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C-Section with Twins: My Story, Recovery, and Tips

C-Section with Twins: My Story, Recovery, and Tips

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Like most things in my life lately, I had hoped to get this C-Section post out sooner rather than later. No, there wasn’t a real deadline, I really just wanted to help as many people as soon as possible through this piece and make sure I didn’t forget anything. Earlier this month, I saw that April is deemed International Cesarean Awareness Month, so what better month to push myself to get this written and published? Finally completing it in the nick of time on April 30th! I’m now 6+ months postpartum and feel like I have a good idea of what recovery looks like. I hope this post helps you and makes you feel ready for your procedure, whether your c-section is planned or unplanned.

Though I wrote this specifically about twins, I believe it can help anyone with a c-section, so even if you have a singleton you might still find this helpful too!

Read on for more of what I would do differently, am happy I did, and some tips and tricks for the future.

Before reading…

I wanted to preface this by saying several things before getting started with this post so you know what to expect / what you are getting into. This is not a traumatic story and to my knowledge I don’t find it to be triggering. If I had to do it all over again, I wouldn’t change anything, well except take more meds sooner, but I’ve already forgotten that pain! I would relive it just as it was and feel very lucky to have a pleasing birth story / memory. I know not everyone is so lucky. My OBGYN (obstetrician gynecologist) is an angel, my MFM (maternal fetal medicine) doctor is amazing, and the staff at the hospital I was at were phenomenal.

A few things to note:

  • I will mention some specifics of my birth story, but you can read an in-depth account of my twin birth story here.

  • I don’t feel sad that I had a c-section as I was able to safely bring two beautiful babies into this world.

  • I prefer not to use the phrase “belly birth” as it typically seems to carry a negative connotation with it, making someone feel *less than for not having a vaginal birth. For some reason “belly birth” triggers me / makes me roll my eyes even though I obviously know that is what it quite literally is. *I said “less than” because I actually had people say things like that to me… To make a blanket statement that one way is better or is not “real” is extremely uneducated as ways to birth is not a one-size-fits-all game. What is best for you may not be what is best for someone else considering their specific situation.

Did I know I was going to have a C-Section?

Not 100% certain, but I figured I would end up having one, so like 99% sure? My mantra during my pregnancy was that I couldn’t control anything, so I wasn’t going to stress or even think about stressing over what would happen and just trust my doctor.

There are a lot of things I avoided reading and researching while pregnant, mostly things that could go wrong due to my previous miscarriage. Cue my pregnancy after loss post here. While I did avoid traumatic posts, I did not let myself avoid being prepared and took a c-section class that I will mention later. My obstetrician was open to trying a vaginal birth with twins as long as they were head down. From her experience (she has delivered over 10,000 babies), she prefers to have one of two births… an easy vaginal delivery or an easy cesarean section. Note that she has a very low c-section rate of 3% and does not simply schedule a c-section or induction based on patient preference. (3% of her deliveries were c-sections, compared to the national average of above 30% as reported in 2018)

Twin births are higher risk because, well, there are two babies. Even if someone opts for a vaginal birth in the hospital, they do so in an operating room (or) in case anything goes wrong and they have to revert to a c-section. When my doctor recommended a c-section for my twins, I went with it. Obviously I wouldn’t know this until the very end, but my twins were only both head down for a short stint around 24 weeks, which hurt my hips so much!! They constantly moved around until the bitter end, though never went back to both head down or even one head down for that matter. To paint you a picture of how much they moved, my son was above my daughter for the majority of my pregnancy and ended up being below her and coming out first. So crazy, considering there was pretty much no room to switch sides, but somehow they managed it. For reference, both were transverse (horizontal/sideways) at the time of birth.

All that to say, I had a general idea that I would end up having a c-section over vaginal birth and that is what I mentally prepared for.

What kind of twins did you have and how long did you last?

I had boy-girl twins, which is always a di-di pregnancy as they are always fraternal. I answered a lot of twin questions on this blog post.

Di-di twins are considered full-term at 38 weeks and I lasted 38 weeks and 1 day!

Was it an emergency C-Section?

Technically yes in the sense that they had to bump up from my scheduled date. My OB scheduled me for 38 weeks and 3 days - nothing specific about that date, that’s just how it fell. She originally wanted me scheduled for the day prior (38 weeks and 2 days), but the hospital was booked. I went in for my last non-stress test (NST) of the pregnancy when I was 38 weeks and 1 day and they ended up keeping me and scheduling my c-section for that evening due to my platelets being low. I went into a lot of detail here. “Early delivery” was a “me” issue, not a baby issue, though obviously a problem with the mother can cause problems with the babies, which is why it needed to be addressed as soon as possible. If my platelets had dropped even further / not stabilized, I would have been put under for the entire c-section birth versus staying awake (local versus general anesthesia).

