What do I need to know to prepare for c-section?

[klocke]

So for those who have had scheduled (or not) c-sections what advice would you give to a first time c-section,LOL. I have had 2 vaginal hospital births followed by an awesome home birth. This time I am having twins and they are not in favorable positions for delivery so I am having to schedule a c-section. (Long story but no one, OB or midwife, will let me deliver vaginally so it is going to be a c-section for sure) I am not a huge medical person to begin with never had any form of surgery or even stitches so I'm kinda freaked out. Don't even remember the last time I went to the doctor because I was sick. I am also total type A personality and want to have everything as planned out as possible so I'm not surprised by anything. My DH is going to be in the OR with me. And we will have 3 kids to come home to (5, 3 1/2, & 2 years old). I'm trying to arrange family help but realistically that will only be for the first week or two and then I'm pretty much on my own since DH has to go back to work. Luckily older two will be in school until late May so that will help some.

So what would you do differently or the same? Anything that you didn't expect with regards to the surgery, recovery, nursing after, or healing time?

[Super~Single~Mama]

I've never had a c/s, so I can't help there.

My one piece of advice would be to try and stagger the help. Like, have one person come for the first week, another the second, someone else the third, etc. That might be tricky, but you'll probly appreciate having someone to do random stuff around the house after your DH goes back to work.

Good luck and congrats on having twins!

[rachelsmama]

Bikini cut underwear+bikini incision=uncomfortable itching. Granny panties are your friend.

[MamaJenese]

Ask for stiches not staples. I can not believe how much more comfortable I was with the stiches plus it healed faster and better.

[Storm Bride]

Second the stitches. I've had four c-sections with staples. I had my last with stitches. It wasn't even remotely the same kind of recovery. (I've had the gamut..."emergency" c-section over my refusal, scheduled by being bullied into it because of some emotional issues that pregnancy, scheduled after coercion, true emergency, with stillbirth, and a truly elective one...although I still hated it.)

Let's see. If they "won't let" you eat, I strongly recommend getting someone (dh, in my case) to get you some food. They only gave me fluids for 3.5 days with my first, and I thought there was a real reason for it. It's very difficult to get through the post-partum part, the post-op part and establish breastfeeding (especially for twins, I'd think!) without fuel! I chose lots of juicy fruit (berries, plums, peaches, etc.) to help with post-op constipation, and yogurt, just because it went down so easily.

Think about anesthesia and pain management. Standard pain management at my local hospital is one of the morphine drugs. I refused it last time (intended to with my third, but the doctor gave it to me without telling me), because it make me itch, and I'd rather be in pain. I'll be honest - I haven't found any pain medication that's made me pain-free. YMMV. I know some women say they had no pain at all, but that hasn't been my experience, even with the morphine. I'm not a fan of "no pain", anyway - I think pain is the body's way of telling us something, and if we can't feel it at all, we may miss something, yk? For me, a PCAP with Demerol worked really well last time. I gave myself a shot when I really needed it (before trying to sleep and the first couple of times I got up to use the bathroom), but not all the time. Again, ymmv...the nurses all assumed I was allergic, which wasn't the case.

Find out when your dh can come in. When I had my second one, they told me dh could be there. They didn't tell me that he had to wait until I'd had the spinal. I went through that again with my third. I finally made it clear I wanted dh there, and the anesthesiologist on duty agreed to let him come in (it's that doctor's call, not your OB's, and not the hospital). I don't know if that matters to you or not - it was a huge deal to me, because the spinal scared/scares me about as much as the surgery. However, I don't know if they'd have let him in if I hadn't had a previous stillbirth. (Most hospital staff will treat a mom with the loss the way they should treat all moms, ime.) It's just something to be aware of ahead of time, imo.

Generally...get as much food taken care of ahead of time as you can. I'm guessing it's hard to handle meals in the first few days post-partum, anyway. Combine a surgical recovery with twins, on top of other kids? Just getting stuff from the freezer to the oven is about as much as you want to have to deal with, imo.

