Wednesday, November 19, 2014

What to expect from a C-Section

When I had my son, I was all set with my natural birth plan and then I ended up in emergency with some sort of virus.  Less than 8 hours later he was delivered via C-section one month before his due date.

At the time, I had done little reading about C-sections. Why would I? I was entirely confident that my birth plan would be adhered to, and it didn't even cross my mind that a surgical intervention would be needed.

This time around I was prepared. Given my age and the fact that it has only been 2 years since the last C-section my OB strongly recommended we go that route again.  So I did my research and thought I was set to go.

However, even with all of that reading under my belt I was still thrown a few surprises.  So I want to share the information with other mothers in the hopes that they will be as prepared as they can be!

Before your surgery

  1. Pack the freezer with meals. Trust me, you aren't going to feel like cooking. Standing on your feet for more than a few moments will be uncomfortable. You will be busy trying to care for a newborn, so the microwave will be your new found friend.
  2. Ensure you have Tylenol in the house.
  3. Pack your bag for the hospital. Just because you have a C-section date scheduled doesn't mean that the baby won't arrive early. Our daughter came 4 days before her scheduled surgery date.
  4. Buy some Depends and put them in your hospital bag.  The hospital will give you some very awkward and bulky pads to use, trust me - the Depends are easier and will go up high enough over the incision site so as not to irritate it.
  5. Discuss with your OB how you would like the surgery to go. Do you want to hold the baby immediately? Will you be breastfeeding? Is it ok for them to give the baby formula? Who will go with the baby?
  6. If you will be breastfeeding, pack a Madela Nipple Shield in your bag, size 24.  You will be so swollen from the IV that this will assist you in the first week or so and ensure baby can latch.

During your surgery
  1. Decide if you want an epidural or a spinal block. They are not the same thing.
  2. You will be given a catheter. It's awkward, but won't hurt.
  3. You will be entirely naked in front of a room full of strangers. Don't worry, they put a "curtain up" so you can't see you are naked.  Pretend you are at the spa. Try not to think of alien abduction scenarios.
  4. Speak up. I know it feels strange. You are lying on the table while they slice you open. But don't be afraid to tell them how you are feeling, or if something feels uncomfortable. Tell the anesthesiologist if you feel hot or nauseous in any way.
  5. If you chose to see the baby before it is whisked away, be prepared for the fact that you may cry and be upset.  Of course you will be! Your sweet newborn has been taken from your tummy and is now gone.  Rest assured that whomever you have chosen to be there for the baby will be showering it with love until you come out of the recovery room.  However, if you feel nothing - don't feel bad about it. You are drugged up lying naked on a table being stitched up by strangers. You are not exactly yourself at the moment.
During Recovery
  1. The nurses need to see that movement is coming back to your limbs. So keep trying to move those legs. If they can see that you are improving they will send you off to reunite with your baby.
What to expect in hospital
  1. Our hospital keeps a C-section patient for two days following surgery. The first day you will have limited movement in your legs. Keep trying to move them and when you are able to, begin to do circles with your feet.
  2. The nurses will need to come in and inspect the incision, and will also wash and rinse your entire "nether region".  So don't be surprised when they come in armed with wash bottles and dry towels. At this point, all dignity has been lost but you won't care.
  3. You will need someone to help with the baby and bring it to you to nurse as you will be unable to get up.
  4. Women around you in other rooms will be going into labour and having babies. Within hours they will be up and walking around with their babies. Don't let it bug you.
  5. You will likely be given Ketorolac (a pain killer) on a drip, along with your IV.  You will also be give Oxytocin to shrink the uterus.  All of these fluids are going to make you swell. Keep drinking LOTS of water to flush out your kidneys.  The nurses will want to see that you are passing gas before they allow you to go home, so eat and drink.
  6. Once you can move your legs, they will allow you to sit up. I can't stress this enough - the sooner you sit up, the sooner you walk (albeit at a shuffle) the faster you will recover.
  7. On day two my catheter was removed, this was a huge milestone! I could now shuffle to the bathroom.  Even dragging the IV pole it felt like recovery.
  8. End of day two they removed the IV and I was switched to oral painkillers.  The oral painkillers are not as effective, so be prepared for some pain.  Use a small pillow to support your tummy as you walk.  Try not to hunch if you can. The sooner you stand upright, the sooner you will have less pain.
  9. Back pain is to be expected. The spinal block can give back spasms, so don't be caught off guard. They can be super painful.
Once home
  1. Keep walking. It is so important to keep moving.
  2. Come off the pain meds as soon as you can and switch to Tylenol. The pain meds (in my case, Toradol) made the edema worse.
  3. Do not lift anything heavier than the baby.
  4. Watch the swelling of your legs. If after 5 days you are still swollen, get some prescription compression socks from the doctor.
  5. If you are breastfeeding, DO NOT take a diuretic.  It may dry up your breast milk. Try natural diuretics instead. Lemon water, pineapple juice....
  6. Back spasms from the spinal block happen in 1/100 women. I was one of those lucky ducks. They are incredibly painful. Like "knock you to your knees" painful.  The Tylenol will dull the pain, but really there is not much you can do. Grin and bear it. Mine began to pass around the second week.
  7. You will still look pregnant for some time. Get used to people asking when you are due even though you are carrying a newborn.  Try not to be envious of the moms who delivered naturally and now fit into their skinny jeans.  
  8. Speaking of might not fit your maternity pants. The additional swelling takes you up a size.  Enjoy wearing your husbands track pants. It's amazing how creative your wardrobe gets.  Black and grey are your friends.
  9. Pyjamas are allowed in public, especially if it's just a trip out to Walmart. By this point you have such cabin fever you won't care.  Enjoy the fresh air.

Use this time to rest, relax and enjoy your little one.  Within two to three weeks you will begin to feel like yourself again, and within 6-8 weeks you may even begin to feel normal. 

Have you had a C-section? Care to share your experience?

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