Being pregnant with multiples, you are told to be prepared for them to come early, so I had my bags packed and ready around 30 weeks. Most literature says that on average twins arrive by 36 weeks and more than 50% arrive by 37 weeks. A lot of people I spoke too had multiples that came at or around 34 weeks, so mentally that is what I prepared for. I truly expected them to come early and was in shock when they didn’t. I was very glad they were able to cook as long as they did, but honestly could not believe it. I had finally wrapped my head around the fact that I was going to make it to my scheduled date only to be kept at the hospital and delivered prior to that! I had prepared the whole pregnancy for this, yet when it happened at the last possible second I was shocked.

I know a lot of people who had an emergency c-section found it to be very traumatizing, but since I kind of went in with a c-section in mind, I was already mentally set on that so that probably helped my anxiety. I also didn’t switch from a vaginal birth to a c-section which also can be traumatizing, especially if it isn’t what you imagined. Though mine was emergency Cesarean, I felt very much at peace and calm after the initial shock of being told I wouldn’t leave the hospital and would be delivering that evening. My doctor is amazing and I trusted her abilities entirely. My MFM was also present for the surgery as an extra set of hands.

Did your water break?

No. I was never in active labor either. I had a few contractions here and there, but nothing of an active labor sort.

Towards the end, I saw a doctor every week and alternated between my OB and my MFM. My OB kept telling me she was expecting me to call her and say my water broke because of how big my belly was!

Did you have any pregnancy complications?

As I mentioned above, I was admitted earlier than scheduled because I had low platelets. The week prior I told my MFM I had a really bad headache that lasted for over a day. I mentioned it, as I knew it could be a sign of pre-eclampsia, which is life-threatening. We checked my blood pressure (BP) and my urine for protein - my BP was fine and my urine only had trace amounts. He wanted me to have another NST that week, which I already had scheduled since I was going twice a week anyway. I actually mentioned the headache to my nurse at my first NST that week and she took my labs to check on things. During that second NST, we started to run routine labs I went in to monitor everything more closely. At my second NST that week they noticed that my platelets were dropping. (113 K/uL, normal is above 140) For that reason, my MFM had me schedule another NST that weekend, totaling THREE NSTs for that week alone! During my third NST, my platelets had actually popped up (to 119 K/uL) which was awesome. I went in three days later (Wednesday) for my final scheduled NST prior to my (Friday) delivery. That morning when they checked my platelets, not only had they dropped, but they had plummeted to the lowest amount they had been. (86 K/uL). They phoned my doctor and that is what prompted them to keep me all day and delivery me that evening! They re-took my platelet levels a couple hours before surgery to make sure they hadn’t dropped further and thank goodness they hadn’t. If they had dropped below 75 K/uL I would have been put under complete anesthesia and Nick would not have been allowed to be present at the birth / in the OR.

**Just a note, YOU need to keep track of what you need to have done. Pay attention, ask for people to repeat things, take notes, and if you think something is weird or needs to be done, mention it. We only started tracking my labs because I mentioned my symptoms. If I hadn’t spoken up, we may have been too late and I might have had to be put completely out for the delivery of my twins. It was in my file at the hospital to do routine labs and I had several accounts where the nurses asked ME which labs needed to be run or they forgot to do them and I reminded them. I had a great experience at my hospital and had amazing staff, just wanted to remind you that a million things are going on around you and to advocate for yourself, because it starts with you!

How was the surgery? Were there any complications?

There were no in-surgery complications!

If there was going to be a triggering section, this would be it. Nothing bad happened, but if reading about some issues I had is going to make you fixate on it rather than just gain knowledge, I’d skip this part. It is important to be informed though, so if you can manage, personally I would suggest reading this as it may help you notice red flag symptoms of your own.

My OB said my surgery was textbook, which is amazing, considering my low platelet issue going into the procedure. They had blood and platelets on hand in the OR in case I needed them. Thankfully, I only lost half as much blood as they would expect for a multiple gestation c-section and my platelets remained stable, so they didn’t need either backup. Note that I spoke with a hematologist during my hospital stay and they continued to monitor my platelets during my entire time there. This often happened VERY early in the morning, but they were so fast. I still left with lots of bruising on my right inner elbow, but it was pretty much painless thanks to the talented phlebotomists. My platelets didn’t pop up to normal range during my hospital visit, but they continued to rise and were normal a month or so later.

