births — method of delivery .

Larsson C, Djuvfelt E, Lindam A, et al. Surgical complications after caesarean section: a population-based cohort study.   PLoS One . October 2021;16(10):e0258222. doi:10.1371/journal.pone.0258222

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By Rachael Zimlich, BSN, RN Zimlich is a critical care nurse who has been writing about health care and clinical developments for over 10 years.

This is Patient Engagement content

Postpartum Care After Cesarean Delivery

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The following information offers guidance on how to care for yourself from the time you deliver your baby to 6–12 weeks after delivery ( postpartum period ). Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.

How to care for yourself

Perineal care

• Keep your perineum clean and dry. Use medicated pads and pain-relieving sprays and creams as directed.
• Redness, swelling, or pain.
• Fluid or blood.
• Pus or a bad smell.
• You may use a squirt bottle instead of wiping to clean the perineum area after you go to the bathroom. As you start healing, use the squirt bottle before wiping yourself. Make sure to wipe gently.
• To relieve pain caused by an episiotomy, vaginal tear, or hemorrhoids, try taking a warm sitz bath 2–3 times a day. Use a portable sitz bath that you can put over the toilet. Make sure the water covers your buttocks and perineum when you sit on the seat.

Vaginal bleeding

• During the first week after delivery, the amount and appearance of lochia is often similar to a menstrual period.
• Over the next few weeks, it will slowly decrease to a dry, yellow-brown discharge.
• For most women, lochia stops completely by 4–6 weeks after delivery. Vaginal bleeding can vary from woman to woman.
• An increase in bleeding.
• A change in color.
• Large blood clots.
• If you pass a blood clot the size of an egg or larger, contact your health care provider.
• Do not use tampons or douches until your health care provider says it is safe.
• If you are not breastfeeding, your period should return 6–8 weeks after delivery. If you are breastfeeding, the time when your period returns varies based on whether or not you are breastfeeding exclusively.

Breast care

• Within the first few days after delivery, your breasts may feel heavy, full, and uncomfortable ( breast engorgement ). You may also have milk leaking from your breasts. Your health care provider can suggest ways to help relieve breast discomfort. Breast engorgement should go away within a few days.
• Wear a bra that supports your breasts and fits you well.
• Keep your nipples clean and dry. Apply creams and ointments as told.
• You may need to use breast pads to absorb milk leakage.
• You may have uterine contractions every time you breastfeed for several weeks after delivery. Uterine contractions help your uterus return to its normal size.
• If you have any problems with breastfeeding, work with your health care provider or a lactation consultant.
• Take over-the-counter medicines as told by your health care provider to help with pain or discomfort.
• Wear a well-fitting bra and use cold packs to help with swelling.
• Do not squeeze out ( express ) milk. This causes you to make more milk.

Intimacy and sexuality

• Ask your health care provider when you can engage in sexual activity.
• You are able to get pregnant after delivery, even if you have not had your period. If desired, talk with your health care provider about methods of family planning or birth control ( contraception ).

Follow these instructions at home:

• Take over-the-counter and prescription medicines only as told by your health care provider.
• If you were prescribed an antibiotic medicine, take it as told by your health care provider. Do not stop taking the antibiotic even if you start to feel better.
• Take your prenatal vitamins until your postpartum checkup or until your health care provider tells you it is okay to stop taking them.
• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• You may have to avoid lifting. Ask your health care provider how much you can safely lift.
• If possible, have someone help you at home until you are able to do your usual activities yourself.
• Try to rest or take naps while your baby is sleeping.

General instructions

• Drink enough fluid to keep your urine pale yellow.
• Do not drink alcohol, especially if you are breastfeeding.
• Do not use any products that contain nicotine or tobacco. These products include cigarettes, chewing tobacco, and vaping devices, such as e-cigarettes. If you need help quitting, ask your health care provider.
• Keep all follow-up visits. Your health care provider will check your healing after delivery and also check your blood pressure.

Contact a health care provider if:

• Breasts that are painful, hard, or turn red.
• Stopped breastfeeding and you have not had a menstrual period for 12 weeks after you stopped breastfeeding.
• Not breastfed at all and you have not had a menstrual period for 12 weeks after delivery.
• Trouble holding urine or keeping urine from leaking.
• A bad-smelling vaginal discharge.
• You have bleeding that soaks through one pad an hour or you have blood clots the size of an egg or larger.
• You have questions about caring for yourself or your baby.
• Feeling unusually sad or worried.
• Having little or no interest in activities you used to enjoy.

Get help right away if:

• Chest pain or difficulty breathing.
• Pain, redness or swelling in an arm or leg.
• Severe pain or cramping in your abdomen.
• Thoughts about hurting yourself or your baby.
• You faint or have a seizure.
• A fever or other signs of infection.
• Bleeding that is soaking through one pad an hour or you have blood clots the size of an egg or larger.
• A severe headache that does not go away or you have a headache with vision changes.
• Do not wait to see if the symptoms will go away.
• Do not drive yourself to the hospital.
• Call the National Suicide Prevention Lifeline at 1-800-273-8255 or 988. This is open 24 hours a day.
• Text the Crisis Text Line at 741741 .

This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.

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Postpartum Care

When a woman arrives home from the hospital with her newborn baby, it can be easy to focus on the baby and forget about her own postpartum care. Postpartum means what you think it does: Care after your baby is born, but this is care for the mother.

