I’ve had two cesarean sections (C-sections) within two-and-a-half years; the first unexpected and the second, planned. My first baby was born when I was 37, within the bracket of what modern reproductive medicine considers advanced maternal age.
Older mothers giving birth are a far more common occurrence today, but also have a higher risk of complications with pregnancy in general that make a C-section delivery a greater possibility. Still, it never crossed my mind that I would end up having one. As much as I had intended to have a vaginal birth with my first pregnancy, a point came during delivery when it became clear that the baby was having trouble coming through the pelvis. I had the choice to stay in labor, which was becoming increasingly risky, or opt for surgery. The focus shifted to bringing my little boy into the world with as few complications as possible, and just like that, I became a C-section mom. And…
Find an OB-GYN for the journey to come
Was I prepared? Not exactly.
C-sections are major surgery that involve abdominal and uterine incisions and pulling apart muscle to get to the baby. Even in all my time spent preparing for baby’s arrival, impending motherhood, and what would surely be one of the greatest events of my life, what happens after a C-section was simply something I’d neglected to prepare for. And since the surgery happened so quickly, I had no time to prepare for that postpartum, post-surgical reality until I was in it.
A little wobbly at first
Some C-section patients have an epidural before birth. I had a spinal block, which is similar to an epidural, just different placement of the anesthesia. The spinal numbed my lower half and I was still awake and cognizant of what was happening during surgery. It took me almost 10 hours to fully regain feeling after the spinal and birth, and for that reason I wasn’t allowed out of my hospital bed for 12 hours after baby was born. Since I couldn’t control anything below my waist, I also had a catheter for urination during that immediate postoperative time.
I spent most of that time in my hospital room with my husband and baby, bonding, reading and watching TV. When I finally did stand and take my first steps, it was from the bed to the bathroom about 10 feet away, and back. I felt shaky, wobbly, and uncertain, and had to hold tightly to the rails in the bathroom to be able to sit down. I was on pain management medicine, but even so felt a strange tightness across my abdomen, with searing pain if I tried to move too fast. I learned quickly to avoid any twisting movements, even sitting in bed.
Managing pain and bleeding
The intense physical aspect of the C-section recovery period surprised me more than almost anything else. I was able to get up and move around the room more after the first 12 hours, but for the first three days my movement was limited to steps around the hospital room and a few short walks down the hospital corridor. Every woman is different, but because the body is healing from a surgical procedure, total recovery from a C-section generally takes longer than a vaginal birth and can be upward of four to six weeks or more. The soreness in the incision area and around the abdomen was the worst the first four days, but gradually got better. Taking short, frequent walks seemed to speed recovery as my body got used to moving again.
Another surprise was the post-delivery bleeding that lasted several weeks. I found out that vaginal bleeding after a C-section occurs as the body removes the thick lining of the uterus that builds up during pregnancy. Depending on the patient, the bleeding comes and goes, tends to get lighter over time, and can last four to six weeks. I also experienced strong cramps seemingly out of nowhere my second day after delivery that were far more intense than even menstrual cramps. I found out later that these cramps are common and happen as the uterus shrinks back to its pre-baby size.
Acknowledging early limitations
I’d had a C-section and was recovering well at home, walking more each day, but still had a newborn baby that needed around-the-clock care. It was a demanding as a new mom to balance breastfeeding and caring for my baby with recuperating from surgery. I also wasn’t allowed to lift much or drive the first couple of weeks and had to rely on others not only for help with the baby but also transportation to and from pediatric appointments.
These limits, combined with an often-napping newborn, meant I spent many of my first post-birth weeks simply hanging out at home with the baby. Luckily, I had a husband to help and several family members who stayed for a few weeks to pitch in. Still, there were days I felt frustrated by what I couldn’t do, overwhelmed by what my baby needed, and like I wasn’t a good mom.
