How to sleep after a c-section: positions, getting out of bed

Leah Holloway, BABYGO® team

You're home. The scar's under its dressing, the painkillers are lined up on the kitchen side, and the bed you've slept in for years has turned into the hardest piece of furniture in the house.

Lying down pulls. Rolling over pulls more. And getting up for the 2am feed, when you've forgotten for half a second that you've had an operation, is the one that makes you swear.

It's the bit that gets missed in the rush of the ward. So here's how to set the bed up, the positions people manage in the first fortnight, and the roll and push way of getting up that the hospital physios teach.

Key facts

• Most women go home 1 or 2 days after a caesarean, and the NHS wants you out of bed and moving as soon as you can be.
• The cut is usually 10 to 20cm across, just below the bikini line. The dressing stays on for at least 24 hours, and stitches or staples that don't dissolve come out after 5 to 7 days.
• Driving, exercise, lifting anything heavier than your baby and sex all wait until they feel comfortable, which the NHS says may not be for 6 weeks or so.
• Your baby sleeps in the same room as you for at least the first six months, in their own clear, flat, firm sleep space (Lullaby Trust). A bedside cot, set up the way its own instructions say, saves a lot of bending. Painkillers that make you drowsy are one of the Lullaby Trust's reasons never to share a bed, so the cot is where they sleep, however tempting 3am makes the alternative.

What's the best sleeping position after a c-section?

There isn't one that's best for everyone, so I'll give you the three that people manage and what each one is for. The test is simple. It should pull as little as possible on the scar, and you should be able to get out of it without doing a sit-up.

On your back, propped up

The first couple of nights, this is usually where you start. Head and shoulders up on two pillows, and a pillow under your knees. The knee pillow is the bit people miss: with your legs straight, the front of your tummy is pulled taut and the scar feels every bit of it. Knees up, it goes slack.

The problem with your back is getting out of it. You can't sit up, so you're rolling to your side anyway. Which is why the side is where you end up living.

Sleeping on your side after a c-section

Your side is the position for most of the first fortnight, and it's the one for feeding lying down if you'd rather not sit up at 3am.

Two pillows do the work. One between your knees, so your top leg doesn't drop forward and twist your pelvis. One long one along the front of your tummy, so if you roll in your sleep you roll onto a pillow, not onto the scar.

A pregnancy pillow does both jobs at once because of the curve, and if you already own one from the bump, this is its second life. Fold the bottom end under if you're shorter, rather than fighting the length.

Getting onto your side in the first place is the same move as getting out of bed, which is further down. Knees bent first, then roll shoulders and knees together.

One reviewer wrote: "The cover feels soft and the curved shape works well for side sleeping." Another uses hers "for support when reading in bed", which after a c-section means every feed for a fortnight.

How to get out of bed after a c-section

This is the sequence the physiotherapy leaflets from NHS maternity units teach, and it works because it never asks your stomach muscles to do a sit-up. Bedfordshire Hospitals' version is a good one to have on your phone. Practise it in the daytime, when you're not half asleep.

1. Knees up. Bend one knee, then the other, so both feet are flat on the bed.
2. Brace, gently. Draw the lower part of your tummy in a little. Not a clench, just enough to feel it.
3. Roll in one piece. Reach your arm across in the direction you're going and roll your knees and shoulders over together. If your top half goes first and your hips follow, that's the twist that pulls.
4. Push up, legs down. On your side at the edge, push your top hand into the mattress and let your legs straighten off the edge at the same time, so your feet come down to the floor as your body comes up.
5. Sit for a breath. Especially in the first few days. Then hands on the bed either side of your legs, draw your lower tummy in, lean forward and push up to standing.
6. Stand tall. Everyone curls over the scar. Try not to, once you're up. The leaflets are clear that walking upright is part of the recovery, not a risk to it.

Getting back in is the same thing backwards. Sit on the edge, lower yourself onto your elbow and then your shoulder, and bring your legs up together with your knees bent. Then roll onto your back if that's where you're sleeping.

Coughing, sneezing and laughing

These are the three that catch you out, and the fix is the same for all of them: lean forwards and hold the scar. Your hands, a rolled-up towel or a small cushion pressed over the wound takes the sting out of it.

