This guest post was written by Austyn Smith
The book “Taking Charge of your Fertility” by Toni Weschler provides deep insights into what happens in a woman’s body during a typical menstrual cycle. Learning about these changes in detail helps women become very in tune with their body’s physical signals of fertility (or lack thereof). In part one of this series, we discussed using Toni’s Fertility Awareness Method to help in troubleshooting infertility issues naturally, and ultimately achieving pregnancy. In part 2, we will discuss using this same method as a means for birth control.
Natural Birth Control After Baby
I have successfully used the Fertility Awareness Method (FAM) for natural birth control for over four years, and have loved it. It entails charting your body temperature, your cervical mucus, and your cervical position as a means for noting your fertile and infertile times, and then planning intercourse accordingly. Although this method is not for everyone, it can be a great option for women who prefer not to use traditional birth control or have adverse reactions to it (myself). Using this method does require a bit of planning and consistency in order to be effective, so it is ideal for the organized or schedule-driven mama.
Plan on charting two full menstrual cycles before you begin using this method so that you can get a true understanding of charting, how it works, what it all means, and identifying your own body’s cues and signals of fertility. During each cycle you will be taking a daily basal body temperature (you need a special thermometer for tracking), recording cervical mucus, and cervical positioning (optional). A sample chart of a typical cycle is below.
As a reminder, there are three phases of a typical menstrual cycle: the pre-ovulatory infertile phase, the fertile phase, and the post-ovulatory infertile (luteal) phase. I recommend re-reading FAM part 1 to review the basics of the signs of fertile and infertile phases, before continuing on. I also highly recommend reading the book in detail before trying this method in order to get a clear picture of the procedures in detail. At any rate, here is an overview.
Phase One: Pre-Ovulatory Infertile Phase Rules
The first phase of a cycle begins on the first day of bleeding during your period. During this phase, there are two rules to follow.
First five days rule
You are only “safe” to have intercourse during the first 5 days of a menstrual cycle if you have had an obvious temperature shift 12-16 days prior.
Having this shift means that ovulation has indeed occurred and the bleeding you are experiencing is not ovulation spotting or implantation bleeding. Remember sperm can live for up to five days in a fertile environment, so any time after these first five days consider yourself potentially fertile, even if you are still bleeding. You may consider yourself “safe” beyond the first five days if you then keep the second rule.
Dry Day Rule
Before you ovulate, you are safe on the evening of every dry day—meaning you do not have any cervical discharge during the course of the entire day. If you have been dry and then have intercourse, the next day you must be careful since semen may mask cervical discharge. If at the end of a day after intercourse you have been dry all day, consider yourself safe once again (remember, sperm cannot survive in a dry environment).
Phase Two: Fertile Phase
Ideally, you are only having unprotected sex when you know for sure you are in your infertile phase. If you do decide to have sex during your fertile phase, you will need to use a barrier of some type (like condoms—we are huge fans of these), or explore other areas of arousal and climax without penetration. A woman’s egg once released survives only 24-48 hours. However, if the uterine environment is right, sperm can survive for several days, so there is a range on either side of ovulation day where you must consider yourself potentially fertile. To err on the side of caution, assume most women have an 8-10 day range of fertility. As a basic review, the signs of fertility include:
- Cervical mucus changes from dry to sticky, then creamy, then eggwhite (extremely fertile), to sticky or dry, and finally menstruation.
- Cervical positioning changes from firm, low, and closed to soft, high, open, and wet and then closed and low again.
- Basal Body Temperature Shifts: a spike of several tenths of a degree which remains high for 3 consecutive days will indicate that ovulation has occurred. Remember you need a special thermometer for tracking.
- Ovulatory Pain: Some women experience cramping in the lower abdomen on one side indicating ovulation is occurring.
Phase Three: Post-Ovulatory Infertile Phase
During this phase remember the Temperature Shift Rule.
Temperature Shift Rule
You are “safe” the evening of the third consecutive day your temperature is above the coverline.
