If you've had a C-section, or plan to have one, you'll want to take special care of your body and incision afterward in order to manage the normal post-operative pain. Complicating matters, you'll also have a newborn baby to care for, which can be challenging given that after a C-section, you need plenty of rest. While there are some standard options for treatment of post C-section pain at home, doctors have increasing options for helping to relieve your pain while you're still in the hospital.
Surgical delivery of a baby is called a cesarean delivery or cesarean section, and involves a small incision through the abdominal skin, muscles of the stomach, and wall of the uterus. Your baby is then passed through this incision. After both the baby and placenta have been removed from your uterus, the incision is stitched up. In most cases, cesarean sections take place under regional anesthetic, rather than while you're unconscious. While the surgical nature of a C-section means that almost everyone will experience some discomfort afterward, a 2006 study published in the journal "Anesthesiology" by Dr. Peter Pan and colleagues notes that preoperative anxiety and expectations are strong predictors for postoperative pain. In other words, you're more likely to experience more pain after your C-section if you are worried about the pain, or anticipate that the pain will be severe.
Pain After the Procedure
There are a number of in-hospital options for management of C-section pain. Some of these include narcotic drugs. However, because many narcotics can cause you to feel sleepy, you may want to avoid going this route so as to maximize your ability to care for your newborn. Further, some narcotic drugs aren't compatible with breastfeeding. A 1999 study published in the "Canadian Journal of Anesthesia" by Dr. S. Siddik-Sayyid and colleagues reports the use of epidural tramadol to relieve pain. This has two distinct advantages over intravenous narcotics. First, tramadol doesn't appear to have an effect on breastfeeding infants, since it's passed into breast milk to a very minimal degree. Second, the epidural administration further reduces the risk of infant exposure, since the drug isn't entering the vascular system.
One difficulty associated with a C-section is that it can be quite uncomfortable to breastfeed, because in many of the common breastfeeding holds, your baby rests on your abdomen and puts pressure on your incision. To prevent breastfeeding-associated pain after a C-section, try using some alternative nursing holds. The book "The Womanly Art of Breastfeeding" -- a publication of La Leche League International -- suggests a "football hold," in which you tuck your baby under your arm on the same side of your body as the breast you're using to feed. The baby's feet curl around near your back, and you can support the baby's head for nursing. Using pillows under your baby to support the infant's weight can ease the strain on your back in this position. Alternately, you can use a position in which you lie on your side facing your baby, who is also side-lying. In this case, you nurse the baby off the lower breast. Note that side-lying is not safe on a sofa or soft mattress; talk to a lactation consultant or your obstetrician for safe nursing guidelines.
In rare cases, your postoperative pain may not diminish with time, resulting in chronic pelvic pain. A 2002 study by Dr. E. Almeida and colleagues in the "International Journal of Obstetrics and Gynecology" notes that having had a C-section predisposes women to chronic pelvic pain, but was unable to demonstrate an effective mechanism for resolving the problem. The authors noted that because C-section rates are higher than they've been in recent decades, chronic pelvic pain related to a C-section has the potential to become a significant public health issue. Research in recent years has not yet determined a mechanism for predicting which women will experience chronic pelvic pain after a C-section, nor have any studies yet identified a remedy.
- "Anesthesiology"; Multifactorial Preoperative Predictors for Postcesarean Section Pain and Analgesic Requirement; Peter Pan et al; 2006.
- "Canadian Journal of Anesthesia"; Epidural Tramadol for Postoperative Pain After Cesarean Section; S. Siddik-Sayyid et al; 1999
- "The Womanly Art of Breastfeeding"; La Leche League International; 2010
- "International Journal of Gynecology & Obstetrics"; Cesarean Section as a Cause of Chronic Pelvic Pain; E. Almeida et al; 2002