For most women, becoming a parent brings a mix of exhilaration and anxiety. Amid the anticipation of nurturing a tiny human, there’s also concern about the possible discomforts and pains of childbirth. More than 32 percent of babies in 2021 were delivered via Cesarean section (C-section).1Total cesarean deliveries: United States, 2021. March of Dimes. PeriStats. https://www.marchofdimes.org/peristats/data?reg=99&top=8&stop=86&lev=1&slev=1&obj=9&dv=ms Some women schedule a C-section for personal reasons; for others, it’s medically necessary. All women need time and special care to recuperate following the procedure, and many require physical and emotional support for months.
What Happens to the Body During a C-Section
“With a C-section, the baby (or babies) are delivered through an incision made in the abdominal wall and uterus,” says Amy Hobson, ND. “Surgery may be necessary if the mother had a previous C-section, labor is not progressing as expected, there are indications of fetal distress, or for other medical reasons. A C-section can be planned, or it can be an emergency procedure.”
Before the procedure, the surgical team will explain the steps and potential risks to the patient, obtain consent from the mother, or, if she’s unable to respond, from the family. The mother will then be fitted with a urinary catheter and receive anesthesia via spinal block or epidural to numb the lower body (in certain situations, general anesthesia may be necessary). Additionally, an IV line will be established for fluid and antibiotic delivery.
During the procedure, a surgeon makes an incision through the abdominal wall and uterine wall to reach the baby. After delivery, the surgical team clears the baby’s airway. Incisions are closed, and mom and baby return to a hospital room for two to three days.
General Post-Cesarean Care
A C-section is considered major surgery, and patients should adhere to post-operative care guidelines, limiting exercise and watching for signs of infection.
Stay Alert for Post-Surgical Symptoms
The most significant pain and discomfort usually begin to fade two days to two weeks following a C-section, but patients could feel tender for up to a month or longer. It’s normal to experience cramping or what feels like “mild contractions.”2Kathleen Kennedy, MD. Recovering from a C-Section: What’s Normal and When to Call the Doctor. The University of New Mexico. October 21, 2022. Accessed December 3, 2023. https://unmhealth.org/stories/2022/10/c-section-recovery-whats-normal-when-to-call-doctor.html#:~:text=Some%20changes%2C%20such%20as%20feeling,instructions%20after%20a%20C%2Dsection Other common symptoms include dull belly pain, gas, bloating, and irregular bowel movements. There will be lochia—bleeding and/or discharge—after any kind of birth. Bleeding will lessen over time, fading from red to pink to yellow or white.
Post-surgical reports of mild nausea, grogginess, or headaches from surgical medications are typical. Itching near the incisions is also expected. Incision care3Going Home After a C-Section Information. Icahn School of Medicine at Mount Sinai. Accessed November 29, 2023. https://www.mountsinai.org/health-library/discharge-instructions/going-home-after-a-C-section#:~:text=At%20first%2C%20your%20cut%20 should closely follow a doctor’s specific guidelines, including covering and managing closures with bandages like Steri-Strips. Efforts should be made to keep incisions dry for up to 3 weeks by refraining from baths and swimming.
Naturopathic doctors (NDs) support additional postpartum healing, tending to symptom or scar management, nutrition, rebalancing the mind and body after surgery, and generally supporting maternal health. NDs will collaborate with an integrated team to manage various aspects of postpartum care. Acknowledging the body’s innate healing ability, even following significant surgery, is integral to a holistic recovery process.
Protecting Mom’s Mental and Emotional Health
A mother’s emotional well-being is of utmost importance following childbirth. While cradling a newborn for the first time is a joyful experience, many mothers also grapple with feelings of guilt, shame, fear, and a sense of failure.
For some moms, a C-section birth can trigger mixed emotions. Some mothers are distressed by the missed experience of a natural birth. The ultimate goal of all births is a healthy baby and a healthy mom, but when the original birth plan calls for an unmedicated, vaginal delivery, an unexpected surgery can be very upsetting. Many patients need time for grief and sadness—important parts of the healing process—before moving forward to bond with the new baby.
“As a naturopathic physician, it was definitely not in the plan to have both of my pregnancies end in C-sections, one urgent, one emergent,” says Mona Fahoum, ND. “I can attest to all the above emotions. Thank goodness for conventional medicine when we need it for a safe entrance to the world.”
After initially feeling a sense of “failure” to deliver naturally, Dr. Fahoum focused on acceptance and healing. “I was able to establish a strong emotional bond [with my baby] through breastfeeding and realized this was the better space to place my now-stretched time and energy.”
A truly effective healing plan considers a woman’s physical, mental, and spiritual health. Mothers should check in with themselves often, and partners can help monitor for sadness and depression. Emotions rise and fall postpartum, as hormones fluctuate.
Eating for Postpartum Health
Eating healthy when you’re up all night with a newborn and learning the ropes of breast- or bottle is easier said than done. Opt for whole foods when you can and make sure to incorporate plenty of protein for healing. “I recommend [freezing meals ahead],” suggests Dr. Fahoum. Stocking the kitchen with ‘one-handed snacks’ to fuel on the go will come in handy when you’re too busy to sit down.
Foods That Promote C-Section Recovery
- Vegetables: Bags of pre-washed and cut carrots, celery, broccoli, snap peas, jicama, etc. Veggies are chockful of antioxidants and vitamins to speed healing, as well as fiber and water to aid bowel issues that may result from pain medication.