Review how to chart temperatures and calculate coverline here. Essentially, the first day there has been a temperature rise by 2/10 of a degree, and has stayed elevated for 3 consecutive days, you can be sure you have ovulated. Highlight the previous 6 temperatures, and identify the highest of those. Draw your coverline on the chart that is one degree higher than the highest of those temperatures.
You are considered infertile at 6pm on the third consecutive night your basal body temperature is above the coverline. If your temperature is on or below the coverline during those 3 days, you must start over once your temperatures are back above the line. Remember, sex is still okay, only you must use a barrier method.
There are a few exceptions to these rules that will throw your body off a little bit—being sick, traveling, breastfeeding, or sleeping poorly for instance. So definitely review the book in detail before trying out this method.
Monitoring and charting fertility signs not only helps women understand their fertility in a very detailed manner, but can also serve as a diagnostic tool for infertility, as well as a means of natural birth control. It can be a great alternative for women who do not want added hormones, surgery, or the pressure of remembering to take a pill for birth control. I have found great success in using the Fertility Awareness Method both to prevent pregnancy, and to achieve pregnancy when I want to conceive. You may find a copy of Toni Weschler’s book here, and more information and community resources about using the Fertility Awareness Method at Taking Charge of your Fertility or ovagraph.com.
This guest post was written by Alina Horrocks who holds a Doctor of Physical Therapy.
I am a mother of 3. I am also a physical therapist. My background is mostly acute (hospital) care. I’ve shifted from working full-time as a PT, to being a stay at home mom. When I became fully immersed in the “mom world” and was meeting other fairly new mothers, I was surprised at how many of these women were having pelvic floor issues (mainly incontinence).
In my experience as an OB/GYN patient, none of my providers really took any time to explain the importance strengthening the pelvic floor or the correct way to do it. In talking to several friends, that has been their experience as well. Many ended up seeing a Women’s Health specialist PT for incontinence issues postpartum, and they were very surprised at what they didn’t know about their own body and how simple the treatments are.
Women’s Health & Physical Therapy
Having had the advantage of going to PT school, I at least knew a little about my pelvic floor and the Women’s Health specialty within the world of physical therapy. It is a fairly new but growing specialty. But even in school, the amount of curriculum dedicated to Women’s Health and/or pelvic floor issues was minimal. I’ve had to really do a lot of my own research and take some extra courses to learn more.
A systematic review published in 2014 found that “PFMT (pelvic floor muscle training) during pregnancy and after delivery can prevent and treat UI (Urinary Incontinence)”. This research shows the benefit of exercising the pelvic floor, but the problem is that our current healthcare culture doesn’t promote much preventative education in this arena.
What I want all mothers and mothers-to-be to know
I think many women just accept the fact that some urine leakage after having a baby is expected. Many women do experience this, yes….BUT that doesn’t have to be the case. Urine leakage is a dysfunction of the pelvic floor and there is treatment available!
There are physical therapists that specialize in Women’s Health that can help with all kinds of things (urinary and bowel incontinence, breast cancer, lymphedema, pelvic girdle pain, pediatric pelvic health, male incontinence and pelvic health, sexual dysfunction, pregnancy and postpartum, to name a few…). However, you may have to seek them out. The American Physical Therapy Association (APTA) has a Section on Women’s Health (SOWH) where you can look up therapists who’ve been specially trained and certified – look for someone with a WCS after their name (Women’s Health Clinical Specialist). For more info, go here.
Performing a pelvic floor contraction
Think about pulling the whole area from your pubic bone to your tail bone “up and in”. Another description I’ve heard is to “stop the flow of urine”, but actually I think a more accurate description is to “stop the passing of gas”. The contraction needs to include the muscles around the vagina as well as around the anus. You should not be holding your breath or contracting the abs. If you have difficulty doing this or are unsure if you are doing this correctly, you may want to seek out a Women’s Health specialist.
Exercise your pelvic floor
- Quick flicks – contract your pelvic floor as hard as you can.
- Sustained contraction – contract your pelvic floor and hold the tension starting for 5 seconds and working up to 10+ seconds.
- Elevator – contract and lift up your pelvic floor little by little, like you’re going up floor by floor in an elevator. When you get to the top, or your maximal contraction, don’t just completely release the tension. Instead, control and let down the contraction little by little (or floor by floor) until you are completely relaxed.