One reason I’m really glad I had the Cesarean section is because while my OB was performing the c-section, she found a couple cysts on my uterus, as well as my ovaries. They tested them after removing and thankfully they were benign. She wouldn’t have been able to do so if I had tried for a vaginal birth.

There were no complications, though I did have an issue of pooled blood that I began to notice once I was able to get up and walk / about 24ish hours after surgery. This was likely due to my low platelets, which caused my blood not to clot properly. On the right side of my body, around my inner hip area, I experienced extreme pain when I tried to sit up, get out of bed, or re-situate while in bed. Honestly, I thought it was a normal feeling, because so many people said that a burning sensation was a common c-section scar side effect. Looking back it was more like a blaze versus a small burning flame. On Friday mid-morning, (remember my surgery was Wednesday evening) when my OB was checking on me (she did so daily), she asked if I would consider having more children or if I thought I was done and my response was that I couldn’t even think about that because of the amount of pain I was in. She immediately said that wasn’t normal and requested to look at my scar. I said sure and mentioned that a nurse looked at the area at least once a day and hadn’t said anything. I’m guessing the bruising hadn’t show up yet? I hadn’t noticed it yet either as my stomach was still rather large and I couldn’t see below it, though my OB was able to show me in a mirror. Basically down the right side of my groin and inner hip was a purpleish and swollen, aka the pooled blood, which was the root of my pain. We upped my meds, rather I started taking the heavier drugs and I used a heating pad which helped a lot regarding pain management.

I will also note that on day 3 I passed a huge blood clot. They have you urinate into specimen container when you first start to use the restroom for this very reason. Because I was using collection container, I was able to catch the clot and the doctors were able to look into it. It was around the size of my hand, but upon further inspection, my OB was not worried and said it was likely just trapped during surgery and finally made its way out. If you pass large clots, definitely say something, as it can be a sign of something else. Around week 2 postpartum (pp), I passed a 2 inch blood clot at home. I notified my OB again and there wasn’t an issue. I didn’t have any other blood-clots for the rest of this time.

What did having a C-Section feel like? Did it hurt?

Nope, I couldn’t feel anything! Okay, so I could feel slight tugs here and there, but it wasn’t bad or in a negative at all. I thought I would have issues with thinking about what they were doing, but I didn’t at all. Between the medication and the oxygen, I was fine. If I had to describe it in any way, I felt immediate relief. When they pulled out baby a, I could breathe again. When they pulled out baby b I thought I was at a yoga retreat I could breathe so deeply.

Common misconceptions during c-sections, and what I got to do:

It all depends on how your surgery goes and if there are any complications with you or the baby. Since mine went well all around, I go to do several of the things on my birth wish list.

  • Babies on Chest. I didn’t get to do actual skin to skin until I got to the recovery room, but I did get to experience them both laying on me fairly immediately. They did this while I was being sewn up as it has a similar affect to skin to skin and helps the act of labor complete itself within the body, ie shakes which I’ll mention later.

  • Breastfeed. I didn’t do this until I was in the recovery room, but regardless I was able to feed my babies first!

  • Delayed Cord Clamping. This is somewhat hard to do with twins, but we were able to delay about 30 seconds each, which is pretty much the max time for a multiple birth. Also, Nick was able to trim their umbilical cords once the babies were at their station! He didn’t do the initial cut / clamp , but that isn’t something you’re able to do during surgery to my knowledge.

  • Cord Blood. We did cord blood and cord tissue collection for both twins! If you use my link or mention Lauren and Nick Mulenos over the phone should you decide to bank with CBR, you will get special pricing / a discount.

    *Also, I’ve had some people ask me if my hands were clamped down and the answer is no. I think that might be a common misconception that people think happens during a c-section.

What kind of incision do you have? How big is your scar?

I have a horizontal scar that is very low, about 1.5 - 2 inches from the center of my pubic bone. Note that I do have a long torso so it looks extra low, but even if I didn’t it would still be very low.

The scar is about 7 inches under my belly button. I’m 6+ months pp currently so my scar has shrunk over time, but right now it is a little less than 5 inches long.

My doctor closed my incision with glue and placed one staple on the right side of my incision for the final closure. If you’re interested in this, ask your doctor their plan as there are different methods for closure - stitches, staples, sutures, etc.

What I thought would be hard, but turned out not to be so hard:

  • The C-section itself. I totally trusted my doctor and knew I would be in good hands so I was at ease in that sense; however, I was unsure of how I would feel during the surgery. I suffer from vasovagal syncope so I was worried I would pass out or something crazy during the surgery. Although, I did not have any pain or even mental issues during the procedure!! During the surgery you have oxygen flowing through your nose, so that helps prevent lack of breathing issues which also heighten anxiety. It also went by faster than I thought it would. I believe I went to the recovery room outside of the OR around 10:30 and was in our pp room by 12:30 am. Everything after they were out is a blur and I truly lost track of time.

