C-Section for Plus Size Women

In the United States, 30% of births are via c-section and that percentage dramatically increases for plus size women. I recently asked the following question on the Plus Mommy Facebook page, “C-section mamas – what’s something you wish you would’ve known beforehand? What advice would you give to a woman who is scheduled to have one?” That thread received over 130 responses.  I divided the advice and some research I did in the following way: preparing for surgery, operating room, immediately following surgery, hospital recovery, and home recovery.

This article, C-section for Plus Size Women, is all about providing support! It is my greatest hope it will help women to feel less afraid and more knowledgeable about what they might experience. After learning a lot about the procedure I have this to say, women who experience a cesarean birth are amazing. They did not fail and are not any less of a woman. If anything they’re even stronger than they think they are!



Preparing for Surgery

  • Needing a c-section is in no way a failure, it’s an understanding that you need a little help to safely bring your baby into this world.
  • If you had desired a vaginal birth know that many women can go onto have a vaginal birth after cesarean with future births.
  • Consider writing a birth plan for your c-section.
  • Watch this c-section video to have a better understanding of what the experience will be like.
  • Consider hiring a doula to support you and your partner through this experience.
  • Make lots of freezer meals and plan to have people lined up to offer you support once you’re home.

Operating Room

  • The anesthesiologist, not your OB-GYN, decides who can join you in the operating room.  Usually they will only allow one person to join you, however, it never hurts to ask. Request to have your partner and another support person, like a doula or family member, by your side. One support person can stay with the baby and the other with you.
  • Blow out when they are inserting the spinal block.
  • It might take them multiple times to get the needle in, just breathe through it if it happens to you.
  • The spinal block can make you really cold and weak. Don’t be concerned if you’re shaking, it can be a normal side effect.
  • If you’re having an emergency cesarean you might be under general anesthesia and not awake for the surgery. There might be other reasons why your care provider will suggestion general anesthesia even if you aren’t having an emergency c-section but those occurrences are uncommon. Talk to your care provider about any concerns you may have.
  • The operating room is very cold. Ask for warm towels and blankets to be put over your arms, chest, and around your head.
  • It’s not uncommon for moms to have their arms strapped down during the procedure. If this bothers you have a conversation with the OB-GYN in advance. Always be your own best advocate and speak up for what’s important for you and your birth.
  • It’s not uncommon for plus size women to have their bellies lifted and taped so the OB-GYN has easy access to make an incision.  While this isn’t painful, it can be a little disconcerting.
  • Some women appreciated having two small holes on either side if their incision to help with draining.  Or even having a drain placed.  Ask your care provider about this.
  • Ask for comforting music to be played rather than hearing the doctors talk about their weekend plans.
  • If you feel anything from the waist down speak up and your pain meds will be increased.
  • A catheter will be inserted since you will be unable to walk right away.
  • You may feel tugging as the baby is gently removed from your uterus and cramping as your baby is born.
  • There will be a divider put up so you won’t be able to see what’s happening. Some moms have requested having the divider brought down the moment their babies. This will be at the discretion of the OB-GYN.
  • Have your partner take pictures of your first moments meeting your little love.  Consider asking a nurse to snap your first family picture.

cesarean for plus size women

Immediately Following Surgery

  • Family Centered Cesareans is still a very new concept but it’s one that’s helping to transform the birth and bonding experience for cesarean birth moms. This includes having the opportunity to do skin-to-skin with your baby! If this is of interest to you we really encourage you to do some research and have conversions with your OB-GYN early on.
  • If you’re unable to do skin-to-skin, ask to have the baby’s first blankets placed upon your chest. This will help to release hormones within your body to contract your uterus and let your body know it’s time to produce milk.
  • Have your partner provide your baby with some much-needed skin-to-skin if you are unable to. Most often there’s a 45 – 60 minute waiting period before you’ll be able to hold your baby in the recovery room.  Often you will be able to touch your baby and be cheek-to-cheek before they are taken to the nursery while you’re being stitched up.
  • If given the choice between staples or stitches, many women of size preferred stitches.

