Dear Doctor,

I had my first baby through C-section a week ago, and was advised to not take a full bath lest I get an infection for at least two weeks. So, I wrap a towel around my scar area and take a sponge bath. However, my sister who has had three Cesarean sections, tells me I do not need to go the whole two weeks as advised and that she was fine taking a normal bath a week after. I’m a little worried though. How long should it take before I take a normal bath and what can I look out for in case of an infection?

Dinah

Dear Dinah,

Congratulations on becoming a mom. A C-section, or caesarean section, is usually done to deliver a baby from lower abdomen if the labour is not progressing as anticipated. It is also done as a safe alternative to normal delivery if any problem is expected, or occurs, posing a health risk for the mother or new born.

After a C-section, stitches are put in the inner layers of the abdomen, which are cut to open the womb to remove the baby. Outer layer is closed by strips of glue. The entire procedure is carried out under local anesthesia, usually an injection given in the spinal cord which numbs the abdomen and legs. The after care of a C-section includes some precautions. These include; not lifting any weights or bending for about three months, to avoid weakening of abdominal muscles, avoiding strain on back muscles which could cause chronic backache later and aids in healing of the C-section wound and stitches. Driving is also banned for about six weeks to avoid strain on abdominal and back muscles. One is asked to avoid sex for six to eight weeks to avoid risk of any infection to the genital and or urinary system. Usually, the outer strips of glue dry up and fall spontaneously, in a few days, say a week or 10 days. The stitches also heal slowly from 10 days to two to three weeks. The abdominal muscles cut, regain their normal tone and strength in about four to six weeks or so. However, this period varies among different women, depending on several factors. Body weight of a woman, amount of fat in abdomen, her personal hygiene, any previous C-sections, or any other surgery/trauma affecting the abdomen, any chronic disease reducing immunity like diabetes, etcetera, are some factors which decide duration of healing after a C-section.

Not taking a bath, particularly soaking in a bath tub, is also one of the precautions included in after care of C-section. Immediately after a C-section, there is risk of the stitches getting infected after getting wet and being contaminated by soap. The adhesive strips put on the top layer of the abdomen can also come out after a hot bath. Hence, one is prohibited to take it. Six weeks is an arbitrary period given to ensure that infection does not occur, internal stitches heal very well and adhesive strips come out smoothly. It is not a hard and fast period. If the glue strips have come out, the wound site is clean with no sign of infection like redness, swelling, pain or pus discharge, one can take a bath earlier as well. A shower can be taken early, three to four days post C-section, after putting a thick absorbent cloth over site of C-section.

Dr Rachna is a specialist in internal medicine at Ruhengeri Hospital

rachna212002@yahoo.co.uk