In the postpartum period after both of my C-sections, I experienced bouts of what is known as postpartum depression (PPD), or baby blues, as well as postpartum anxiety (PPA). To be clear, I’m not suggesting for a moment that having C-sections was the cause. Lots of women have C-sections without postpartum issues. I’m just being transparent about my experience.
My first baby seemed to cry almost nonstop. I constantly worried that something was terribly wrong with him or that he disliked me and didn’t want to bond with me. By the end of most days during my maternity leave when my husband came home from work, I felt so stressed out that I’d frequently hand the baby off and go cry alone in the shower. I often felt like a complete failure as a mother.
It turned out my baby likely had colic, a condition recognized in about 10 to 25 percent of babies, characterized by fussing or crying for more than three hours at a time, more than three times per week. But during the first six to eight weeks of his life when the crying was at its peak and I was still recovering from my first childbirth, there were times I wondered if I’d made the right decision to become a mom. Did I have what it takes to succeed in motherhood?
While my second baby wasn’t colicky, my anxiety around her health and well-being soared through the roof. Because she was born during the COVID pandemic, I had both a newborn and my toddler at home. Managing both was frequently challenging, and I worried if she was getting enough attention. I agonized over her sleep patterns and if she was getting enough sleep and if I was approaching sleep “the right way.” We moved her to a crib in her own room at four months, and I found myself obsessing over her breathing at night, getting out of bed as many as 10 times a night to check on her. She’s now six months, and while I still have some of these fears, my PPA finally seems to be on the downslope.
It took me awhile to be able to accept my often-excessive worrying and racing thoughts after the birth of each child and acknowledge that I had PPD and PPA. I was finally able to address how I felt with my Novant Health OB-GYN, who assured me that what I felt was quite normal, treatable, and would eventually subside, and it did. New mothers also need to understand that PPD and PPA are very common. If you think you might be suffering from one of these, talk to your doctor immediately and ask about the possibility of medication.
My new focus: healing
I’ve always prided myself on being committed to a regular exercise regimen of cardio and strength, but after my C-sections, the extreme workouts went on the back burner for several weeks as I had to concentrate on walking and healing my body. Most women who have C-sections are advised to wait a minimum of four to six weeks, to begin strenuous exercise, sometimes longer. Likewise, part of my new routine included eating a balanced diet and making sure I was well-hydrated to keep up my breastmilk supply.
Incision care was important
The incision itself stayed swollen for several weeks after the surgery, taking on a puffy and pinkish look, and appeared raised higher than the skin around it. Over about a week the pain decreased and became tender to the touch and for several weeks after the entire incision and skin around it felt almost numb. I learned that numbness may come and go and some women experience it and some don’t. Also important was keeping the incision area clean either with water or water and a mild soap. I personally had Steri-Strips which I could wash and pat dry, that came off in about two weeks. High-waist (to the navel) briefs meant specifically for postpartum C-section women were a great alternative to help keep the incision clean and free of anything that might irritate it. In the weeks following both C-sections I had appointments to see my obstetrician, who would check the incision to make sure it was healing properly.
‘We’re going to be OK’
The mental challenge of an unanticipated surgery can be difficult for almost anyone, including me. Like some women, not having the birth experience I had anticipated with my first child made me feel almost inferior at first, like I hadn’t lived up to expectations of being a new mom. But I realized quickly that a C-section birth is just as much a real birth as vaginal delivery and is simply delivering a baby by another method.
Letting go of my unease around the unexpected circumstances of my first C-section helped me shift my mindset to a different recovery, to recognize the strength it takes to bring a new baby into the world, and to know that we were both going to be OK.
Logan Stewart Kureczka is a 40-year-old mom of two, freelance writer, and Novant Health patient. Dr. Stephanie Barbaradora-Froelich and Dr. Elizabeth Montague-Farwell with Novant Health NoDa OB/GYN each delivered one of her children. You can find Logan on Twitter at @lbstewart.
Caption top photo: Logan Stewart Kureczka , husband Evan Kureczka, kids Davis and Georgia, and Ruby.