You can perform these exercises sitting, standing, or lying down. Like any exercise, start small and build up. I recommend 2-3 sets of 5-15 reps of these exercises a day. Perform these consistently, maybe there is something already in your daily routine where you could incorporate your pelvic floor exercises. For example, when you brush your teeth, take a shower, cool down from a workout, nurse your baby, or watch commercials during your favorite TV show. Practice these both during pregnancy and after.
Once you are confident you are correctly contracting the pelvic floor, try doing it while pulling your belly button into the spine (contracting the transverse abdominis). Also, try contracting your pelvic floor while walking or going up and down steps.
Find a Physical Therapist
Try doing these simple exercises on your own and if more help is needed or other issues arise, a physical therapist can really help. Most states these days don’t require a prescription from a doctor to see a physical therapist so you can go directly to a specialist for an evaluation.
Our bodies go through so much during pregnancy! And we give so much to be mothers! My hope is that we can create more awareness in our communities on ways women and mothers can take care of themselves and also to let them know there are people to help.
This guest post was written by Alina Horrocks. Alina graduated from Texas Woman’s University in Houston, TX with a Doctor of Physical Therapy in 2010. She has worked primarily in the hospital setting, helping inpatients regain and improve functional mobility. She welcomed her third child last year and is now using her professional and personal experience to help other moms take care of their bodies during pregnancy and beyond.
This guest post was written by Sasha Ruscheinski to share about her and her husband’s experience with miscarriage. The rainbow dad tee can be found here.
When my son, Lincoln, was 15 months old, my husband and I decided to try for our second child. We had no idea the journey we were about to go on. Within eight months, we had lost three pregnancies. The first was a missed miscarriage at 10 weeks, the second was an ectopic at 6 weeks and the third was another missed miscarriage at 6 weeks. It was excruciating and has forever changed me. I had been very lucky in my life and had never really experienced a loss. I am married to the only person I have ever dated, so I had never even experienced a lost love before. There were many nights where I would lay in bed and just sob. It felt as though my heart was going to burst through my chest. Losing those babies really took a toll on me. Being able to talk freely about my feelings really helped during the grieving process. I had friends texting me daily to see how I was doing, I was sent flowers on the due dates of the babies we lost and was given a beautiful necklace by my closest friends. Even hugs from friends and family always lasted a little longer. The support I received was amazing and really helped me get through it. When a woman miscarries the support is usually given to her, but what about dad?
I know the saying goes “when a woman becomes pregnant she becomes a mother, when man holds his child he becomes a father”. Yeah, that may be the case for some, but I know that the instant we got a positive pregnancy test my husband started dreaming about our child. He started to envision our life with this new family member. I know that our losses crushed him. He never saw them coming. With the first baby we lost, I had had a feeling that something wasn’t right, but my husband always kept telling me that everything would be okay. It was at our first ultrasound, on his birthday, that we found out the baby hadn’t made it past seven weeks. I will never forget that look on my husband’s face when the tech told us. It was pure anguish, yet the first thing he did was grab me. Men carry such a heavy burden when you miscarry. They are grieving the loss of their child, but they also have a partner that needs major support.
Recognizing Rainbow Dads
Our rainbow baby, Britton, was born on November 16th, 2016. It was one of the best days of my life. Since his birth, I have been drawn to all things rainbow and when I saw the Rainbow Dad shirts from Bryn, I knew I needed to get one for my husband for Father’s Day. When I first picked up the shirt, I looked at the beautiful rainbow and the words “rainbow dad” and I had this wave of emotion just hit me so hard. Even as I write this, my heart is tightening and I can feel tears coming. I had always just seen myself as a rainbow mom and Britton as my rainbow baby. I can honestly say that during our (I initially wrote “my”) miscarriages, I didn’t really give much support to my husband. Our losses completely consumed me, so I never stopped to think that maybe they consumed him as well. I think it is very easy to forget about dad; I know I did.
