What to Expect after Cesarean Birth: First 72 Hours

After much anticipation and waiting, your baby’s birthday is finally here! Giving birth comes with many significant physiological events, and a whirlwind of emotions as well. In the first few days after giving birth, your body will undergo major changes as your baby also learns to adjust to life outside the womb. In this blog post, we’ll discuss what to expect after C-section, so you can best prepare for the remarkable transformations to come.

No matter how your birth unfolds, the day you meet your baby is one you’ll never forget. If you give birth by Cesarean, it may have been either planned or unexpected. You may have spent a long time in labor, or you may not have experienced labor at all. A c-section is a major surgery, and your recovery will take time, rest, and mindful awareness of your body. Healing from a Cesarean while also learning to care for your newborn is no small feat. In this blog post, we’ll discuss what to expect after a C-section in the first 72 hours postpartum.

Immediate Postpartum: Post-Op

For the vast majority of Cesarean births, you will be able to be awake throughout the process. This means you will most likely have regional anesthesia, whether from an epidural, spinal, or combination of the two. If you must undergo general anesthesia, you will be asleep throughout the surgery and will be awoken later in a recovery room.

How long does a C-section take? The whole process involves preparation, the initial incision, birth of your baby, birth of your placenta, and suturing of the incision. This whole process typically takes around 30-45 minutes. The surgery can be expedited if necessary if you must undergo an emergency C-section.

You will lay face up on a surgical bed, and there will be a screen that blocks the lower half of your body from view. As your baby is lifted from your womb, you provider may lift your baby over the screen a bit so you can see your baby right away. From there, the cord will be clamped and cut, and your baby’s care will be taken over by nurses who will typically clean, swaddle, and bring your baby back to you. Your baby will undergo a brief initial exam to ensure that their vital signs are stable.

If everyone is doing well, you’ll be able to see and possibly even hold or breastfeed your baby while your incision is repaired. From there, you and your baby will be transferred to a recovery.

Bonding with your Baby: The Golden Hour

If you and your baby are both stable, you will be able to hold and bond with your baby almost immediately after your surgery. Immediate skin-to-skin contact has many proven benefits for both parents and newborns, such as increased oxytocin levels and regulation of the newborn’s temperature, breathing, and heart rate.

Your newborn has just gone from the dark, warm, quiet environment of the womb to the bright shock of the outside world. As soon as possible, minimizing loud noises and bright lights during this time can help them regulate and take in their surroundings. This sensitive time in a baby’s first moments after birth is referred to as “the golden hour.” Protecting this time by allowing continuous skin-to-skin contact and minimizing disruptions can have a lasting positive impact on parent-child bonding.

Immediate Care for Birthing Parent and Baby

Within the first few hours after birth, your baby will be weighed, measured, and given a thorough head-to-toe assessment. Both parents and baby will receive hospital wrist bands and babies will also receive an ankle band with a security device that will stay in place throughout their hospital stay.

Birthing parents can also expect a head-to-toe assessment, with particular emphasis on your vital signs, postpartum bleeding, and incision site. Healthcare providers will regularly check your fundus to ensure your uterus is doing a good job clamping down after birth to prevent postpartum hemorrhage.

If you received an epidural or spinal anesthesia during your C-section, it will typically wear off within 2 hours after birth. Your support team will assist you closely the first few times you exit the bed after delivery. They will also accompany you to the bathroom and make sure you’re able to urinate without pain.

You may feel very swollen and sore after a Cesarean delivery. If you went through labor and experienced pushing, you may be particularly sore. Remember that you just underwent a major surgery, and there are pain management options available to you that are safe for you and the baby.

Nurses will regularly check your vital signs after giving birth, slowly decreasing in frequency as your body shows signs that it is recovering well.

Day One Postpartum: Many Firsts

No matter whether this is your first baby or your fifth, the first day with your newborn is a day of many firsts for both parents and babies. Knowing what to expect after C-section on the first day is helpful so you can be prepared for what’s to come.

Within the first hour or so after birth, you’ll offer your baby their first feeding, whether by breast or bottle. If breastfeeding, your mature milk won’t be in just yet. Your body will produce colostrum, a nutrient-dense superfood that provides a high level of calories and antibodies. Your newborn will need eat every 1-3 hours in the first days after birth, as their tiny stomach gradually increases in volume.

