What to Expect in a C-Section

Risks; post-op

The Pitfalls of Surgery
Compared to a vaginal delivery, the risk for the mother in a C-section is generally twice that of a vaginal birth for bleeding, infection, and other complications. Having said that, the overall risk of having a complication is one to three percent.

The mother could also have injury to other organs, including the bladder and intestines. In rare cases, the uterus may continue to bleed despite conservative efforts to stop the bleeding. In those situations, it's possible that a hysterectomy might have to be performed. This would be done as a last resort to save a woman's life. The decision is never taken lightly. With any surgery, there is also the risk of scar tissue or adhesions, which could cause pain later.

One of the obvious risks for the baby is that the doctor could cut the baby's skin with the scalpel. Because the baby's head or face is pressed against the uterus, the doctor has to go very slowly and carefully when incising the uterus, clearing away blood before making his every cut. That is where experience and touch come into play for the surgeon, who is often blinded by the extensive amount of blood. Other injuries the baby could suffer might be a neck injury, as it is being pulled out.

Post-Op and Recovery
After the woman is all stitched up, she is transported (referred to as towed in the Navy) to the recovery room for at least an hour. There her vital signs are monitored to make sure there are no significant complications from surgery that would require her to go back to the OR. If the baby is doing fine, she may see the baby at this point, or she may have to wait until she goes to her room. Sometimes, it's hard for family members to visit in the recovery room due to privacy issues with other patients, so don't expect a lot of visitors.

Typically, your OB will sit down and explain how the surgery went and answer any questions. Afterwards, the patient is transferred to a recovery room or a postpartum room, where she will stay until she is discharged, which will probably be in two or three days, barring complications.

The Day of the Surgery
The day of the surgery, if you're the patient, you will feel pretty tired and have some pain issues. You will be required to rest a lot. The catheter will stay in place so that you don't have to get out of bed to go to the bathroom. Pain medicines will be administered through an IV. You will not be allowed to eat at first, although fluids are provided. Mostly, you'll just want to rest (and see your baby, of course).

The First Day Post-Op
By the first day after surgery (post-operative Day 1), the doctor will evaluate you to make sure you're stable. The bandage will be removed so the doctor can look at the incision, and then it will be left uncovered. The Foley catheter is removed. The patient is asked to begin walking, if she hasn't already done so.

Walking will be a little bit challenging at first, but with effort, the majority of women find they can walk pretty well by the end of the first day. Dr. John always asks patients to sit up for a few minutes first to make sure they aren't dizzy, and then stand up with a hand close to the bed to give themselves another minute before they walk around the room.

You will still have an IV with fluid flowing. You should sit in a chair if you're tired but don't feel like sleeping. If you're tired, use the bed to sleep, but if you're not tired, doctors prefer that you try to use the chair. Sitting and walking not only restores confidence, but also helps prevent clots from forming in the legs. You'll be asked to increase your walking daily.

It's time for food, if you feel like eating. The first meal you will eat will be a soft diet of easily chewed foods. If those are tolerated well, you'll advance to eating regular foods.

The Second Day Post-Op
On the second day, the hospital staff and your doctor will evaluate your progress and take a blood test to make sure you haven't lost too much blood. You'll continue to walk the hallways, obviously more than the day before. In some instances, patients may recover so well that they can be discharged at the end of the day, but this is usually reserved for post-op Day 3.

The Third Day Post-Op
On post-op Day 3, you'll be examined, the staples will be removed if necessary, and you'll be given instructions on how to take care of yourself at home. Things to watch out for include fevers, increased vaginal bleeding (more than a period), and pain that is not responding to pain meds that could indicate complications from surgery. The doctor will recommend that you don't lift anything heavier than your baby.

Next: Home care >>

excerpted from:

Reproduced from Absolute Beginner's Guide to Pregnancy, by John Adams and Marta Justak, by permission of Pearson Education. Copyright © 2005 by Que Publishing. Please visit Amazon to order your own copy.

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