What to expect before, during, and after a Caesarean Section
Every health facility is different. If it is a planned, or elective Caesarean you will come to the hospital two hours before surgery. Your doctor should have discussed Consent for the surgery where doctor will discuss risks and reasons for the surgery, and signatures are completed. You will bring this “consent “to the hospital, and give to your midwife prior to the surgery, or alternatively, you may be visited by a doctor prior to surgery to sign consent. Also;
Blood will be collected to type and cross match (in case you need blood)
Your observations will be completed
Baby’s heartbeat will be assessed
You will be asked to put on white stockings for prevention of deep vein blood clots.
You may be visited by an Anaesthetist after your, arrival or in the theatre prior to surgery
Sometimes the lower abdomen will be shaved if needed prior to surgery
You will need to change into a gown for surgery
If you have a support partner, they will be provided with surgical clothes to change into.
Before your surgery time, you will be transported to theatres for your procedure and checked in!
EMERGENCY CAESAREAN
Most emergency caesareans are Category 2 and mostly are done about an hour after the decision is made. Life threatening Category 1 caesareans aim to be done within 30 minutes.
In an emergency, there might not be time to give you an epidural or spinal block. You may need a general anaesthetic, although this is rare. When you wake up you may feel dizzy, nauseous, and you may have a sore throat.
Many women are happy after an emergency caesarean and relieved that the baby is healthy. But some women may feel upset and disappointed that the birth didn’t go to plan. How you feel often depends on your expectations before the birth.
You can be helped to recover emotionally by going over the reasons why the emergency caesarean was necessary. Discuss this with the midwives, doctor or obstetrician before you leave hospital, or arrange to meet them afterwards to talk about why you needed the caesarean and what this means for any future pregnancies.
After your Caesarean birth
Following surgery, you will go to recovery for approximately one hour to closely assess your immediate recovery following a Caesarean section birth. After assessment of your stable observations, there may be an opportunity to have your baby on your chest to allow skin to skin contact which reduces baby’s stress after birth and may initiate attachment of baby to the breast when the sucking reflex is strongest whilst baby is wakeful.
· You will have a “Catheter “inserted during your surgery to collect your urine.
· You will have a calf compression machine with attachments wrapped around the bottom half of each leg gently squeezing and releasing your calves to prevent blood clots forming.
· You may have intravenous fluids running to either aid your uterus to reduce bleeding, or for additional hydration until you are drinking regularly, or both running simultaneously
· You will have your bleeding assessed to ensure it is normal
· You will be given medication if you are feeling nauseous
· Your pain level will be assessed
If your condition is stable, you will be transferred to a Maternity unit
Your feelings after caesarean birth
Some women feel fine about having a caesarean, whereas others feel disappointed or sad that they weren’t able to give birth vaginally.
For women who have an unplanned (emergency) caesarean, the change in plan can sometimes be a shock. Whatever your feelings, they’re OK. But it can really help to talk through those feelings with someone you trust.
If the birth was very traumatic, it is possible to develop post-traumatic stress disorder (PTSD). Symptoms of PTSD include:
intrusive memories or flashbacks, which make you feel anxious and panicked
avoiding anything that reminds you of the birth, like television programs or conversations about childbirth
sleep problems, angry outbursts and difficulty concentrating
If you have any of these symptoms, or if you feel like hurting the baby or yourself, contact: in (Australia)
Pregnancy Birth and Baby Helpline on 1800 882 436 to speak to a Child & Family Health nurse for advice and free counselling, 24 hours a day, 7 days a week.
Lifeline on 13 11 14
beyondblue on 1300 22 4636
PANDA on 1300 726 306
Pain relief after a Caesarean birth
In the early days, it’s OK to take pain relievers.
You have experienced major surgery, and while some discomfort is normal, pain relief is given to reduce any severe pain.
Ask your midwife whether you have regular medications ordered by your doctor, or you need to ask for pain relief. The aim of your pain medication regime is to keep your medication regular during the first few days to keep your pain control stable. If your current pain relief is not helping, ask to be reviewed, or for something else more effective for relief of your pain.
Some women find that basic things like coughing, laughing and showering can hurt in the first weeks after a caesarean.
Talk with your doctor or midwife about which pain relievers will be best for you, especially if you’re breastfeeding.