Get up as soon as you can, even if you can only stand up for a second. It does help. But, judge for yourself how much you can do. I've had nurses really harass me into walking before I was ready (see aforementioned liquid diet - I was weak as a kitten for days)...and those same nurses badgered me for "pushing too hard" when I was ready to walk. I knew what I could handle, and they didn't.

Gentle exercises...kegels as soon as you can. Roll and stretch your ankles/calves as soon as you can - it helps keep the blood flowing and reduces your chance of blood clots.

umm...if I think of anything else, I'll let you know.

[klocke]

Thanks for the info. I am already going to request stitches because I have a metal allergy and don't want to risk it with the staples. I have also been stocking up my deep fridge with prepared meals anyway since I knew it was going to be hard with twins either way I delivered. I have about a month worth of dinners ready.

Keep it coming ladies I want as much info as I can get, good or bad.

[liberal_chick]

My advice is to stay ahead of the pain, especially in the early days. They gave me percoset for pain (which didn't make make me drowsy or anything) after the spinal wore off and I let myself start hurting before I took any. Big mistake! I should've taken them every X hours instead. I was able to switch to advil by the 5th or 6th day.

[Monkeygrrl]

I had c-sections for both of my babies. The first one wasn't planned, the second one was scheduled.

Get two or three people who can come to the hospital to be with you. One person to be at your side, two people who can be with the babies. This ensures you have people on your side who can advocate for you and the babies.

I had spinals instead of epidurals - I know they both affect the babies, but I didn't like what I was hearing about epidurals. Check with the anesthesiologist regarding medication for nausea - and choose one that doesn't cross the blood brain barrier - at least until the babies are disconnected from your body.

Bring some comfy tshirts/bottoms if you don't want to have to use the hospital gowns.

Arrange for a few people to come every day for the first 2-3 weeks, on a rotating schedule. One person at a time, even for a couple hours a day.

Get up as soon as you feel you can. Start with sitting up in the bed. Then sit at the edge of the bed. Then standing. Then walking.

Bring a pillow - like a throw pillow. Hold it against your stomach as you move from laying down to sitting, from sitting to standing. It always felt like my stomach was going to fall out of my body, and the pillow helped put pressure on my body - and made it feel like it would all stay in.

I used pain meds for the first two days, then started to wean myself off of them. It is major surgery. Listen to your body and what it is going to be ok with, and follow it.

Umm, that's all I can think of for right now. If I think of anything else, I will come back and add to it.

Congrats!

[Babina's Mommy]

I took the Percocets and Motrins for the first few days and weaned off the Percocets I think at the end of the week...

I wore a lot of dresses and pants that could be pulled way up over the incision....

After the C-section and baby coming home I got a nasty yeast problem and baby got thrush, etc and I don't know if this is standard but it seems they put antibiotics in my IV when getting the section. So remember probiotics, yogurt, stuff for yeast, etc. I used gentian violet on my nips a few days after we came home. Glad I had it in the house.

The hospital and doctor made me get out of bed, walk around, told me to walk when I got home. It helps with healing. My friend said her advice is to drink a lot of water....They told me right after my C-section that if I could keep the fluids and jello or whatever down, then I could have real food. I was starved so I had the liquids and jello and then they gave me real food.

My husband was only out of work one week, including the hospital stay, so when he went back to work, my mother inlaw came over to take my daughter for a few hours so I could sleep with baby, so that helped...Had to remind my daughter a few times to not climb on my belly...It was sore for awhile, and it is still sore in some spots and itchy and numb in others...

The only thing was that after the section it takes your gastro system awhile to get back into gear, so it's hard to pass gas, but walking the halls helps with that...and you may not have a bowel movement for awhile. The hospital staff usually keeps prune juice on hand, but you may not go until well after you are home from the hospital, that's normal...