  • The Epidural / Spinal. Yes, I had a mixture of both. It was honestly the biggest turnoff to pregnancy for me as I have scoliosis and have been nervous they wouldn’t be able to inject me correctly and it would really hurt. My mom has scoliosis and she experienced that during my birth. My anesthesiologist was awesome and did it so well. During the surgery they stay near you to manage the pain and meds! The medicine made me feel very relaxed and warm! I mention that because the OR is really cold. The pinch of the needle wasn’t the worst part for me… I had a HUGE belly that protruded forward versus wide. When getting it, you have to sit on the table with your back arched like “cat” in cat-cow pose, yet relax at the same time which was challenging. Because I often pass out, they had a nurse in front of me who I was basically hugging so I wouldn’t fall if I were to faint. (Note that I didn’t faint!) I was all up in her neck, plus I had to wear a mask because of COVID-19, which was challenging on top of me already getting clammy and not breathing oxygen well. At that point I did not have the oxygen in my nostrils yet. That was the hardest part - I mention that so if you’re worried for pain or the needle, just know it wasn’t as bad as I thought it would be in my opinion. The only thing I wish that was different is that I wasn’t alone - Nick wasn’t allowed for this part. I understand why they don’t allow “guests” during this part though. He was with me for the entire surgery otherwise. To my knowledge the only time they don’t allow anyone else is if you have to be put completely under versus local anesthesia.

  • Post C-section. I was slightly worried about being strapped to the bed initially and not being able to get up after the surgery. My operation began at 8:00 pm meaning they took me back and began to administer the anesthesia at that time. I mention that because I thought that meant they were cutting into me at 8:00pm, not just starting everything. For a time reference, the babies were born at 8:43 and 8:44 pm - They came out in under 5 minutes from when they first started. My only point of time reference is that we barely made it through 2 songs on our playlist and they were here. Anyway, they put the catheter in right after the epidural took affect and they removed it the following afternoon. Until then you are in the bed with your calves in these compression boots of sorts. It was sad because I couldn’t stand up / help with the babies, but even when I wasn’t strapped in, I wouldn’t really be able to lift them because of the incision.

  • Walking. I was told to get up and walk as soon as I was able. It was hard to get out of bed, but the actual walking part wasn’t that bad, I just went really slowly. I tried to go at least once, usually twice a day around the floor. Sometimes I went with the nurse’s assistant, sometimes Nick and I pushed the babies, and sometimes I just went by myself.

  • Long hospital stay. I ended up staying 4 nights and 5 days. I was hoping to go home day 4, but my doctor had me stay another day due to my pooled blood. It ended up being a blessing because I was under their care still and I got to visit with several lactation consultants.

  • The two IVs. Some people make a really big deal about getting an IV and saying you don’t have to opt into it specifically regarding a vaginal birth. Personally it doesn’t bother me (other than the fact that is slightly uncomfortable and sometimes hurts to move your hand. In the OR it is my understanding that you have to have one and with twins they like to put two in. It is there in case they need to quickly administer things to you and with two babies there is more risk. I wasn’t hyped about this, but it wasn’t that bad, plus I am pro being on the safe side. They removed one immediately after surgery and removed the other one around day 3 I believe.

  • Passing gas. I did this really easily and actually before I was able to pee or poop! No problem here. I did have issues pooping though and got a suppository on day 4 just to get my system going. I have ulcerative colitis (UC) and the meds I was on have a side effect of constipation, so I talked to my doctor and asked my nurse for one. It did the trick!

  • Frequency of visits. While my doctor appointments leading up to birth were 4-5 a week between OBGYN and MFM, NSTs, acupuncture, physical therapy, and chiropractic care (before 34 weeks), my hospital doctor visits were kind of scarce. I was prepared for people to lots of interruptions as that is what my friends had occur during their stay, but thankfully I didn’t experience that. I do think it is due to the nature of my hospital though. You do reserve the right to ask people to come back later.

