|Delivery by Cesarean ~ Tips From Members
This past spring, a poll was conducted amongst our StorkNet members in which they were asked to describe their c-section experience. Statistics show that 25% of women have c-sections, and those of us who have had been through this want to let women know what to expect. Many members who participated in the poll reported that knowing what to expect can make a big difference in the overall experience.
There are some really excellent tips here. Some may feel applicable to your situation, and some won't. Jot down the things that strike you as especially important, and make it part of your birth plan.
The Surgery Prep
- The catheter can be put in after they do your spinal or before. Many women opt to have it done afterward since they'll then be numb. If you do choose to have it placed before your anesthesia, rest assured that while it is by no means "comfy," it doesn't hurt.
- In a non-emergency situation, if people are prepping you and you feel like too many people are doing things (for example: one nurse is inserting an IV, another is shaving your pubic area (if necessary) and another is asking you to sign consent forms), tell them "one thing at a time." You don't need to get overwhelmed.
The Surgery Itself
- Insist that your OB talk to you and no one but you (unless out of necessity, of course). Celia had her OB give a play-by-play. With her first c-section, the doctors talked amongst themselves about what they were having for dinner.
- You will be amazed at how many people are in the room - everybody that needs to be there, and a backup for each one.
- See if the hospital can play CDs in the OR. Jer had Mozart picked out for her birth, and they piped it into the room for the c-section, too. Her daughter was born to the strains of the overture to 'The Marriage of Figaro'!!
- Make sure that the doctor explains everything to you before you go in, and you make your wishes known (let Dad hold the baby next to you, etc.)
- Because of medications, you may feel like you're freezing. Don't be afraid to ask the nurses to put a heated blanket on you.
- Katie'sMom says that she was soooooo thirsty she thought she was going to die! She recommends that if you're able, load up on your popsicles and ice chips before you get in because they won't give you anything to drink until after your epidural is out.
- Ask the anesthesiologist to leave at least one arm free so that you can touch your baby. Being able to do only a cheek nuzzle is a very disappointing first touch, in Celia's opinion. Ursula negotiated for more than that. She absolutely insisted that her unswaddled baby be put on her chest so she could hold her while she was being stitched up. When the doctor balked at this (ahead of time), she said, "If I'm too out of it to hold her, my husband can help me." When the doctor said that it would be too cold in the OR to leave the baby unswaddled, she told him, "I'm not going to be cold, right? So put her skin-to-skin on me with a sheet over us, and we'll be toasty." Ursula reports that she can never express the importance of holding her daughter in those early minutes. "When I saw her," she says, " I couldn't feel anything, but when she was put on my chest, that is when we connected."
- Remember the anesthesiologist is your friend in the O.R. Tell him if you feel pain, anxiety, or anything. LesleyP reports that with her last one it felt like someone was sitting on her chest, so she told him and he helped her out.
- If you know if you get nauseous easily, ask the anesthesiologist to put something for that in your IV. Deborah (devila) says she hates the nausea morphine gives her, but she likes the pain relief! Because of that, she always asks for something for nausea.
- If the baby had good APGARs, there is no reason your husband or partner can't hold the baby near you while you're getting stitched up.
- Make sure everyone involved knows your birth plan (and yes you can have one with for a c-section whether it was scheduled or not). MissyL stresses the importance of that because she ended up being one of the women who was put out while they were stitching.
- Often as you're getting stitched up, you can feel panicky and the anesthesiologist will give you meds to offset that. Celia's anesthesiologist offered, and she repeatedly declined. She was so glad she did because she heard of so many women who take those meds and "check out" for a while and become loopy and have unsatisfactory first meetings with the baby then, and have rougher starts with breastfeeding. Instead of accepting the meds, concentrate on keeping your breathing steady, focus on a spot on the wall, and breathe with your mouth in the shape of an "o". This is just about the same as breathing through labor.
- Donna (Ilmomtobe) feels that there is nothing wrong with being given meds that let you sleep. She feels that it's a part of recovery.
- Inquire as to whether or not your partner can take pictures in the OR. A c-section is every bit as special as a vaginal delivery, and you will want pictures of it!
- Don't panic if the NICU team is brought in for the delivery and the baby is taken to NICU for observation after delivery. It's standard procedure for c-sections in most hospitals, especially if it is an emergency c-section. It doesn't necessarily mean that anything is wrong with the baby. Click here for helpful articles in the event that the baby goes to the NICU.
