Eating to Support C-Section Recovery
If you are like me and went down the c-section route to bring your child into the world (whether planned or not), there are a number of nutrients that you can eat more of to speed up your recovery. While not a magic bullet, quality nutrition can encourage tissue and wound repair, muscle recovery and scar healing to help your body restore itself from the inside out.
HOW CAN FOOD SUPPORT YOUR RECOVERY AFTER C-SECTION?
A c-section, caesarean section, or abdominal birth, is major abdominal surgery that involves making an incision into the uterus, through a number of layers of tissue and muscle to deliver a baby. Due to this, recovery can take around 6 weeks while the wound repairs and tissues heal. During this time, you will likely be given a list of activities you cannot do by your doctor, as well as exercises/instructions from a physiotherapist to promote muscle recovery.
Did you know that you can also support the healing process through nutrition? Pregnancy is a nutritionally demanding process and many women enter the postnatal period already depleted in vitamins and minerals, such as iron, omega-3’s, iodine and vitamin D. Add into this breastfeeding, potential blood loss of surgery, lack of sleep and tissue healing and the body can struggle to repair effectively. Utilising a whole-food approach and ensuring you are eating a variety of the foods below, can help your body heal and repair itself so that you can get back to enjoying active time with your family.
NUTRITION TO SUPPORT RECOVERY AND WOUND HEALING
Protein and Collagen
Protein comes top of the list as it is vital for wound healing and repair, muscle recovery and supporting the immune system to fight off potential infections. Protein is made up of amino acids, considered the building blocks of the body. There are 9 essential amino acids that we must get from food as the body cannot make them. Animal protein generally includes all 9 essential amino acids, while plant protein is commonly missing some, with the exception of soy (tofu, edamame, tempeh), quinoa, chia seeds, hemp seeds and buckwheat, which are considered ‘complete’. Eating quality protein from a variety of animal and plant sources will ensure you are fuelling your body with the protein it needs to heal effectively.
Collagen is a type of protein that makes up about 30% of the body’s protein content. It is important for connective tissue structure and function, improving the elasticity of the skin and underlying tissue, blood clotting and wound healing (1). This is also a consideration for the shrinking of the uterus and skin as they return to a new ‘normal’ after birth. Collagen is mostly made up of the amino acids proline, glycine and hydroxyproline. Binding these amino acids together to make collagen needs additional nutrients such as vitamin C and zinc (see below), so aim for a few sources of these daily.
As collagen is found mostly in connective tissues, muscle and skin, try to include slow-cooked meats, broths and stews to get collagen from food, along with many other beneficial nutrients. Alternatively, you can buy collagen powder to add to meals, just be sure to check the label for additives. Aim for organic, grass-fed or free-range meat where possible.
Sources: Meat, poultry, fish and seafood, eggs, dairy (milk, greek yogurt, cheese), nuts and seeds (almonds, walnuts, cashews, chia seeds, hemp seeds, pumpkin seeds), soy and tofu products, legumes (lentils, peas, chickpeas, beans) and whole grains.
Vitamin A
Vitamin A, from retinols or carotenoids, such as beta-carotene, has a number of roles in the body, but it is especially important for wound and skin repair. It stimulates new skin growth and skin structure which is crucial when it comes to c-section repair (2). Animal food sources contain retinol which is the active form of vitamin A, whereas plant sources contain beta-carotene which needs to be converted to the active form in the body. The conversion rate is not that high so like protein, try to get a mix of animal and plant sources listed below where you can.
Sources: Retinol is found in liver and organ meats, oily fish (salmon, mackerel, trout) and seafood, full-fat dairy and eggs. Beta-carotenes are found in fruits and vegetables such as sweet potato, carrots, butternut squash, spinach, kale and apricots.
Zinc
Zinc is a mineral involved in many bodily processes and is a co-factor for over 300 different enzymes (proteins that have specific functions, many of which need certain vitamins and minerals to do their job properly). In terms of c-section recovery, zinc helps with wound healing, skin regeneration, immune response to fight infection and as an antioxidant and anti-inflammatory, all important for healing (3). Zinc also has other important roles in the postpartum period including regulating hormones which shift drastically after birth, making neurotransmitters for brain and mood health and helping the stomach maintain acidity so it can break down and digest food more effectively.
Sources: Fish and seafood (oysters in particular), red meat, poultry, dairy, cashew nuts, pumpkin seeds, hemp seeds and wholegrain (oats, quinoa, brown rice).