What was harder than I thought it would be:

This looks like a long list, but I feel like it is just a lot of little things. Remember that my overall birth experience was great! Just sharing this so you can be prepared and have more knowledge :)

  • Peeing after having a catheter. Wow! This was HARD. Not only were nurses standing outside of my door waiting on me which caused actual mental pressure / stage fright, but you have to use a specimen collector. This complicates things in a lot of ways, but the main one is that you have to make sure you don’t overfill it / get pee all over the floor. It is kind of hard to use in general, but exceptionally hard when you still can’t see below your stomach. The first time I tried to go, I finally gave up and said I’d try later. The next nurse on shift was an ANGEL and gave me the best tip to go - blow bubbles. I had tried everything before this, even the peppermint oil trick. This nurse gave me a cup of water and a straw and said “blow.” It worked like magic! You don’t have to have a have a straw or a cup of water though, you can just blow out of your mouth in general. I used this method countless times to go for the first month or so. Note that the catheter itself wasn’t scary to me. They placed it effortlessly while I was numbed up in the OR, but they take it out after the fact… I was nervous because if you end up not being able to pee after a certain amount of time, they have to re-insert it and you aren’t numbed… Anyway, don’t be afraid, just use the blowing bubbles trick!!

  • The hospital bed. Perhaps it was because I was in it for 5 days non-stop, but omg my tailbone hurt so bad! The bed was uncomfortable, but I can usually tolerate it. For some reason the tailbone part was way worse than anything I experienced uncomfy bed-wise. I asked if there was padding or something we could use and they said no.

  • Pooled blood. This wasn’t something I expected to happen, but was nonetheless the hardest part for me. It hurt SO BAD. It hurt less overtime, but all I can say is speak up if you’re in pain and don’t be afraid to take the medicine. Oh and use a heating pad! It will feel good on your scar too.

  • Not being able to drink water. Okay I may have lied…this might be tied with the pooled blood, though I wasn’t in physical pain. I arrived in the morning around 9 am for my NST. I had woken up late and barely scarfed down breakfast. I had just settled in with my juice cocktail and that’s when they told me they weren’t releasing me and I was going to deliver that evening. Because I was going into surgery, I had to follow the no eating or drinking 12 hours prior rule. This is what I was planning to do Friday morning (my original scheduled time), but that was easy, as most of those hour are sleeping. I was SO thirsty. People ask what my first post-birth meal was and I say ice. All i wanted was ice chips. Honestly I didn’t really miss food. I was finally able to drink water I think 24 hours(ish) later.

  • Nausea / not being able to eat. This came hand in hand with my water woes. I think it was a mixture of the birth, the anesthesia, and my lack of food and water, but while they were sewing me up on the operating table, I had this overwhelming sense of nausea and threw up. I have a family history of reacting to anesthesia like this, so I should have taken Zofran or something before beginning the surgery. It is what they gave me after the surgery, but it took a while to kick in. My first meal post-birth was Friday morning, which means I went without solids for 48 hours. I was able to eat jello and broth 24 hours later. Oh and cranberry cocktail! I actually became obsessed with it and drank it for months after delivery. Hah!

  • Gas bubbles. I had never heard anyone talk about this, so I was taken by surprise. My stomach was obviously still big, but instead of being filled with babies and firm, it was softer and had these (painful) little gas pockets all over my stomach that you could physically feel on the outside of my belly. They went away before I went home.

  • Anesthesia side effects. Sure my nausea and vomiting was likely induced by it, but I’m actually referring to chills and itchiness. I was very cold and was SO itchy for the 48 hours after the twins were born. It was the worst when I had the calf boots removed because I was able to actually scratch and had to practice self control to not claw my skin off.

  • Chapped lips. This was likely due to the fact that I couldn’t drink water along with the cold and dry climate of the hospital. My lips were dry, cracked, and hurting. They were so red they looked like I was wearing lip color! I slathered BKR Paris Balm on my lips and it helped so much.

  • “Regular” afterbirth. This wasn’t hard, I just didn’t expect it. I was aware of the shakes and frequent abdominal massaging that comes with a vaginal delivery, but for some reason I didn’t think they accompanied a c-section. Regardless of how you birth your babies, your body will shake after they are born. I actually tried to stop the shaking as I feared I would make them mess up putting me back together post delivery. I continued to shake through the recovery room stay, but had stopped by the time I made it to the postpartum unit. My OB noticed me doing this and told me to let it happen. It is all part of the process! I also thought that I wouldn’t bleed as much post-birth since they basically cleaned me out? Not the case. I bled for about 4-5 days then it tapered off, only to come back a little heavier. I bled for a little over a month pp. I didn’t get my period back until I stopped pumping, about a month after I stopped, around 5 months pp.

  • Taking medications. Any meds you take have to come from the hospital pharmacy. Even something as small as a vitamin! This is annoying because you have to pay for it and often wait for it to be ready.

  • Laughing. Nick makes me laugh a lot. This is a good thing, but not so good post-surgery. It hurts!