Keep a small cushion on the bedside table for exactly this. You'll use it more than you think, and it's also the thing to hold when you first stand up.

When can I sleep on my stomach after a c-section?

There's no date for this one, and nobody on the ward will give you one, because it depends on the wound rather than the calendar.

Lying on your front puts your whole weight on the scar, so it waits until the wound has healed over and lying on it doesn't hurt. Weeks rather than days is the honest answer, and if you're a lifelong front sleeper the first fortnight is going to feel long.

When you do try it, put a flat pillow under your hips so your weight sits on your pelvis rather than on the cut, and come out of it the moment it pulls. If the scar is still open anywhere, weeping, red or more painful than it was, don't try it, and ask your midwife to look. Those are the signs the NHS says need checking anyway.

Setting the bedroom up for the first two weeks

Most of what makes the nights bearable gets sorted in the daytime, ideally before you go in if the section is planned.

• Your side of the bed is the one nearest the door, the loo and the cot. If that means your partner moves, your partner moves.
• Bed height. A low bed is hard work for a fortnight. If there's a higher one in the house, or a sofa bed you can get off without folding in half, use it. Knee height is about right.
• The cot. The Lullaby Trust's advice is that your baby sleeps in the same room as you for at least the first six months, in their own clear, flat, firm sleep space. A bedside cot with the mattress level with yours means you can reach them, and put them back, without bending or getting up.
• Within reach. Water, your pain relief and a note of when you last took it, your phone, a muslin, the cough cushion, and a lamp you can switch on without sitting up.
• The loo trip. You'll be up in the night for it whatever else happens. A peri bottle by the toilet means rinsing with warm water instead of reaching and twisting to wipe, which is the movement that hurts. Keep pads and a clean pair of knickers in the bathroom too.

What to sleep in after a c-section

Nothing with a waistband on the scar. A nightie or a big T-shirt on top and, underneath, a pair of high-waisted knickers that sit well above the cut.

They go on over the dressing from day one, they hold a maternity pad through the heavy bleeding of the first week, and the light hold across your tummy is doing the same job as the cushion when you cough. One reviewer wrote: "I wore them day and night during the early recovery stage. The fabric is soft over tender skin but still feels supportive."

Two things worth knowing before you order. We can't take knickers back for hygiene reasons, even unworn with the tags on, so check the size guide rather than buying two sizes to try. And darker colours are the sensible choice for the first fortnight.

For the rest of the wardrobe, day by day, there's what to wear after a c-section. For how long the whole thing takes, recovery from a c-section has the timeline.

Questions we get asked

Can I sleep on my back after a c-section?

Yes. Propped up, with a pillow under your knees, it's often the easiest position of all in the first few nights. Flat on your back is the version that pulls.

Why does my scar hurt more at night?

Three usual reasons. Your pain relief has worn off, so take what you've been given regularly in the first week rather than waiting for it to hurt, and ask your midwife about timing the last dose for bedtime. You've done more in the day than you think. And you've slid down flat in your sleep, so the knee pillow has stopped doing its job.

Can I use my pregnancy pillow after a c-section?

Yes, and it often gets more use after the birth than before it. On its side it's the between the knees and in front of the scar pillow in one. Folded, it's a back rest for sitting up in bed, and a lot of people use it as the feeding prop so they're not hunching over the baby.

Should I wear my postpartum belt in bed?

No. A belt is for the hours you're up and moving, and it comes off to rest. After a c-section it waits until the wound has healed and you feel ready, so it isn't a first fortnight thing anyway; if you're not sure, ask at your postnatal check or ask your midwife. There's more in our post on whether postpartum belts really work.

Is it safe to have my baby in bed with me while I recover?

The Lullaby Trust says the safest place for your baby to sleep is their own clear, flat, firm sleep space in the same room as you. After a section you're sore, on pain relief and more tired than you've ever been, which is exactly when a bedside cot earns its keep. If you're thinking about bed-sharing, talk it through with your midwife first.

If you're sorting the bed before a planned section, the c-section recovery collection has the knickers, the pillow and the peri bottle in one place, and the postpartum knickers size guide tells you which size to go up to.

This is general guidance from the BABYGO® team, not medical advice. Your midwife or GP knows your pregnancy; ask them if anything here doesn't fit your situation.