Preparing For A C-Section

[holyhelianthus]

A c-section is a greater possibility this time around and I am scared out of my mind! I'd really like to hear any sage wisdom any c-section mamas may have. How did you/would you have prepared for your c-section? Any tips for postpartum? Anything a mom going in for her first c-section should know?

Although I may still have a vaginal birth I just really want to be prepared for this. I feel like if I can just prepare a little (because I know you can't be 100% prepared for something like this) I won't be as scared and will be able to cope better. Also does anyone know of a good step-by-step description of what goes on I can read?

TIA, mamas! :

[Storm Bride]

This one goes into a fair amount of detail on the procedure itself:

http://www.ican-online.org/recovery/...during-surgery

This one addresses some recovery issues:

http://www.ican-online.org/recovery/...cesarean-birth


Let's see what I've found works for me, personally...

Eat fruit after surgery. After ds2, I got dh to bring me plums, peaches, grapes and bananas. They helped keep me hydrated, and helped prevent any constipation. You do not want to be constipated after a c-section - not even one little bit. Believe me.

Talk to your OB about food ahead of time. Some places/practitioners still follow pretty strict rules about what you can eat after surgery. I went 3.5 days post-op with no solid food after ds1, because they were waiting for me to pass gas. I finally lied...and it's a good thing, as I didn't actually pass gas for weeks. I didn't have any gas! Trying to recover from surgery (and labour, if applicable) and establish breastfeeding when they won't let you eat is not fun.

Find out what works for you re: breastfeeding. Everybody and their dog recommends the football hold and/or side-lying to cesarean moms. One or the other or both seem to work for most of them. I hate them both. I can't hold my baby well in the football position, and side-lying makes my incision hurt a lot. I still do it during the night, but only because getting up and getting back into bed sounds worse.

Many moms like "granny panties" post-op, because they don't put pressure on the incision. I actually prefer my panties to ride on the incision, over the bandages, because I get a lot of sweat down there if I'm wearing undies that push my "apron" of fat onto the incision.

Be careful of stairs. I don't have much trouble with them, but they're a major problem for a lot of women.

Everyone says getting up and moving asap is important. I honestly haven't found that it makes that much difference in my recovery, but many women do. (With ds1, I couldn't stand up for over a day - too weak - and I had a really good recovery with him. With ds2, for example, I was up and walking around the ward as soon as possible...and that surgery ended up taking the hardest toll on my body.)

Basically, try to make sure you look after you...but that's harder than all the advice makes it sound. I remember mom coming by to see how we (ds1 and I) were doing when he was about 8 days old. I was really out of it, and she asked me if I was hungry or something. I said, "no - I just had a bowl of Cheerios"...before realizing that was at about 9:30 or 10:00 in the morning and it was now 5:00 pm...


I read through the links (have read them before, but it's been a while, and I didn't remember them that well). The procedural description mentions pulling and tugging. Be prepared for this. It doesn't seem to bother some women, but it really, really freaks me out. Despite not being able to feel actual pain, I don't have the necessary ability to divorce the sensations from the knowledge that I'm being cut open. I spend my time in OR in a state of barely controlled panic every time.

Oh - maybe see about an anesthesia consultation beforehand (probably only possible if you end up scheduling, but you might be able to talk to them at the hospital, as well). That way, you can go over what drugs he/she is planning to give you. You can also, if you want to, find out the policy on partners/support people in OR. It's most common to allow them during the surgery, but not during the prep. I'm going to see if I can have dh with me for the anesthesia this time. I hate that part.

[claras_mom]

Line up lots of help for when you're first home. My mom was there for two weeks for my first c/s and will be there again. Cooking, cleaning, and laundry. It will hurt to bend over; you won't be able to--well, allowed to, and it's a good thing--lift anything heavier than the baby for several weeks. I found that nursing sitting up with a couple of folded blankets in my lap was the best deal.

And yes, eat fruit and take the stool softener they'll probably offer.

[holyhelianthus]

Thanks so much!

Originally Posted by Storm Bride

I read through the links (have read them before, but it's been a while, and I didn't remember them that well). The procedural description mentions pulling and tugging. Be prepared for this. It doesn't seem to bother some women, but it really, really freaks me out. Despite not being able to feel actual pain, I don't have the necessary ability to divorce the sensations from the knowledge that I'm being cut open. I spend my time in OR in a state of barely controlled panic every time.

