I have had two c-sections, but never delivered twins, so your situation may be a little different. At any rate, c-sections aren't as bad as a lot of people make them out to be. The first one is the hardest, though. You can expect moderate to severe pain if you allow your pain medication to run out during the first 48 hours. I learned this the hard way. If I can offer no other advice it is to take your pain meds religiously during the first few days! Call the nurse before you think you REALLY need it. I know that sounds bad, but you don't want to wait until you're in pain and then deal with a delay if the nurse is busy or there is a shift change or whatever. I'm not sure what your hospital's policies are on pain management - the ansethesiologist will decide (along with you) whether to give you a spinal or an epidural for the surgery. If they give you an epidural, they may decided to leave it in for a while after the surgery and give you a hand pump. I had that with my first baby. It was great for managing pain, but I didn't like that I couldn't get up and walk around at all until it came out. My second c-section they gave me a spinal which wears off within an hour after surgery. I liked this better, but had some complications after the fact. I still think I'd take the spinal if offered a choice. You can expect bleeding, similar to if you had a vaginal delivery, only maybe slightly less since the doctor can cauterize any major bleeders while they are sewing you up. You can expect a nurse to come in and push on your belly to feel that your uterus is going back down as it should. I think they do this with vaginal deliveries too, only you don't have the brand new incision that is healing, so that makes it a little painful. Take the ibuprofen that your doctor prescribes when you go home. This helps to minimize the swelling in your uterus and incision, and helps keep the bleeding down. Also, I know this is hard with two other little ones at home, but keep your lifting and activity to only what is absolutely necessary. This is essential to your healing - you will notice if you are doing too much because your bleeding will increase all of a sudden. You didn't mention if you were planning on nursing... I didn't have too much trouble with nursing in a regular cradle hold (using a My Brest Friend nursing pillow), but you might have more luck with using a boppy or pillow on the side and trying a football hold. This keeps the pressure off of your incision. Oh, and I'm not trying to scare you, but make sure you wash you hands A LOT and try not to touch your incision. And if doctors or nurses come in to check your incision, make sure they wash hands and wear gloves - no matter what. With my 2nd c-section, I got a pretty nasty MRSA infection. No idea how I got it, but it wasn't fun, so be careful! I'm not sure what else to tell you... It's been over 3 years since my last c-section, and it seems like forever ago. Good luck! I hope you have a smooth and uneventful delivery!