Making decisions about birth after caesarean

Recovery & complications after previous caesarean

Even though caesarean is now considered to be a routine medical procedure, it remains a major operation. Women may take more time to recover than after a vaginal birth and there will be some pain and soreness as the wound heals. Of course, everyone's pain threshold is different and recovery varies from person to person. Several women we talked to felt they had recovered quite quickly and did not experience any problems with their scar healing. Still, many women mentioned the after-effects of having a caesarean and the length of recovery as important reasons why they might want to avoid caesarean birth in future pregnancies (see 'Reasons for wanting vaginal birth after caesarean').

Women are usually advised to get up and start moving around within six to twelve hours of the operation to aid circulation and help avoid the formation of blood clots in the legs. However, many women find moving around in the first few days quite painful and need plenty of pain relief. Even with pain relief, women may find that their movement is limited and they need the support of those around them.

Amongst the women we spoke to, experiences of recovery varied greatly. A couple of women felt well enough to get up and move about within a day of the operation and were surprised to feel much better than they had expected. Others had the opposite experience and were surprised at the amount of pain they experienced. Several women said they found it difficult to get in and out of bed and to lift their baby. A few commented that the information they had received from professionals before the operation had not prepared them for the length of recovery time. Experiences of support from hospital staff were mixed. A few women found it difficult to ask for help from busy staff. They felt relieved when they could return home. Several women had been advised not to drive for the first six weeks after the operation. For some, not being able to use a car made them feel even more dependent on others. 

Several women had worried that they might not be able to breastfeed their baby after a caesarean. Women may struggle to lift the baby by themselves or to find a comfortable position during feeding due to pain from the scar. Some research also suggests that a caesarean can affect the milk coming in, though it is not clear why this might happen. Many women we talked to didn't experience any problems breastfeeding after caesarean. A couple of women who had planned on breastfeeding their babies felt too unwell to do so immediately after the operation. They were upset that being so poorly themselves meant they missed out on the close contact and bonding with their child immediately after the birth. 

None of the women we talked to felt that they had suffered serious long-term complications as a result of caesarean birth. Such complications are rare, but they do happen. 

A few women we talked to felt quite badly affected in the first few days and weeks after the operation. Depending on the circumstances of the operation, women may remain connected to a drip or catheter for several hours afterwards. More rarely, women who have lost a large amount of blood may be given a blood transfusion to help them regain their strength. They may also receive a course of antibiotics to prevent or treat infections of the uterus or caesarean scar. Bleeding from the uterus (known as the 'lochia') is the same as those experienced after vaginally delivery and can last for up to six weeks. A couple of women we spoke to, who felt very ill and tired immediately after the birth, said receiving a blood transfusion had helped them regain their energy. 

Very rarely, women's experience of birth can be so stressful that they might experience symptoms of post-traumatic stress disorder (PDST)

Several women had concerns about their caesarean scar. These included concerns about the visible appearance of the scar and concerns that the wound might get infected. Some were also concerned about whether the scar would affect future pregnancies. Many women said that it had taken them a fair while to get 'back to normal' in all aspects of their lives. Several women felt nervous at first about going to the toilet or resuming their sex life. A couple of women were amused to receive advice on contraception when having sex was the last thing on their mind. A couple of women also said they were put off by the thought of becoming pregnant again.

At the time of the operation, many women said that their main concern had been for their baby and not for themselves. Most women felt confident that a caesarean was necessary for their baby's health and safety. However, a few women worried about how a caesarean might affect their baby. For example, one woman was concerned that her baby might get cut during the operation (Interview 29). A few women had also read that coming through the birth canal is good for the baby as it helps to clear mucus and stimulate breathing. They wondered whether being born by caesarean might have been more stressful for their child.

Two mothers who'd had their babies delivered prematurely needed to have them looked after in the Special Care Baby Unit (SCBU) for several weeks. They felt helpless about the situation and were very upset to return home without their baby. A couple of other women had to have their babies readmitted to hospital due to weight loss and other concerns.

(See also 'Bonding, feeding and support after caesarean' and 'Women's feelings about their previous caesarean'.)

* APGAR score (a measure of the baby's condition at birth).

Last reviewed August 2018.
Last updated November 2012.


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