Discharge Instructions Following Cesarean Section

Patient instructions following a c-section:

Activity

• It is important to rest. Rest helps you heal and gives you the energy you need to be a parent. Be open to offers of assistance from friends and family, especially when you return home.

• Slowly return to normal activities. If you have been on bed rest for a long time during your pregnancy, it will take you longer to return to your normal level of activity.

• Do not lift anything heavier than 10 pounds for the first two weeks and no more than 20 pounds for four weeks after that.

• Do not drive for two weeks after your c-section. Your reaction time may be slow, and you may not be able to press the brakes quickly enough in an emergency. When you can resume driving depends on how you are healing, your comfort, and the pain medicine you are taking.

• You may have some swelling in your feet and lower legs. This is normal and will resolve within two weeks. For temporary relief, lie down and raise your feet above the level of your heart. Support stockings may be helpful. Call your provider if you experience pain, redness, warmth, or swelling in one lower leg more than the other.

Bowel function

• Bowel function may slow after surgery due to hormones, decreased activity, or the effects of anesthesia and medicines, such as iron supplements. Oxycodone and other pain medicines may worsen constipation.

• Increase dietary fiber, found in fruits, vegetables and whole grain bread, cereal, and pasta, to support regular bowel movements.

• Drink 6-8 cups of water each day.

• Increased gas can also be a problem after a c-section and may cause discomfort if it does not pass easily. Drinking warm beverages, like hot tea, can help to stimulate your bowels so you can pass gas.

• Walking also helps with constipation and gas. Increase the distance of your walks as your strength and endurance improve.

• Colace® (docusate) is a stool softener. Take 100mg by mouth once or twice a day as needed to keep your bowel movements soft. If you are still having difficulty with bowel movements, you may take a laxative like milk of magnesia (magnesium hydroxide) or Miralax® (polyethylene glycol 3350).

• If you are having difficulty passing gas, you may take Mylicon® (simethicone) 80mg every 6 hours as needed. These are over-the-counter medicines available at drug stores.

• If you have tried these medicines and still have not had a bowel movement or if you are uncomfortable, please call your healthcare provider.

Diet

• Eat a regular, balanced diet with protein, carbohydrates, fruits, and vegetables.

• The average woman needs about 2200 calories per day. If you are breastfeeding or pumping, you will need about 500 more calories each day to produce nutritious breast milk. Breastfeeding or pumping mothers need extra fluid, protein, and calcium. Milk and dairy products such as cheese, yogurt and ice cream can supply protein and calcium to your diet.

• If you are breastfeeding or pumping, avoid tobacco, alcohol, and unnecessary medicines since they may pass into breast milk and affect your baby. The pain medicines you are taking now are safe for breastfeeding. If you have any questions about other medicines, please call your provider or speak to the lactation consultant at CHOP.

• Continue taking a prenatal vitamin daily while you are breastfeeding or pumping.

• People who may become pregnant should consume at least 400 mcg of folic acid daily. This could come from your prenatal vitamin, another multivitamin, or from fortified foods.

Pain

• Before you leave the hospital, you will be offered prescriptions pain medicine.

  • Oxycodone: Take 1 or 2 tablets by mouth every 4 to 6 hours as needed for pain. You should need this medicine less often over the first 1 to 2 weeks. It can cause constipation, so only use it when needed.

  • Tylenol® (acetaminophen): Take 1,000 mg every 6 hours as needed for pain. Tylenol is available over the counter.

  • You may also take ibuprofen (Advil®, Motrin®) 600 mg every 6 hours as needed for pain. If you are using over-the-counter ibuprofen (200 mg tablets), take 3 tablets every 6 hours. 

If you are allergic to any of these medicines, your team will order a different medicine you can take.

Hygiene

• You may shower.

• Vaginal douching is not recommended because it increases the risk of yeast infections and bacterial vaginosis.

• Do not use tampons or menstrual cups for four weeks after delivery.

