What to Expect During a C-Section
According to the Centers for Disease Control, there were 1, 272, 503 Cesarean births in the United States in 2015, accounting for almost one-third of all births. While many of these C-sections are performed in emergencies, many are scheduled for a wide variety of reasons. If you’re joining the ranks of one in three women who have a C-section birth, what can you expect? What can you do to make your experience and your recovery easier?
What should you do before the procedure to prepare?
Long before your surgery, be sure you are staying as active and exercising as much as your doctor recommends. Susie Gronski, DPT, PRPC, says, “Motion is lotion.” She explains that staying active during your pregnancy means you have more physical and psychological resilience, so you recover more quickly. She recommends working on posture, core stability, proprioception and balance, and pelvic floor function. She also suggest that you focus on what you are eating, so you maintain a “healthy gut micro biome,” which speeds recovery by reducing inflammation and improving your immune system. Her suggestions include sticking to “real” food, in its natural form whenever possible, and limiting sugar intake, especially that of fructose and lactose.
Sara Twogood, MD, OB/GYN, concurs with the need to stay healthy and active throughout your pregnancy. She also recommends writing down any questions you have and asking them in the doctor’s office before birth day, when you are likely to be more relaxed.
What happens before the procedure begins?
Actually, some of the preparation will take place the night before. Kristen Oliphant, a C-section mom, shared from her experience that you will need to stop eating at least 8 hours before your scheduled surgery. You may be given special wipes, although other experts report no need for special skin treatments ahead of time. Some doctors or hospitals may say to skip the lotions, powders and deodorants, as well.
Dr. Twogood points out that your day will begin with some administrative tasks. You will check into the hospital room, where a nurse will ask you a series of questions, as well as starting an IV and drawing blood for lab tests. The IV fluid will likely include a medication designed to help reduce your reactions to the anesthesia. There will also be forms to sign – probably lots of forms; your doctor and the anesthesiologist will also come in to talk with you.
Next, you will either walk or be wheeled into the operating room. “It is not uncommon for a scheduled C-section to be delayed due to emergent situations on the labor and delivery floors, so try not to worry if the team is running behind,” says Dr. Twogood. She also mentions that your birthing partner/coach will be asked to remain outside the OR for this next preparation period.
According to Sheetal DeCaria, MD, a board-certified anesthesiologist, you will next receive your anesthesia. “It is typically preferable for women to have an epidural or spinal so that they can be awake during the surgery and meet the baby immediately after they are delivered, but are numb from the chest down to their feet so the surgery is painless.” On his website, Babymed.com, Amos Grunebaum, MD, explains that a spinal anesthesia works in minutes, but may take longer to wear off, and it is usually administered in a single does, while an epidural is administered through a spinal catheter and provides a continual flow of pain medications. The epidural may take as long as 1 1/2 hours to reach its maximum effect. In some circumstances, a patient might require a general anesthesia and a breathing tube.
Who will be in the operating room?
According to Dr. DeCaria, you can expect a pretty good-sized crowd to be with you for your baby’s birth. Your birthing partner/coach will be there, if you choose, along with a number of medical personnel: an anesthesiologist or nurse anesthetist, the obstetrician, the obstetrician’s surgical assistant, a surgical tech, and an operating room nurse. In some cases, there might also be a pediatrician on hand. If you are having the surgery in a teaching hospital, you may also be joined by residents, medical students, attending physicians, and nursing students.
What happens in the operating room?
Once you’re settled on the operating table, you will receive a dose of antibiotics, if they haven’t already been administered. Your belly will be cleaned with an antiseptic, usually povidone-iodine (Betadineｮ), and a surgical drape will be placed in that area, as well. Your birthing partner will be invited in, and the surgery will begin. Dr.. Twogood reports that a C-section usually takes 20 to 40 minutes, although there are factors that may cause it to take a bit longer.
During this time, you’ll feel some pressure and touching, but you should not experience pain. If you do, the anesthesia provider can increase the medication. Typically, you’ll get the chance to see baby before the nurse takes him or her to the side to check vital signs and do the usual new baby assessments. After that, you and your newest family member will be taken to the recovery room. Dr. Twogood points out that it is normal to spend several hours there before being transferred to your postpartum room. You will receive pain medications, and you will be able to begin breastfeeding, if you’ve chosen that route.
What can you do to speed your recovery?
Most likely, you’ll spend several days in the hospital; in fact, your baby may be ready to go home before you are. Dr. Twogood says, Getting out of bed and ambulating a bit can help recovery and prevent post op complications. I encourage patients to get out of bed about 24 hours after their C-section. I also encourage patients to take pain medications when they need it. When a patient’s pain is uncontrolled it is a harder and slower recovery. The medications are temporary and are usually needed for the first week or so.”
Dr. Gronski has more postpartum advice, as well. She suggests abdominal massage, especially near the surgical scar – not directly on the scar itself and not too aggressively; you may also enjoy using pure Vitamin E oil or coconut oil. She goes on to say, “Myofascial release work and visceral manipulation to work on adhesions. As a visceral manipulation practitioner I feel for altered or diminished motion within the viscera as well as any restrictions in the entire body that might be leading to dysfunction, pain, and tissue restriction. Releasing these tissue tensions will help create an environment optimal for healing and recovery.” Finally, she recommends diaphragmatic breathing to aid with abdominal healing.
The experts also recommend avoiding heavy lifting, bending, and intense exercise for at least six weeks. After the first few days at home, take advantage of any offers of assistance, especially with lifting and bending. And, remember – you’ve had major surgery. It’s perfectly fine to ask potential visitors to wait until you feel up to guests. This is your time to heal and to bond, so set the rules that work best for you.
Pam Martin has been writing professionally since the early 1980s, on a wide variety of topics. She brings 20 years of classroom teaching and tutoring experience to the party, including early elementary classes and courses in writing, reading and literature, history, geography and government at middle and high schools. She is also accomplished in crafting and in writing about projects, including her blogs, Roots and Wings From the Village, The Corner Classroom, and Sassy Scribbler, which encompass crafting, cooking, lesson plans, and professional writing advice.
