C-Section Guide

I typed this out for the March and April mommies, they suggested I come here. Last time I was pregnant with Adam this board was dead, glad to see a few here this round.
--------------------------------------------------------------------------------
Many of us know what a scheduled c-section is like and are having to go though it once again. There are going to be first time moms that are going to have to live though this experience as well due to complications. If you're against c-sections, this isn't the thread for you. This is not the place to contradict other moms for their choices to have a c-section, there's other threads for that. I'm creating this thread as a place for comfort and assurance for those who are going though it for the first time or more. Some place to get anwsers to questions and ease some fears. Many of us won't know until 3d trimester if our babies are breach, or other complications, but perhaps this is a good time to start gathering information.

Below is simply a guide line, a rough layout I got from a book, "The Essential C-Section Guide". There are always going to be differences from patient to patient and hospital to hospital. Some of us will heal faster than others, some have a better pain control and the recovery won't bother them as much. Others will have a slightly rougher time. The experience for each of us will be different, but many pratices will be simular in nature.

Types of Anestisia:
Most of us will get an epidural or spinal block. Spinal block is more commonly used because it allows for better pain control from the chest down. A spinal block is less painful than an epidural because the needle is smaller. It's easier to administer because the area on the spine is more easily located. You can expect the side effects to last from 2-4 hours. Most c-sections last about 45 minutes from start to finish so that's more than sufficient. In some cases the epidural or spinal block can cause "the headache." The reason for "the dreaded headache" is the tiny hole created by the needle in or around the spinal sac. It may cause a miniscule amount of spinal fluid to seep out, causing brain sag, that puts pressure on the brain until the body has a chance to heal in about 3 days.

The Preperation (will be variations from hospital to hospital):
You and your husband will be gowned up.
You're given a cathater to drain urine and and IV to keep fluids up. (The cath they use these days is small and pretty much painless going in.)
If needed, nausuia medications are given along with other antibiotics to decrease the risk of infection. If you've tested positive for HB Strip, anitibiotics for that will now be given though IV.
Depending on hosp regulations you'll be wheeled into the OR or allowed to walk.
The anesthesiologist will have you lay on your side or lean forward and begin to administer your spinal/epidural. Husband is not usually allowed in the room at this time.
Once on the table they'll probably tilt you slightly to your left side to aviod compressing the vena cava vein that feeds oxygen to the major heart valve and your uterus.
Sometimes you're given a drink to reduce stomach acid.
Hubby will come in about the time curtain is going up in front of your face.
Pubic hair may or may not be shaved.
Lower half of your body is washed with soap then scrubbed with an antimicrobla solution such as iodine.
You're hooked up to machines to monator your heart rate and blood pressure. You might not be allowed to move one arm.
About five minutes after your epi/spinal block, the doctor will do checks to make sure your sufficiently numb.

The Surgury:
Once numb the surgen will start the insision. Depending on various things, the cut could go one of three ways: classical, maylard, or pfannenstel. You can also be cut differently on the inside than you are on the outside. It's good to know what kind of cut is used on you for possible future pregnancies. The type of cut can decrese your chances of a V-back.
Anyone experiencing a c-section for more than the first time may spend longer on the table due to previous scaring. Typical operation is 45 minutes, but can take up to an hour or longer.
After the cut is made the doctor will break your water if it hasn't broken on its own.
Time for baby to come out. Have that camera ready, dad! Mom's going to need lots of pictures! She is going to be VERY curious about the birth she can't see over the sheet in front of her face. And will need you to relate it to her over and over again.
The cord is clamped and cut. If keeping the cord blood the assistant practitioner will collect it at this time.
The placinta is then delivered.
Some doctors will remove the uterus completely from the body to stich it up, allowing them better vision, either way, you're getting stiched next.
Some of the umbilical cord blood will be taken to run tests on such as syphilis.
You'll get outside staples, glue or stiches, depending on your doctor. These are removed about 10 days after surgury.

Recovery:
Due to the Mother's Health Protection Act, federal law requires insurance companies to cover at least ninety-six hours of hospital care following a c-section. However, most women who have an uncomplicated c-section opt to stay between fourty-eight to seventy-two hours. Seeing that you've just had surgury and given birth, take advantage of all the time given! After a couple of days the hospital might seem a bit boring but at home you won't have a full time staff changing your sheets, bring your food, bring your pain meds with a glass of water at 4:00am. And while family will tend to your needs, they most likely be available 24-7.
During first few hours the nurses will come in often to monator your recovery with daily checks from your obstetrician.
Depending on how baby's doing, he could be with you the majority of this time or spending time in the NICU under the warmer, getting his first baths and medical checks.
Once given a green light to leave the recovery area, you'll be moved to your room where you'll stay the rest of your visit.
From here your first priority is rest, allowing your body to recover. It won't be easy with regular visits from the nurses! Each visit from the nurse you can expect her to check:
your general state of health
your breathing and resperation
bowel sounds
how much you're urinating
for blood clots
for side effects from laboring
your sanitary pad
the incision