- Protein: Especially when breastfeeding. Quick, healthy proteins like hard-boiled eggs, hummus, nuts/seeds, string cheese, and low-preservative deli boost recovery and breastmilk production.
- Fermented foods: Yogurt, sauerkraut, miso, and kombucha feed good gut flora post-surgery and contribute to your baby’s healthy microbiome.
- Water: Hydration is a must for recuperating after a C-section to “flush out” inflammation and produce breast milk. Try drinking 16 oz. of water whenever you feed your baby.
Avoiding C-Section Complications
- The risk of urinary tract infections (UTIs or bladder infections) may increase postpartum and following a C-section. Rose hips may help reduce the occurrence of post-surgical UTIs. Foods listed above (and lots of water) will help prevent infections.
- Take it easy! Listen to your body and your providers. Recommendations not to lift too much weight or move too quickly prevent further injury to healing tissue.
- Avoid constipation by consuming plenty of fiber and water. Magnesium softens the stool, making bowel movements easier.
- Studies suggest that simple, liquid diets during the 24 hours following a C-section can mitigate digestive symptoms and bloating postpartum.4Chantarasorn V, Tannirandorn Y. A comparative study of early postoperative feeding versus conventional feeding for patients undergoing cesarean section; a randomized controlled trial. J. Med. Assoc. Thai. 2006;89 Suppl 4:S11-16. https://pubmed.ncbi.nlm.nih.gov/17725138
Addressing Post-Cesarean Complaints
A C-section cuts through abdominal muscles and may affect core strength. Pregnancy also stretches ligaments and tissues to support the rapidly growing uterus and abdomen. Core muscles decrease in thickness as pregnancy progresses. Naturopathic doctors employ many of the same treatments for postpartum care after C-section as for vaginal births. Physical health and fitness after delivery are common concerns, especially when discussing the abdominal and pelvic floor muscles.
Diastasis Recti and Pelvic Floor Dysfunction
When abdominal muscles separate during pregnancy and following birth, the condition is called diastasis recti. Cesarean births put women at increased risk for diastasis recti. Abdominal separation can lead to back pain and digestive issues, such as gastroesophageal reflux disease.
Pelvic floor dysfunction is another common challenge after pregnancy. Weakened muscles cannot fully tense or relax, and a variety of unpleasant symptoms like constipation, urinary incontinence, and sexual dysfunction5Grimes WR, Stratton M. Pelvic Floor Dysfunction. [Updated 2023 Jun 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan. https://www.ncbi.nlm.nih.gov/books/NBK559246 may result.
The first line of treatment for diastasis recti and pelvic floor dysfunction is typically rehabilitation through physical therapy. Extreme cases could require surgical intervention.
Post C-Section Exercises
Exercises designed specifically for C-section recovery focus on strengthening muscles that may have been damaged during pregnancy and surgery. These gentle, natural movements include seated kegels, wall sits, belly breaths, leg slides, and scar massage. It’s important to consult with your medical care team before engaging in postpartum physical activity.
Once your medical providers give you the go-ahead, incorporating core exercises can aid in fortifying the core muscles and those affected by the surgery. At first, this might involve simple actions like flexing the abdominal muscles and engaging the pelvic floor. Planks, which strengthen without excessive strain, may be incorporated in time to help achieve full functionality.
Healing Wounds and Scars
C-section scarring is a natural part of recovering from surgery. Some women may notice thickened or raised scars. Naturopathic advice on post-surgical scar care includes the following suggestions.
- When the incision has completely healed, organic, virgin coconut oil may help minimize scarring by stimulating collagen cross-links and reducing inflammation.
- Over-the-counter products like Mederma may help reduce scarring. The cream contains onion extract, along with provitamins and hyaluronic acid to promote healing.
- Specialists in myofascial release, visceral manipulation, and cupping will tend to scars two to three months post-surgery to stimulate further, deeper healing and prevent adhesions. Many naturopathic doctors are trained in these hands-on modalities.
Footnotes
- 1Total cesarean deliveries: United States, 2021. March of Dimes. PeriStats. https://www.marchofdimes.org/peristats/data?reg=99&top=8&stop=86&lev=1&slev=1&obj=9&dv=ms
- 2Kathleen Kennedy, MD. Recovering from a C-Section: What’s Normal and When to Call the Doctor. The University of New Mexico. October 21, 2022. Accessed December 3, 2023. https://unmhealth.org/stories/2022/10/c-section-recovery-whats-normal-when-to-call-doctor.html#:~:text=Some%20changes%2C%20such%20as%20feeling,instructions%20after%20a%20C%2Dsection
- 3Going Home After a C-Section Information. Icahn School of Medicine at Mount Sinai. Accessed November 29, 2023. https://www.mountsinai.org/health-library/discharge-instructions/going-home-after-a-C-section#:~:text=At%20first%2C%20your%20cut%20
- 4Chantarasorn V, Tannirandorn Y. A comparative study of early postoperative feeding versus conventional feeding for patients undergoing cesarean section; a randomized controlled trial. J. Med. Assoc. Thai. 2006;89 Suppl 4:S11-16. https://pubmed.ncbi.nlm.nih.gov/17725138
- 5Grimes WR, Stratton M. Pelvic Floor Dysfunction. [Updated 2023 Jun 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan. https://www.ncbi.nlm.nih.gov/books/NBK559246
