This topic will review the postoperative care of women who have undergone cesarean delivery and discuss potential sequelae of this procedure. Preoperative and intraoperative issues are discussed separately. (See "Cesarean delivery: Preoperative issues" and "Cesarean delivery: Technique".)
In the immediate postoperative period, the woman is monitored for evidence of uterine atony, excessive vaginal or incisional bleeding, and oliguria. Blood pressure is monitored to assess for hypo or hypertension, which could be signs of intraabdominal bleeding or preeclampsia, respectively.
Patient controlled opioid analgesia followed by oral nonsteroidal antiinflammatory drugs provides adequate pain relief for most women. (See "Anesthesia for cesarean delivery", section on 'Planning postcesarean analgesia'.)
There is no evidence that routine urine culture or a trial of catheter clamping is useful before removal of the bladder catheter [1,2]. Although a meta-analysis reported antibiotic administration prior to catheter removal reduced rates of catheter-associated urinary tract infection , there were multiple limitations to these trials (see "Catheter-associated urinary tract infection in adults"). We do not recommend this intervention.
The mother can be instructed in ways to hold her newborn to avoid contact with the incision; lying on her side or a 'football hold' may be used, or a pillow may be placed over the incision and under the infant so the direct contact with the incision is minimized. Heavy lifting and lifting from a squat position confer the greatest increases in intraabdominal pressure [4,5]. These activities should probably be minimized in the first one to two weeks of wound healing, although there are no data regarding the impact of various intraabdominal pressures on wound healing .