This rainbow dad shirt made me stop and think. It made me ask my husband about what it was like for him when we lost our babies… a question I had never asked him before. My husband would be the first one to say that his main concern was me; he wanted to make sure that I was okay. He let me cry when I needed to, let me be angry when I needed to be and just sat there in silence with me when I needed it. I wish that I had been able to do that for him, since I know he suffered in silence. I wish I had sat down with him and let him fall apart the way he let me. I wish he was given the same amount of support that I was given. I know he is at a new place in his grieving process, but I know he needed me back then.
People come to me a lot for my advice when they are going through a miscarriage. My advice is always directed at the woman and making sure to give her support. Moving forward, I am going to make sure to remind them to not forget about the dad the way that I did. Dads need to be given the chance to fall apart as well and have someone there to comfort them. So often men want to be the fixers. They want to be the strong man and support their wife. I asked my husband what he would say to another man who lost a baby and his words were simple: it is okay for you to
The Birth Hour also makes Rainbow Kid and Rainbow Mom shirts if you want to match as a family!
I never had anxiety before having kids and even after my kids were born it was mostly normal every day worry not full blown anxiety. Then, when my son was one year old, my best friend’s son was stillborn and full on anxiety kicked in. I was there with her when we found out he was gone and I was one of her go-to people of support in the dark days after her loss. I wanted to be there for her and was glad that she was opening up to me, but it didn’t come without it’s own affects on my mental and physical well-being. I began to have anxiety attacks that manifested in the form of what fell life labor contractions and would last for hours and sometimes days.
I went to therapy for the first time in my life and opened up about not just about the loss of my friend’s son and the affect on me but also issues that came up from my past. I highly recommend therapy to help with anxiety or at the very least talking to someone in your life rather than holding it in. Although, I never felt I needed pharmaceutical drugs, I know there are many people who do benefit from them. In this post I wanted to share some of the things that helped me through this dark time and continue to help me today as I deal with daily bouts of anxiety and occasional anxiety attacks.
Initially I had a really hard time falling asleep as I tried to process what I had just been through and kept putting myself in my friend’s shoes knowing she was suffering and that for whatever I went through it was so much worse for her. I found that falling asleep to a guided meditation was very helpful to me and I ended up recommending it to my friend and she benefitting from it as well. I especially love Expectful if you are in the pregnancy or motherhood stage of life. I also discovered this special headband that makes falling asleep with headphones a bit more comfortable.
This supplement continues to help me immensely with managing anxiety. If I start to feel a little anxious for no apparent reason, I squirt some in my mouth and I notice a real difference very quickly. Warning, it tastes gross but if you chase it with some water, the taste goes away quickly. This tincture, also has motherwort in it and was created by a midwife I know well to increase fertility so if you’re trying to conceive and anxious, I recommend it highly as well!
The mental benefits of even a 30 minute walk are pretty amazing and if you want a more intense workout my favorite free resources are the 7 minute workout app or yoga videos on youtube. If you’re expecting, I’m a huge fan of Knocked Up Fitness which offers specific breathing techniques, yoga and workout routines for pregnant moms.
Getting enough sleep when you’re dealing with anxiety is really important but it’s also often hard to turn your brain off in the evening. My friend loved a relaxation technique that can be found in the Yoga for Grief Relief that has lots of great resources she loved. Basically before going to sleep, while lying down you start at your feet and concentrate on each part of your body being totally relaxed. Repeat in your head, “my feet are completely relaxed,” and once they start to tingle you move up to your calves, thighs, pelvis, stomach, etc. until you’ve done your entire body. She said this exercise helped her not to lie down in bed and toss and turn thinking about everything.
For anxiety at bedtime, my friend also swears by this Eucalyptus spray that her mother-in-law who’s a L&D nurse recommended. It’s pricey but lasts for quite awhile with just one spray on the pillow each night.
Specific Support Groups
My friend shared with me that social media groups help you feel less alone and crazy and the more specific the group is to your own experience, the better. For instance, there’s a FB group for pregnancy after loss specifically for moms of 3rd trimester losses. I imagine that regardless of what is causing anxiety for you, there’s a Facebook group or even local in-person support group that could help.
