Caesarean Section Your Path to Recovery Name: _ Primary Nurse: _ Family Doctor: _ Women s and Children s Program Richmond Hospital 7000 Westminster Highway Richmond BC V6X 1A2 Tel: 604-278-9711
INTRODUCTION Welcome to 3 Maternity This booklet is to help you understand what happens after you have had a baby born by Caesarean section. A Caesarean delivery may be unplanned. When this happens, some women feel guilty, depressed or experience a sense of failure. These are all normal feelings. The best way to get over these feelings is to talk with someone you trust and spend time with your baby. INFORMATION You will find helpful information in several other pamphlets or handbooks your nurse will give you in the hospital. Welcome to Maternity Exercises for After Your Caesarean birth Baby s Best Chance Remember that when you deliver your child by Caesarean, you are still giving birth. You will be staying in the hospital about 3 days and will be ready to go home when: Your incision is healed Your uterus is firm and below your belly button You are having minimal bleeding Your pain is managed with oral pain medicine You are able to move about your room by yourself Your appetite has returned Your baby and you require less help with latching and breastfeeding This pamphlet outlines the care you will receive while in the hospital. Every person is different, so your treatment plan may be slightly different than the one outlined here. 2 3
DAY ONE Checks The nurses do the following checks frequently to make sure you are making a good recovery. Monitor your vital signs (pulse, blood pressure, and temperature) Press on your abdomen to make sure your uterus is shrinking in size Check your vaginal discharge to make sure it is decreasing in amount Check your Foley catheter (the tube in your bladder) to make sure it is draining properly Check the dressing on your incision Check your IV (intravenous infusion) to make sure it is running well Teaching Deep Breathing and Coughing: Your nurse will teach you how to do these exercises Breastfeeding: It is important to have skin-to-skin contact with the baby as soon and as frequently as possible today. Peri-care: Tell your nurse if you have passed any clots or large amounts of blood on your peri-pad or in the toilet. Use the peri-wash bottle after you go to the bathroom. Care of baby: You may find it physically hard to care for the baby today. Your support person can help and learn the care of the baby along with you. The nurse will ask you to keep track of the baby s feedings and diaper changes to monitor your baby s progress. AFTER SURGERY THE FIRST 24 HOURS Common Questions What can I eat? You should not eat straight away, start with sips of fluids. You should be hungry and want to eat a regular diet within 24 hours. Discuss eating with your nurse or doctor. What about going to the bathroom? You will have a catheter that will allow the urine to drain out of your bladder for 12 24 hours. You will probably not need to have a bowel movement today. Talk to your nurse if you get constipated easily. What activities can I do? It is a good idea to get up and walk around your room about 8 hours after your delivery. The nurse will help you with this, as you may feel a bit dizzy. You can start to do some easy exercises they are explained in the exercise handout you will get from your nurse. How should I deal with the pain? Most women have some pain after their Caesarean section. Your Anesthetist will give you medication that will help. This should last up to 24 hours. This medicine may make you feel sick or itchy; your nurse can give you another medicine that will relieve these symptoms. The medicines that are given during the surgery may affect your breathing. You may need oxygen. You can also start taking acetaminophen or ibuprofen. This usually works the best if you take it every 4 hours. 4 5
6 DAY TWO Checks The nurse does the following checks at least every 12 hours to make sure you are having a good recovery. Monitor your vital signs Check your uterus Check your vaginal discharge Remove your Foley catheter and then check you are passing urine without difficulty Remove the dressing on your incision or infection. Teaching The nurse will teach or review the following: Breastfeeding: How to get the baby to latch on properly Different positions for breastfeeding Burping the baby How often to feed the baby and for how long How to tell if the baby is getting enough milk How to care for your nipples and prevent engorgement Care of baby: Bathing Diapering Cord care Positioning for sleep How to lift, hold, and carry the baby Baby behaviours (crying, sleeping, feeding cues) Signs of jaundice Feeding Signs that baby is getting enough to eat The importance of noting wet and dirty diapers 24 48 HOURS AFTER SURGERY Common Questions What can I eat? Today you can eat whatever you want. If you are breastfeeding, you may find you are hungry and may need to eat more than you usually do. Remember to drink plenty of fluids. You may have food bought from home if you wish What about going to the bathroom? You will probably have your catheter removed today. If you find it is stinging or hurting when you