Nurse-Led Early Ambulation After Caesarean Birth: A Cluster Randomized Controlled Trial of Recovery and Well-being Outcomes.

PURPOSE: To evaluate the effectiveness of a structured, nurse-led early ambulation program on postoperative pain, uterine involution, gastrointestinal recovery, and psychological outcomes among women after cesarean delivery.

METHODS

A cluster-randomized controlled trial was conducted in a tertiary hospital in India among post-cesarean women assigned to either a structured early ambulation program or routine care by study week (10 clusters, 1:1 ratio). The intervention began 8-10 hours after surgery and continued for 4 days under nurse supervision. Primary outcome was pain intensity; secondary outcomes included uterine involution, constipation, psychological well-being, anxiety, obstetric recovery, and global health, assessed on postoperative days 1 and 4.

RESULTS

Sixty women were equally allocated. The intervention group showed greater pain reduction, faster uterine involution, fewer gastrointestinal symptoms, improved psychological well-being, and better perceived global health. Obstetric recovery scores were higher, and early ambulation independently predicted lower pain on day 4.

CONCLUSIONS

A structured, nurse-delivered early ambulation program initiated within 10 hours post-cesarean reduced pain and promoted early recovery.

IMPLICATIONS FOR PRACTICE AND RESEARCH: Early ambulation is a feasible, low-cost strategy that can be integrated into routine post-cesarean care.

PRECIS: Early nurse-led ambulation improves physical and psychological recovery after cesarean birth.