Whether you have a planned or unexpected cesarean section birth, the recovery can present challenges for any woman and being prepared for certain possibilities can help relieve you of added stress. After all, this is major abdominal surgery affecting nearly one-third of women in the United States and even higher numbers in some other countries; c-section prep and recovery are definitely worth thinking about and planning for, no matter what kind of birth you have in mind.
In Hospital Cesarean Recovery
If you know ahead of time that you will have a c-section, here are some things to bring and what to expect of your stay after delivery.
What to bring to the hospital
Aside from your normal hospital bag, these few extra items might be helpful.
- Nice shampoo and lotion. Your favorite shower items can be a nice way to treat yourself.
- Clothing. Definitely do not pack anything restrictive that could cut into your incision area. Maternity pants, sweats, and robes are all good options. These high-waisted panties have great reviews for c-section comfort and a bit of support.
- High fiber snacks. Many women report some degree of GI pain and discomfort following surgery, and constipation is not uncommon. Having some fibrous foods on hand to eat during your stay can aid in normalizing your bowels. Pack some easy snack items to munch on between meals. Apples, oranges, pears, berries, nuts, and dried fruit are all good options. Remember to drink as much water as you can!
- Slip-free shoes. Slippers with rubber soles or flip flops will be handy when you go for laps around the floor and to the bathroom. It may be difficult to regain your balance post-surgery because you use all those core muscles that are currently on the mend. So make sure your shoes have good grip.
- Fabric wrap for your waist. Purchasing a belly band or bringing some stretchy fabric to wrap snugly around your waist can really help with added support when you are moving around post-surgery. Even coughs and sneezes can be quite jarring to your incision area, so having that core stabilization is nice. It also helps to encourage your abs to come back together after separation during pregnancy (diastasis recti). Holding a pillow tight around your stomach when coughing or sneezing can also help ease the pain, but having a wrap or belly binder allows you to have support and free up your hands for holding your new baby.
What to expect post surgery
Hospital policies vary but a three or four day stay is most common. Recommendations for getting up and walking will vary based on the type of anesthesia you were given as well as how your body responded to it, but it’s not uncommon for the staff to have you up and walking around after approximately 12 hours. If 12 hours post-op falls in the middle of the night they will probably keep the catheter that was placed for surgery inserted and wait until the next morning. Some hospitals don’t suggest getting up to walk until 24 hours following surgery. This is something to discuss with your doctor to decide what is the best course of action for you personally.
Mobility After Cesarean Birth
The reasoning behind getting you up and moving as soon as is safe is to encourage good blood flow to your extremities and prevent clots. Walking will also help with digestion, but will likely wear you out, so don’t overdo it. Taking a lap around the floor every couple of hours is probably sufficient.
While you’re still in the bed you’ll likely wear cuffs around your lower legs that occasionally pump up with air and squeeze tight. These compressions lower the risk of blood clots when you are less mobile.
Some women may feel very gassy and bloated. This can make it uncomfortable to try to pass gas as well as cause discomfort to your incision area where the muscles used for bowel movements are still healing from surgery. Answering questions about whether you’ve passed gas or had a bowel movement yet can be embarrassing but the staff needs to know your GI tract is back up and working to ensure you don’t have any complications there.
Your first bowel movement can be a nerve wracking event. The act of pushing can be painful to your healing muscles so you’ll be given stool softeners beginning right after surgery to help minimize the amount of pushing required. Many women report the anticipation of pain during a bowel movement was much worse than the actual pain experienced while some women do experience severe discomfort.
Anesthesia, surgery, narcotic pain relievers, and decreased mobility can all contribute to constipation so it’s important to take the stool softeners regularly, drink plenty of water, eat wholesome fiber rich foods, and be as mobile as your energy and pain level permits to help alleviate possible GI issues.
Following all types of birth the uterus needs to contract in order to expel any remaining blood or tissue inside of it. Some women report no noticeable afterbirth pains (the uterine contractions that occur after baby is born), while others experience such strong ones that they equate them to labor pains.
