Sections In recent years, throughout the world there has been a tendency towards an increase in cases of delivery with the help. A caesarean section is the birth of a baby by cutting the anterior abdominal wall and uterus. Although cesarean is called, we should not forget that this is a serious abdominal operation. Indications for this operation can be various pathologies on both the mother’s and the child’s sides. Starting from anatomical features (such as a narrow pelvis), physiological (improper position of the fetus or placenta previa), and to serious pathological conditions (fetal hypoxia, etc.) and developmental defects. A caesarean section can be performed as planned or as an emergency procedure; this directly depends on the reasons for surgical delivery. Recovery of a young mother’s body depends on the indications for surgery and her general condition.

The first days after cesarean

On the first day after surgery, you will be in the intensive care unit or intensive care unit, under the supervision of an anesthesiologist and nurses. It is recommended to get up on the second day after surgery.

Some mothers begin to get up earlier, but if, for example, there was spinal anesthesia, then there is no need to be a hero (even if you feel that you can move mountains) and It’s better to get up only after the doctor’s permission. Otherwise, there may be long-term headaches, which will not be at all useful when you need to take care of your baby. Getting up for the first time after surgery must be in the presence of a nurse or doctor. Do not rise abruptly from your back, it will be easier and less painful for you to get up from the position on, this way there will be less stress on the press. Put on the bandage, it will ease the condition and support the stomach. You should put it on before getting up, but in bed it is better to do without it. After a caesarean section it is recommended to wear a bandage from the first days after surgery. It will help your muscles recover faster and your tummy won’t be saggy, it’s much easier to move with it, and in the first days it will be simply irreplaceable. You will then determine the duration of wearing it yourself, as they say “experimentally”, basically it is three weeks.

Food and drink

You can drink the water after 4-6 hours, starting with small sips. It may happen after anesthesia, don’t be alarmed, this is quite normal. Start eating the next day, light, low-fat food (broth, kefir, pureed meat and vegetable puree, etc., which is suitable for a nursing mother), in small portions, gradually increasing the volume and variety of dishes. You can drink tea or rosehip decoction, not carbonated water. In the first days, it is better to exclude fruits in order to avoid manifestations in the child. It is better to adhere to a gentle diet, since increased gas formation in the intestines can cause discomfort and pain, and your baby will minimize the likelihood of intestinal colic.

When you are transferred to a regular ward, if possible, use the help of relatives to care for the child. But in turn, try not to lie in bed, move more, walk around the ward. Movement helps prevent postoperative adhesions, allows you to quickly establish intestinal function, and avoid congestion. You should walk straight, without bending like a question mark; you should not feel sorry for yourself and listen to the slightest pain, otherwise the process of recovery of your body will be delayed and can lead to complications. But you shouldn’t exhaust yourself either; if you feel unwell or have any discomfort, it’s better not to overdo it with stress.

If there are no contraindications to feeding, try as often as possible, so milk will appear faster and psycho-emotional contact with your child will be established. A midwife or children's nurse can teach and explain how this is done. Listen to their advice if you have your first child, they will be very helpful. Even if everything worked out for you and you are doing well on your own, ask the midwife to check the feeding process to see if the baby is latching onto the nipple correctly. This is the key to successful long-term breastfeeding, and therefore the health of your baby.

Pain after cesarean

One of the disadvantages of operative delivery is pain. In the first hours, while the effect of anesthesia wears off, the pain will not be severe, but later it may intensify. Usually, after surgery, narcotic or rather strong non-narcotic analgesics are prescribed.

After a cesarean section, pain can occur for several reasons:

• The postoperative scar will of course hurt. After all, when we cut our finger, it hurts, but here the scale is much different;
• uterine contractions are quite painful, especially in the first days after;
• When you cough, there will also be pain in the area of ​​the postoperative wound. After general anesthesia, you will definitely need to clear your throat well; coughing can be made easier by holding and pressing your stomach while coughing; a bandage will also come in handy;
• formation of gases in the intestines. Violation of peristalsis can become a serious problem;
  complications or infection as a result of surgery.

If you suffer severe pain for a long time, tell your doctor about it. He must find out the cause and select a painkiller that can be taken by nursing mothers. You shouldn’t subject yourself to agony; there are medications that are allowed during lactation.

The pain will intensify when breastfeeding, as the uterus will contract. In the first days, contractions are more intense and are accompanied by copious bleeding with clots. There is no need to be afraid of this, this is a normal physiological process of cleansing the uterus.

Discharge after cesarean

The discharge after a cesarean section is the same as after a normal birth, but they may last a little longer and depend on the characteristics of the woman’s body. Postpartum discharge (lochia) lasts about 2 months. During the first week they are the most abundant, then the amount of discharge decreases and they change color, become brown, then gradually lighten, become scarcer and disappear. Never use tampons after childbirth, as this can lead to infection of the uterus. Regular, highly absorbent pads will work just fine. Also pay attention to the nature of the discharge, its color and smell. If the discharge is bright red and abundant for more than one and a half to two weeks or has a sharply unpleasant odor, be sure to see a doctor.

Caesarean suture

During your stay in the maternity hospital, the medical staff will take care of the stitch. Now as a rule sutures are removed 5-7 days after surgery. If a cosmetic suture was applied, there is no need to remove anything, the suture material will dissolve on its own, and the scar will be almost invisible. Tell your doctor before surgery that you want cosmetic stitches, although they often apply them themselves without asking women. In the first days, it is not recommended to wet the seam to avoid infection. After a shower, you need to thoroughly blot the seam with a napkin. Do not rub with a washcloth or towel. At home is strictly prohibited take, it may provoke or cause an infection. If there is slight redness around the postoperative wound, you can use any antiseptic and treat the suture two to three times a day. A solution of chlorophyllipt helps very well, in a small dilution so as not to cause a burn. If the formation of the scar is delayed, serous or bloody discharge appears, the skin around the scar becomes inflamed or reddened, or increases in blood pressure, then immediately go to the doctor.