Other firsts during the first day after birth may include:

• your baby’s first diaper changes – their first pee and bowel movement (known as meconium) can be expected anytime within the first 12-24 hours after birth
• your first postpartum shower – which is known to feel absolutely amazing! Be sure to bring your own favorite products for an especially satisfying experience. Hospital soap is not known to be the most luxurious.
• lochia – your postpartum bleeding – will begin after your C-section. For the first several days it will like a heavy period, then it will continue to taper down for the first 4-8 weeks after birth.

Your partner will also get to experience their first time holding their baby. Skin-to-skin contact has many benefits for the non-birthing parent, too.

Day Two Postpartum: Settling In

On your baby’s second day of life, everything will still feel very new. Emotions are still very raw, but the initial shock of having finally met your baby may start to settle down. You may be very tired, or you may be surprised at how energized you feel – thanks to adrenaline!

As far as your hospital stay goes, what to expect after C-section on day two is that it’s not yet a common time to be discharged from the hospital. Most parents who delivered by Cesarean should expect a 3-4 day postpartum hospital stay.

Day Three Postpartum: New Normals

By day three postpartum after a C-section, you may be ready to be discharged home. Knowing what to expect after C-section on day three is helpful to ease your transition home.

The idea of going home may feel like a relief, or you may feel totally unprepared to take your baby home. All of those feelings are completely normal!

Before you do get the okay to head home, your healthcare team will want to ensure a few key details:

• that your baby is feeding well, whether by breast or bottle
• that your baby is having adequate wet and dirty diapers
• that you and your baby’s vital signs are stable
• that your incision site is healthy and starting to show signs of healing

Your baby will also undergo routine procedures, such as:

• blood screening to detect metabolic abnormalities (known as the PKU test)
• a newborn hearing screening
• a thorough newborn assessment to check their reflexes and any abnormalities
• initial injections, such as a Vitamin K shot and Hep B vaccine

Some babies may also need to undergo other testing such as blood glucose checks or a car seat test to ensure they are ready for life outside the hospital.

When you do finally arrive home, emotions are all over the place, and it’s common to experience temporary mood swings known as the baby blues during this time. On day three postpartum, your bleeding will still typically be heavy at this point, but it may also have started to slowly taper down. If your bleeding gets heavier, this is a sign that it’s time to slow down. Always contact your healthcare provider if you’re concerned about your postpartum bleeding.

If you’re breastfeeding, your milk may have already started to come in, or you may still notice the thick, yellowish colostrum: both are normal! Most breastfeeding parents notice a transition to mature milk around days 2-5 after birth, and it can take a bit longer after a Cesarean birth.

Your milk coming in can come with a full feeling in the breasts known as engorgement. Your baby may also behave differently at the breast, with more frequent, audible gulping as they learn to take in a larger volume of milk.

As your mature milk comes in, your baby will need more frequent diaper changes. The chart below from La Leche League Canada is a helpful tool to know what to expect regarding your baby’s diapers:

Transitioning Home with your Baby

Having a baby comes with a whole world of unknowns. While you won’t know exactly how your C-section and recovery will go, learning about these general expectations is a helpful starting point.

When you finally get to bring your baby home, a whole new chapter of life begins. Building your support system is a crucial step to ensure a smooth transition for the whole family. A Newborn Care Specialist or Postpartum Doula is a wonderful asset for new families, offering comprehensive support to ensure a soft landing home with your baby. You may want to line up daytime postpartum care, overnight newborn care, or around the clock care (whether temporary or longer term) to ease your family’s transition home.

Your body needs time to heal from a Cesarean, so prioritize self-care and accept help from loved ones. Adequate rest, hydration, nutritious meals, and gentle movement can support your recovery and overall well-being as you adjust to your new role as a parent. You will likely be advised to not lift anything heavier than your baby, to avoid stairs as much as possible, and to avoid driving until cleared by your provider.

What to expect after C-section is a world of profound change, growth, and bonding for both parents and babies. By knowing what to expect and embracing this transformative period with patience and self-care, you can lay a strong foundation for a healthy postpartum recovery and nurturing start to parenthood.

Embrace each moment, trust in your instincts, and remember that this journey is unique to you and your baby. Welcome to the extraordinary adventure of parenthood!