• Change sanitary pads often. You will have a vaginal discharge called lochia that will last for 4-6 weeks. Lochia may increase while you are breastfeeding or pumping or changing position. Call your provider if your discharge has a foul odor, returns to bright red after having been white or pink, suddenly increases, has bloody clots, or if you feel faint or have a fever.

Incision care

• Keep your incision clean and dry.

• You may have Steri-Strips™, thin pieces of tape, on your incision. These should remain in place for seven to ten days after your c-section, and then you can remove them. Simply soak them with a warm, wet washcloth to loosen them before peeling them off.

• Call your provider if your incision is red, swollen, tender, or warm to the touch or is draining fluid or pus

Breast care

• Breast milk usually comes in three to five days after delivery. Your breasts may feel full and hard, and you may experience a throbbing sensation or discomfort during this time.

• Lactation consultants are available both in the hospital and at home if you are experiencing breast or nipple pain or have any concerns about pumping or breastfeeding. Ask your healthcare team if you need a referral for a lactation consult.

• If you are not breastfeeding or pumping, do not manually express milk as this will encourage your body to produce more milk and the engorgement will worsen. To stop milk production, wear a supportive bra that is comfortable but not too tight, like a sports bra.

• Ibuprofen can help with breast discomfort and soreness from both breastfeeding and stopping milk supply. Take 600mg every 6 hours.

Sexual intercourse

• Providers often recommend waiting at least 4-6 weeks to have sexual intercourse. Vaginal bleeding usually stops at this point. However, it is a personal decision, and you should resume when you are comfortable and feeling ready.

• Vaginal dryness can happen because of hormone changes and may make intercourse uncomfortable. If you had stitches, this may also cause discomfort. You can use water-soluble jelly, like Astroglide® or K-Y® jelly, to provide extra lubrication and increase comfort.

• It is important to remember that you can become pregnant again even before your period returns. Talk to your healthcare provider about birth control options before leaving the hospital.

Birth control options

• You can become pregnant again even before your period returns. Talk to your healthcare provider about birth control options before leaving the hospital.

• Discuss with your healthcare provider how long to wait before another pregnancy. Recent studies suggest it may be safest to wait at least two years after fetal surgery.

Postpartum emotions

Having a new baby usually brings a surge of emotions, including extreme highs and lows. These feelings are normal and can be the result of changing hormones and having a baby that is in the hospital. Many new mothers experience the baby blues during the first week after birth. You may experience:

• Mood changes

• Weepiness or sadness

• Anxiety

• Lack of concentration

• Feelings of inadequacy

A smaller group of women experience a perinatal or postpartum mood or anxiety disorder (PMAD), like postpartum depression, which is different from the baby blues because it lasts longer and is more severe. Symptoms of postpartum depression may include:

• Excessive worrying or anxiety

• Irritability

• Persistent weepiness or sad mood

• Inability to sleep

• Difficulty concentrating

• Loss of interest in activities that you used to enjoy

• Thoughts about harming yourself or your baby

Although the cause of depression is unknown, it is important to understand that these symptoms do not make you an unfit parent. If you start to have any of these symptoms or if your family members are concerned about how you are coping, please call your healthcare provider right away. You may need medicine, counseling, or both. Sometimes hospitalization is necessary. Most women recover completely with the proper care. Remember that postpartum depression is real, it is nothing to be ashamed of, and help is available. Learn more about how to spot different types of PMADs and how to get help.

Contact your CHOP healthcare team with questions, concerns or if you have:

• Pain, redness, warmth or swelling in one calf more than the other

• Vaginal bleeding with a foul odor, soaking a maxi pad in an hour or less, or passing large clots

• Signs of infection at your incision, like redness, swelling, drainage or it is warm to the touch

• Increased redness or tenderness in your breasts

• Postpartum depression symptoms described above Fever (greater than 100.4ºF)

Call your local healthcare team if you are recovering at home.

If you are staying in the Philadelphia area from out of town and you have any concerns, please call:

Richard D. Wood Jr. Center for Fetal Diagnosis and Treatment

Reviewed October 2025 by Sarah Robinson CNM, Cecelia O'Neill MSN, RNC