Physical exercise

in the first month after a cesarean section are not very advisable, try not to lift weights, leave grocery shopping to your husband or other family members. Lift no more than your child's weight, gradually increasing the load. Be careful with the stroller, do not carry it across floors, find an alternative solution. Let relatives carry her out and bring her in, or use a sling in the first weeks.

Figure and beauty

Fitness or abdominal exercises will help bring your figure back to normal, but no earlier than in a month, after complete healing of the scar. And without fanaticism! Be very careful with this.

Sex after caesarean section

Almost all young mothers who have had a cesarean section are worried about when they can have sex again.

Doctors recommend no earlier than 2 months after surgery when the uterus has completely contracted and postpartum discharge has stopped. You need to see a doctor and only after that “plunge into the pool of passion.” But many do not adhere to these rules and resume sexual activity earlier. The most important thing is to listen to the desires and capabilities of your body. If the discharge has stopped and you feel good, try it. But if it hurts or you have doubts, it is still better to be patient so that there are no unpleasant consequences.

How to make sure that you can return to normal sex life?

Doctors are confident that if there are no complications, then sexual activity can begin as soon as the bleeding after the operation (lochia) has stopped, and there are no problems with the sutures. In order to verify this, you need to perform an ultrasound. This procedure shows how strong the stitches are and whether they will come apart during sex.

Even if a woman feels that she is ready to resume sexual activity and has a desire, consultation and permission from a doctor are necessary. Only a specialist will be able to determine how the postoperative suture is healing.

Besides the stitches, the fact is that after the placenta separates from the uterus, an open wound is formed. We must not allow it to become infected. Therefore, any tampons are excluded, as is sexual activity. Until the wound heals completely.

Statistics

After cesarean section, sexual activity begins no earlier than a month later. According to statistics, the bodies of 10 percent of women after surgery fully recover within four weeks. And from a physiological point of view, you can already begin to be sexually active again. Another 10% of women, due to the individual characteristics of the body and complications, cannot be rehabilitated even after 8 weeks. The remaining 80% recover after cesarean in a period of 1.5 to 2 months.

Physiological side

After a cesarean section, a woman needs to listen to her body. Before resuming sexual activity, you need to wait until the bleeding stops. After this, do an ultrasound and consult a doctor.

At first it is necessary to use contraceptives. But during the lactation period, birth control pills are most often contraindicated, and the IUD can only be inserted six months after surgery. The best options are condoms or vaginal suppositories.

The onset of sexual activity after cesarean section should be gentle. The man must move very carefully, smoothly, to avoid damaging the recently healed stitches. In the first months, sharp, rough movements, pressure and deep penetrations are excluded. For six months, only classic poses are recommended.

During the first intimate relationship after surgery, a woman may feel discomfort. Pain often appears after a caesarean section. But these feelings will pass over time. Ligaments, muscles and tissues of the body will stretch and become toned. This takes time.

Some ardent couples, in the very first months after resuming sexual life, try to replace classic poses with others. This should not be allowed, since penetration of fingers and even tongue can introduce bacteria into the body. Another danger is if the woman reacts violently. In this case, the tension may cause the seams that have not yet strengthened to separate.

According to scientists, during breastfeeding a woman produces hormones similar to those produced during sex. This often explains the reluctance to resume sexual activity. And this happens most often after a cesarean section.

After cesarean section, sex life fades into the background for women. The thing is that a woman in labor is not adapted to a quick return to sex. The partner will have to be patient, since prolactin (the maternal hormone) forces the woman to focus only on the newborn. The body is very “busy” at this time. He is engaged in feeding the offspring. At the same time, sexual desire is not perceived by him as parallel and is considered less important. This condition goes away after some time.

At first after surgery, a woman may not always experience orgasm. For some, it takes about a year to experience the same pleasure again. But 40 percent of women note that after a while they began to experience orgasm twice as often.

Psychological side

At first, when sexual activity resumes after cesarean section, a woman often experiences fear of sex. Fatigue, worries about the child, sleepless nights, and depression are largely to blame. Most often, the first time after resuming sexual life, it will not give the same pleasure as before.

In such a situation, a woman needs to talk to her partner and tell her about her fears. And the man must be patient and not only support her morally, but also help with household chores and let her get enough sleep if possible.

A woman often feels unattractive. After childbirth, the stomach and chest sag greatly. Excess weight often gets in the way. But this can only be corrected over time. During this period, a man needs to be more attentive to his soul mate. Over time, the desire will return. To “stimulate”, doctors often recommend romantic dates or watching erotic films together.

Pain after caesarean section during sex

After a cesarean section, pain may occur during sex. Moreover, their localization most often changes. They can also appear in the vagina. The thing is that the hormonal process of contraction of the uterus and vagina starts, but it was not subject to deformation. Discomfort during sex is experienced due to excessive contraction.

Sexual activity after a caesarean section in the absence of lubrication can cause severe pain to the woman. Often the reason is psychological constraint. In such cases, you can use special hygienic gels or lubricants. If during sex there is a sharp pain or discharge begins, you should immediately consult a doctor.

Do's and don'ts after cesarean section

You cannot begin sexual activity if your partners have sexually transmitted infections or inflammations. And also if the lochia has healed and the sutures continue to bleed. Before starting sexual activity after surgery, the partner must undergo a full examination. Anal sex and heavy lifting are strictly prohibited.

What can you do after a cesarean section? It is necessary to use contraceptives to avoid pregnancy, since the next one can be planned only after two years. Over time, you can start choosing a pose. This must be done very carefully and gradually. The most successful will be those in which the woman herself can control her own movements. Most often this is the “on top” position.

Recovery after cesarean

During the first period of recovery after cesarean section, the woman is prescribed bed rest. She should lie in bed from 3 to 12 hours. You need to get up carefully, without sudden movements, slowly and preferably gradually. It's best in someone's presence. You can start sitting up only on the third day after cesarean section.

