Hospital Stay

Women with a C-section birth will typically stay in hospital for 48-72 hours for their first baby, and 24-48 hours for subsequent pregnancies. Stays may need to extended for maternal medical reasons, or if the baby is not yet ready for discharge. Moms and babies room in together, and partners are encouraged to stay and help.

The woman’s own OB typically will see her daily, except on weekends and holidays, when rounds are done by the on-call OB. The OB discharges the mother, pending discharge of the newborn by the Pediatrician. If a baby requires an extended hospital stay (eg. greater than one week), the mother will be usually be discharged independently of the baby. In select cases, mother/baby pairs can be admitted together to the Rabbit Pod at BC Children’s for more extended stays. Upon discharge, a nursing home visit will be arranged.

NUTRITION, pain relief, AND Activity

Women can generally eat and drink, as tolerated, upon admission to the postpartum unit. Mothers are encouraged to mobilize early, and pain medications will be provided to optimize this. They are all safe for breastfeeding. In most cases, acetaminophen (Tylenol) and an anti-inflammatory (naproxen) will be given at regular intervals for the first 48 hours, and a strong opioid (hydromorphone) will be available upon request for breakthrough pain. While it’s important for pain relief to be adequate, women should try to use the minimum amount of hydromorphone necessary, and to wean off as soon as possible. These opioids can make mothers groggy, nauseous, and constipated, and are highly addictive when used long term. After the first 48 hours, women are given a self-medication bottle, which includes acetaminophen and ibuprofen, to use as needed. These medications are available over-the-counter, and should be continued after discharge. Some women will still need hydromorphone after leaving the hospital, and they should mention this to the OB arranging the discharge, as a special duplicate prescription is required.

Women should avoid heavy lifting or straining (anything heavier than the baby) for the first 6 weeks post-operatively. Stairs are fine, as long as they are taken slowly. Driving should be avoided while there is a functional impairment; there is no set time for this, but it’s usually 10-14 days.

Wound Care

The incision will typically be closed with a dissolvable suture under the skin and then covered with steri-strip tape. Sometimes, the skin will be closed with staples, which will be removed 3 or 4 days after the surgery. Removal is done by the ward nurse, or by the primary care provider if removal takes place after hospital discharge.

The incision area should be kept clean and dry. It’s fine to shower on the first day after the operation, and for the soapy water to run over the incision. The area should then be blotted dry with a towel. Soaking in a bathtub should be avoided until the skin has fully healed-over (10-14 days).

The steri-strips should be removed after about a week, if they have not fallen off on their own. They are easiest to remove after showering, when they are wet. Leaving them on longer can lead to bacterial contamination.

Wound infections can occur, and are more likely with emergency C-sections done in labour than with planned C-sections. The usual timing is 5-7 days after the operation and women are usually home by then. Signs of infection include increasing pain, redness and heat around the incision, drainage of pus from the wound, and fever/chills. If any of these are noted, the wound should be assessed by directly contacting the OB’s office, or attending the Urgent Care Centre (UCC) at BC Women’s. 

Even after a C-section, it’s normal for women to have vaginal bleeding postpartum, and it can be as much as a heavy period. Typically, it tapers off over time, but it can persist up to 6 weeks after the delivery. Very heavy bleeding (soaking a pad in less than an hour/huge clots) requires immediate attention.