Vitamin C
Vitamin C has many roles in wound healing and repair. It serves as a co-factor for making collagen, improves skin barrier function to help prevent infection, and helps improve immune system function through its role in white blood cell production, again helping to fight potential infection while the skin heals. It also promotes the growth of new blood supply to the affected tissue, and lastly, acts as an antioxidant to help remove damaging oxidants (free radicals) and reduce inflammation at the wound site (4). Citrus fruits like oranges and lemons are commonly known sources of vitamin C, however, there are lots of other options too such as kiwi fruits - 2 of which provide you with over the daily recommendation of vitamin C, with gold kiwi’s having even more than green ones (2 green kiwi fruits = 130mg vitamin C, 2 gold kiwi fruits = 250mg vitamin C, approximately).
Sources: Acerola cherries, capsicum, kiwi fruit, broccoli, cantaloupe melon, strawberries and other berries, kale, tomatoes and citrus fruits.
Iron
Iron is a vital mineral needed in higher amounts during pregnancy, mainly due to the increase in blood production while pregnant to supply mum, baby and the placenta. It is needed to form haemoglobin in red blood cells which carries oxygen around the body (amongst other roles). Iron deficiency will leave you feeling tired and lacking in energy. As a guide, the requirement for iron in pregnancy goes up to 27mg/day, from 18mg before pregnancy! Due to these massive demands and depending on if you were supplementing during pregnancy or not, many women enter the postpartum period already deficient. Add to this the potential blood loss through a c-section (500-1000ml) and the need for iron after c-section is clear. Iron requirements decrease a lot after pregnancy to 9mg/day, which accounts for the fact that women generally do not get their period back for a number of months postpartum. Once a regular menstrual cycle resumes, iron needs return to 18mg/day.
Iron is a notoriously tricky mineral for the body to absorb, in fact only 5-15% of iron from plant sources is absorbed, compared to 15-35% from animal sources. For this reason, it is recommended to get most of your iron from animal sources, while adding in plant sources on a regular basis. Eating vitamin C rich foods, alongside iron helps to increase absorption, whereas tea, coffee and calcium rich foods lower the absorption.
Supplementing iron if not needed can be inflammatory and detrimental to health, so it is always recommend that you have your levels tested before self-prescribing, or even better, arrange an appointment with a natural healthcare practitioner for personalised supplementation and dietary advice (as some forms of iron supplement can cause digestive issues).
Animal sources: liver and organ meats, red meat, poultry, fish and seafood and eggs. Plant sources: tofu and edamame, legumes (beans, lentils, chickpeas), nuts, seeds, dried apricots, dark leafy greens (spinach, broccoli, kale, silver beet) and wholegrains.
A WHOLE FOOD APPROACH
As you may have noticed, many of the foods listed above contain a variety of beneficial nutrients, for example, organ meats contain protein, iron, vitamin A and zinc, while kale contains beta-carotene, vitamin C and some iron. Eating meats slow-cooked or in bone broths, along with cooked vegetables helps the body digest and absorb more nutrients during this recovery period.
Having a consultation with a clinical nutritionist is highly encouraged in the postpartum period to investigate any nutrient depletions from pregnancy, and ensure you are nourished during recovery from birth and for breastfeeding your baby. After all, nutrient needs while breastfeeding are higher than at any other time of life! While there are many great supplements out there to choose from, nourishing your body with real foods can be a great addition to your recovery process from c-section and help you to thrive in the postpartum period.
REFERENCES
Mathew-Steiner, S. S., Roy, S., & Sen, C. K. (2021). Collagen in wound healing. Bioengineering (Basel), 8(5):63. PMID: 34064689.
Polcz, M.E., & Barbul. A. (2019). The role of vitamin A in wound healing. Nutrition in Clinical Practice, 34(5):695-700. PMID: 31389093.
Lin, P. H., Sermersheim, M., Li, H., Lee, P. H. U., Steinberg, S. M, & Ma, J. (2017). Zinc in wound healing modulation. Nutrients, 10(1):16. PMID: 29295546.
Bechara, N., Flood, V. M., & Gunton, J. E. (2022). A systematic review on the role of vitamin C in tissue healing. Antioxidants (Basel), 11(8):1605. PMID: 36009324.
DISCLAIMER
The information provided in this article is for your educational purposes only. It should not be considered as medical advice. We recommend you consult with a GP or other healthcare professional before taking or omitting to take any action based on this article. While I endeavour to provide accurate and true content, I make no guarantee or promise and assume no liability regarding the accuracy, reliability or completeness of the information presented. The information, opinions, and recommendations presented in this article are for general information only and any reliance on the information provided is done at your own risk.