Other than that, it wasn't too bad at all to recover from, and I've had one vaginal birth and one C-section.

My section wasn't scheduled and was after 27 hours of hard labor at an attempted homebirth...so the spinal was a big fat relief for me. Loved it. Nursing went really well after my C-section, and also I was and am extremely bonded with my son and was right away....So for me, my C-section was a big old happy ending, lol. Conversely, when I had my daughter naturally, it took me longer to bond with her, I felt worse after...and I couldn't wait to get out of the hospital. With my son, I was more willing to accept the help from the hospital and appreciate the fact that they were bringing me food 3 times a day and helping me until I went home and was on my own. No cooking, cleaning or other heroic acts for the first couple of weeks. Make any visitors do it, haha. Good Luck!!

[rachelsmama]

Originally Posted by liberal_chick

My advice is to stay ahead of the pain, especially in the early days. They gave me percoset for pain (which didn't make make me drowsy or anything) after the spinal wore off and I let myself start hurting before I took any. Big mistake! I should've taken them every X hours instead. I was able to switch to advil by the 5th or 6th day.

Appropriately used pain meds can be really really good, and can make it easier to focus on being a mom.

[limette]

Originally Posted by Storm Bride

Second the stitches. I've had four c-sections with staples. I had my last with stitches. It wasn't even remotely the same kind of recovery. (I've had the gamut..."emergency" c-section over my refusal, scheduled by being bullied into it because of some emotional issues that pregnancy, scheduled after coercion, true emergency, with stillbirth, and a truly elective one...although I still hated it.)

Let's see. If they "won't let" you eat, I strongly recommend getting someone (dh, in my case) to get you some food. They only gave me fluids for 3.5 days with my first, and I thought there was a real reason for it. It's very difficult to get through the post-partum part, the post-op part and establish breastfeeding (especially for twins, I'd think!) without fuel! I chose lots of juicy fruit (berries, plums, peaches, etc.) to help with post-op constipation, and yogurt, just because it went down so easily.

I concur about the stitches.

Crappy food: Seriously, what is up with that?

My first was a c-section and they had me on a diet of broth and jello. I was starving and getting low iron levels. I finally convinced them to give me real food on day three. Real food was overcooked tasteless chicken breast, plain rice and sweet corn.

When I was given the okay to go home they gave me a prescription for iron pills because I was now anemic. I tossed the script and went home and had Christmas dinner. Prime rib can fix anything!

[MeepyCat]

Definitely keep ahead of the pain. I have terrible reactions to percocet, so I did the thing on alternating tylenol and motrin, but just take them by the clock for the first week or so.

The other thing - there's no way to put this delicately - pooping and farting kind of suck in the first week or so post surgery. I can remember gas pain so bad that I screamed and cursed just to get through it. Simethicone (aka mylicon or Gas-X) is very helpful. So are stool softeners. It might be a good idea, also, to have some hemorrhoid cream on hand.

They let me eat pretty soon after the surgery, although the anesthesia made me throw up. Keep that first meal really simple, or follow the advice of my friend, who told me that chocolate ice cream tastes the same coming or going.

If I had it to do over again, I would prepare by telling my underfoot kids all about how important it is to be gentle with mama when she's just had a new baby.

[Storm Bride]

Originally Posted by limette

Crappy food: Seriously, what is up with that?

My first was a c-section and they had me on a diet of broth and jello. I was starving and getting low iron levels. I finally convinced them to give me real food on day three.

Yeah. I went into labour on Thursday night, and didn't keep dinner down. I wasn't really able to eat during my labour (a few grapes and a couple other little things, but it was seriously maybe half a cup of food, probably more like a third of a cup). Went into hospital on Friday night. Got my first real food - and I can't even remember what it was - on Tuesday. Yeah - juice, jello, clear broth, tea and coffee...that'll keep you going, I don't think. I finally lied about having passed gas, and got food. I was finally able to walk on my own after one meal. (I'd been able to make it to the bathroom, but needed help from my ex, before I ate.)

