Recovery from a C-Section: Tips and Tricks

Recovery from birth can be tricky and you want to make sure you're taking care of yourself. Recovery from birth via cesarean section has an added level of challenge because it's surgery! I asked moms who have had cesareans what their best advice was for those first few days and weeks postpartum after a c-section and got some great responses! Several of these I would say apply to birth in general, but especially to recovery from surgical birth!

• Dresses are great for going home and the first few days around the house. The incision line will be very sensitive!
• You might consider packing a thick towel for the car ride home, fold it and put it over your belly to protect it from the seat belt.
• If you are having a scheduled cesarean, make sure you have lots of food in the freezer! Trying to cook in addition to caring for yourself and baby is just too much in the first weeks postpartum! Don't forget to have quick easy snacks on hand!
• You will be sore and maybe in pain, but don't put off walking in the hospital too long. The walking helps with recovery! Just a small bit of walking at first massively helps with recovery.
• It will take a couple of weeks before you have full range of motion. Plan to have help during that time! Partner, family or a postpartum doula!
• Your body has been through birth, your body has been through major abdominal surgery - you need time to recover!
• Take stool softener while you're on pain meds
• Take pain meds on schedule the first few days at least.
• Drink lots of water!
• Hire a postpartum doula!
• Have extra large, high waisted cotton undies to wear at home for a while afterwards. You don't want anything that might dig into the incision.
• wear a pad, soft side facing you, in front of your incision to protect it from rubbing
• Bring baby to your height to nurse with nursing pillows or extra bed pillows, don't bend towards baby.
• Your milk might come in an extra day or two later after a cesarean. Ask for the hospital lactation support and use that resource!
• Ask for a belly binder in the hospital! It makes a world of difference in recovery! It allows you to feel better about getting up to walk and do daily things. It provides a secure feeling for your incision.
• Don't over do it! When you start feeling better, only add things back to your day one at a time. Take it busy for a few days more so you don't have any set backs. It seems like if you don't over do it early on, recovery as a whole is so much easier and faster!
• Keep a small hand towel folded in thirds by you to hold your incision when you cough/sneeze or go to the bathroom... #2 is tricky.
• You might also like a pillow for the above reason...
• When you get pain medication, ask the nurse when your next dose will be and remind them 30 minutes or so before so you don't lapse. Staying on that pain medication schedule for the first few days will help you to function more quickly and get those important first few walks in to speed recovery.
• Try to time your first walk 30 minutes after you've had a pain pill, give it a chance to work!
• Ask for 2 abdominal binders. One to wear when the other is in the wash. Use these for several weeks!
• Use the bedrails and incline the bed up or down in the hospital so you're not trying to use your core muscles to sit up.
• Before going into the hospital, set up a baby care station in your bedroom so you can be resting without walking all over the house for necessary baby stuff when you get home.
• Make sure to plan who will be your driver for your doctors appointments and babys appointments you won't be driving or lifting baby in the carseat carrier for several weeks!
• Laying down flat is pretty uncomfortable so I slept in a recliner the first few nights at home.
• Yoga pants were the best when I was tired of wearing dresses. I lived in either a dress or yoga pants for several weeks!
• You still bleed vaginally after a c-section!

Interviewing Doulas: Why some questions matter!

Congratulations on your pregnancy and decision to hire a doula! It can be a daunting project to decide what to ask when interviewing doulas and finding the right one for you. Here is a peek behind the doula curtain to see why certain interview questions matter!

You can find lists of questions to ask when interviewing doulas all over the internet and one of the first questions they recommend is how many births have you attended? A better question to ask is: How has your training prepared you to support me in my labor and birth? You might even ask a bit more about what their training was like and what it involved! Everyone has to attend their first few births, I have to say, I did an amazing job supporting my very first client! It is about so much more than numbers. A good training will have your doula ready to support you whether it is her first birth to attend or her twentieth! Your connection with your doula honestly matters more than the number of births she has attended. Do you feel comfortable and supported with her? That's what you should ask yourself!

