• Pain after a Caesarean section is normal. It usually improves over the first 1–2 weeks.

    We control pain in layers:

    • Regular pain relief: paracetamol plus an anti-inflammatory (if appropriate)

    • If needed: a stronger medicine such as tramadol

    • Rescue: a short course only for severe pain

    A simple timetable:

    • Day 0–3: take the regular medicines on schedule.

    • Day 3–7: begin reducing any stronger medicine as your pain improves.

    • After 1–2 weeks: most people only need paracetamol.

    Most pain medicines are compatible with breastfeeding when taken as prescribed. If your baby is very sleepy, difficult to wake or feeding poorly, seek medical advice.

  • Most people go home with a combination of:

    Regular baseline pain relief

    • paracetamol

    • an anti-inflammatory medicine (such as celecoxib) if appropriate

    If needed for breakthrough pain

    • a small supply of a stronger pain medicine (such as tramadol)

    Support medicines

    • medication to prevent constipation (if needed)

    • medication for nausea (if needed)

    Use the regular medicines first, then add the stronger medicine only if necessary. You do not need to finish the packet. Most people can stop stronger pain medicine by day 3–7.

  • Paracetamol is the main pain medicine.

    • Works best when taken regularly for the first few days

    • Generally safe while breastfeeding

    • Avoid other medicines that contain paracetamol

    Typical supply

    • 100 tablets

    Approximate cost

    • $4–6

  • Celecoxib

    • reduces inflammation and surgical pain

    • reduces the need for stronger pain medicines

    Typical supply 30 capsules

    Approximate cost $10–15

    If celecoxib is not suitable, ibuprofen may sometimes be used instead.

  • Tramadol

    • used for breakthrough pain only

    • reduce and stop as pain improves

    Typical supply 20–30 capsules

    Approximate cost $8–12 (varies by pharmacy and brand)

  • Opioid medicines can cause constipation.

    Typical medication Docusate

    Typical supply 30 tablets

    Approximate cost $8–10 (often less at discount pharmacies)

    Tips

    • drink fluids

    • keep fibre in your diet

    • gentle walking can help

  • Some patients experience nausea after surgery or from stronger pain medicines.

    Typical medication Ondansetron wafer

    Typical supply 6–10 wafers

    Approximate cost $10–15 (brand versions can be higher)

  • Stronger pain medicines are reduced as your pain improves.

    Reduce and stop the stronger pain medicine first. Then reduce the anti-inflammatory medicine. Paracetamol is usually the last medicine to reduce.

    Most women do not need stronger pain medicine beyond 1–2 weeks. If you still need stronger pain relief after this time, see your GP.

  • Safety tips:

    • Avoid alcohol with any pain medicine and do not take extra paracetamol from other medicines.

    • Do not drive or operate machinery if you feel drowsy or unwell.

    • Store medicines out of reach of children.

    • Return unused stronger pain medicine to a pharmacy.

    When to seek medical advice:

    • pain is worsening after several days or not improving by the end of the first week

    • fever, wound redness, discharge or a bad smell from the wound

    • heavy bleeding, chest pain or shortness of breath

    • persistent vomiting, severe headache, vision changes or severe swelling

    • you need stronger pain medicine for more than 7–10 days

    • your baby is unusually sleepy or feeding poorly after you take tramadol

  • Prices listed are approximate private pharmacy prices and may vary between pharmacies.