Whether yours are mild or strong, they serve a purpose. It’s important for your uterus to begin the process of shrinking back down to its pre-pregnancy size. The nurses will need to assess the size and firmness of your uterus but palpating your abdomen. This is typically a fairly uncomfortable assessment whether you’ve had a cesarean or vaginal delivery. They have to press down hard to accurately assess the size of your uterus as well as how firm it is.
A shrinking, firm uterus is what they are looking for, whereas a ‘boggy’ uterus could indicate a problem requiring medication to help it contract more. The act of pressing down on it through your abdomen can help it along as well, and while they don’t usually have to press down very long it can be painful. The nurses will use this time to assess your level of bleeding as well. We recommend this afterbirth tincture.
Many women are surprised to learn that following a c-section you will still have very heavy vaginal bleeding, just like vaginal deliveries. This lasts for about 4-6 weeks and the protocol is the same—no tampons allowed, only big absorbent pads. Your caregiver will likely provide some large mesh disposable underwear to use after delivery. These are a great option for the first few days following birth as they typically don’t irritate your incision site or put any pressure on that area the way some underwear elastic can—basically they are glorious! Stocking up on these as well as large overnight pads (these are our favorites) is a good idea since you’ll be changing them frequently the first couple of weeks.
Passing some heavy clots is fairly normal. The rule of thumb is generally if you pass a clot smaller than your fist, it’s okay. Anything larger—call your doctor.
Cesarean Incision care
Following surgery, your incision will be covered with a bandage that usually isn’t removed until the next day. Your incision will either be closed with sutures (dissolvable or non-dissolvable), staples, steri strips, or surgical glue on your abdomen. Staples and some types of sutures will need to be removed by your doctor a few days after you’re discharged. Before being discharged you will be given incision care instructions specific to your type of closure.
Keep in mind that your incision will look very different immediately after surgery than it will eventually. Most incisions will shrink down considerably and flatten to a thin line. Itching and tenderness around your incision is normal but annoying, anything more severe than that would warrant a call to your doctor. Try this spray or salve for expedited healing and scar reducing.
Advocate for Yourself at the Hospital and Home
Recovering from surgery, adjusting to new motherhood, getting the hang of breastfeeding—the first few days after a cesarean can be stressful and overwhelming. It’s important to make your needs known to the staff. If they don’t know your wishes, they can’t follow them. It’s your job to advocate for yourself and your new baby. Be open and clear with the hospital staff and expect the same from them—you’ll both benefit from respectful and clear communication. Never be afraid to request a new nurse if you aren’t receiving the care you feel you need or even if your personalities are not meshing well.
You never get the first few days with your new baby back again and they’re too precious to have marred by having someone around who puts you on edge, this goes for visitors and family as well. While well meaning and excited for you, visitors and family often end up putting more strain on mom than support. If friends want to come see the new baby make them earn the visit! Have them hold the baby while you take a shower or nap. Fold a basket of laundry while you chat. Fix some lunch or start a freezer meal in the oven for you. Have older kids? Ask friends to take them to the park for a hour and let them peek at baby when the come to pick them up.
You might be surprised at how eager people are to help when given specific tasks! But if the thought of a house full of people fills you with dread then don’t put yourself through it. Ask your partner or a supportive family member or friend to spread the word that you aren’t ready for visitors yet but appreciate everyone’s well wishes and put a sign on the door with the same sentiments.
Breastfeeding after a Cesarean Section
The first few days, your breasts produce a nutrient-dense, antibody-rich yellow liquid called colostrum. Colostrum is nature’s first perfect food for baby and provides all the nutrition, immunity, and vitamins your baby needs. Colostrum usually transitions to mature breast milk within 2-6 days of delivery. It’s not unusual for milk production, or ‘coming in’, to be delayed following a cesarean due to the use of IV fluids and other medications such as Pitocin. Once this occurs your breasts will be much larger and you may experience some engorgement. The best remedy for the discomfort of engorgement is removal of milk from the breast by the baby. Your baby will signal the amount of milk she needs your breasts to make and your supply will normalize. There are wonderful breastfeeding resources to be found here.