If the operation was performed under general anesthesia and gurgling and wheezing are felt in the chest, you need to cough to get rid of the mucus accumulated in the lungs. Rocking in a chair, deep breathing and eliminating any foods that can make you gassy and carbonated drinks from your diet will help you cope with gas.

If constipation begins, physical activity (but moderate), dried fruits and vegetables help to normalize stool. All of the above can be reflected in the psychological background of a woman. And during this period it turns out to be reduced.

During the recovery period after a caesarean section, lubrication is often poorly produced. In this case, active petting helps a lot. You can use aphrodisiacs or incense. To minimize stress on the abdomen and hips in the first months, it is best to use the “back” or “missionary” position. You can try others gradually, but at the same time pay attention so that pressure on the vagina does not cause pain.

Content

If a natural delivery is impossible for a woman for a number of reasons, the doctor prescribes a caesarean section. After this operation, proper recovery is necessary. Every woman preparing to become a mother should know about the recovery period.

Rehabilitation after caesarean section: features of the first days

A new mother immediately has a lot of responsibilities, which complicates recovery after surgery. The woman will have to spend a day in the intensive care unit. Due to anesthesia, a woman in labor cannot get out of bed for 12 hours. To make recovery after a cesarean section easier, remember the following recommendations:

1. You will lie on your back, but you will need to turn over on your side often to release blood clots and prevent adhesions from starting. Place your feet on the bed, lift your hips higher, turn them out and lower them. Take it slow. Smoothly expand your chest.
2. When general anesthesia is restored, you will experience a cough as mucus builds up in your lungs. When coughing, press down the seam with a towel or diaper to prevent it from coming apart.
3. To get out of bed, roll over onto your side and dangle your legs. First, get up and sit for a while. Move your legs, stretch them. When you stand up, try to take as even a vertical position as possible.
4. Taking deep breaths will help you get rid of gases in your intestines during the recovery period. You can also rock in your chair.

How to quickly recover after a caesarean section - recommendations

Any woman wants to get back into good shape as soon as possible. A quick recovery is possible if you remember certain recommendations. Your entire lifestyle matters: nutrition, daily routine, intimate hygiene. Try to strictly follow all the doctor’s instructions to avoid health problems in the future. To understand how to recover from a cesarean section, remember a few basic rules. This way you will protect yourself from a lot of troubles.

Proper nutrition after cesarean section

It is best to eat hospital food prepared taking into account the peculiarities of the recovery of the body of women in labor. Supplement your diet with what you can eat after a cesarean section. Diet according to recovery days for a young mother:

1. After a caesarean section, you are only allowed to drink water for the first 24 hours.
2. On the second day of recovery, lean meat broth with vegetables is suitable. Introduce dairy products into your diet: yogurt, cottage cheese. Eat a small piece of lean meat minced through a meat grinder.
3. On the third day of recovery, you can eat steamed cutlets, meatballs, porridge with water, cheese, cottage cheese, pureed vegetables, chicken, and beef. Food should not be hot. If you have problems with stool, drink kefir.
4. In the subsequent days of recovery, include dairy products, meat, vegetables and fruits, eggs, butter and vegetable oil in your diet.

After a cesarean section, avoid eating the following foods:

• natural honey;
• garlic;
• citrus and exotic fruits;
• strawberries;
• mayonnaise, mustard and other sauces;
• marinades;
• carrots;
• smoked meats;
• canned food;
• seafood;
• sausages;
• chocolate.

Physical activity

The sooner you start moving after a cesarean section, the less likely it is that adhesions will develop. While you are recovering from anesthesia, roll over from one side to the other, try to move your legs and rotate your feet. When you feel better, pull your knees towards your chest. Be sure to start doing Kegel exercises right away, this will help avoid difficulty urinating. After surgery, you will have to get out of bed on the second day.

Suture care after cesarean section

For 5 days in a row, all procedures will be carried out by a nurse. She should treat the wound with antiseptics and change the bandage. If the threads do not dissolve on their own, they will be removed after about a week, from which time it is allowed to wet the incision and not wear a bandage. Treatment with antiseptics should be continued independently. The seam should be washed with liquid soap and wiped with a disposable towel. After some time, you can use ointments to heal scars.

Wearing a bandage

Many doubt the need for this accessory and consider it too inconvenient. Modern experts say that it is necessary to wear a bandage for at least a month during the recovery period. It should not be universal, but special - postoperative. Wearing a bandage promotes proper and rapid recovery of the abdomen after a caesarean section. The accessory will protect your seam from damage, it will be much easier for you to walk and take care of your child.

Physical exercise

Remember that intensive restoration of your figure after a caesarean section is possible for you only after six months. In the first couple of months, you need to take care of yourself and not lift any weights other than the baby. One of the most dangerous consequences of overload is rupture of the uterine suture. Before you start exercising, consult your doctor. Until six months have passed, walk a lot, do simple exercises for your arms and legs, without straining your abdominal muscles. Don't forget about Kegel exercises.

Menstrual cycle

His recovery after a cesarean section proceeds in the same way as after a normal birth. For one and a half to two months, lochia will appear - a discharge similar to menstruation. The first two periods should be very heavy. The cycle should normalize in 3-5 months. If it does not stabilize, you need to undergo examination and make sure that there are no complications, for example, endometriosis. The process of restoring a normal menstrual cycle after a cesarean section depends on:

1. Age. The younger the woman, the sooner she will begin menstruation and fully resume childbearing function.
2. Lifestyle. It affects how a woman eats and whether she exercises.
3. Lactation. If the mother feeds the baby with breast milk, menstruation will begin in approximately 6-8 months. In the absence of lactation, they appear after 8-12 weeks.

Sexual activity

Doctors recommend that patients after a cesarean section begin intimate relationships after one and a half to two months. If there were or are any complications, then the issue of resuming sexual activity after pregnancy should be discussed with a doctor. Don't forget about contraception, because you shouldn't get pregnant until two, or preferably three, years after your cesarean section.

