Postpartum Care After Cesarean Delivery

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

• If your C-section (Cesarean section) was unplanned, and you were allowed to labor and push before delivery, you may have pain, swelling, and discomfort in the tissue between your vaginal opening and your anus (perineum). You may also have an incision in the tissue (episiotomy) or the tissue may have torn during delivery. Follow these instructions as told by your health care provider:
  • Keep your perineum clean and dry. Use medicated pads and pain-relieving sprays and creams as directed.
  • If you have an episiotomy or vaginal tear, check the area every day for signs of infection. Check for:
    • Redness, swelling, or pain.
    • Fluid or blood.
    • Warmth.
    • 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

• It is normal to have vaginal bleeding (lochia) after delivery. Wear a sanitary pad to absorb vaginal bleeding and discharge.
  • 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.
• Change your sanitary pads frequently. Watch for any changes in your flow, such as:
  • 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.
• If you are breastfeeding:
  • 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.
• If you are not breastfeeding:
  • 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:

Medicines

• 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.

Activity

• 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:

• You have:
  • A fever.
  • 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.
• You feel unable to cope with the changes that a new baby brings to your life, and these feelings do not go away. These include:
  • Feeling unusually sad or worried.
  • Having little or no interest in activities you used to enjoy.

Get help right away if:

• You have:
  • 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.
• You have any of the following symptoms and you were unable to reach your health care provider:
  • 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 911.
• 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.