C-sections: They Don't Have to Be Scary

Cesarean, Caesarean, or C-section means the delivery of a baby by cutting into the womb. This way of giving birth is becoming more and more common in hospitals. Just because it is more common these days for many different reasons, it is still a MAJOR surgery.

Some C-sections are emergency C-sections. In that case, there is no time getting prepared, gathering facts, or thinking about what is going on. In this case the doctors are concentrating on what needs to be done to save the life of mother and/or baby.

Other C-sections are scheduled or a mother is given a choice to try a vaginal birth or go with cesarean delivery. In these instances, the mother has time to get prepared, do a little research, think, and consult with her doctor as to what to expect. But, the doctors don't tell you everything.

Once you, the mother, are in the hospital and a C-section is planned, several steps are done prior to going into the delivery room. First, the area just below the stomach and just above the hairline, where the incision will be, is disinfected and shaved. Then an I. V. is put in to give pain medicine, fluids, or whatever you may need. Then a catheter is put in place. Catheters can be a little uncomfortable, but not painful. After a few minutes, you don't even realize it is there. Now you wait until the doctors, nurses, and the operating room is ready for you.

When everyone is ready, you are wheeled into the bright, shiny, sterile, and extremely chilly operating room. First thing is that they transfer you to the C-section/operating table. This table looks like something out of a prison movie where the death row guy gets the lethal injection. This is a narrow bed that has long padded boards that extend perpendicular from the bed out each side to strap down each arm, if needed.

Once you are on the bed, the anesthesiologist will begin the process of inserting the epidural or spinal needle into your back. You have to sit on this narrow bed, with your chin to your chest, and your spine curled as much as possible. This is very difficult considering you have a baby in the middle that stops you from curling over. The inserting of the needle is not all that painful. The anesthesiologist says it feels like a bee sting, it doesn't at all. It feels like a little prick, HARDLY any pain. Once the needle is inserted, your back is taped with one large piece of tape that covers most of your lower back. This is to ensure that the needle stays in place. You are then laid down and you immediately start feeling numb from your chest down. The anesthesiologist extends your arms and he may strap them down. He remains by your head to monitor your condition from now to the end of your surgery. This person is now your best friend. If you feel nauseous, tell him and he will slip you something in your I. V. and/or place an alcohol pad on your forehead.

Then when you are down, the nurses start putting up the curtain so that you can't see what is going on with the operation. The curtain is placed at your chin, and goes up about a foot or so, and extends a little longer than shoulder to shoulder. When the curtain is in place, the nurses will then iodine the area of the incision sight, which will be about 6 to 8 inches long. Thick plastic is then laid on top of you to catch the blood and amniotic fluid that comes out.

Now, it's the doctor's turn. They start by talking with you to make you a little less nervous. When he asks how you are doing, or if you feel any pinching, that means that he has started cutting and is probably close to your uterus. The doctor may tell you that he sees a hand or a foot, this means that he is in. At times you may feel pressure from them trying to get the baby in position to pull him out. The pressure may be slight, or it may be intense. Once the baby is out, the pressure will be released.

You will hear the baby cry and the doctor will give you a quick peak at your new little person. The nurses then start cleaning and doing assessments on the baby and the doctor continues to work on you. He will remove the placenta and start stitching, stapling, and cleaning you up. Depending on the anesthesiologist, he may leave you awake for the stitching up or he may knock you out completely. Either way, the next place for you to go is to recovery.

Once in recovery, you will have a nurse at your bedside nonstop for at least an hour to observe you. You will still be hooked up to the catheter until you can get up and walk around. The I.V. will also remain in place. This is now being used to control your pain medicine-Morphine. You are only permitted a dose every few hours. You will be given a button that is hooked to your I.V. so that you can administer the dose yourself. This is called a "pain pump". Also while you are in recovery, they will bring your baby in for you to feed or nurse.

Once your hour is up, the feeling starts returning and you really start experiencing the pain of the incision. You then will be taken to the room that you will stay in for the next 3 or 4 days. The nurses will keep coming in to check on you, change your pads, check your I.V. and vitals. They will also message your belly. This loosens the clots so that they can flow out. This hurts, but it needs to be done.

FYI-The pain from a C-section is not a superficial cut. You are cut VERY deep and you can feel it with every movement. It is a very hard ache that sharpens whenever you move. Advise anyone that has a habit of making you laugh to stay away the first day in the hospital. Laughing will hurt extremely bad.