Some women have no additional difficulties breastfeeding following a cesarean than after a vaginal delivery but some find positioning difficult while their incision area is still tender (we love this breastfeeding pillow for keeping off your incision). Utilize the lactation consultants at the hospital as much as you need them while there. It’s a great idea to have an outpatient lactation consultant’s contact info saved already prior to delivery in the event you need more assistance following discharge. Ask friends who have had fulfilling breastfeeding relationships with their children for references to check out before you’re home with a new baby, sleep deprived, and probably pretty emotional.
The International Cesarean Awareness Network has some great info available regarding breastfeeding after a cesarean that can be found here. Kellymom.com is a great breastfeeding resource website in general and wonderful article about breastfeeding after cesarean can be found here.
Recovery at home after Cesarean Birth
photo via @littlewhale3
Bringing a new baby home is an exciting time for everyone, but don’t forget to take care of yourself as well. Your baby needs a cared for mother as much as she needs to be cared for herself. Accept offers of help! People love to feel useful but may not know how best to help or are hesitant to step on toes. Give them direction and don’t be afraid to set boundaries when it comes to having people over. Physically, you’ll need to take it easy for a while. It’s often recommended that you not to lift anything heavier than the baby or drive for 2 weeks. After that, follow your body’s cues and rest as much as possible.
The best way to encourage a speedy recovery is to allow your body the time it needs to heal. Rushing the process can result in setbacks that will only prolong it. Once you feel up to it, which will vary for every woman, light exercises like walking can be beneficial.
Medication After C Section Birth
The types of medications prescribed for pain will vary from doctor to doctor and patient to patient. Ask someone (like your partner) to keep track of what time you take your medications as trying to remember on a sleep deprived brain is probably not the best plan. Many people recommend taking the meds on a strict schedule the first few days regardless of whether you’re in enough pain to feel you need it yet. This is suggested to prevent the pain getting ahead of you and then having to wait for the meds to kick in. Some people prefer to begin a slow weaning process off of the meds sooner if they don’t like the way they feel on them.
Pay attention to your reaction to the meds and to your pain level and make the best decision for your body. Don’t hesitate to call a nurse or doctor if you are concerned about any symptoms. There are many post-surgery symptoms that while totally benign, can alarm you if you haven’t experienced them before. Reach out for information when you need to.
Some women report referred pain in their shoulder during recovery. Not all women experience it, and it seems to be worse for patients who had general anesthesia vs. spinal anesthesia. The pain is due to irritation of the diaphragm, and trapped gas. Anti-gas medication and walking will help. The more regular you can get with your bowels, the sooner the pain will subside.
Bed comfort for Cesarean Mamas
Keep that wrap handy for when you get in and out of bed, to help with support. Wrapping before you get up and lay down provides stability and a little bit of comfort. Feel free to even keep it on for a while so you don’t have to constantly adjust it. Some women find it difficult to get up from a flat lying position in bed. Roll on your side first and push up with your hands to prevent straining your abdominal muscles. If this is still too uncomfortable try putting several pillows behind your back and rest or sleep in a reclined position. Your pelvis will be working to get back in its pre-pregnancy position and can ache after delivery. Try sleeping with a special pillow between your knees and ankles to help alleviate some pressure.
There are lots of hormonal changes that take place right after delivery, and your body is also getting rid of a lot of excess fluid it carried while pregnant as well as any intravenous fluids given before, during, and after surgery. All of these factors combined might have you waking up at night to find the bedding and your clothes completely soaked. For the first couple of weeks, some women sleep on an extra sheet folded in half, or a towel so they can remove it midway through the night to have clean linens beneath them. Others suggest having clean pajamas handy for a quick middle of the night change. Remember to keep drinking a lot of water. It sounds counter-intuitive to replace excess fluid you are losing through sweat, but remember how much water is going toward milk production, so it’s necessary to keep things functioning well, and restore balance.
Mobility After A Cesarean Birth
For some women, stairs prove to be tiring and awkward to navigate the first couple of weeks. If possible, you might consider setting things up at home so that all the supplies for baby and for yourself will be mostly on one floor. Then stay in that area most of the day minimizing the need to navigate the stairs repeatedly. For other women the lure of being in their own bed on the second floor is enough to make it worth it. Just don’t hesitate to ask for help going up and down, even just having someone walk along beside you can be reassuring.