  • C-section bulge. Aka the mommy pouch. I didn’t gain much weight during pregnancy and the weight I did gain was all baby. I lost about 75% of my baby weight in the first 2 weeks pp. I still haven’t lost the last 25%. I don’t care so much about the number, I just wish the pooch was gone. Now that I am cleared to workout I can strengthen it and hopefully work towards getting it to look somewhat like what it used to.

What I would do differently if I had another C-Section:

As mentioned, I am very thankful for my birth experience and would do it all the same; however, these are some things that I would change going into it another time.

  • Take anti-nausea medicine. I would ask for Zofran or an anti-nausea drug pre-surgery to try and get ahead of the vomiting. I took Diclegis my whole pregnancy, so that coupled with my family history of anesthesia nausea, I should have known better.

  • Speak up about pain levels. I thought what I was feeling was normal and I was being a baby about pain? I don’t feel like it was a pride issue, I just didn’t want to take harder drugs for something that was “normal”. Once I did, I realized it wasn’t the common feeling and I had pooled blood, and upped my meds and was therefore in a better mood, as I wasn’t in constant pain. I wish I would have spoken up sooner.

  • Don’t pack personal medication. This just took up space in my bag, because you have to get all of your medications, even your regular ones, through the hospital. It makes sense as they are taking care of you, but it is annoying and inconvenient and I should have left it at home.

  • Shave your bikini line before you go. They mentioned this in my c-section class, but I didn’t think it was a big deal since they could do it for you. I honestly would not have been able to do it myself since I didn’t know I would deliver that day, but I would make sure I did it in the future! They gave me the worst hack job I have ever had down there in my entire life. They use these dull electric sheers and not only does it leave you with razor burn and an awkward bikini line, but you are then stuck with it for a while while your scar is healing.

  • Continue scar treatment. This was the one thing I didn’t do that my doctor told me to do. She said to apply Kelo-Cote twice a day and I usually only did it once a day and kind of stopped after I made it through three tubes / about three months pp. It was annoying to put on because you had to let it dry and I was so tired and just wanted to go to sleep. I also chalked it up to the fact that I didn’t care what it looked like or if it faded. The problem now is that most of my scar is still raised and it is starting to hurt / bother me. I did do a good job of scar desensitization though, so the surrounding area and the scar itself feels fine. It is just certain raised parts that hurt. Make sure you massage yours / touch it frequently to help it feel normal. Tingly sensations are your nerves doing their magic! Side note, scrubbing the glue, etc off my incision was not my favorite. It got stuck on things, hence the shave tip I give above. It’s already tender and having to pick it out isn’t fun nor does it feel good. I just made a commitment to scrub it or concentrate on a certain part of the remaining glue for about 30 seconds each shower. I started doing this after two weeks post op.

  • Bring formula of choice. The headline is that my milk took a week to come in after birth. If your body wasn’t in labor, chances are your milk will come in at a later date. My twins were losing 9% -10% of their birth weight, so we had to start them on formula and they were combo fed through 6 months. I stopped pumping at 4 months, they stopped nursing on their own around 3 months, within 2 weeks of each other. The hospital has formula, bit they weren’t my top choices. For guidance, I gave some tips here to picking the best formula for your babies.

  • Footprints. I’m not sure if my hospital didn’t do them or what, but we don’t have the twins’ footprints from birth. I would probably put it in my birth wishlist as I do wish I had them.

During Pregnancy C-Section Tips:

  • Take a C-Section Class so you are mentally prepared

  • Go to physical therapy regularly

  • Log roll out of bed (roll to your side then push up to get out of bed versus sitting straight up)

C-Section Tips for your Hospital Stay:

  • Get up and walk as soon as you can after surgery

  • Wash your face, brush your teeth, and change your gown as soon as you can get up - it will make you feel like a new person

  • Pretend to blow bubbles or request a straw and a cup of water to blow bubbles when you need to pee for the first time

  • Ask for a belly band and wear during your walks (You will likely want another one pp that is better - I ordered one at 3 months pp)

  • If there is an option for a specialist, take it (We had to pay out of pocket to have my MFM present at the surgery and I’m glad we did because it went faster and his knowledge and expertise was worth it)

  • Take a shower as soon as you can - I did on day 3

  • Request quiet hours (Our hospital had required quiet hours from 11:00 am - 3:00 pm and it was SO NICE. I have friends who were pestered all hours of the day and never got rest.)

  • Take home hospital supplies, but make sure you get the c-section mesh underwear and not the vaginal delivery ones. The c-section mesh holes are smaller so they don’t catch on / irritate your scar. They are more comfortable too! Grab those pads too!