During pregnancy the body goes through significant changes and continues to adjust after giving birth. It is important for new mothers to take care of themselves during the postpartum period to insure that their body has a full recovery. There are practical considerations besides how the mother feels.

Being in good health helps a mother care more effectively for her baby. And good health includes good mental health. As many as 15 percent of new mothers experience postpartum mood disorders, including postpartum depression (PPD). When a mother is depressed, her newborn can be affected in several ways.

Struggling with anxiety and mood changes? The University of Colorado’s PROMISE clinic offers excellent emotional support and PPD solutions for mothers who delivered within our network.

Get Help Here, Now

What to expect in the postpartum stage

A woman’s body goes through a grueling journey during pregnancy and birth. It takes time to recover after birth. The postpartum period generally lasts about six weeks. Individuals’ experiences can differ, particularly regarding mood swings and depression, which may occur as long as a year after delivery.

Postpartum changes may cause women to experience the following symptoms in the days and weeks following their baby’s birth:

• Vaginal soreness
• Vaginal discharge
• Contractions
• Urination problems
• Hemorrhoids and painful bowel movements
• Sore breasts and leaking milk
• Hair loss and skin changes
• Weight loss
• Mood swings, including serious PPD.

These physical symptoms are normal and, in most cases, relieved with over-the-counter pain relief medication, physician guidance and time. If at any point symptoms worsen or if an unusual symptom occurs, a woman should contact her doctor immediately.

Postpartum depression and mood disorders (baby blues)

The University of Colorado PROMISE clinic offers emotional support for women who have delivered within our network. PROMISE stands for Perinatal Resource Offering Mood Integrated Services & Evaluation, and offers excellent care and education for women experiencing postpartum mood disorders.

It is important to note that only a healthcare provider can diagnose a mother’s postpartum depression. The following signs of postpartum depression may be reason to seek an evaluation by an OB-GYN:

• Feeling empty or hopeless
• Mood swings, irritability, anger
• Sleep troubles, not enough or too much
• Being distracted, having trouble concentrating
• Doubting one’s ability to be a mother
• Thoughts of harm to oneself or one’s child.

Managing physical changes after pregnancy

After all the changes and challenges a woman’s body goes through in pregnancy and birth, it is little wonder that physical problems may follow. Just like athletes taking time away from their sport after an injury, mothers must take some time away from certain activities after giving birth. The following activities and day-to-day regulations may seem imposing, but they will lead to a faster, more successful birth recovery.

Pelvic rest

For the first six weeks after giving birth, women should not participate in sexual intercourse, douche or use tampons. The body needs time to heal after delivering a baby and the best way for that to happen is to eliminate any interferences (yes, even if you had a c-section!).

In addition to pelvic rest, it is important for women to allow the rectal area to heal. Doctors often recommend taking an over-the-counter stool softener to make bowel movements easier to pass and less painful.

Avoid vigorous exercise and heavy lifting

After any medical procedure, doctors advise patients against strenuous exercise or heavy lifting. Delivering a baby is one of the most exhausting things a woman’s body can go through and it needs rest before taking part in physical activity. Rest is especially important in the case of a cesarean section (c-section), because heavy lifting and exercise could lead to complications with healing.

Don’t drive

Sometimes women are prescribed pain killers to reduce the pain associated with a c -section or vaginal tears that occur during delivery. Any person taking prescription pain medication should not drive or operate heavy machinery.

Caring for c-section incisions

It is important for cesarean section patients to keep the incision clean and dry. It is best to let water and soap run over the incision in the shower. Doctors do not recommend scrubbing or applying lotions of any kind directly to the incision during the early healing stages. For women who are eager to begin applying scar cream, it is important to wait until the incision is completely healed before beginning any sort of scar treatment.

Medications and treatments

Most of the physical symptoms associated with postpartum care can be managed with the following approaches:

• Pain associated with cesarean section.  Pain medication is often prescribed. Motrin and Percocet (or another Tylenol/narcotic derivative) are the most commonly prescribed pain medications for post-cesarean section pain relief.

• Pain associated with vaginal birth.  In most cases, over-the-counter Motrin (ibuprofen) will control pain. In some cases, the physician may prescribe narcotic pain medication for women with severe vaginal tears.

• Constipation.  If constipation occurs, over-the-counter Colace, Milk of Magnesia, or Miralax may be recommended.

• Hemorrhoids.  Over-the-counter Tuck pads, Preparation H and Proctofoam can be used to relieve and treat hemorrhoids that develop during childbirth.

• Cracked/sore nipple.  The early stages of breastfeeding can lead to painful side effects. For cracked or sore nipples, over-the-counter lanolin cream is recommended.

• Prenatal vitamins.  Our OB-GYNs recommend that women who are breastfeeding continue to take their prenatal vitamins.

Postpartum follow-up visit

For most women who delivered vaginally, the first follow-up visit will be six weeks after delivery. This appointment is referred to as a postpartum exam.

For women who underwent a cesarean section, the first follow-up visit should be two weeks after delivery. At this appointment, the incision scar will be checked and steri-strips will be removed if they have not yet fallen out on their own. Another appointment will be scheduled for the standard six-week postpartum exam.

Women should call their doctor immediately if any of the following symptoms occur prior to their scheduled follow-up appointment:

• Signs of mastitis (breast infection), including reddened, hard or tender areas of the breast accompanied by a fever
• Excessive vaginal bleeding
• Abnormally tender abdomen accompanied by a fever
• Any opening of a cesarean section incision
• Drainage coming from a cesarean section incision.