It is a very good idea to have someone there with you so that they can help put the baby in the bassinet and take him out to feed for you. Due to the incision, you are very limited in the movements you can make. Even though you have the "pain pump", you still experience an incredible amount of pain.

A couple of hours after surgery, a nurse will come and tell you it is time to get up and start moving around. This is not a joke. It is very important that this is done for several reasons.

1. You had MAJOR surgery. When your body was cut open, air was brought into it. When you are stitched up, the air trapped inside. Your body absorbs the air, but it needs to escape. This will escape in the form of gas. Yes, they want you to fart, and as much as you can. If you don't get up and move around, that air just sits there. Eventually, it becomes EXTREMELY painful. This "gas" pain can best be compared to the MOST EXTREME case of menstrual cramps imaginable. This pain, in addition to the C-section incision pain, is a twelve on the one to ten pain scale.

2. Getting up brings circulation in to your legs. If you are in a prone position too long, your risk of blood clots developing in your calves increases. These blood clots can travel through your body and eventually cause death.

3. Getting up and moving around sooner speeds up the healing process.

You will find out that just sitting up is extremely painful. Just take baby steps. When it gets to be too much, stop. Don't quit. Just stop for a moment. Give your body a chance to adjust. When you feel the pain subside, go a little further. Don't rush it. Unless someone has had a C-section before, no one can truly understand how this kind of pain feels. Utilize the bed's side rails to help push off, pull on, or just as support. Have a loved one there for extra support. Another person shouldn't pull or push you. They should be there for YOU to pull on or push off of. THEY ARE JUST FOR SUPPORT!

Once you have made the amazing accomplishment of standing up, you will fill a gush of blood flood out. The nurses expect this and it's normal and it usually stays in the pad. But next comes the art of walking. You never realized how many stomach muscles are used to walk until you take that first step.

After a couple of steps, it's time to rest. To rest, you need to get back in bed, and this is really hard. After 3 C-sections, this is the easiest method to get in-even out-of the hospital bed that I have learned. It is NOT graceful, but it works.

1. Have the bed in an "L-shape" as much as possible: back of the bed straight up, the bottom flat down.

2. With your back toward the bed, slowly lower yourself as close to the handrails and as far back as possible onto the bed.

3. Once you are sitting down, try to push yourself backwards by using the handrails.

4. Lean back so you are against the top of the bed and relax for a moment.

5. Gently pull your legs onto the bed.

6. Use the guardrails to push off of and scoot to get yourself comfortable.

7. One you are on, lower the bed to the position that is most comfortable.

8. Give yourself a boost of pain medicine from your pain pump…if permissible.

In a few more hours, the nurse will be back in to squeeze your belly, change your pad, take your vitals, and get you out of bed once more. When you are able to walk far enough to get the restroom, the catheter will be removed. And eventually your I.V. will be removed too and then you will be able to shower. You will need someone there to help you with the shower the first time. You will still be in A LOT of pain and bending and twisting is not an option for you at this time.

The day after your C-section you should be able to walk. With the I.V. out, you now will be getting pain pills. Not having the I.V. hooked to you, makes getting around a lot easier. You will need to walk the halls at this point. This will help the healing and allow the nurses to monitor your progress better.

The last day of your hospital stay, the staples holding your incision together will be removed. There are usually around twelve staples or so and having them removed is virtually painless. Having the nurse take off the tape hurts worse then the staples themselves. You may find that there are a few stubborn staples that sting a little, but not bad. After the staples are all removed, they are replaced with butterfly tape. Your incision will finish healing with the tape holding it together.

You are now ready to go home. The doctor will give you a prescription for pain pills. Once you are home, you will still be in a great amount of pain. You may find the easiest way to get out of bed is by rolling out, then standing up. Your incision will hurt for awhile. You will notice that the pain will start to subside after being home for about a week, but you will feel it for a few weeks. You will notice that after several showers that the tape holding your incision together, is starting to come off. DON'T PULL IT OFF!! Clip the tape that is already off, and leave the rest to finish healing. If you pull it off, you risk reopening your incision. You will also find that the skin around your incision is numb. This is normal. That skin will remain numb for awhile, maybe indefinitely.

C-sections are amazing! They have saved countless lives for as many reasons. And C-sections are very painful, but NOT unbearable. However, when you know what to expect in advance, they don't have to be scary. It hurts worse then a vaginal birth, the healing time is longer, but you have to same outcome-a beautiful baby! And one positive note-when the baby gets to be a four year old asking, "Mommy, how did I get out of your belly?" All you have to say is "Honey, the doctor cut you out." End of story!