- Ask that at least your husband/partner and your baby be with you in the Recovery Room. Any exams done on your baby can be done while you are being transitioned to your regular room AFTER you leave recovery.
- You may have uncontrollable shaking afterwards - it doesn't hurt but it's difficult to not be in control.
- You can make your first breastfeeding attempt in recovery while you're still not feeling anything.
- If you have a doula, have her stay with you while dad goes with baby during baby's exam, etc.
- Consider that you can negotiate to have the baby with you at all times if his/her condition permits it, even though you've just had major surgery. It would be necessary, of course, that you have a family member with you at all times, but it something that's quite possible to arrange.
- You may experience itching afterwards. This can be relieved with Benadryl even if you're breastfeeding.
- Unanimously, everyone agrees that you must get yourself out of bed as soon as possible. Get up and walk as soon as possible; it speeds your recovery like nothing else. Devila suggests that you try to walk before your pain meds wear off. She used to do laps around the nursing station pushing the baby in the isolette.
- This may sound awful, but it's about the catheter. Celia swears to you, they took that catheter out and she could NOT urinate (she later found out this may be a side-effect from the epidural). After hours and hours of dealing with desperately needing to and not being able to, she begged them to put the catheter back in for relief. Finally she had a nurse tell her that if she was lying in bed and felt the urge to go, she should just go right then and there in the bed. It wouldn't matter because they have all sorts of waterproofing beneath you. After you do it once, it's easier after that.
- Don't try to be a hero and ask for your pain meds (if you feel you need them) on a regular basis. It is much easier to take it regularly than to let it wear off and try to get on top of the pain again afterward.
- Don't feel as if you have to have rooming in with your baby. It doesn't make you a bad parent to want them to take the baby away and let you get some rest. If you want to exclusively breastfeed though, just remind the nurses that you will be more than happy to nurse whenever the baby gets fussy; they just need to bring him or her to you.
- Every form of pain relief has its bad sides, epidurals can make you feel ill, and spinals can cause you to feel hot in the face and give you the sensation of not being able to breathe. You can request what type of medication you get if for some reason you have a preference and the opportunity to make a choice.
- Bring pillows from home! You will need them to get comfortable at all hours of the day, and you can use them to help get positioned for feeding the baby. Also, a pillow in the front seat of the car with you is a lifesaver on your way home. Hold it over your incision and it will make the bumps and railroad tracks almost bearable!
- Be prepared that you will bleed vaginally just like you would have with a vaginal birth. Some women are totally unprepared for the amount of blood. It seems like so much, but it's normal. Here's a bonus: you get to wear those cool net panties with the enormous pad!
- Here's some good advice from Lenore: "The nurses showed me how to "roll" in and out of bed in such a way that it put minimal stress on the abdomen. While getting in, sit on the bed, lean toward your pillow and set your far heel on the rim of the bedstead. Bring up your other heel beside the first. Lean further, and bring your outside foot to the bed, then your near foot. You're almost lying down on your side now, and can just roll to your back. Getting out, reverse."
- Bring a shower brush with you -- you might not be able to bend far enough to wash your feet and calves at first otherwise!
- Let the staff know as soon as you "pass gas" so you can eat real food!!! It may be embarrassing, but many hospitals sometimes don't let you eat until this happens . . . and you may be hungry! Eat as soon as you can. New research shows that women who eat solid food within 6-12 hours of a c-section recover much faster than those who don't. Talk to your doctor ahead of time so you don't have to wait unnecessarily.
- Bring your own nightgowns and maybe sweats or comfy shorts and t-shirts to wear. You'll be in the hospital for 4 or 5 days. By day two you'll probably be ready to be at least somewhat dressed.
- TraceyM wants to make sure you know not to let your doctor push you out of the hospital before you feel ready. Find out beforehand how long your insurance will pay for you to stay in. She was released less than 48 hours after her section. Her doctor told her she was leaving that day, and she was in shock. She still had her catheter in, hadn't had a bowel movement, and hadn't even showered since the surgery. But she didn't know she could tell him she wanted to stay longer. She now wishes she had insisted on staying at least one more day because she was not ready to be home.
- If you happen to feel amazingly well afterward, take the advice of others to take it easy anyway even if you don't feel like it. Otherwise, it will eventually catch up with you -- and if you're unlucky, it will catch up with you after all the people who have shown up to help you have gone home!
- Give your baby lots of kisses. They need TLC; they have been through a lot.