Observation by a gynecologist

Visit a specialist for the first time 10 days after a caesarean section. He will definitely do an ultrasound of the uterus, register you and observe you for at least two years. Then consult a doctor when the lochia stops coming out, that is, after one and a half to two months of recovery. The next visit is six months after the day of abdominal birth. Then you need to visit your doctor every 6 months.

How to remove belly fat after cesarean section at home

Be sure to wear a bandage and use creams to restore skin elasticity, and do body wraps. If you don’t know how to restore your stomach after a caesarean section, then try to pull it in more often, this helps a lot and can be done in any conditions. Abdominal exercises, breathing exercises, and yoga will help. Training with a hoop will be effective. If possible, sleep on your stomach to help your muscles contract properly.

Video: effective exercises after cesarean section

Attention! The information presented in the article is for informational purposes only. The materials in the article do not encourage self-treatment. Only a qualified doctor can make a diagnosis and give treatment recommendations based on the individual characteristics of a particular patient.

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A caesarean section is an operation that delivers a fetus by removing it through an incision in the abdominal wall and uterus. The postpartum uterus returns to its original state within 6-8 weeks. Trauma to the uterus during surgery, swelling,

the presence of hemorrhages in the suture area, a large amount of suture material slow down the involution of the uterus and predispose to the occurrence of postoperative purulent-septic complications in the pelvic area involving the uterus and appendages in the process. These complications after cesarean section occur 8-10 times more often than after vaginal birth. Complications such as endometritis (inflammation of the inner layer of the uterus), adnexitis (inflammation of the appendages), parametritis (inflammation of the periuterine tissue) further affect the reproductive function of the woman, because can lead to menstrual irregularities, pelvic pain syndrome, miscarriage, and infertility.

The initial health status of women, the choice of a rational method and technique for performing the operation, the quality of the suture material and antibacterial therapy, as well as the rational management of the postoperative period, prevention and treatment of complications associated with surgical delivery, determine the favorable outcome of the operation.

A transverse incision in the lower segment of the uterus is made parallel to the circular muscle fibers, in a place where there are almost no blood vessels. Therefore, it least traumatizes the anatomical structures of the uterus, which means it disrupts the healing processes in the operating area to a lesser extent. The use of modern synthetic absorbable threads promotes long-term retention of the wound edges on the uterus, which leads to an optimal healing process and the formation of a healthy scar on the uterus, which is extremely important for subsequent pregnancies and childbirth.

Prevention of complications after cesarean section

Currently, in order to prevent maternal morbidity after cesarean section, modern highly effective broad-spectrum antibiotics are used, since microbial associations, viruses, mycoplasmas, chlamydia, etc. play a great role in the development of infection. During a cesarean section, prophylactic administration of antibiotics is carried out after cutting the umbilical cord in order to reduce their negative impact on the child. In the postoperative period, preference is given to short courses of antibiotic therapy to reduce the flow of drugs to the baby through mother's milk; If the course of a cesarean section is favorable, antibiotics are not administered at all after the operation.

On the first day after a cesarean section, the postpartum woman is in the intensive care ward under the close supervision of medical personnel, while the activities of her entire body are monitored. Algorithms have been developed for the management of postpartum women after cesarean section: adequate replacement of blood loss, pain relief, maintenance of cardiovascular, respiratory and other body systems. It is very important to monitor discharge from the genital tract in the first hours after surgery, because there is a high risk of uterine bleeding due to impaired contractility of the uterus caused by surgical trauma and the effects of narcotic drugs. In the first 2 hours after the operation, a constant intravenous drip of drugs that contract the uterus is carried out: OXYTOCIN, METHYLERGOMETRINE, an ice pack is placed on the lower abdomen.

After general anesthesia, there may be pain and sore throat, nausea and vomiting.

Great importance is given to pain relief after surgery. Within 2-3 hours, non-narcotic analgesics are prescribed; 2-3 days after surgery, pain relief is carried out according to indications.

Surgical trauma, entry into the abdominal cavity during surgery of the contents of the uterus (amniotic fluid, blood) cause a decrease in intestinal motility, paresis develops - bloating, gas retention, which can lead to infection of the peritoneum, sutures on the uterus, and adhesions. An increase in blood viscosity during and after surgery contributes to the formation of blood clots and possible blockage of various vessels by them.

In order to prevent intestinal paresis, thromboembolic complications, improve peripheral circulation, and eliminate congestion in the lungs after artificial ventilation, early activation of the postpartum woman in bed is important.

After the operation, it is advisable to turn in bed from side to side; by the end of the first day, getting up early is recommended: first you need to sit in bed, lower your legs, and then start getting up and walking a little. You need to get up only with the help or under the supervision of medical staff: after lying for a long enough time, you may feel dizzy and fall.

No later than the first day after surgery, it is necessary to begin drug stimulation of the stomach and intestines. For this, PROZERIN, CERUKAL or UBRETID are used, in addition, an enema is performed. In an uncomplicated course of the postoperative period, intestinal motility is activated on the second day after surgery, gases pass on their own, and on the third day, as a rule, independent stool occurs.

On the 1st day, the postpartum woman is given mineral water without gases and tea without sugar with lemon in small portions. On the 2nd day, a low-calorie diet is prescribed: liquid porridge, meat broth, soft-boiled eggs. From 3-4 days after independent bowel movement, the postpartum woman is transferred to a general diet. It is not recommended to eat too hot or too cold food; solid foods should be introduced into your diet gradually.

On the 5-6th day, ultrasound examinations of the uterus are performed to clarify its timely contraction.