Speaking of a good training - ask her if she is Certified? If so, with what organization? There are many doula training organizations out there! Some people pick a big name company or a smaller one that they connect with their ideology and philosophys. Sometimes you will have an uncertified doula tell you that she has decided to remain uncertified although she trained with xyz organization because she found their "scope of practice limiting". Honestly, if they found it limiting, they needed to find another organization that has a broader scope or one they agree with more and certify with them. Ask them what about that scope was limiting? Was it that they can't use essential oils? Is it because they aren't allowed to do cervical exams? (if your doula says she will do cervical exams RUN! that is not her job!)
You can be a great doula without being certified but here's why I advocate for certification - it holds the doula to a higher standard! If I was running around doing things I shouldn't (catching babies, acting unprofessional, not showing up to births etc) my clients can contact the 3 (yes 3!) organizations I hold certifications with and I would have someone to answer to. I get resources and materials from these organizations, I don't want to do something to ruin that relationship with my cert org because that's part of me staying in business! Doulas are not regulated (like midwives or doctors) so working with someone who has taken the time, expense and effort to maintain a certification is an indicator that you have found a professional, not someone doing this as a hobby.

Some other certification/training questions: Do you have to recertify yearly? (or did they get a lifetime stamp of approval regardless of how they practice?) Tell me about your training? (was it an in person hands on training or was it all distance education and books or a combination of both? There isn't a good or a bad here, just what fits their learning style best. If they've only attended a handful of births, is it important to you if they had hands on training?)

Ask about continuing education. A professional doula should always be working towards learning and growing, if her certification organization requires yearly recertification she will be working on something. This is also great for you! Continuing Education is when doulas pick up skills beyond the basics they learn at training. Accupressure, TENS, Massage, advanced situation training (ie bereavement doula), rebozo, spinning babies etc. These are just an example of things a doula can add to her tool belt to help you have a supported birth!

What unique or challenging experiences have you faced as you have supported clients? This is where the number of births comes into play, you can have a doula that has been to 50 births, but they all happen to be uncomplicated vaginal births. You can have a doula who has attended three and all three had a complication arise that has afforded the doula unique and invaluable experiences.

Some people ask how many children a doula has. That might be important to you, but I know doulas that do not have children and they are awesome at their job! Instead ask, Do you have reliable childcare? How long will it take you to get to me when I am in labor? Doulas who do this professionally have some awesome on call childcare options! When I take on a client I have a game plan of where my children can be dropped off at a moments notice for the 5 week on-call window, 24/7!

What is your birth philosophy? is a common interview question -  it isn't a bad question, but a better question would be if she can support you in your desired birth? (water birth, hospital birth, birth center birth, home birth, vbac, unique complication, c-section whether planned or emergent)

How do you work with my husband/partner? Doulas and dads should complement each other. A doula should not take a partners place (unless that's what the birthing person and partner want!). Sometimes I'm at an interview and a pregnant mother wants me to convince her husband that a doula is a good idea. Doulas love to talk about what we do and how we can help you have an awesome birth but please understand we can't make him do anything. I don't know the dynamics of your relationship and if he doesn't really want me there and it has been forced on him, it probably won't be the greatest birth environment when half of the birthing couple doesn't want the doula present. Hopefully after meeting a doula your partner is on board with a supported birthing experience!

Another frequent question is whether or not a doula has worked at your particular birth place or with that provider. I am in the Dallas Fort Worth metroplex, we have hundreds of care providers! While there are some providers I have worked with more than once, chances are I won't ever work with all of them! It still might be nice to know if the doula has worked with them, but don't put a lot of stock in that response! You should ask the doula instead, I am planning a ______ birth. What questions would you suggest I ask my care provider to see if he/she will support my wishes.

Do you have any "black out dates" around my due date? This is a great way to also learn about their back up doula! Doulas are people too and sometimes we need to go out of town or attend a wedding etc. There's about a 3% chance of going into labor on any given day, so the chances of you laboring on the day(s) that your doula isn't available are slim but she should have a solid back up relationship regardless of black out dates! If your doula does have a black out date, ask if you can meet the back up doula if you'd like!

