c-section meds question(s)

[bubbamummy]

so far im headed toward an 'elective' c-section due to breech presentation. There is NO one that will deliver a breech here and really, if its still breech by 39 weeks even though I dont want a c-section by any means im willing to go that route. So anyway, I want to be as alert as possible post op and able to hold my baby and breastfeed. I dont want to give them ANY reason to say im 'too sleepy' or 'not with it' enough to be left with my baby.

Im not 'terrified' of surgery so I really dont think I will need to be sedated at all.

what should I ask for? a spinal or epidural?

post op what is my best choice for a pain med? I want the IV out ASAP how can I facilitate that?

my friend said she just had Tylenol after her op...is that really possible?

[Tizzy]

I only had a regular tylenol after my c-section, the nurse kept bringing me T-3's but I really didn't need them. I have no idea what they may have put in the IV but I had a spinal (rather than an epidural) and specifically requested no extra pain medications. The anesthesiologist had issues getting the spinal in properly so I wasn't able to walk for a full 12 hours which probably helped with the whole pain issue.

[MaryLang]

I've had pretty good c/s's, never been told I was "too out of it" or anything ( and I've had 4). Got to nurse as soon as they stitched me up. The baby never left mine or dh's side. I got a spinal, some anti-nausea meds cause I started sorta throwing up on the table last time. And Motrin 800's and I know they put some sort of pain med in the IV as soon as the baby is out, a little morphine I think. Some pain meds are a good thing IMO. This is the farthest thing from a natural birth and after major surgery I'd rather be able to be comfortable and relax with my newborn than "tough it out". I do understand your concerns though. You never want to take more meds than you need. But IMO I wouldn't rule them out for something like this.

[Storm Bride]

I don't know what to tell you. I hate the pain meds. By far my best recovery was when I got a PCAP, and administered it when I needed it...basically the first two nights, when I wanted to get some sleep, and before I got out of bed the first time. I hate taking a bunch of pain medication. It still hurts like heck, but it takes the edge off...which is how I wound up with a twisted staple after my third one, which then resulted in an infected "pocket" in my incision, which didn't close for almost two months. I'd rather have the pain - seriously. That was almost five years ago, and I still have a weird little dimple at that end of my scar...after two more c-sections, and that particular scar isn't even there anymore.

However, even when they've given me the horrible morphine, it hasn't made me too out of it to hold my baby, though. It's just made me itch...really, really itch.

[mamabadger]

I have known women who managed on just Tylenol, but they are tougher broads than I am! I tried to postpone meds which made me drowsy until after nursing the baby, so I could be alert. This was just for the first two days; after that, plain Tylenol was plenty.

Depending on the hospital rules, you might be able to have full rooming in with the baby if you get somebody to stay with you in the hospital room at all times. Your DH, friend, mother, postpartum doula, or whoever, can take it in shifts until you are able to manage on your own.

[Storm Bride]

Oh, OP - they've used a dicoflenac suppository the last four times I've been in. It's an anti-inflammatory, and I have mixed feelings about it, but it does seem to help, and it definitely doesn't cause any fuzzy-headedness. Maybe you could look into that?

[wombatclay]

There is a book called The Essential C-Section Guide. It's not the book you want for planning a vbac, but it's an amazing book if you know you're having a c/s. Very detailed and pretty nitty-gritty. Your library may have it, or it could be part of your local ICAN chapter's lending library.

A lot will depend on hospital policy/protocol so speak to someone in anesthesiology about options, and to someone in the mother/baby unit about your post-op preferences as soon as possible. I'm not saying you should just accept what "they" say, but do find out what the policies are at the hospital you'll use, and their reasoning for those policies, so you'll know where you might need to push.

My hospital was very mama/babe friendly... post op a nurse stayed with us any time my dh had to leave (many hospitals wont leave a babe with a post-op mom till mom is considered mobile/recovered and that time may vary by hospital), they aim to have post-op moms up and walking (with IVs out) in the first 8 hours or so, they don't restrict eating/drinking, and they offer a variety of meds... I had percocet for the first day, then tylenol 3 along with an iron pill and a gasX pill for the remainder of my stay. They use spinals for all c/s unless the mom had a labor epidural in which case they use that line.

I just had a second vbac at a different local hospital and their policies were very different... they also did spinal only, but they keep mom in bed on IV/cath for 24 hours post-op, restrict food/drink during this time, wont leave babe with mom during that time (and they don't provide nursing staff if mom doesn't have another adult), etc. Although I planned a vbac, I met with hospital staff and had a backup plan in my chart that met their concerns and my needs. For example, we had approved support staff lined up so we could room in even if I was post-op and dh was with our other children.

Anyway, I hope your babe turns! But either way, do find out the specific policies surrounding c/s at that hospital so that you'll be able to put your energy to good use. And check out the MDC natural family living cesarean resources thread (it's a sticky on this forum) for ideas about making your birth the best experience possible and your recovery swift!

[limette]

I'm not sure what the difference is between the spinal and the epidural but whatever I got for my emergency c-section took two doses to take and completely numbed my arms which apparently it wasn't supposed to do.