Oh - post-op with my last two, I've taken probiotics and iron (Floradix with dd2) as soon as I went home. I got the idea after my fourth one, which was a brutal experience and a physically recovery from hell, and it did help, so I did it again with dd2. They do give antibiotics in OR - don't know if that's universal, or just really common, but it's something to consider.

The gas can be really painful, but i have no tips on that, if it happens. I didn't get it until my fourth section, and it wasn't really bad until my fifth. Stool softeners are definitely worth consideration, although I've managed with just lots of fruit for four out of five.

I like the fruit, because it also adds hydration, and I feel really dehydrated after a c-section, especially the scheduled ones (because of the intake restrictions beforehand, I guess).

[ariel79]

I second the granny pants suggestion. Regular bikini underwear hits right on the stitches. Get the kind that go up to you belly button, you'll feel more protected. Be prepared to support your belly when you laugh. The days after my daughter's birth (after a very long l/d ordeal) were filled with laughter, and man did it hurt! I also second the motion to stay on top of your pain. It will allow you to get active faster which will help your recovery. Good luck with those twins!

[mrsfru]

I second everyone who said stitches, not staples, a pillow for your tummy, stay ahead on your pain meds, and prepare things at home.

I'm going to add--for your peace of mind, go to the hospital you are delivering at and ask to speak to the head labor and delivery nurse. She can walk you through the OR, show you the recovery area, explain to you their standard procedures, and you can ask her to help you with your specific concerns (such as I didn't want them to take my baby off to the nursery for newborn procedures, which is standard where I had to deliver at b/c of staffing). The head nurse was able to help come up w/a solution by scheduling the staff differently since we knew ahead of time, and although it didn't end up perfect, b/c one nurse called in sick, my baby still was able to stay w/us and have *most* of the newborn stuff done while in the OR. It made me feel so much better!

It's okay to stand your ground about things in the hospital, so don't be afraid to ask for the nurse manager or chief of staff--that's what they are there for! If you are uncomfortable or need something and it isn't getting done, complain (nicely, but complain).

Also, ask *anyone* you know for help afterwards. It's okay if it's an acquaintance or neighbor you don't know really well--if they're trustworthy and they offer, take it!! Even an elderly neighbor can be a supreme help if all she does is come over and play cards and board games w/your oldest kids for an hour! Don't be afraid to ask anyone who walks in your door to move the clothes in the washer to the dryer, unload the dishwasher, take the garbage out, sweep your kitchen floor, or help change the sheets on your bed--seriously, most people will not mind. If they are stopping by, they want to help (and if they don't, shame on them and who cares if you insult them and they don't come back?)

Best wishes!!!

mrsfru

[Storm Bride]

Originally Posted by ariel79

Be prepared to support your belly when you laugh. The days after my daughter's birth (after a very long l/d ordeal) were filled with laughter, and man did it hurt!

I've never had days full of laughter post-op (and I honestly find it hard to imagine), but some support can help when you cry, too. I honestly didn't find it made that big a difference, but it really seems to do a lot for most women. (These threads always leave me feeling vaguely like a mutant.)

I also second the motion to stay on top of your pain. It will allow you to get active faster which will help your recovery. Good luck with those twins!

I'll go ahead and say do this, even though it didn't work for me, at all. I suspect, more strongly every time one of these threads goes up, that I'm somewhat atypical when it comes to the straight pain part of the recovery.

[CookieMonsterMommy]

Respectfully tossing in my 2 cents as an L&D nurse.

I'd shave an inch or two off the top of your pubic line. If you don't, the nurse or tech will, and it'll be with a cruddy electric razor, which can be irritating and scratchy. May not be the neatest job either. Shave right before you go in though, to minimize chances of nasty ingrown hairs or razor bumps (again, uncomfortable, and if they get infected could be an issue). The lower you shave, the less likely that the tape will catch your pubes when they remove the dressing.