  • Bring a pillow for both you and your partner as you will 100% appreciate it in the room for added comfort. You can also use this for the ride home. I was told it was a must have for the car ride home to hold against your incision, but honestly, I don’t think I needed it. I had so much weight from the twins that were no longer causing me pain, the ride home was a BREEZE. I literally said outloud “this is nothing”. Hah!

Once you’re home C-section tips:

  • Take it easy. Don’t do too many stairs, too much cleaning or food prep if you can manage. If you overdo it your body will let you know, especially by increasing bleeding and pain.

  • Protect your space. It will likely hurt feelings, but do not let people in who don’t agree to follow your parenting requests or may make things harder on you. I’m not saying keep them out forever, I would just protect those first few weeks as it is a major adjustment and you are recovering from a major surgery. Feelings are high and sleep is low.

  • Go to physical therapy. You just had a major surgery and will greatly benefit from it! Try finding a specific postpartum PT. I started going around 8 weeks once I was cleared. The main thing I worked on in PT was my diastasis recti. I had about a 1.5” separate in the top and middle of my stomach and a 1” separation towards the lower half of my stomach. You will notice this early on from doming. Lay on your back and laugh and see if it looks like the Loch Ness monster is popping out of your stomach. I also had some knots in my stomach that my PT massaged regularly for me. They caused pain, especially when walking, so addressing them was key. Don’t forget to look into a pelvic floor PT too! I have about a level 2 prolapse case.

  • Go on walks. I started this around 2 weeks. My PT didn’t clear me to work out until around 6 months pp. I suffered from diastasis recti (separation of the abdomen) and going back to other types of exercising too soon would have worsened my condition. If you want more of a challenge and you aren’t cleared yet, try added ankle weights to your walks.

  • Work on your scar. I started apply Kelo-Cote as soon as I got home from the hospital. Make sure to massage and touch it to desensitize it.

  • Don’t try to wear pants too soon. I wore my beloved align leggings to a pediatrician appointment and afterwards was like NOPE. Too soon. I pretty much lived in loose dresses like this one and this nightgown for the first 3-4 weeks.

  • Go to acupuncture if you can. I didn’t visit until around 8 weeks postpartum, but they gave me some herbs in the interum to work on flushing my body out and increasing milk supply.

  • Don’t take baths. People may try to recommend this to you, but you c-section recovery is a little different than vaginal delivery. Talk with your doctor to see when you are cleared to take baths, but is usually around 3-4 weeks post-op.

  • Continue to log roll out of bed. Your abs are essentially shot and sitting straight up is still not a good idea. I’m still log rolling to get out of bed!

  • Check for hip dysplasia in your babies. This isn’t for you, but I wanted to mention it as most c-section babies aren’t head down. When they aren’t head down (aka. born breach) they are more likely to develop hip dysplasia. You can check this on an ultrasound to get ahead of it should your baby have it. We checked ours around 3 months old, but would have done it sooner if there was availability.

To buy for home care after a C-Section:

  • High waisted underwear. There are a lot of undies that say the are c-section underwear, but are polyester or a poly-blend. You want cotton underwear, because they will breathe the most and you are about to have quite a bit of hormonal sweats. It doesn’t really matter what you get, but high waisted works really well because the panty line doesn’t mess with your scar. I really liked these and still wear them.

  • Kelo-Cote. Scar ointment that helps it flatten and not create keloids, along with fading treatment. Apply twice daily as soon as you are home from the hospital.

  • Prenatal Vitamins. Keep buying them / taking them pp and they will help your body find its new equilibrium and help bring you nutrients while breastfeeding.

  • Belly Band. You can buy this head of time if you want, but I might wait to see if you even need it. I bought mine around 2ish months pp as my stomach was taking longer to flatten. This helped me fit into clothes with confidence (it was around Christmas party times) and help my uterus shrink down. This does not take the place of PT or exercises; it works best in conjunction with those things. I have this one in a size XS. I was in-between sizes with my current measurements so I sized down. At first I was worried because it didn’t fit, but I squeezed into it. I found it easiest applied when I laid down on a bed and sucked in while Nick tightened it. I also like wear it backwards, as that prevents weird lines or bulges on the front.

  • Heating pad. You’ll use this on your scar and if you have any stomach pain. I have this one.

  • Squatty Potty. I had this pre-pregnancy and swear by it! It will help with straining and hemorrhoids.

  • Peri bottle. I didn’t think I would use this because I didn’t have a vaginal birth, but I did. Really helpful towards the end of pregnancy when your belly is large. I liked using it while I was still bleeding post-op. I have this one.

  • Pads. Some people like to wear diapers for pp bleeding, but I preferred my high waisted underwear with these organic cotton pads.