In the postoperative period, the dressing is changed daily, the postoperative sutures are examined and treated with one of the antiseptics (70% ethyl alcohol, 2% tincture of iodine, 5% potassium permanganate solution). Sutures from the anterior abdominal wall are removed on the 5-7th day, after which the issue of discharge home is decided. It happens that a wound on the anterior abdominal wall is sutured with an intradermal “cosmetic” suture using absorbable suture material; in such cases there are no external removable sutures. Discharge is usually carried out on the 7-8th day.

Establishing breastfeeding after cesarean section

After a cesarean section, difficulties with breastfeeding often occur. They are caused by a number of reasons, including pain and weakness after surgery, the child’s drowsiness due to the use of painkillers or disturbances in the newborn’s adaptation during surgical delivery, and the use of formulas to give the mother a “rest.” These factors make breastfeeding difficult. Due to the need for a low-calorie diet for 4 days, the formation of lactation occurs against the background of a deficiency of macro- and microelements in the diet of a nursing woman, which affects not only the quantity, but also the quality of milk. Thus, daily milk secretion after cesarean section is almost 2 times lower compared to spontaneous birth; Milk has a low content of main ingredients.

It is important to ensure that the baby is latched to the breast in the first 2 hours after surgery. Currently, most maternity institutions operate on the principle of mother and child being together.

Therefore, if everything went well without complications, you can express a wish to keep the baby next to you and begin breastfeeding under the supervision of staff as soon as the anesthesia wears off and you have the strength to take your baby in your arms (about 6 hours after the operation). Postpartum women whose feeding is postponed for various reasons (the birth of children requiring special treatment, the occurrence of complications in the mother) should resort to expressing milk during feeding hours to stimulate lactation.

One of the main conditions for successful breastfeeding after a cesarean section is to find a position in which the woman is comfortable feeding the baby. On the first day after surgery, it is easier to feed while lying on your side. Some women find this position uncomfortable because... in this case, the seams are stretched, so you can feed while sitting and holding the baby under the arm (“soccer ball under the arm” and “lying across the bed”). In these poses, pillows are placed on the knees, the child lies on them in the correct position, and at the same time the load is removed from the suture area. As the mother recovers, she can feed the baby while lying down, sitting, and standing.

In order to stimulate lactation, physiotherapeutic methods of stimulating lactation are used (ultraviolet irradiation of the mammary glands, UHF, vibration massage, ultrasound, sound “bioacoustic” stimulation), herbal medicine: decoction of cumin, dill, oregano, anise, etc. To improve the quality composition of breast milk, it is necessary to introduce In the diet of a nursing mother, food additives (specialized protein and vitamin products): “Femilak-2”, “Milky Way”, “Mama Plus”, “Enfimama”. All these activities have a beneficial effect on the physical development of children during their stay in the maternity hospital, and the mother is discharged with well-established lactation.

Gymnastics after cesarean

6 hours after the operation, you can begin simple therapeutic exercises and massage of the chest and abdomen. You can do them without an instructor, lying in bed with your knees slightly bent:

• circular stroking with the palm over the entire surface of the abdomen clockwise from right to left, up and down along the rectus abdominis muscles, from bottom up and top down obliquely - along the oblique abdominal muscles - for 2-3 minutes;
• stroking the front and side surfaces of the chest from the bottom up to the axillary region, the left side is massaged with the right hand, the right side with the left;
• hands are placed behind the back and the lumbar region is stroked with the dorsal and palmar surfaces of the hands in the direction from top to bottom and to the sides;
• deep chest breathing, to control the palms are placed on top of the chest: on the count of 1-2, take a deep breath in through the chest (the chest rises), on the count of 3-4, exhale deeply, while lightly pressing on the chest with the palms;
• deep breathing with your stomach, palms, holding the suture area, inhale for a count of 1-2, inflating your stomach, exhale for a count of 3-4, drawing your stomach in as much as possible;
• rotation of the feet, without lifting the heels from the bed, alternately in one direction and the other, describing the largest possible circle, bending the feet towards oneself and away from oneself;
• alternate flexion and extension of the left and right legs, the heel slides along the bed;
• Coughing while supporting the suture area with your palms.

Repeat exercises 2-3 times a day.

Restoring physical fitness after cesarean

Warm dousing of the body in parts from the shower is possible already from the 2nd day after the operation, but you can take a full shower after discharge from the maternity hospital. When washing the seam, it is better to use fragrance-free soap so as not to injure the crust. You can immerse yourself in the bath no earlier than 6-8 weeks after surgery, because By this time, the inner surface of the uterus has completely healed and the uterus returns to its normal state. Going to the bathhouse is possible only 2 months after examination by a doctor.

To make the postoperative scar resolve faster, it can be lubricated with prednisolone ointment or CONTRACTUBEX gel. The scar area may feel numb for up to 3 months until the nerves that were cut during surgery are restored.

Restoring physical fitness after a cesarean section is of no small importance. From the first day it is recommended to wear a postpartum bandage. The bandage relieves lower back pain, helps maintain correct posture, accelerates the restoration of muscle and skin elasticity, protects the stitches from coming apart, helping to heal the postoperative wound. However, wearing it for a long time is undesirable, because muscles must work and contract. As a rule, the bandage is worn for several weeks after childbirth, focusing on the condition of the abdominal muscles and general well-being. Therapeutic exercises should begin 6 hours after surgery, gradually increasing its intensity. After removing the sutures and consulting a doctor, you can begin to perform exercises to strengthen the muscles of the pelvic floor and the muscles of the anterior abdominal wall (Kegel exercise - compression and relaxation of the pelvic floor with a gradual increase in duration up to 20 seconds, retraction of the abdomen, elevation of the pelvis and other exercises), which causes a rush of blood to the pelvic organs and speeds up recovery. When performing exercises, not only physical fitness is restored, but also endorphins are released - biologically active substances that improve a woman’s psychological state, reducing tension, feelings of depression, and low self-esteem.