As far as eating goes, there certainly is a reason that we starve you afterwards. As much as I hate denying a new mama food, keep in mind that the medication that basically paralyzes your legs for a few hours also paralyzes your intestine for much much longer. If you eat food or drink too much before your body is ready, you run the risk of experiencing terrible gas or even something called an ileus (or paralytic ileus), where the food you ate basically sits in the intestine and causes a blockage--very painful. I'm not trying to scare anyone, nor I am saying this will definitely happen, but in my 4 years of being an OB nurse, I've seen it literally dozens of times, and most times the patient admits to sneaking food or lying about passing gas. This usually resolves without need for surgery or any long term damage, but treatment really sucks--tube through your nose into your stomach to continuously suction out the secretions, nothing to eat or drink (incl ice chips) for days, which also means a longer hospitalization and time away from your family. Again, I'm not trying to scare anyone, but I believe in informed decision making, and encourage everyone to weigh the risks and benefits before they decide whether to eat or not.

But when you are able to eat, have someone bring you something. After such an event, you deserve some kick-butt food! Not what is usually crappy hospital food.

Other than that, I second what everyone else said about preparing everything at home before hand, the pillows, bracing before you laugh/cough/cry/sneeze, granny panties, asking about hospital policy, etc.

Good luck on the upcoming birth of your babies!

[Norasmomma]

I've had 2 c/s-the first a real emergency/crash c/s due to poor positioning of DD(30 hours labor, 3 pushing only to have both DD and myself start to crash) due to DD's being pushed so far down, and so stuck I have a T-incision on my uterus which made a VBAC a no go ever, due to a high chance of rupture(15-25%-learned that from the NMW who admitted us for DS c/s last fall.

DS was planned, I had the same team I had for DD's. I came on here often, I really researched about my options and for my situation with the T it was pretty obvious the choice was another c/s.

Anyway-I like to know what is going to happen with DD's it was an emergency, I was out of it, it was a surreal thing-very weird. This time it was rather zen, I know you here of all these horror stories, but it was a very nice thing honestly. I mean I'd rather have a baby naturally, but my body just has some issues, so this was fine.

I advise meet with the anesthesiologist before for sure, ours was AMAZING. He was a wonderful jovial guy and he was the man in charge, he let my DH in quickly after my prep and told him when to take pictures(yes take pics, it is your babies birthdays). A spinal is the way to go, although I did get poked with the friggin needle on the bone(my vertebrae don't like to separate). OMG that still feels a bit weird, that was a bit uncomfy. For us the whole OR was very excited due to the fact we didn't know what the baby was, they all said they couldn't remember a baby where the parents didn't know gender. That kinda made it fun, for what it was.

I know that many people say you can't eat, and I couldn't from 9pm the night before, but I came out of that OR starving, like I was gonna die starving. They told me I could have jello, so I ate it, then they said I could have juice-I drank and asked for more jello. The thing is that many people's bodies react unfavorably to the spinal block and it makes them sick. Throwing up and c/s=not good. I am not that person, I don't have any reaction, I get numb and then it wears off. My nurse was a family friend, so I basically told her that I was going to freak the f*** out if I didn't eat-like now, she gave me a puke bag and said I better use it. It was lunch by this time and so she brought me lunch, all the nurses and staff kept saying that I would puke, I never did. I actually ate SO much that day, lunch, Subway sandwiches, dinner, snacks-I probably ate 6000 calories that day. In all honesty once DS was out I felt so much better, his pregnancy made me ill.

We did have a list of procedures we did/didn't want done:

No Hep B
No eye goop
We did do vit K
No circ if boy(our hospital doesn't at birth anyway)

I also did let a med student observe my c/s, many people are not comfortable about this, but my Dr had him as an intern or resident near the end of my pregnancy, so I had been around him. Plus I feel that it is necessary for someone to be willing to help people learn, he wasn't doing the procedure, so I was comfortable with his learning through observation. Many aren't comfortable with that and I completely understand this.

