How to Survive a C-section

Cesarean is a major abdominal surgery that is becoming quite common these days. The aftercare is important, and that means sufficient rest for a speedier recuperation. External scars are the stitches/staples closing the skin and do not form the whole picture. There are layers of muscle and fat, and a uterus, which all have been cut during surgery, and there are layers of stitches inside you. If your aftercare has been properly managed severe pain should not be an issue.

Dealing with the Stitches and Incision

• In the early days the surface scar may appear intimidating: bruised, raised and dark in color. Once the tape and dressing are removed it is important to keep the stitches dry and clean. Suture removal occurs four to six days. The removal is a painless procedure, at the most a pinching sensation. Dissolvable stitches will dissolve on its own like the internal stitches. Even after the sutures are removed, it is still imperative to keep a close eye on your scar, as it will still be healing.
• The scar will start to itch in the first few weeks. Don't be tempted to scratch, rub or pick at the scar since it must be left alone to heal.
• You can expect a little bit of spot bleeding as long as the wound is not tearing apart. Avoid using any cream besides the antiseptic cream prescribed by your doctor.
• It is important to have adequate rest after a C-section to avoid excessive vaginal bleeding. If bleeding increases it can mean you are doing too much too soon - take the cue and rest more.
• If you notice any abnormalities with your scar e.g. it becomes inflamed, starts to pus or leak, or you develop a temperature report it to your doctor at the earliest.
• As mentioned, internal layers of fat, muscle and finally the uterus will be cut to get the baby out, after which these layers will be restitched using soluble stitches. Finally the external layer of skin will be stitched or clipped. A vital step to surviving a c-section is to request for dissolvable stitches instead of staples. The advantage of dissolvable stitches is the incision heals more quickly and is somewhat less painful.
• A very important step you should take after your op is to try your very best to be as mobile as quickly as possible. This helps the circulation in the body, which in turn helps the incision to heal quicker and restore your bowel and bladder functions. Avoid leaning forward when you walk. Walk short distances but frequently.
• Do not strain your incisions by lifting heavy objects or exercising until your doctor approves. Avoid driving until you have checked with your doctor.
• When standing or if you cough or laugh or sneeze, you will want to push a pillow against your stomach or place your hands over the incision site to avoid sudden discomforts.
• Many cesarean patients experience numbness around the incision and even in the abdomen for quite some time after surgery. The nerves and muscles were cut and it takes time for them to regrow and for numbness to go away. Aching and soreness at the site of incision is a common experience and may continue for weeks or months.

Dealing with the Pain and Discomfort

• Pain usually kicks in about 48 hours when the effects of epidural and IV anesthesia wear off. After the surgery you will be offered pain relief such as paracetemol (and something stronger like codeine in the initial stages when the anesthesia wears off) at regular intervals. Inform your midwife as soon you feel any pain so that proper pain relief can be arranged in time, and with your pain under control, you will be able to move about and around faster. Immobility gives rise to risk such as deep vein thrombosis or DVT and slows down the recovery rate.
• Gas accumulates and settles around the incision region, causing you a lot of pain and discomfort, not to mention the bloated look and feeling; your body needs to expel the gas. Besides moving around, you could also push a pillow or cushion against your tummy and request your midwife for antacid to provide the relief.
  
• Feeling constipated and fear of the first bowel movement following the surgery is quite typical. It becomes vital, once you have a c-section, to drink as much fluids as possible. Stick to soft foods in the initial days until you are ready to eat a normal diet. This can assist in ensuring your body returns to normalcy as soon as possible. You could also request for a stool softener to help BM.
• It is very hard to sit up and get out of bed for several weeks post-op. The best alternative is to have something to pull up on so that the arms and not the stomach muscles are strained. The railings on the side of hospital beds are of great help. At home you can perhaps depend on your partner to help you get up or alternatively when getting out of bed, move on to your side and use your elbow to support yourself up, and then gradually lower your legs onto the floor to avoid straining your abdominal muscles.