Breastfeeding after caesarean
You can try different positions for breastfeeding to find what’s most comfortable for you. Ask the midwives to show you different positions while you’re in hospital. You can organise a visit with a lactation consultant if you’d like extra support, or you can call the National Breastfeeding Helpline on 1800 686 268.
Positions you might find useful for breastfeeding after caesarean birth are:
sitting with a pillow on your lap to support your baby and protect your wound
lying down on your side
holding baby underarm with baby’s feet towards your back – the ‘football’ position
Why are baby’s so mucousy after a Caesarean birth?
When a baby is born via C-section, they will likely have extra fluid in their lungs to expel because they didn't experience the "squeeze" of passing through the vaginal canal. Additionally, this may occur because they likely didn’t go through labour, which triggers the gagging mechanism for babies to get rid of the fluid from the lungs.
While seeing your newborn gagging can be alarming, try to stay calm and allow your baby's natural reflexes to help clear their airways.
Hold them upright, or on their side until the episode of gagging is finished.
Tip- Colostrum has a breaking down effect on the mucous!
Caesarean wound care
Your caesarean wound will usually be along or just below your bikini line. Very rarely it might be straight up and down your tummy. It will usually have dissolvable stitches, staples, or one large suture that will
Keeping your wound clean and dry helps to prevent infection.
The wound will be covered by a waterproof dressing for several days, and you can usually shower with this on.
Once the dressing has been removed, you can gently wash your wound with water and dry around it with a towel. It’s best to leave it uncovered to ‘air dry’. Be especially careful if your wound is under a tummy fold because this will make it harder to keep dry.
Some bruising around the wound is common. Numbness or itching around the wound is common too. This can last a long time in some women.
TIP - Wear loose cotton clothing that doesn’t press on your wound.
It’ll take 6-10 weeks for your wound to heal completely.
Getting up after a Caesarean section
Its routine to get up out of bed within the first 12-24 hours after a caesarean.
If you are in uncomfortable pain, it is recommended that you take pain relief 30 minutes before getting up.
Your indwelling Catheter will be removed just prior to you getting up for the first time.
(Removal of a catheter is very quick, and not painful)
The midwife will help you to slowly mobilize to the shower.
Tip- Have your first shower pack ready in a plastic bag to grab easily out of your bag)
From now on, you will pass urine in the toilet as required. The first 2-3 will be measured by your Midwife to ensure that your bladder is emptying and back to normal after the catheter removal.
You will need to pass urine 4-6 hours after catheter removal depending on the facility policy.
Drink regular fluids, and rest in between short walks in the ward corridors, increasing the goal each day.
BOWELS
After feeding, this topic pre-occupies every new mothers waking moments!
Do’s and don’ts;
Don’t eat a steak dinner straight after your surgery- your intestines have ground to a holt while they have been pushed around during surgery! Peristalsis (food being processed moved through the intestinal system to the bowel) starts back up with the first indication when you pass Gas or wind.
Start with frequent lighter snacks, building up to larger meals as you feel your appetite increase.
Don’t overdo the narcotic analgesia which can contribute to constipation especially codeine and morphine
Don’t take anything for constipation containing Senna if you are breastfeeding
Do drink fluids regularly
Do walk regularly to allow gas to pass, and aid peristalsis
Do eat natural aperients’ such as prunes, pears, mango, wholegrain foods, and cereals
Lifting, stretching, and bending
You’ll definitely need some help with any jobs that involve stretching upwards, lifting or bending, because of the strain these activities put on your caesarean wound. This means you’ll need someone to hang washing on the line, do the vacuuming and help with any other strenuous household jobs.
Don’t lift any weight that’s heavier than your baby or anything that causes you pain – for example, a full basket of wet washing or a toddler.
If your toddler is used to being picked up, there are other ways for the two of you to be close. For example, your toddler could sit next to you on the couch while you have a cuddle and read a story together.
Driving
Doctors usually recommend that you avoid driving a car until your caesarean wound has healed and you can brake suddenly without feeling sharp pain. This is usually around 4-6 weeks. It’s best to talk with your doctor or midwife about when it’s safe to start driving again.
Check the policy of your car insurance company because some companies won’t cover you if your doctor hasn’t cleared you to drive.
Routine Check up
You will see your health care provider at around six weeks if there are no concerns prior to this time.
Topics to discuss are;
· Contraception
· Sexual activity
· If there are any prolonged emotional (longer than 2 weeks) or physical concerns
· Possibility of caesarean or vaginal (VBAC) if another pregnancy is planned