After surgery, lifting weights of more than 3-4 kg is not recommended for 1.5-2 months. You can start more active activities 6 weeks after giving birth, taking into account your level of physical fitness before pregnancy. The load is increased gradually, avoiding strength exercises on the upper body, because this may reduce lactation. Active types of aerobics and running are not recommended. In the future, if possible, it is advisable to engage in an individual program with a trainer. After high-intensity training, the level of lactic acid may increase, and, as a result, the taste of the milk deteriorates: it becomes sour, and the baby refuses the breast. Therefore, engaging in any kind of sport for a nursing woman is possible only after breastfeeding has ended, and not for breastfeeding women - after the restoration of the menstrual cycle.

Sexual relations can be resumed 6-8 weeks after surgery by visiting a gynecologist and asking for advice about a contraceptive method.

Second and third births after cesarean

Gradual restoration of muscle tissue in the area of ​​the uterine scar occurs within 1-2 years after surgery. About 30% of women after a cesarean section plan to have more children in the future. It is believed that the period 2-3 years after a cesarean section is more favorable for pregnancy and childbirth. The thesis “after a caesarean section, childbirth through the birth canal is impossible” is currently becoming irrelevant. For a variety of reasons, many women attempt a vaginal birth after a cesarean section. In some institutions, the percentage of natural births with a uterine scar after cesarean section is 40-60%.

According to statistics, today every fifth woman preparing for motherhood gives birth by caesarean section. At the same time, there is a persistent increase in operative delivery both in Russia and abroad. Caesarean section is an abdominal operation under anesthesia. With this method of delivery, the baby completely bypasses the birth canal and is removed from the mother's body through an incision in the lower abdomen. Like any other surgical intervention, a caesarean section entails a long and painful recovery.

Recovery of the body after cesarean section

The first day of labor is spent under the constant supervision of medical staff in the intensive care ward (ICU). To prevent complications, a number of measures are taken:

• taking the main indicators of the mother’s condition (measuring temperature, blood pressure, pulse),
• correction of blood loss using medications and other methods (medicines that increase uterine tone, blood transfusions, blood replacement drugs),
• prescription of broad-spectrum antibiotics,
• pain relief with drugs combined with breastfeeding,
• urinary catheter control,
• restoration of intestinal motility of the mother in labor,
• postoperative suture care (treatment with antiseptic solutions, changing dressings),
• general monitoring of the mother’s condition and well-being and assistance to her.

On the second day, if there are no problems or complications, the mother and child are transferred to the postpartum ward. Now the new mother’s activity increases, and all care for the baby falls on her shoulders.

Let's consider what restrictions and difficulties women who give birth by cesarean section encounter.

When can you get up, start walking and sitting?

You can try to get out of bed 6–8 hours after giving birth. The first ascent must be carried out under the supervision of medical staff or relatives. Getting up early helps prevent intestinal problems.

It is necessary to rise very carefully, without haste, so as not to provoke dizziness. First, it’s better to sit for a while with your legs hanging off the bed. Then try to stand up briefly, leaning on the bed with one hand. It is better to hold the stitches with your other hand, this will reduce pain.

With each subsequent rise, you need to increase the time you stay on your feet and try to take steps. If there are no complications on the second day, women in labor should move independently to provide care for their children. A postoperative bandage will be a good helper for mom. It must be purchased in advance at the pharmacy and brought with you to the maternity hospital. The main thing is not to abuse wearing the bandage, use it no longer than three hours in a row and only in a standing position and while walking.

The best way to restore a mother's strength after a cesarean section is proper sleep. Therefore, you need to rest as much as possible while lying in bed. The first two days are accompanied by severe pain in the incision area, so it is better to avoid prolonged sitting, for example, while eating. It is possible to sit fully after surgery only 3–4 days after birth.

How much weight can you lift?

In this matter, much depends on how the birth went and how the mother felt. Doctors recommend that women lift no more than two kilograms in the first months after surgery. But the harsh realities are such that a young mother has to take care of her baby almost 24 hours a day, so such restrictions are simply impossible. If the mother’s condition allows her to carry the child in her arms painlessly and without difficulty, then let the baby be the only burden for the mother for the next couple of months.

In this case, the acceptable weight for lifting after a caesarean section is 3–5 kg for 2–3 months.

Acceptable severity after cesarean section - the weight of the child

When can you lie on your stomach and side?

Doctors' opinions differ on this issue. Some believe that lying on your stomach helps the uterus contract faster, and this is true. But for women in labor with a painful suture on the abdomen, this can be extremely problematic. Therefore, it is advised to try lying on your stomach no earlier than 2 days after birth. This should be done very carefully. In case of the slightest pain, it is better to stop these attempts for a while, but do not quit.

Almost immediately after the operation, you can and should lie on your side and turn from one to the other. This will help restore intestinal motility and reduce the risk of adhesions.

After childbirth, it will be advisable to perform simple exercises in the absence of general contraindications:

• perform head rotations,
• gently bend and straighten your legs,
• make circular movements with your hands,
• rotate the feet and hands,
• strain and relax your buttocks to strengthen them,
• use the Kegel method (from 3 days after birth).

Table: list of exercises allowed in the early postoperative period

№ exercises	Starting position (I.P.)	Progress of the exercise	Note
1.	Lying on your back, arms at your sides	We raise our hands up We spread our arms to the sides - inhale, I.P. - exhale	Breathe deeply
2.	Lying on your back, arms at your sides	We bend our arms at the elbows - inhale, Extend your arms - exhale	Breathing is uniform
3.	Lying on your back, arms at your sides	We bend our hands and feet - inhale, Extend the hands and feet - exhale	Breathing is uniform, Tempo is moderately fast
4.	Lying on your back, arms at your sides	We bend our legs at the knees - inhale, Extend your legs - exhale	Breathing is uniform
5.	Lying on your back, hands behind your head	Raise your head - inhale, I.P. - exhale	When raising the head, the elbows are spread to the sides, Don't bend your knees Fix the feet

When can you shower and bathe?

If you perform such simple gymnastics from the first day, you can avoid many complications and health problems. The uterus will contract faster and the intestines will begin to work; the former shape and size will return faster.