Do you have an hourly clause in your contract? Hourly clauses work a couple of different ways: Some doulas charge a base rate for their services and if your labor exceeds a certain number of hours an hourly fee begins to retain your labor support. Sometimes it's 12, 15, or 18 hours of labor support that is built into the existing fee and hourly labor support varies but it's anywhere from $12-$20/hour. I do not charge more based on the length of your labor nor do any doulas that I have a back up relationship with!

Most doulas have a clause in their contract about bringing in a back up (if needed) if labor goes beyond a certain number of hours. For example, 15 hours, if your doula is with you for 15 hours she reserves the right to bring in a back up doula to relieve her and bring in fresh awesome support for you (so she can get some rest! We're pretty awesome but we're not super human! Trust me, you want a rested doula). Check to see if you are responsible for paying the back up doula or if that is covered in your fee.

These are just a few questions you might consider asking in a doula interview. At the end of the day, I believe that it matters most how you personally connect with the doula. If you feel on edge, or like you're being judged by the person you are interviewing - she isn't the doula for you! It should be a pretty easy connection and someone you look forward to seeing.

Check out this post for a more complete list of doula interview questions!

Rebekah Lewis is a birth doula, professional belly binder and placenta encapsulator serving families in the North part of the Dallas Fort Worth area. She serves families in Denton, Cooke, Tarrant, Dallas, Wise and Collin counties.

Pumping & Building a Stash: Products and Tips for Moms

For moms who aren't returning to work - building up a milk stash

For mom's who don't need a lot of milk to return to work at 6 or 8 weeks (etc) I recommend not pumping until they are at least 6 weeks postpartum. Pumping becomes a full time job if you do it often with cleaning all the pump parts and the time commitment it takes. Breastmilk supply is a supply-and-demand process. If at three weeks postpartum you start pumping, your body is going to be over-producing milk and that's a recipe for engorgement and mastitis if you're not careful! Here are a few tips and tricks I've learned & clients usually find helpful!

If you are returning to work or will need to be away from baby (or just want to bottle feed in addition to breastfeeding!) these are still great tips, but I'll have a separate post for you soon! 

Milk Savers - Your "Breast-Friend"

ha, ha. Awful joke I know. There are a couple of different kinds of these. These will collect milk for you while you do absolutely nothing, just whatever you would normally drip into a breast-pad, you can gather to turn into a bottle for baby at a later date!  

Shells: I love the shell ones for the early days postpartum. It prevents friction on your nipples when you can barely stand to have a shirt touching you, much less a bra. They are also awesome at allowing air to get to your nipples to reduce the chance of developing an infection while your supply is regulating and everything seems to be getting soaked in breast milk. (link to shell here)  If you have flat nipples, shells are a *must* and you really need to start wearing them before baby comes! They will absolutely collect milk that you drip during the day but the base where milk will pool and collect isn't very deep and can spill out easily as you bend over (so still wear breast pads!).

Milk Savers: The same spilling situation can happen with the milk savers, but they are deeper so less likely if emptied regularly. (link to milk savers here) You could absolutely just buy one of these products (I'm all for buying less, good quality gear!) but some people find the milk savers to be bulky - it's really just a personal preference thing! 

Clients: Let me know if you think you might have flat nipples at a prenatal (I promise, this won't be awkward to bring up... I bet I also openly recommend sex at some point in our conversations!) and we can talk about ways to set yourself up for breastfeeding success! 

Use a silicone breast "pump" to start your stash

I say "pump" because I don't think these would actually be effective at draining your breast as your primary pump. They are however wonderful to compress, attach to the breast you aren't feeding from and collect whatever let-down flow comes. It's a freezer stash with almost no work! You can start doing this as early postpartum as you would like. 

You can find a Silicone Breast Pump here. 

 

Store parts in the refrigerator

You can store pump parts in a gallon zip lock bag in the refrigerator for up to 24 hours between sterilizations. I would still give them a good rinse in the sink to keep the fat in the milk from coating the parts and making them hard to clean, but this will cut down on the time commitment you're making when pumping so you only have to wash and sterilize once a day! For working moms or moms that are needing to pump often, I recommend having two sets of pump parts so that one can be cleaned and drying on the rack while you have another set to use.