Keep up with the pain meds, prep a bunch of food now.

Start soon telling kids that mama will need help and you can't be jumped on(DD had just turned 3 so this was a biggie).

I packed all my own clothes and changed as soon as the let me, I didn't quite get granny panties, but I did get some black Hanes Hipster briefs that I could careless about and wore those.

Try to get up as soon as they'll let you. Walk a bit if you can, if you can't that's fine too.

Not sure but has anyone else ex[erienced those weird hot flashes through your spine after the spinal or epi-I get them a few days later.

Sorry so long winded, I could keep thinking of things

[Storm Bride]

Originally Posted by CookieMonsterMommy

As far as eating goes, there certainly is a reason that we starve you afterwards. As much as I hate denying a new mama food, keep in mind that the medication that basically paralyzes your legs for a few hours also paralyzes your intestine for much much longer. If you eat food or drink too much before your body is ready, you run the risk of experiencing terrible gas or even something called an ileus (or paralytic ileus), where the food you ate basically sits in the intestine and causes a blockage--very painful. I'm not trying to scare anyone, nor I am saying this will definitely happen, but in my 4 years of being an OB nurse, I've seen it literally dozens of times, and most times the patient admits to sneaking food or lying about passing gas.

This is interesting. When I talked to the OB about it ahead of my third section, he told me that the reasons for the fluids only fast had been discredited, but hospital policy continued to enforce the fast. He ordered a food tray for me with my third child with no hesitation.

I've eaten after my last three, and only had the bad gas pain with one of them (and it started before I'd eaten anything) - possibly two - my body was so shot after I had Aaron that I don't know what caused what, to be honest. My mom and sister (3 sections and 1 section, respectively) didn't eat until they were "allowed" to with any of their sections, and had bad gas pain every time.

What's the explanation for it when the section is done under general anesthesia?

But when you are able to eat, have someone bring you something. After such an event, you deserve some kick-butt food! Not what is usually crappy hospital food.

You know...after 3.5 days (well, 4.5, but 3.5 in the hospital) with no food, I really didn't care if it was good or not. "Kick-butt" food was the last thing on my mind. I just wanted some fuel to keep my body going, and produce milk!

[CookieMonsterMommy]

Originally Posted by Storm Bride

What's the explanation for it when the section is done under general anesthesia?

*that* can be credited to the "Well, it's always been policy, You just shouldn't do it." nonsense. No physiological reasons I can think of. I mean, once you're fully away anyway. I had one patient choke on her percocet because she literally fell back asleep while trying to swallow them. But once you're alert, you should be able to eat once it's clear that you're not hemorrhaging (we like to wait an hour after all births, just to make sure the uterus is clamping down nicely.

And of course everyone is different. I've had patients who snuck in a ham sandwich in the PACU and AFAIK they were fine. I've had patients get an ileus from fruit salad, pudding, plain bread, simple stuff like that. Each body reacts differently. But I can say that with one exception (who had pre-existing stomach/intestinal issues) I've never had an ileus patient who did not eat before she was supposed to, whether it was sneaking food or lying about passing gas. The significance of passing gas, btw, for those who do not understand, is that it means that your intestine are functional and have worked that gas through the tract and out into the world.

as far as having good food-hospital food saldly tends to not be super nutritious either (which is pathetic imo). Gelled or syrupy fruit salads, a croissant, fake mashed potatoes, processed meats, way overooked veggies, white grains (white bread, white pasta, etc), gravies and sauces made with oils and cornstarch and HFCS. I'm just saying, if possible, have someone bring you something that might fuel you better as well as satisfy your palate.

lol, having said that, i remember a bloody roast beef sandwich on white being one of the best meals of my life--it's all they had after I delivered ds. And I dont even eat red meat!