It is strictly forbidden to wet the seam until it has healed. You can limit yourself to rubbing and washing. You will be able to take a shower no earlier than a week after giving birth. You cannot rub your stomach with a washcloth for two weeks.

You will have to forget about a hot bath for at least 6-10 weeks, until the lochia (bloody discharge from the uterus after childbirth) ends.

Failure to comply with restrictions in water procedures is fraught with:

• deterioration of scar tissue on the abdomen,
• slowing down the healing process of sutures,
• suppuration,
• increased blood circulation and, as a result, intense bleeding,
• inflammation of the uterus due to the penetration of bacteria and microbes from tap water.

• thoroughly wash the bathtub with safe, proven products,
• observe the temperature regime (not higher than 40–42 degrees),
• use high-quality natural soap,
• exclude aromatic oils, foam and salt,
• periodically take a bath with herbal decoctions (chamomile),
• start with 5 minutes and each time increase the time spent in hot water.

How to breastfeed

It is extremely important for a child to receive colostrum on the first day of life in order to start the digestive system and adapt to existence outside of the mother. Nurses should advise women on feeding positions that are comfortable for both them and their babies. In the first days, feeding is possible only in a side lying position.

• lie down on your side
• place a pillow under your knees to prevent you from sliding down the bed,
• use a second pillow to protect your stomach from the baby’s push,
• hold the baby's head
• Make sure that the baby's head and body are in the same plane.

In the future, you can feed while sitting. Use a pillow to raise your baby to chest level and protect your incision.

The “cradle” feeding position is very comfortable after a caesarean section.

It is imperative to avoid positions that place pressure on the painful abdomen. The “In the cradle” and “Under the arm” poses are very convenient to use.

The “Underarm” feeding position will help not strain the mother’s stomach.

When can you get pregnant again?

Any childbirth is a huge stress for a woman’s body. Therefore, before subjecting it to such tests again, you must wait at least 2-3 years. Everything is individual. And only an experienced obstetrician-gynecologist, after a complete examination of the mother’s health, can “give the go-ahead” for a second pregnancy and childbirth.

You can get pregnant after a cesarean section just as quickly as after a natural birth, so you need to think about a contraceptive method before resuming sexual activity.

Read more about pregnancy after cesarean in the article -.

Every woman will be able to choose the method of contraception that is suitable for her

• intrauterine device (IUD) - allowed from 7 weeks after surgery in the absence of contraindications,
• barrier contraceptives (condoms, caps, diaphragms) - acceptable after the cessation of lochia,
• spermicides (in the form of suppositories, tablets, creams) - chemicals that destroy sperm,
• injection contraceptives (combined and containing only progestogens) - recommended from the moment the menstrual cycle resumes,
• voluntary sterilization by surgery.

Use contraception responsibly after a cesarean section. After all, pregnancy that occurs before two years after surgery is very dangerous for the health and life of a woman.

Recovery after caesarean section with spinal anesthesia

A cesarean section is always performed under anesthesia: general or local.

For pain relief, epidural or spinal anesthesia, in which the woman in labor is conscious, has recently become more and more often chosen. This allows the mother to see the birth of the child with her own eyes, hear his first cry and almost immediately try to attach him to the breast.

During a caesarean section under spinal anesthesia, the mother in labor can immediately see her baby and even hold him

The advantages of spinal anesthesia are:

• effectiveness (100% pain relief),
• no risk for the child (if the dose is correctly calculated and administered),
• non-toxic effect on the mother's body,
• ease of implementation,
• minimal complications after surgery.

But individual reactions to drugs are always possible. Thus, many women who have gone through childbirth with spinal anesthesia report the following symptoms:

• severe dizziness and headaches,
• drop in blood pressure,
• loss of feeling in legs,
• yeast attacks,
• raw pain in the back, in the injection area,
• shortness of breath and difficulty breathing,
• vomit,
• numbness.

If a woman experiences such symptoms after spinal anesthesia, doctors recommend bed rest for the first day, without getting out of bed.

Recovery will be faster and more successful if the young mother, even while lying in bed, does:

• turns from side to side,
• simple exercises for arms and legs,
• breathing exercises.

Restoring the monthly cycle after cesarean section

For 6–10 weeks after the birth of a child, a young mother secretes lochia; they have nothing to do with menstruation.

In terms of restoring the menstrual cycle, childbirth by caesarean section is no different from natural birth. The arrival of menstruation is influenced by completely different factors:

• age, health and lifestyle of a woman,
• the course of pregnancy, its features and problems,
• breast-feeding.

Lactation can be called the driving force behind the restoration of menstruation. It is the duration of breastfeeding and its frequency that determines how quickly the cycle will resume.

Women who are breastfeeding get their periods 6–12 months after giving birth.

If artificial feeding, then the restoration of the cycle can be expected after 2-3 months.

Restoring the menstrual cycle after childbirth occurs differently for all women.

It is imperative to consult a gynecologist if there is no menstruation for more than a year after the birth of the child, in order to rule out inflammation and other problems.

Restoring your figure after caesarean section

Every young woman dreams of quickly gaining a beautiful figure after giving birth to a child. It will be easier to return to your former shape after childbirth if you follow a number of recommendations:

• getting up early after surgery,
• physical activity during the day,
• good sleep (only possible with the help of relatives),
• proper nutrition,
• playing sports (within the permitted time limits).

Nutritional Features

In the maternity hospital, the medical staff is responsible for the mother’s food, so following the diet will not be so difficult. It is very important to adhere to proper nutrition at home. This will be beneficial not only for the figure of the young mother, but also for the health of her baby if the child is breastfed.

To return to normal after surgery and provide the baby with milk, the mother must:

• eat a balanced diet,
• consume only high-quality natural products,
• exclude carbonated drinks and fast food,
• drink enough water.

Any diet aimed at losing weight is contraindicated for breastfeeding women.

