Objective: To analyze the effect of ropivacaine combined with dexmedetomidine for transversus abdominis plane block (TAPB) analgesia on uterine hemodynamics, lactation, and gastrointestinal function after cesarean section. Methods: A total of 150 pregnant women who underwent cesarean section in Department of Obstetrics and Gynecology of Qinhuangdao Maternal and Child Health Hospital from June 2021 to January 2022 were selected as research subjects. They were randomly divided into a study group and a control group, with 75 cases in each group. The subjects in the study group were treated with ropivacaine combined with dexmedetomidine TAPB combined with sufentanil for patient-controlled intravenous analgesia (PCIA), and the subjects in the control group were treated with PCIA alone. The general data and analgesic effects between the 2 groups were compared. The peak systolic blood flow velocity (PSV), the end diastolic blood flow velocity (EDV), the resistance index (RI), and the pulsatility index (PI) of uterine artery at prenatal and 72 h after the operation between the 2 groups were compared. The colostrum secretion time, the lactation volume, and the serum prolactin (PRL) levels at prenatal and 24 h after the operation between the 2 groups were compared. The incidence of analgesic adverse reactions within 72 h after the operation between the 2 groups was compared. Results: At each time point after the operation, the Visual Analogue Scale (VAS) scores of pregnant women in the study group were lower than those in the control group, and the Ramsay sedation scores were higher than those in the control group. The first compression time of analgesic pump of the subjects in the study group was longer than that in the control group, and the pressing times of analgesic pump and the dosage of sufentanil were lower than those in the control group. The PSV, EDV, and PI of uterine artery of the subjects in the study group were higher than those in the control group 72 h after the operation, and the RI was lower than that in the control group. The lactation volume and the serum PRL level at 24 h after the operation in the study group were higher than those in the control group. The colostrum secretion time, the first anal exhaust time, the first defecation time, and the recovery time of bowel sounds were shorter than those of the control group. The incidence of postoperative nausea and vomiting and the total incidence of analgesic adverse reactions in the study group were higher than those in the control group. The above differences were statistically significant (all P<0.05). Conclusion: The application of ropivacaine combined with dexmedetomidine TAPB analgesia and opioid PCIA after cesarean section can achieve better analgesic effects than PCIA alone, as well as reducing the dosage of opioids and analgesic adverse reactions, and having better effects in promoting the recovery of lactation, gastrointestinal function and uterine hemodynamics.