Day One:
Do pleanty of deep breething exersices while resting in bed. It clears the lungs of remaining anesthesia and recuses the risk of respiratory difficulties and the possiblity of phenomonia.
Do not touch your insision without washing your hands! You may get a spunge bath from the nurse. If not, and no complications, are usually allowed to take a short shower no the 3d day. Lightly blot the are dry with a clean towel.
Controlling pain should be your first order of business. Don't wait until you're yelling out in the middle of the night screaming for pain meds. If you know you get your meds every 3 hours and haven't seen the nurse, call her. Very little of these drugs pass though breast milk so they're considered safe for baby. Though they might make baby sleepy. The physical stress of a c-section can reduce the amount of hormones produced such as oxytocin and prolactin, whitch are needed to produce breast milk. Staying ahead of your pain can reduce these effects.
Controlling pain is overall key to recovery. If you don't feel well, you don't sleep well, you don't feel like moving or nursing. It's important to take your dose of pain meds before they wear off.
Listen to your nurses! If they give you the okay to drink fluids, do it, lots of it! When cleared to get up (with help) do so. Walk. Walking will decrease gas in the stomach that can cause painful cramping. When your body tells you to stop walking, listen, rest.
If they offer you another dose of Colace (stool softener), take it!
If pain is not too bad, change positions, lay on your side. But don't torment yourslef.
Don't sneak food until given the okay from your nurse or practitioner! And when given the okay, take it easy on yourself at first.
Limit interuptions such as phone calls and visitors. If overwhelmed by the interuptions and start to feel drained, simply say you need your rest and wish to take a nap. Most will be understanding. Or if you're having trouble, ask that they visit only within certain hours of the day, such as from two to four.
Get up out of bed at least once every two hours. Make sure the nurse is there to assist you in case you suddenly feel dizzy or woozy.
Ask for help with breast feeding! Ask for help with anything you're having trouble with!

Healing at home:
Focus on yourself. Now's not the time to play hostess to guests. Put a note on your door, anyone entering is expected to help out with household chorse or AT THE VERY LEAST pick up after themselves, you're recovering from a c-section, just had a baby, not in shape to entertain.
Let hubby and relatives do most of the cooking, cleaning and laundry. You're doing enough taking care of yourself and nursing the baby.
The risk you could open your insision is small, but a possibility, that's why you're not allowed to lift anything heavier than your infant.
Not allowed to drive: There's a few reasons why you won't be allowed to drive after you get home. First, you've just had surgery and you're tired, so you might not be ablet o react quicklyin an unexpected traffic situation. Second, you're still on narcotic medications that effect your judgement and reaction time and could be held liable if placed in an accident while in these medications. Fineally, you're suppose to be home resting, not out shopping or trying to run a triathalon!
No vaccuming! You will exert your stomach muscles when pushing a vaccume. Again, let someone else take over the house hold chorse.

Things to do to speed recovery:
Lower expectations. Planning on cleaning closets and doing spring cleaning while home recovering? Don't. Post pardum is not a synonym for vacation. Take the time to bond with your baby instead.
Accept all offers of help, and don't be afraid to ask for help.
Consider hiring help such as a dula.
Let dad handle some of the weight.
Practice relaxing. Getting tense? Feeling stressed? Fatigue wearing you down from helping with the baby? Take a breether, count to ten!

Leave well-wishers a message on the anwsering machine. Most callers just want the news. Baby's name, birth weight, how you and baby are doing, ect. After they have that info, most will hang up, let you sleep, those that want more than that will be more persistant.

Exersize:
When cleared by your doctor, take it easy. Start with just a few simple leg lifts, lifting one leg at a time for a few seconds, then resting it down. Work your way up slowly.

This is great advice! I wonder if we could sticky this?

I don't think we've a problem with sticky's. This chat is pretty quiet still. Waited three days now, not much activity.

Thanks for posting this. I read it over on March :) I think it should be stickied.

Glad you like it. Reccomend the book if you find a mother scared when facing down her first c-sectoin. It's good information. I've a girlfriend now trying to get pregnant, just mailed her all my books.

My last c-section was pure horror. Nothing was even close to how it was supposed to be and I had a horrible doctor. I am hoping this new one will be a much better experience as I am opting for a c-section this time due to the extreme complications I had the last time.

Thanks. My first c section was very unplanned and was an emergencu. The doctor came in after I woke up and told me poibt blank, you can go through,labor again but more than likely you'll end up with another c-section, so this time we will be doing the reccomended c section.