  • Stool softener and fiber. Since I have UC, I pay attention to when I poop and when I don’t. Likely due to the drugs, my regularity was very off pp. For the first couple of weeks kept prunes on my nightstand and would eat 2-3 when I woke up every morning. I took Colace once daily and Benefiber 2-3 times a day, along with my ginger digestion tea every night (use discount code ELLEMULENOS). Later I just took Benefiber and my tea, but it took a month or two for my body to become regular again.

  • Shapewear. This was my most recent buy. I wanted them for all of the upcoming weddings I am in and attending. They help suck me in and prevent people from asking if I am pregnant. I like these and just wore them for my sister’s wedding.

Do you have stretch marks?

No. These are genetic, but I did religiously use creams. Here are my favorites. I do have “twin skin” which is wrinkly skin because my belly stretched out so much. The only way to get rid of that is a tummy tuck. To paint you a picture, the last I measured my belly was less than a week before delivery and I was about 45 inches around. My pre-pregnancy waist was around 28 inches.

I don’t really like the way I look right now, but I was able to carry my twins full term which is such a blessing. I mentioned these feelings here.

When do you see your doctor post-op?

Whereas most non-c-section deliveries come in at the 6 week mark, I actually saw my doctor around the 2 week mark (technically 16 days after) so she could check on the healing of my incision and remove the single staple.

I saw her again about 5 weeks after that (a little over 7 weeks post surgery) to check on everything once more and get a pap smear.

From there we schedule another visit around 3 months pp. Sometimes symptoms don’t pop up until later and unfortunately, the mother’s health is often told to take a backseat. My OBGYN is very good at recognizing the importance of maternal health! At this appointment we did a hormone panel even though I was still breastfeeding, just to get a base line read on things.

We scheduled a follow up a little less than 3 months later // around 5 months pp to go over the results and do another check-in.

I have another check-in with her in a little less than 2 months (~ 8 months pp) . I assume we will do another hormone panel then to see where I’m at! I had high DHEA prior to pregnancy and I’ve had some acne flare ups, so I’m interested to see my results soon. I stopped nursing / pumping mid-February and they say it takes about 3 months for your body to shift back into its “normal” after your last session

I realize that this might seem like a lot of visits, but I do think they are necessary as I navigate this time, plus I love my doctor!

What I’m still dealing with pp:

  • Diastasis Reci (DRA). I still have some separation, but officially don’t have any doming anymore. I was cleared around 6 months pp to do yoga and other workouts. I am working on regaining strength now.

  • Prolapse. My pelvic floor is weak and my urethra is hanging a bit low (this is known as Prolapse). My posterior wall is caving in too. I’m doing exercises with my PT.

  • Clothing. I am going through a style crisis where I am changing, but more than that, I don’t really fit into my old clothes. It’s hard because I didn’t really buy a lot of maternity clothes, so when something doesn’t fit I don’t have a ton of options. I could just wear baggy clothes, but then I don’t really like the way I look in photos. My DRA is getting better, but I still have somewhat of a pouch, Trying to get past this mentally!

  • Postpartum Anxiety (PPA). I don’t have full blow PPA all the time but have had a couple scary episodes and intrusive thoughts regarding myself.

  • Hormones. I’ve had some hormonal acne pop up (where is my pregnancy / birth glow?!), so I started limiting my dairy and gluten again. We’ll see what my test results tell us and go from there.

In summary:

I know this was a lot, so if I had to summarize, my biggest take aways would be:

  • Do physical therapy

  • Don’t be afraid to take pain meds

  • Get up and walk as soon as you can

  • Blow bubbles when you pee for the first time

  • Massage your scar regularly and use treatment on it

If you made it this far, thank you for reading and I hope it helped! Please let me know if you have questions or want me to discuss things I didn’t cover.

Remember that I’m not a doctor and this is not medical advice. Be sure to chat through things with your doctor(s) when you can. Everyone is different and heals differently. Just try to have an open mind!

I started to feel more like myself around 2-3 months. 6+ months pp now and I barely remember any of the pain or complications. Thank goodness for the notes I took to write this. You can thank past Lauren - hah!

Oh and one more thing to note… I already operated in this manor pre-birth, but if you’re going to visit someone who just had a baby, c-section or not, don’t overstay your welcome, bring something for the mother, and don’t leave their house dirtier than you found it.

I’ll write another post about my hospital bag and what to bring soon, though you might be able to guess a lot of the items I brought from this post. I’ll provide a concise list during one of the naps my twins may or may not decide to fight ;)


If you liked this post, you’ll probably find these helpful:

First Trimester with Twins

Second Trimester with Twins

Third Trimester with Twins

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