Questions to Ask in Preparation For Possible or Planned Cesarean - Mothering Forums

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#1 of 3 Old 08-14-2013, 04:44 PM - Thread Starter
 
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Others familiar with this procedure whether planned or emergency, please add anything you feel it is important to find out about cesarean, comment or correct any errors in the questions I have.  These could be directed at the hospital in which the cesarean is to occur OR the surgeons who could be providing it. 
 

For anyone planning to give birth, it is a good idea to prepare yourself for the possibility of cesarean.  There simply is an inherent risk to the inevitability of one, and while unpleasant for many to contemplate, I think you will feel much better if you prepare ahead of time for the possibility of it.

 

I myself have decided to plan a cesarean (and will hopefully make it to my surgery date) and have been reading about it.

 

I am compiling a list of questions for my OB, questions that perhaps other women should ask if they have chosen to use an OB for their care, since there is on average a 30% chance of getting a cesarean for women who give birth in the hospital in the USA.  There is plenty more to giving birth, the focus of this post just happens to be one possible scenario.   

 

Questions:

 

1. Do you give me antibiotics before the incision is made? (this is shown to reduce odds of infection)

2. What is done with the placenta?
3. Can you perform the suturing with the uterus kept inside abdomen. (this may decrease certain risks)
4. I had xyz complication during a previous surgery.  Should this in any way affect the procedure?
5. Can you lower the screen and let me hold the baby immediately?  (some do this in a planned surgery)
6. Do you cut the peritoneum and pull the bladder down? (I forget)
7. Can you check/look at  my ovaries before exiting? (basic cancer screening)
8 Can you suture my uterus in two layers? (shown to reduce certain risks in recovery and future births)
9. Can you not wear powdered gloves, minimize bleeding as much as possible, and ensure my organs don't dry out? (general conduct to ensure minimal adhesions)
10. Will you not suture the bladder peritonium and allow the layers to find their most appropriate opposite sides and heal? (shown to be better)
11. Will you suture the parietal peritonium since it might reduce the likelihood of bowel adhesions?
12. In addition to sututures, do you also glue the skin for added closure? (I hear it helps)
13  At what point can the staff assist in breastfeeding? (the sooner the better)
14. Can you prescribe a belly band for me to wear post-op? (I have heard these help a lot).
15. Can you use regular sutures or is there a reason staples must be used during closure? (I hear that staples are a drag)
 
ETA: The nature of these questions might change in the event that you are asking in a just in case scenario, and the answers to some of these may vary from doctor to doctor depending on whether it is planned, emergency, which hospital it is at, how long the OB has been doing this procedure, how well informed they are,, Etc.  I am just throwing out what I have gathered in my early stages of preparation, so please do your own research in addition to whatever information I might share  herethat is useful.
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#2 of 3 Old 08-15-2013, 01:47 PM
 
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That's a good list. (I should add--for my 2nd CS I had no external staples OR sutures. All my sutures were internal and the OB used glue--the result was extremely good, better than the sutures for my first.)

 

Also:

 

1) Do you strap down arms for surgery? (Answer to this should be no, it is no longer needed)

 

You should have a second set of questions for the anesthesiologist (you can ask for a consult, mine did routine consult and consent pre-op for scheduled cases)

 

1) What technique do you use for the anesthesia (the most common answer for planned cases is spinal as it's simplest and has the least chance of only working on one side or giving a window, but some anesthesiologists prefer epidural or CSE--epi is good if there's any question over the length of the procedure. usually not an issue but occasionally)

2) What will post-op pain relief be--Duramorph in spinal (IIRC most effective), PCEA (only available with epi/CSE) or IV PCA? (Weirdly I was told they like IV PCA, and was nervous but on the day got Duramorph)

3) Do you routinely give benzodiazepines? (Mine said they never do, but some hospitals apparently do)

4) Do you give Benadryl routinely to prevent a histamine reaction to Duramorph (ie itching, incorrectly believed to be an allergy by some) - some docs do. I don't mind but some people don't like antihistamines

 

For the OB - more questions on post-op pain relief - what do they use? I had Duramorph + IV toradol for 24h then Percocet and ibuprofen layered. 


DD 01/2007, DS 09/2011

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#3 of 3 Old 08-15-2013, 03:52 PM
 
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I think it's a good idea to ask about post-op self-care - which is perhaps not quite on topic, but obviously useful for immediately afterwards and beyond, whilst healing.

 

I.e. What is recommended in terms of exercise / massage etc, to promote healing in the area, but also future flexibility and motility and minimising the risk of adhesions. I didn't ask about this, didn't do anything special (I was told not to move too much for a few days - but after that, I did nothing special, and feel I should have), and still suffer discomfort in my abdomen from tightness, possible adhesions etc Long term changes like these might not be preventable - but best to be armed with the latest and greatest info on it I think...have a plan for self care.

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