urinate, tell your nurse. You may have a bowel movement today or tomorrow. If you have hemorrhoids, let your nurse know and she can provide you with some medicine for treatment. What activities can I do? You can move freely about your room and the ward. You should be able to shower 24 hours after surgery. If you still feel dizzy ask for help. Do your exercises as outlined in the Exercises after your Caesarean Birth pamphlet. How should I deal with the pain? You may keep taking acetaminophen or ibuprofen to manage the pain. This usually works best if you take it every 4 hours. You may need some codeine. Will I have any tests? You may have a blood test today. Baby will have a Newborn Screening test done after 24 hours of age. For more information on this test, read the What is Newborn Screening? pamphlet. 7
DAY THREE Most women go home 3 days after their Caesarean section. Checks The nurse does the following to make sure you are able to go home. Monitor your vital signs Check your uterus Check your vaginal discharge Check you are passing urine without difficulty Check you have had a bowel movement or you are passing gas Remove your staples or sutures Check your incision for signs of healing or infection. Teaching Breastfeeding: You may feel that your breasts are changing. (This usually happens two to three days after the baby is born.) Your breasts may feel tender and fuller as they begin to produce milk for your baby. You are probably finding it easier to latch and position the baby during breastfeeding. Continue to ask your nurse for help, as most women usually need help with this for a while. If your breasts have started to fill and are firmer, you may find it harder to get the baby to latch on ask your nurse for tips on how to deal with this. Care of baby: You should be able to provide most of the care for your baby by yourself or with help from your support person. The nurse is still available to help you and review what you have learned in the last two days. 48 72 HOURS AFTER SURGERY Common Questions What can I eat? Today you can eat whatever you want. If you are breastfeeding, you may find you are hungry and may need to eat more than you usually do. Remember to drink plenty of fluids. You may have food bought from home if you wish. What about going to the bathroom? If you are having any stinging while urinating, tell the nurse. You may also need to treat hemorrhoids if you have them. An enema may be required to relieve constipation. What activities can I do? You can walk about the unit and shower whenever you like. Remember to keep doing your exercises. How should I deal with the pain? You may find that you are starting to feel less pain. Keep taking your acetaminophen or ibuprofen to keep you comfortable as you begin to do more walking and exercising. What are baby blues? Many women feel restless, irritable, tearful, tired, discouraged, depressed, or helpless after their delivery. This is often referred to as baby blues. This is normal and almost always goes away on its own. If these feelings last for more than a few days, you should talk to your doctor, midwife, or Healthy Beginning nurse. Baby s Best Chance has some good information on baby blues. 8 9
Discharge to Home GOING HOME Breastfeeding You are now more comfortable with latching and positioning the baby for breastfeeding by yourself. You breast may be very full with milk, making latching more difficult. Ask the nurse for tips on how to deal with this before you leave. There are more tips in the Baby s Best Chance section on breastfeeding. Care of baby It is normal to feel nervous about going home with your new baby. You may have never spent any time with babies before you had your own, or it has been many years since you cared for a new baby. New mothers often feel overwhelmed with all the responsibility of taking care of a new baby. Share your feelings with your partner and/or other family members. Whenever possible, ask for help and share in the joy of caring for a new baby. INFORMATION Resources For After You Go Home: The Healthy Beginning nurse will come to visit you at home. The nurse will check on how you and your baby are doing and answer any questions you may have. Baby s Best Chance has lots of great information on caring for a new baby. Your family doctor can help answer many of your questions about you and your baby. Make an appointment to see your doctor several days after you are discharged from the hospital. As you think of a question, write it down so you can ask your doctor during your visit sometimes it is hard to remember all your questions. Car Seat Your new baby will need to leave the hospital in an approved car seat. The nurse can assist you and will check the baby in the car seat before you leave the hospital. Other Resources: Available from Healthy Beginning Nurse LaLeche League Breastfeeding Clinics/Classes Baby Drop-in Groups New Born Hotline 10 11
For more copies, go online at http://vch.eduhealth.ca or email phem@vch.ca and quote Catalogue No. GH.356.C116 Vancouver Coastal Health, January 2005 The information in this document is intended solely for the person to whom it was given by the health care team. www.vch.ca