I have heard of this before and the thought very much freaks me out so I can understand what you are saying. I have warned DH about it so he knows to keep me in my skin. I really am afraid I am going to wig out in the middle of it.

[BetsyS]

Something that I've read in a lot of birth stories that freaks people out is the chit-chat during a c-section. The nurses and doctors just chit-chat about whatever and often, very frivolous conversation takes place (what they did that weekend, where the new restaurant is, etc).

You can ask your OR team to not chit-chat during surgery, or you can ask them to continue (I have a medical background, and that chit-chat reassures me that everything is relaxed and comfortable and normal). But, it's something to be aware of.

I'm also a HUGE fan of taking pain medications as often as you need them. I do them scheduled for a few days, then pretty often for a couple of weeks. Not the big stuff for a couple of weeks, but a good 2-3 weeks of regular Ibuprofen. I think that a pain-free mama is a better mama, so that's why I go with that idea. You'll see some people on here that don't like to take any pain meds, and then I'm at the other end of the spectrum. But, you should think about it ahead of time.

[darcytrue]

Good advice so far. I have had 2 c-sections and will most likely be having a third with this baby. I had very positive experiences with both of my c-sects and have nothing negative to say about them.

Be ready for the pain of standing up and walking for the first time after the surgery. The incision area will feel weird. It will feel like you were split in half and sewn back together and it will be hard to stand straight up at first, but once you do it you will be fine and the sooner you get up and walking the better. Go back and forth to the nursery and do what you can to get moving. It also helps tremendously with the gas!! I had gas really bad after both of mine. Also, in the first hours after the surgery when you are still in bed and moving around it will feel weird in your tummy area almost like your organs are shifting around or at least it felt that way to me. When I tried to sleep on my side the first few days it felt like my inners were shifting when I moved my body from side to side. Not a comfy feeling but it goes away quickly.

I agree with taking it easy like they will tell you to do the first six weeks and don't push yourself. I pushed myself a little too much after the birth of my second child and had heavier bleeding in the first few weeks. Try to take it easy as much as possible and rely on your DH or other people to help you.

[majormajor]

i've had 2 fantastic c-sections. here are some things to be prepared for, in no particular order:
-probably only one other person will be allowed in the OR with you
-check your hospital's policy on having the baby in recovery with you. our hospital wasn't set up to do this because the recovery room was outside of the newborn ankle alarm area (so, the alarms would be set off if the baby was there with the ankle bracelet). i talked to patient relations in advance to make sure my baby could be with me, but it turned out i was sick so i had her stay in the nursery anyway. DH, my mom, and DD were with the baby.
-there is medication if you itch after the surgery, and medication for nausea. the nausea medication makes you really tired, so it's kind of a pick your poison deal.
-i liked granny panties for post-op
-take your pain medication!
-take it easy! i felt so fantastic after both c/s, and i kind of overdid it after the second (walking around downtown for HOURS with DD in a sling at 2.5 weeks pp, back to my usual routine of cooking and cleaning by 2 weeks pp, and my bleeding came back and didn't totally go away until about 8 weeks pp).
-use your arms and upper body instead of your stomach when you get up from lying down or sitting. have someone help you up.
-and finally, don't worry about the experience being somehow "lesser" (i think it's painted like that a lot). my births were the most joyous, spiritual events of my life. i was on a birth high for months after each.

good luck!

[liseux]

Everybody else has said some excellent things, I have just a few things to add.

I had 2 great c section experiences, one reason I am Ok with C sections though is b/c I had a horrible outcome with a natural birth, so its a different perspective that I have.

--I had spinal anesthesia instead of epidural & many women prefer one over the other & you will hear horror stories about both, but....spinals these days involve a much tinier needle than ever before and the chance of a spinal headache is miniscule. The cool thing about a spinal (most of the time & definitley true for me) is you feel Absolutely Nothing. No tugging, no pulling, just the dr. telling my dh to take pictures NOW. I was amazed.

