Pain relief after your caesarean birth

A caesarean birth is a major abdominal operation, and the recovery can be painful. In hospital we give you pain relief so you can recover from the surgery and care for your baby. This leaflet answers questions about pain relief in hospital and at home.

1. What pain relief am I given during my caesarean birth?

Most women or birthing people have a caesarean birth with a spinal or an epidural anaesthetic. This means pain relief is administered into your back, which will last several hours. At the end of your operation a diclofenac suppository is used to provide extra pain relief. Diclofenac is like ibuprofen, and the suppository is inserted into your bottom.

2. What pain relief will I receive after my caesarean birth?

In hospital you will regularly receive paracetamol 1g and ibuprofen 400mg every six hours. Ibuprofen is best taken with food. Some women or birthing people cannot tolerate ibuprofen, and are instead prescribed dihydrocodeine, which can be taken every six hours.

3. What if I am still uncomfortable?

Everyone’s experience of pain relief is different. On top of paracetamol and ibuprofen we provide dihydrocodeine (up to four times a day), or oral morphine up to every two hours. In the first 24 hours after your caesarean it is common to need this stronger pain relief.

4. What if I had a general anaesthetic for my caesarean birth?

If you were under general anaesthesia (asleep) for your surgery you may experience more severe pain. Morphine pain relief is given into your vein during and after the operation. Your anaesthetist may also have given you local anaesthetic injections into your abdomen (tummy) to make the area numb. Rarely you might need a pump called a morphine PCA (where you give yourself morphine via pressing a button). This is usually given for less than 24 hours.

5. Are there any side effects to taking these drugs?

Dihydrocodeine and morphine can cause constipation, but you will be given laxatives to help prevent this. You may also experience nausea (feeling sick) and sickness. We can provide anti-sickness medication to help with this if you do.

6. Is it safe to take these drugs whilst I am breastfeeding?

All these medications, including dihydrocodeine and morphine, are safe to take whilst breastfeeding. Small amounts can pass into your breast milk, but if taken in the recommended doses these are very unlikely to harm your baby. If you notice any signs of increased drowsiness in your baby stop the medication and seek urgent medical advice.

We recommend avoiding codeine and co-codamol (which is codeine and paracetamol) when breastfeeding. This is because individuals vary in the way their bodies handle codeine. These drugs are not the same as dihydrocodeine, which is safe to take when breastfeeding.

For further information, please go to the Breastfeeding Network web site.  

7. What pain relief can I take at home?

Have a supply of paracetamol and ibuprofen ready at home. If you need stronger pain relief, a small supply of dihydrocodeine can be prescribed for you to take home. You will need to speak to your midwife or doctor on the postnatal ward so this can be prescribed for you.

Take your pain relief regularly and as instructed for the first few days after your surgery. You may need to continue taking these for up to two weeks after your surgery.

8. When should I stop taking pain relief?

Most women or birthing people need pain relief for one to two weeks, but this does vary. If you are still in discomfort after two weeks, please speak to your GP or midwife who can help you further.

9. How do I get in touch if I have any concerns?

While you are in hospital the midwives and doctors are available to help you. Once at home your community midwife will be able to assist you.

If you need a prescription for more medication once you are at home, please contact your GP. If your pain is getting worse or you have any concerns, please contact our Maternity telephone triage service on 01227 206737 for help and advice. You can do this up to 28 days after your caesarean birth.