Hospital Recovery

  • Attempt to breastfeed as quickly as possible. Expect your milk to take up to five days to come in but your baby will receive colostrum right away.
  • Connect with a local IBCLC to support you along your breastfeeding journey.
  • You will be unable to stand or walk until the medication has worn off.  As soon as you’re able to move your lower half the medical staff will encourage you to stand and take a few steps.
  • Stand with your feet shoulder-width apart and lower/raise yourself while exhaling.
  • Get up and walk as early as you can. This will help with blood circulation and reduce gas pain.
  • Plus size compression stockings are a must following major surgery and be sure to tell your care provider of extreme swelling of your legs and ankles (some swelling is normal).
  • You will probably experience swelling of your legs and other areas of your body.
  • Drink lots of water.
  • Press a pillow against your stomach when you sneeze, cough, or even laugh.
  • Also, it might be comforting to press a pillow against your stomach while going to the bathroom.
  • Request stool softeners and make sure you have enough on hand for your recovery at home as well.
  • Gas pain can be very unpleasant.
  • Request an ice pack.
  • The area of your incision will be numb for an undetermined amount of time.
  • Make sure someone helps support you while you take your first shower.
  • Keep your incision area clean and dry.  Tuck sterile gauze pads over the incision to help prevent infection.
  • Some women find it helpful to dry their incision with a hair dryer on a low setting after a shower.
  • You will still bleed vaginally.  The hospital will provide you with sanitary pads during your stay.

Home Recovery

  • Accept help! Recovery time varies for each woman but most can’t return to doing normal activities for at least 6 – 12 weeks.
  • Keep the incision dry and clean.
  • Do not lift anything heavier than your baby.
  • Do your best to sleep when the baby sleeps or at least rest when your baby is sleeping.
  • Get up and walk often but don’t over do it.
  • Wear loose-fitting sweats/yoga pants
  • Sanitary pads can be placed against your incision during the healing process.
  • Overnight pads are advisable for this use and vaginal bleeding.
  • Take home some extra mesh panties from the hospital.
  • Vitamin E oil can reduce the appearance of your scar.
  • Eat foods that are high in fiber, like green veggies, to help with constipation.
  • Keep a water bottle near you at all times and drink it!
  • Many women find it really comforting to wear a belly band not only throughout pregnancy but also following birth.
  • Have someone with you for a least two weeks to help with shower breaks, cooking, other children, pets, household chores, etc.
  • If possible make your bed as high as possible so it’s easier for you to get in and out of it. Some women even prefer sleeping in a recliner since laying flat will be extremely uncomfortable for quite some time.
  • Tell visitors you just had major surgery. You are not expected to be a hostess!  Unless they are coming to help clean or bring a meal, ask them to politely stay away until you feel up to it.
  • Consider having a list of things you need so when people call you can let them know how the can be of assistance.
  • Stay on top of your pain medication.
  • Ice packs will help with pain and swelling.
  • Don’t forget to connect with a local IBCLC to support you with any breastfeeding struggles.
  • Consider hiring a postpartum doula.
  • Keep the peri bottle from the hospital. You can use it to help keep your incision clean.
  • Wait to drive until you feel ready to do so. It will take more energy out of you than you can imagine.
  • If you have negative feelings about your birth, contact your local ICAN (International Cesarean Awareness Network) group for support.
  • If your belly hangs over your incision, this is commonly referred to as an apron belly and we have resources for you here – What’s an apron belly? Practical solutions and comfort tips!
  • Keep the list of warning signs your doctor will provide you with handy.  If you have any concerns call your care provider right away (no concern is too small!).

Cesarean Birth Stories

For anyone looking for tips to avoid a c-section I highly recommend this article, Women of Size and Cesarean Sections: Tips for Avoiding Unnecessary Surgery.  We also recommend the book Cut, Stapled, & Mended for women who are struggling emotionally following a c-section.

Thank you to all of the mothers who contributed to this article by sharing their experiences and powerful photos.  If you’d like more support for having a c-section as a plus size woman the Plus Mommy community is here for you.   


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