Pumping Bra Hack 

If/When you decide you're ready to pull out the big double-electric breast pump you will quickly find that it's a two handed process. Mom's often don't have one hand to spare, much less two so a pumping bra can be handy. Not everyone is a fan of pumping bras or a fan of their price tag. Here is a link to a genius pump bra hack on pinterest! This is how I pumped when I went back to work full time after my first! While you're in Pinterest land - this is my breastfeeding board and it has lots of great tips and videos about latches! 

On the topic of bras... when you're purchasing nursing bras - do not get a bra with an underwire. For some unknown reason Motherhood sells these bras with underwires but that can often lead to clogged ducts and mastitis because of the pressure it puts on your breasts. 

Other Tips & Tricks

Cloth breast pads are so much softer than the disposable ones so they're perfect in the beginning! Brand matters with the disposable ones (in my opinion). I'm not a big name-brand gal, but I loved the Lansinoh breast pads. There were other brands I could stand, but those are by far my favorites. There are samples and small packages, so start with a small sampling of each brand and pick which one fits you best! 

If you have a sore on your breast, a little bit of breast milk can help heal it up! It has great antibacterial properties in it! 

Lanolin is recommended by well, just about everyone... and it's great... but so is coconut oil - and that's food based, has natural antimicrobial/antibiotic properties and is my first pick in nipple "creams". If you do find yourself needing Lanolin (I did, you wouldn't be alone!), a little goes a long ways! And it's kind of greasy, so you will want to make sure you're wearing nursing pads to protect your bra and shirt. 

Chamomile tea bags on sore nipples can help reduce swelling. Just dip them in some hot water and squeeze out the excess water (you still want them wet, test on the inside of your wrist, make sure it's not too hot!) Apply and remove as the heat diminishes, you don't want to leave the wet bags against your nipples too long. 

Breastfeeding in Public

You will at some point find yourself needing to feed babe in public. Some of us are a whip-it-out kind of mom and don't mind who notices you feeding your baby, others would prefer a cover and then many fall in the middle. My kids hated the breastfeeding cover. They're hot natured and the covers are hot! I would end up more exposed than if I just didn't use the cover at all when my child would suddenly rip it aside to look at the world going by.  If you use what I call the Two-Shirt trick, you can breastfeed discretely without a cover. 

Under whatever t-shirt you're wearing (because let's just face it, you aren't going to be wearing a dress for a long time... you have to practically undress to breastfeed in many dresses...) just wear a nursing cami. This is a link to some, Target also has a great selection. You just want to make sure it has those same clips to drop the side down as your nursing bras. The cami stays down, your t-shirt comes up and you're only exposing your nipple and a small bit of breast for baby to feed. Practice at home in front of a mirror, you'll be a pro in no time! I can walk around stores feeding and talking to people and many don't even realize what I'm doing! 

Pro-Tip: You can breastfeed in baby carriers and wraps. It might take some figuring out how it will work for you. Many times you'll have to adjust the fit to bring baby down to your breast, but the carrier often provides lots of privacy and no one will know you're feeding unless they are very much in your personal space! Personally, I have had luck breastfeeding while baby-wearing in an Ergo, ring-sling, Moby Wrap and k'tan. 

I hope that some of these tips are helpful to you in your breastfeeding and pumping journey! 

This post may contain affiliate links. This just means that if you clicked an affiliate link and make a purchase I might receive a small commission. These products are things I recommend regardless of potential commission and all opinions are my own. 

Rebekah Lewis provides birth doula and postpartum belly binding services in the North Texas area including Denton, Decatur, Gainesville, Krum, Aubrey, Flower Mound, Grapevine, Coppell, Highland Village, North Fort Worth, Keller, McKinney, and surrounding areas. 

 

Labor Script: Imagery - Journey to the Center of the Womb

Imagine that you are breathing directly into the womb -- where your baby floats in a private sea of crystal-clear water. After a few minutes, imagine that the breath you take in is a soft white light. 