- Oh, please, please, please! Have someone at your beck and call to help you with getting the baby positioned. Celia said that with her first baby, she had a night totally alone with her and thought she would look like a wimp if she called the nurses. Her inability to get the baby properly positioned for nursing REALLY did a number on her nipples! With baby #2, you can bet she had someone with her AT ALL TIMES!!
- It can be painful to rest the baby on your incision, the lactation consultant can show you different positions or how to position a pillow on top of your incision to help with the pain.
- SonjaG wants to recommend that you hire your own personal lactation consultant (LC). At her hospital, which was quite large and busy, the one LC on duty (8am-5pm, mind you) only saw the mothers that were checking out that day. That's fine if you deliver vaginally, because you're often checking out within 24 hours after delivery. But for a c-section, you stay longer. She stayed four days which was just enough time for her baby to lose so much body weight that the medical staff freaked (and so did SonjaG). SonjaG also suffered from PPD because none of the nurses (she saw about 20 during that 4-day period) could help her get the breastfeeding figured out since they didn't have enough breastfeeding-specific knowledge.
- For nursing, RobinW used the football hold for a few weeks (at your side). She also encourages you not to be upset if nursing is less than successful the first try after surgery. She tried right away and was in way too much pain to have it work. Four hours later (her daughter did NOT starve to death, contrary to the nurse's warnings after her husband REFUSED to let them give her a bottle), she nursed just fine and never had any problems after that.
- Be prepared for the unbelievable contractions you will have while nursing your newborn. As if that incision isn't painful enough, as if contractions weren't horrible before surgery, now you get them together! Wow!
- SharonCC says that when it comes to breastfeeding in this condition, you just need to do what works. She said, "I used the most improper positions in those first few days while I was recovering, and it really aggravated the nurses, but oh well - it was working for the two of us."
- Your milk will probably come in while you're still in the hospital which many nurses don't handle well. They may encourage you to pump to relieve the engorgement. DON'T - it will only make your engorgement last longer. Nurse very often and go with the hot/cold therapy - hot compresses before a feeding and cold/ice afterward for a 24 hour period only.
- Visit these artles for more information regarding breastfeeding after c-section:
The First Few Days at Home
- Take it easy at home! If you've got other children, make sure someone else is home to take care of them. If you don't have family nearby, hire a sitter or a post-partum doula, or enlist help from your local church. Ask for help from family members, husband or whomever. You need to recover as well as get to know your new baby. You DO NOT need to be preparing coffee for people who are visiting. Let them prepare it for you!
- No matter how well-intentioned they are, DO NOT let your husband/partner bring home a comedy video during your first few days of recovery. Belly laughs are really unpleasant.
- Consider having a friend or relative come to cook and clean so that your husband is free to just take care of you and the baby.
- Check your incision in the mirror, or have someone check it for you on a regular basis, even after you've been discharged from the hospital. If it looks inflamed, feels hot, or is oozing get it checked out right away.
- From Celia: First let me say that many people will tell you "It doesn't matter how the baby comes out as long as the baby is healthy." IF that comment leaves you cold, please remember that it is OKAY to be disappointed if your child is delivered by c-section. That doesn't mean you love your child any less, and it doesn't mean you regret any decision made to do a c-section. That phrase is just something people just automatically say for some reason. Can we expect anyone to be happy and glowing if they've just had major surgery?
- MissyL is one of many women who knows it can take a year or more following a c-section to completely feel like yourself.
- Remember that your stomach muscles are going to take longer to go back into shape after a section. You need to remember that they were stretched by the baby and by the doctor when he did the section. Unless you are very thin, be prepared for the way your belly will look. Your belly will have a small overhang above your scar (if you have a bikini cut). No matter how thin you get or how many sit-ups you do, it will probably always be there. Various sharp pains, numbness and itching are also normal.
- Attitude! Have a positive one! "Sure I was disappointed that my birth didn't go as planned," RobinW tells us, "but I didn't let that keep me from enjoying my infant daughter." The day she camet home from the hospital, she put her daughter in a snugli and went for a walk around the neighborhood. She was a PROUD new mama, and she was feeling GOOD! Having a c-section is in no way a reflection of you or what type of mother you will be.
- Donna (Ilmomtobe) shared that she really liked saying it doesn't matter how she got her baby, just that he's here. Donna said, "People expected me to be disappointed at not having a 'natural' birth. I hated that; it's still natural if a baby came out. I just didn't have a vaginal birth."