--I never had any chit chat in either of my sections, they always talked to me. I just engaged them in conversation from the beginning, met everyone, inc. all of the nurses, and they stayed focused on me. It probably helps that I'm a little high risk though, so they are watching pretty closely. But, if you have a dr you like & connect with the first nurse that puts your Iv in, I think you will find you won't feel ignored in the OR.

--We brought cookies to "butter up" the nurses, pretty transparent, but it works!

--most ORs play music or will let you pick your own & it can help you relax to focus on the music.

--I think by far the worst part is getting the spinal placed, once you get past that, its pretty easy (most of the time). They numb the injection area first so its not exactly painful, just kind of creepy. After that, you feel very little pain in the first 24 hrs & your new babies will help you deal with the rest. Good luck

[maxmama]

I had two c-sections and have circulated on about a kajillion.

-- Remember not to forget about the rest of your birth plan! The baby can still stay with you (you may need to have someone else stay in the room with you), you can help with the first bath (there's no reason to do it immediately; it can wait until you're up), you can breastfeed in recovery (or in the OR, which I did with my second because she was screaming for the breast from the second she came out), take pictures, etc. etc. A lot of people forget about what happens after the baby comes out.

-- The best nausea medication, hands down, is Anzemet or Zofran. Both will not make you sleepy and are awesome.

-- Bring a sling with you if you want. I wore my baby from the time I walked after surgery (five hours or so) until we left at 36 hours post-op. It was fine.

-- Drink LOTS of water.

-- Move around as much as you can. It will help. I promise.

-- Take your pain medicine! Toradol is great for the first 24 hours post-op (basically, IV ibuprofen) and with the narcotic in the spinal was all I needed until the second day. I schedule narcotics for my patients; it's better than waking up in pain and they can always turn me down. What I don't want is them waking up in pain and then having to wait a) to get their meds and b) for them to work.

-- Enjoy your baby's birth. This is the only birth s/he will ever have. Having positive memories of it is a gift to your baby.

[majormajor]

Originally Posted by maxmama

-- The best nausea medication, hands down, is Anzemet or Zofran. Both will not make you sleepy and are awesome.

thank you for this info!

[maxmama]

Originally Posted by majormajor

thank you for this info!

The generics are dolasetron or ondansetron.

[holyhelianthus]

Originally Posted by maxmama

The generics are dolasetron or ondansetron.

Having hyper emesis with 3 out of my 4 pregnancies I can say that Zofran has always knocked me out. Not as bad as Phenogren but still.

[JollyGG]

Lots of good advise. I would also mention that in some instances your arms will be loosely tied down so that you can't unkowingly disturb the sterile field.
I asked if it was necessary and was told that they wouldn't comprimise on that until after baby was out. Once baby was out the doctor advised me to ask to have my arms untied if I wanted to hold baby right away. I did and there was no problem with my request.

You can ask to have the drape lowered so that you can see as they pull the baby out. I loved being able to watch my child being "born" even if it was a c-section.

Talk with your partner about if he wants to watch over the drape or if you would rather have him concentrating on talking to you face to face. I wanted him to watch then later he could give me all the details if I wanted them.

Ask to wait to have the catheter placed until after the spinal is in.

With my second c-section I was given the option of a spinal or an epidural. The spinal is placed a little higher than the epidural. I had an epidural with the first and a spinal with the second. I found that with the epidural I felt more. With the spinal I had more panick because I couldn't feel myself breath.

Ask about taking pictures. During my first c-section my doctor had passed my care off to the surgeon who did the sections. She grabbed my husbands camera and took tons of pictures of our first moments with our son that I will always cherish. My cousin had a friend and her husband in with her so that her friend could take pictures.

And while I know this board is very much advocates of rooming in I would recomend having tons of help or using the nursery as you need it. Recovery from a c-section is very draining and you need your rest. With my son I roomed in and felt like I went home exhasted and sore (of course I had 24hrs labor then c-section). With my second I made full use of the nursery and went home well rested and ready for the joys of caring full time for my daughter.

I deffinately second the idea to get up and walk as soon as possible.

[maxmama]

Originally Posted by magstphil

Having hyper emesis with 3 out of my 4 pregnancies I can say that Zofran has always knocked me out. Not as bad as Phenogren but still.