Table: approximate daily set of products for a nursing mother

Product name	Quantity	Unit	Note
Milk	200	ml	Without additives, In the absence of allergies, Any fat content
Kefir (ryazhenka, yogurt)	300	ml	Without additives, In the absence of allergies
Cottage cheese (yogurt)	80	G	With the addition of dried fruits and nuts In the absence of allergies
Cheese	10–20	G	Any non-spicy varieties, In the absence of allergies
Oil	20	G	Creamy, Vegetable
Cereals (including pasta)	60	G	Buckwheat, Rice, Barley Pearl barley, Corn, Wheat, Mannaya et al.
Meat (chicken, turkey, pork, beef, etc.)	150–200	G	Boiled, Stewed, baked, For a couple
Potato	150–200	G	Boiled, In uniform Baked, In the soup
Vegetables and greens	500	G	Preferably fresh Frozen, It is recommended to alternate In winter, replace with canned and fresh frozen
Fruits and berries	300	G	Fresh in season In winter, replace with fresh frozen and canned
Juices, compotes, jelly	200	ml	Natural, Preferably without sugar

Table: Dr. Horvath's diet

A woman who has chosen artificial feeding can be offered Dr. Horvath's diet to lose weight. The advantage of this diet is the gradual reduction of extra pounds, which means a lasting effect.

Diet day	First breakfast	Lunch	Dinner	Afternoon snack	Dinner
1	1 egg (boiled or soft-boiled), drink (without sugar or with sweetener), 1 cracker	1 small apple	150 g lean meat, 100 g boiled sweet potato (with salt, but without oil), 200 g vegetable salad, sugar-free drink	sugar-free drink 100 g fruit	120 g lean meat, 1 egg, 100 g vegetables, 10 g butter, A glass of juice
2	Tea with sweetener, 1 cracker		150 g vegetable stew 150 g fruits,	Coffee with milk (100 ml) with sweetener	150 g steamed or baked fish fillet, 150 g green spinach,
3	30 g lean ham, 20 g crackers, Sweetened drink	Small citrus	350 g vegetable stew with meat,	A glass of tomato juice	100 g boiled potatoes, 50 g cottage cheese
4	50 g cheese, 30 g black bread, Sweetened drink	Small citrus	150 g boiled poultry meat, 100 g potatoes (boiled, baked), 150 g cucumber salad	Large apple	2 egg omelette, 30 g ham, 150 g tomato salad, A glass of juice
5	100 g cottage cheese or yogurt, 30g bread, Sweetened drink	100 g berries or fruits	150 g boiled meat, 100 g potato salad, Compote	A glass of kefir	200 g vegetable salad, Juice or mineral water
6	large apple, Drink without sugar	Salad of 2 carrots with vegetable oil	100 g boiled lean meat, 150 g cabbage salad	50 g radish	100 stewed mushrooms, 1 egg, medium fresh cucumber
7	50 g cottage cheese or yogurt, 20 g crackers, Sweetened drink	A glass of milk or kefir	150 g fried meat, 100 g sweet potato, 100 g fresh vegetables	Coffee with milk, 200 g stewed vegetables	A glass of kefir, A couple of cookies

Physical activity in the first two months

The first time after childbirth, the best physical activity, along with caring for the baby, is walking. It doesn’t matter where exactly you walk - at home around the apartment or in the park with a stroller. The main thing is to do it systematically and with pleasure. Don't be afraid that the seams will come apart. A postpartum bandage will help prevent this, as it reduces the load on the painful suture.

A postpartum bandage will be a good helper for a woman after a caesarean section.

It is better to delegate some of the housework to relatives, for example, washing floors or hand washing something large. Avoid lifting anything heavy (other than a child) and putting stress on the rumen.

Playing sports from the third month

After a caesarean section, you need to take care of your belly. You can pump up your abs no earlier than six weeks after giving birth and with the permission of your doctor. He will examine your seam and recommend loads.

To restore your abdominal muscles, you should start with the simplest exercises.

Table: set of exercises from the third month after cesarean section

№ exercises	Starting position (I.P.)	Progress of the exercise	Note
1	Lying on the floor Legs bent at the knees Feet on the floor Knees apart Hands lie crosswise on the stomach with palms down	Inhale through the nose, As you exhale, lift your head and shoulders off the floor, Squeeze your sides with your palms, Stay for a few seconds Accept I.P. and relax	Repeat 5 times
2	Lying on the floor Hands on stomach, palms down	Slow breath A sharp exhalation Pull your stomach in as far as possible hold for 5 seconds, Relax	Repeat 5–10 times depending on how you feel
3	Lying on the floor Back pressed to the floor Arms spread to the sides	Leg movements simulating cycling	Movements are smooth, breathing is even
4	Lying on the floor Hands behind your head	Inhale through the nose, As you exhale, raise your head, shoulders and body, Accept I.P.	Start with 5 repetitions, Increase with every workout

For young mothers with a scar on the uterus, Pilates and water aerobics classes will be useful, where the load on the stomach and abdominal muscles is minimized.

Pilates classes will have a beneficial effect on a woman’s recovery after a caesarean section

Six months after giving birth, you can begin more active training aimed at reducing your belly fat.

Video: a simple way to remove belly fat after a caesarean section

Care after caesarean section

As a result of the operation, a woman is left with a scar on her abdomen for a long time, which must be carefully cared for to avoid suppuration of the tissue. A week after surgery, take a shower every day, but do not rub the seam with a washcloth. Afterwards, treat as prescribed by your attending physician.

Ointments (Contractubex, Solcoseryl) will help remove an unsightly scar.

Video: postoperative suture hygiene

It is quite possible to recover after a cesarean section in a short time if you take this issue seriously. First of all, you should listen to the advice of your attending physicians, observe the restrictions of the postoperative period, and gradually load the body without overtiring it. Physical activity combined with a healthy diet will quickly return a woman’s health and figure to its previous state.