Keep in mind that your center of gravity has drastically changed and your body is still adjusting to that as well as healing from surgery. It’s not uncommon to feel off balance and it’s better to have help nearby just in case. Consider having pillows handy on both floors should you need to squeeze one against your abdomen while coughing or sneezing. Plan to give yourself plenty of time to recover, should it happen sooner than you planned—it will be a pleasant surprise! Be gentle with yourself. All women are different. There is no ‘right’ amount of time for recovery. There are no hard and fast rules for a healing timeline. Listen to your body, introduce things slowly back into your routine, and ease into motherhood.
photo via @chan_askins
Emotional Recovery after Cesarean Birth
Take time to evaluate your feelings about your cesarean experience. Mothers with planned cesareans have the opportunity to consider this beforehand but may still find themselves overwhelmed with conflicting emotions after the fact. Mothers who had an unexpected cesarean may feel blindsided and it’s important to take stock of all of these emotions and know that they are all valid.
It’s ok to feel disappointed in the way your baby was born. If you had planned for or envisioned things going differently, it’s completely normal to be sad it didn’t work out that way. This does not take away from the love and joy you have for your child. You can be deliriously happy that they are here and still be upset about how they came. Birth trauma may sound like a dramatic way to describe it but it’s not uncommon for women to experience varying degrees of trauma after a cesarean birth whether it was planned or unexpected, or especially if it was an emergency situation.
Your Feelings Are Your Own
Birth is a highly emotional experience and any emotions you have towards your child’s birth are valid and you are not alone in feeling them. Perhaps your cesarean was calm, you felt respected, and things went smoothly—this is the hope for all women experiencing a cesarean. Many women feel at peace with their sections and might not understand why others are seemingly devastated by theirs. Other women are deeply saddened by having had a section and cannot fathom why someone would choose to have one unless necessary.
When speaking with other mothers or mothers-to-be, be respectful of others’ experiences and perceptions of their experiences. Just because you loved your c section doesn’t mean another woman is wrong for disliking hers. Just because you hated your experience doesn’t mean another woman is wrong for liking hers. Evaluate and process your own feelings towards your cesarean and reach out for help.
Find others who can be supportive of your journey of processing your cesarean. The International Cesarean Awareness Network provides support, education, and advocacy for women experiencing cesareans and interested in VBAC (vaginal birth after cesarean.) ICAN can be found online here as well as on Facebook and Instagram. They have local chapters across the world which can be located on their website. Many of their chapters have individual Facebook groups and hold in person meetings for support. Talking to other women who have experienced a cesarean is an invaluable resource for processing your experience as well as planning for a cesarean section or a VBAC.
Birth is hard. Birth is beautiful. Birth is transformative. Take the time to take care of yourself and be proud of what you’ve accomplished and experienced for your new baby.
This guest post was written by Austyn Smith and a very special thanks Laura Shawver and Elizabeth Quinn who provided lots of great information while writing this post.
- Hamilton BE, Martin JA, Osterman MJK, et al. Births: Final data for 2014. National vital statistics reports; vol 64 no 12. Hyattsville, MD: National Center for Health Statistics. 2015. https://www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_12.pdf
- Althabe,Fernando; Belizán, José M.; Betrán, Ana P.; Gibbons, Luz; Lauer, Jeremy A.; Merialdi Mario. The Global Numbers and Costs of Additionally Needed and Unnecessary Caesarean Sections Performed per Year: Overuse as a Barrier to Universal Coverage. World Health Report. 2010; Background paper, 30. Health Systems Financing. World Health Organization. 2010. [January 22, 2017]. http://www.who.int/healthsystems/topics/financing/healthreport/30C-sectioncosts.pdf
- Basar, Birsen; Cift, Tayfur; Olmez, Fatma; Ustunyurt, Emin; Yilmaz, Canan. Shoulder Tip Pain After Cesarean Section. Journal of Clinical and Diagnostic Research. Ausust, 1, 2015 [January 22, 2017]. Bethesda MD: National Center for Biotechnology Information. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4576593/