That's unusual. It's not like phenergan at all in terms of sedation, and I've never had anyone complain of sleepiness with Zofran in surgery.

[holyhelianthus]

Originally Posted by maxmama

That's unusual. It's not like phenergan at all in terms of sedation, and I've never had anyone complain of sleepiness with Zofran in surgery.

Maybe it's because I was already weak from HG? I was given Zofran when I was really bad off. Also I was taking it at the same time as a chemo patient friend and she had the same issue.

[liseux]

"Ask to wait to have the catheter placed until after the spinal is in."

This is pretty standard nowadays, but definitely make sure, it is very important!

About the spinal taking away your ability to feel yourself breathe, if you are long waisted this won't happen. If you are more petite, this can definitely happen, but you can be talked through it & once the surgery starts, most people forget about it.

Storm Bride, I forgot to thank you for the suggestion about eating fruit. It sounds so obvious, but I didn't do it before & suffered slow motility so I will definitely do it now.

[maxmama]

Originally Posted by magstphil

Maybe it's because I was already weak from HG? I was given Zofran when I was really bad off. Also I was taking it at the same time as a chemo patient friend and she had the same issue.

Possibly the effect of multiple doses? Or I have noticed that HG patients are exhausted; maybe when you can stop throwing up you're able to notice how tired you are. Not saying it can't happen, only that I've not seen that when it's given as a one-time for surgery.

[a-sorta-fairytale]

I have to echo to be prepared about the feeling like you are not breathing. My first CS was awful for many reasons. My second was a million times better but i still freaked about not breathing. The anesthesiologist even showed me the screen showing my ox stat and i said "yes, i am cognitively aware that i am breathing but i still *FEEL* like i am not."

Also, for the second cs i had my mom come in and give me a little pedicure in the hosp while i was waiting. I remembered from the first one not being able to reach my toes because of pain and having the longest gnarliest toenails. So my mom gave me pretty toes. I wish i had someone french braid my hair because with my first cs my hair got super tangled in the hosp and my dh was of no help and i was unable to lift my arms that high without pain. She also brought me some lavender spray for the room, homeopathics (arnica and somethign else for surgery), and earplugs. It was so nice to sleep through all the 60 millioin "checks" on me because i was not woken up by the darn door opening.

Also, on my second cs i cleared it so that both my hb mw and my dh were in with me. They also handed me the baby right away the second time whereas the first time i only got a glimpse of her.

I was also not prepared for the gas pains in my shoulders and upper back. I had to have dh pound on me to make me feel better. I would have loved to be warned about this and to not have freaked out thinking i was having a heart attack.

the second time I also insisted baby room in and not be taken for ANYTHING. He stayed with me and they weighed/measured etc in my room. It so stressed me with my dd when they would take her and refuse to bring her back for hours and then she mysteriously smelled of formula :
It really helped to have a "helper" there in addition to dh so there was someone there for me if he went to get food go home and shower etc.

[JollyGG]

Originally Posted by a-sorta-fairytale

I have to echo to be prepared about the feeling like you are not breathing. My first CS was awful for many reasons. My second was a million times better but i still freaked about not breathing. The anesthesiologist even showed me the screen showing my ox stat and i said "yes, i am cognitively aware that i am breathing but i still *FEEL* like i am not."

I had to laugh because that discribes my situation exactly. I'm six foot tall so have a fairly long waisted. I was trained (as a teen compeative swimmer) to breath from my diaphram. So not being able to feel my diaphram combined with the sensation of lying flat on my back was disturbing. They did have a towel or something propping one hip up so that I wasn't really lying flat on my back.

I also wanted to add that the check of you uterus where they push on you belly after delivery really really hurt with my first. It wasn't so bad with my second one. I don't know if that was because I was prepared for it or not or that I didn't go through labor. But it is something it is possible you may experience.

[felix23]

Originally Posted by magstphil

Having hyper emesis with 3 out of my 4 pregnancies I can say that Zofran has always knocked me out. Not as bad as Phenogren but still.

It also made me very sleepy, gave me horrle headaches, and made me constipated. I took it for HG and I hated it. It didn't even work that well for me, I still felt sick all the time.