Therefore after she was out I couldn't hold her so just told them to give her to dh (who was not in the OR). I was in recovery for a bit before my arms were functional enough that I could hold her to breastfeed. It had no affect on breastfeeding or attachment.

I took T3s for recovery and they didn't make me sleepy/dopey like they did the last time I took them (when I was 13 for laparoscopy).

[MsVyky]

Originally Posted by Storm Bride

Oh, OP - they've used a dicoflenac suppository the last four times I've been in. It's an anti-inflammatory, and I have mixed feelings about it, but it does seem to help, and it definitely doesn't cause any fuzzy-headedness. Maybe you could look into that?

I had those post c-section too. They were wonderful for the post-op pain

[mwherbs]

I would say go chat with the anesthesiologist at the hospital, and I recommend the essential c-section guide too.

as far as docs in the area that will do vaginal breech delivery if you want one, there is atleast 1 at UMC- but he does not do footling breech deliveries. I know people he has delivered this year. But I do not think that it is a simple choice and it is up to you, vaginal breech delivery is higher risk than vertex.

[Drummer's Wife]

I've had both an epidural and spinal for my 4 sections - I would opt for a spinal, personally.

Pain meds - everyone and every recovery is different - after the morphine wore off, I was on Percocet and advil ranging from 1.5 weeks - almost a month.

[JessicaS]

I am surprised they started discussing a c-section with you when you are not due until late April. There is still plenty of time for your baby to turn. I would be really concerned about my HCP if they were doing that. What sort of breech is it?



When I had a planned c-section I opted for no morphine since it affects me really badly (my perception of reality gets all wrong )

I had a spinal with one and an epidural with the other.

I found the spinal to be more effective than an epidural. With an epidural the surgeon still ended up giving me a local in my abdomen because I could still feel it.

With my first c-section I switched to regular ibuprophen pretty quick with my second it was a very different situation and I needed the meds.

I would fill the script and not take them unless you felt you needed them.

[liberal_chick]

I didn't read the previous posts really throughly, but I didn't see anyone mention a combo spinal/epidural. That is what I recieved during my c-section in 2005 and they actually leave the epidural in (its a "walking epidural," so I was able to get up and use the bathroom and such) for a few days to take the edge off the pain. And they give you the handy button to administer it yourself, which was nice.

[moaningminny]

I had a general with my first, and a spinal with my second.

Obviously, with the first I was out of it and the pain control sucked. The morphine they had me on afterwards really, really constipated me so my incision was being pushed on from the inside making it very difficult as far as pain control went.

My second was a spinal. I loved it. I wasn't "out of it" at all, they don't give you sedation too. Afterwards I refused any narcotics and just kept using extra strength ibuprofen.

It was a much better recovery than my first.

[lyterae]

I had a spinal for my c-section, it was put in with no problem and I've had no problems with the location or anything. The morphine made me REALLY itchy and I also ended up getting benadryl so that I wouldn't scratch all my skin off...

I was given vicadin and motrin for the pain (to alternate between the two of them). I filled the scripts so I'd have them but I planned on trying to get by without them... I generally have a pretty high pain tolerance I needed the medications. Again, they didn't put me out of it but they made it so I could function without being in a lot of pain

Also - I was able to nurse right after the c-section. I was a little bit out of it just because I was so tired from labor (I'd been up for almost two days) but I wasn't "loopy" or anything.

[bubbamummy]

thanks for the input everyone. I wonder since it will be 'planned' whether I will be allowed to discuss things like this with the OB at the hospital (i havent seen an OB at all so far - just a midwife at the birthing center, so the hospital and OB's are new territory )

[wombatclay]

Oh... breastfeeding! I totally forgot.

I nursed dd1 while I recovered, and there was an LC with me to help (since I was loopy from a long labor, and surgery, and all that). Everything seemed fine BUT the pain meds made it so I didn't feel how "off" dd1's latch was. She basically chomped my left nipple, creating a huge blood blister and crack. Nursing on that side was insanely painful for about two months, and she would spit up blood after nursing that side. Ugh.

So anyway, the LC and I corrected her latch but the immediate damage was done. I haven't met anyone else who had this problem (pain meds= not noticing poor latch) but it's something to be aware of.

[mrsfru]

I was under general w/the first, but had a spinal w/the second. W/the spinal, I had great pain control. It was a piece of cake to get it (the nurse anesthetist who did it was awesome--I'll request her again if I have to have another c-section!). I felt nothing, except for some major pressure on my chest, which was actually my ob trying to get me to stop bleeding my squeezing my uterus (yep, my sweet nurse explained it to me, b/c I was beginning to panic).

I've had several surgeries and procedures, and the anesthesiologist always comes in to discuss meds w/you. I had some options.

I know they gave me a long acting pain reliever in the spinal that lasted for hours and hours, but I don't remember what the meds were. I know that I itched a bit, but it was bearable.

I didn't get to nurse right after, b/c my baby wasn't doing that well.

Best wishes whatever happens!

mrsfru