As you continue to breath in, imagine that light filling the womb, surrounding your baby with vitality and health - giving energy. Do this for a minute or so.

Now imagine that the light that fills the womb is beginning to radiate outward in all directions. Let it fill your body with a radiant glow. Keep breathing the light in and breathing out everything that you don't need. any tension, any thoughts that get in your way.

Imagine that the light leads you inside the womb and that you have come to explore.

This is your baby's cradle - warm, snug and secure - where baby is nourished in your being. 

Imagine the baby in their own private sea of crystal - clear water, all enclosed by the warm cavern of the strong membranous sac, cushioned and protected. 

The baby's eyes are closed peacefully, the fingernails and toenails are growing. Every now and then the baby kicks tiny feet against the uterus. 

You and your baby are one, right now. Imagine that you are breathing in harmony with your baby. Let yourself go into a deeper more relaxed state. Take a moment to appreciate your baby's home. Notice the beautiful umbilical cord that connects the baby to the placenta. Through this cord, your baby receives everything needed to grow and be perfect. 

Acknowledge that as your baby is growing, your body is changing in preparation for birth without your having to do anything about it.

The muscular uterus holds your baby gently and lovingly as it prepares for the powerful contractions that will massage your baby for his/her first breath and urge him/her out when your baby is ready.

The cervix is becoming soft and stretchy. It is not ready to open yet, but when your baby is ready it will open a gateway. 

Acknowledge further that your whole being is preparing for parenthood and let yourself relax more deeply, at peace with the sureness of that knowledge. 

Mentally thank your body for the miracle it is now working and will continue to work. Take a deep breath, slowly count to five, stretching gently and open your eyes. 

Labor Script: Relaxation

Close your eyes. Take a few slow, deep breaths in through your nose, exhaling through slightly parted lips. As you begin to relax, let your breathing become just a little deeper and a little slower without straining in any way. 

Now tighten the muscles of your left arm and hand, clenching your fist, hold for a few seconds, feel the tension. Tighten the muscles of your right arm and hand, clenching your fist. Hold for a few seconds, feel the tension. Release, letting your arm and hand go limp. Feel the relaxation. Tell yourself: my arms and hands are heavy and warm.

For the next few minutes, each time you tense a muscle group, feel the tension. Each time you release, take a few seconds to feel the relaxation. 

Tighten the muscles of your left leg and foot, curling the toes. Release, letting your leg and foot go limp. Tighten the muscles of your right leg and foot, curling the toes. Release letting your leg and foot go limp. Tell yourself: my legs and feet are heavy and warm.

Squeeze your buttocks together tightly. Release.

Draw up the muscles of your pelvic floor (as if you were trying to hold back from urinating). Release

Tighten your abdominal muscles, drawing in your belly as if you were trying to touch your backbone with your abdominal wall. Release. Feel your abdomen relax completely.

Observe your breathing, calm and regular. Tell yourself, my uterus and pelvic organs are warm, comfortable and relaxed. 

Arch your back slightly. Release, letting the muscles of your back sink into the surface on which you are lying. 

Tighten your shoulders by pushing them back as if you were trying to make your shoulder blades touch. Release, letting your shoulders fall limp.

Tighten the muscles of your neck by arching the neck slightly as if you were trying to look up. Release, letting your neck go limp. Now say, The muscles of my back and neck are warm and relaxed.

Clench your teeth together, tightening the muscles of your jaw. Release. Tell yourself: my jaw muscles are loose and relaxed. 

Squint your eyes. Release, letting the eyelids fall heavy and tell yourself, my eyelids are heavy and relaxed. Furrow your brow as if you were worried about something. Release, letting the space between the eyes feel as if it were getting wider. With the next breath out - say: my forehead is cool. 

Now, take a few deep breaths, letting your breathing become a little slower, a little deeper than usual, without straining in any way.  Let your awareness travel though your entire body from head to toe, releasing any additional tension you may find on the out-breath. 

Tell yourself: Because I am relaxed, I can labor and give birth better.