Updated April 02, 2015.

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Whether you are having a planned cesarean section or you have an unplanned cesarean in the middle of labor, there can be many surprising things that happen both during and after the surgery. Here are some things that mothers have said surprised them the most after giving birth by cesarean:

Postpartum Bleeding: Many women I talk to are very surprised that they will still bleed after giving birth. “I just assumed that when they were in there that they just scraped everything clean,” said Rose after her first cesarean.

This is what a lot of women believe. Though the bleeding after baby is from the healing of the placental site in the uterus and not simply the emptying of the uterus after birth.

Surgeon Chatter: During the actual surgery, particularly after the baby is born, which is the longest part of the surgery, sometimes the surgeon chats about things that aren’t related to you or your baby. This can be rather annoying. Elizabeth said after her second cesarean, “I still wasn't prepared to be left all alone on the table while the OB chatted away about his weekend plans.” If you think about it before hand, ask that all operating room personnel keep their conversations to a minimum. This can be something you talk about in your birth plan.

Being Left Alone: As you can see above, sometimes, even in a busy operating room, a mom is feeling alone on the OR table. This often happens after the baby is born when her partner goes to be with the baby at the warmer. Even if it is only a few minutes, many women are really anxious during this time.

Using a doula can be a great way to prevent mom from being alone in the OR.

Not Remembering the First Hours: After her first cesarean, Elizabeth says what surprised her was, “…not remembering the 1st 3 days of my son's life because of the ‘cocktail.’” This can be a common theme. Postpartum pain relief is an important part of a cesarean recovery, but the medications do not have to make you so incredibly out of it that you don’t remember what’s going on. If you feel really out of it be sure to talk to your OB and anesthesiologist about the medications you are being given to help avoid this feeling.

Not Seeing Baby Right Away: While this is not always the case, there are still many hospitals that routinely separate mothers and babies after a cesarean birth. This is something to ask about on your hospital tour and to advocate to keep you and baby together as long as you both are healthy. Routine separation can lead to anxiety on your part and is generally not the healthiest thing for your baby. Ask about skin-to-skin care in the OR and/or the recovery room. One new mom explained, “I couldn’t see my son after 4 hours I hated it.”

Breastfeeding Difficulties: With a cesarean birth, you may have some extra breastfeeding challenges. This is fairly common, but with some planning and help from a lactation consultant you can breastfeed successfully. This can be really frustrating for moms, particularly if they are hoping that breastfeeding will be the one thing that will go smoothly for them after a potentially difficult birth.

Pain: This one is a bit more difficult to talk about. The vast majority of mothers talk about how the pain was so much harder than they expected, or that it lasted way longer than they expected. Stephani explains it like this, “With my 1st I was surprised by the pain when I woke up in morning, no amount of pain meds could block the pain, I want to try a VBAC with this baby so I don't have to go through it again.” When I asked mothers in interviews what had surprised them, they talked about pain using words like hell and feeling drugged afterwards, but I had one mom who had a different take, “I was surprised that it didn't hurt as badly as everyone said it would.” So I suppose this is something that you will need to be prepared for, particularly in terms of talking to your doctors about pain medication and ensuring you are taking the right medication at the right dose to control your pain.

Postpartum Complications: A cesarean, while a birth, is still major surgery. This means that you may experience complications after your surgery. These may be relatively minor complications or larger complications. Tristina talks about her complications after the birth of her baby, “My incision got infected. 4 weeks later here I am still in pain 24/7 on pain meds with 2 open holes going in to get them packed everyday…ready for it to be healed!” This is a less common problem, but ask about potential complications and know when to ask for help from your doctor.

That I Had A Cesarean At All: Many moms are just floored that they wound up with a cesarean for their birth. While there are things that you can do to help prevent a cesarean birth, it is impossible to say with 100% certainty that one will be avoided. Prevention is partly good health, a patient practitioner who is willing to honor normal labor, and good luck. If you wind up with a cesarean, do not beat yourself up. Move forward, talk to other moms, join a group to find support, like the International Cesarean Awareness Network (ICAN), and get help if you need it.

“At Least You Have a Healthy Baby”: So many moms who have given birth by cesarean hear this and find it upsetting. It is possible to be happy that you had a healthy baby and yet unhappy that you had a cesarean. The two are not mutually exclusive. Some women feel really traumatized that they had a cesarean, while others aren’t. It is okay to be in either one of those camps, but realize that both exist and neither is right nor wrong.