Caesarean Section

Find out what to expect when you are having a C-section.

Preoperative Information

A Caesarean Section is the surgical delivery of your baby through a cut in your abdomen. The cut is usually made just below your bikini line.

What to do at home:

Prior to your C-section you will be advised to bath and use an antiseptic soap. It is best to not shave your pubic hair 24 hours before the operation. This may increase the risk of surgical site infection. If your pubic hair needs to be removed, it will be trimmed by the gynaecologist just before the C-section.

What to expect at the hospital:

At the hospital, your abdomen will be cleansed, and a catheter will be inserted into your bladder to collect urine. Intravenous (IV) lines will be placed in a vein, either in your hand or arm, providing you with fluid and medication.

C-sections are normally done using a regional anaesthetic which can either be spinal or epidural. It numbs the lower part of your body and allows you to be awake during the operation.

The advantage of this is that the C-section delivery will be safer for you and your baby. Your partner or birth companion can also be in theatre with you. We encourage you to bring a birth companion to theatre, this will ensure that you are comfortable and feel well supported.

What to expect during surgery:

During the operation you will feel touch and some pressure, but not pain. Please alert the anaesthetist if you do feel any pain, so that it can promptly be attended to.

Duration of surgery

The operation will last about 1 hour. Your baby will be examined by the paediatrician straight after the delivery and will then be handed over to you and your partner.

Postoperative Information

After the C-section, you may still need to stay in the hospital for a few days. Your recovery will carefully be monitored in the unit, until you recover from the anaesthetic. Pain relief will also be offered to you. Options include patient-controlled analgesia (PCA) and non-steroidal anti-inflammatory drugs.

Once the anaesthetic begins to wear off, you’ll be advised to drink plenty of fluids. This helps to prevent constipation and deep vein thrombosis. If the doctors see that all is well after 24 hours, the drip and bladder catheter will be removed. You will be encouraged to get out of bed, slowly walk around, and have breakfast.

Expect some vaginal bleeding. If the bleeding is excessive and you are passing clots, inform either the midwife or the gynaecologist.

You can start breastfeeding your baby as soon as you feel ready. After a C-section breastfeeding might be difficult, however the midwife will be able to assist you with this.

When you go home

It is very important that someone is available to help at home. To ensure that you recover fully:

• Avoid driving, doing domestic chores, and do not lift anything heavy.
• Take it easy and rest as much as possible.
• Avoid having sex for six weeks after your C-section, this will prevent infection.

Recovery

You can expect to stay in the hospital for three days. This might be longer if there are any complications with the operation. Full recovery is usually achieved within six weeks.

Before being discharged, the doctor or nurse will discuss wound care with you. Your wound will usually have dissolvable sutures, meaning that they do not need to be removed.

Warning signs and symptoms

It is very important to monitor your health and the wound. Contact your doctor if you notice any of these symptoms:

• Your wound is red, swollen, or leaking discharge
• You have a fever
• Severe wound pain
• Lower abdominal pain
• Vaginal bleeding or offensive discharge
• Cough or shortness of breath
• Painful or swollen calves

Severe mood swings, loss of appetite, overwhelming fatigue and feeling a lack of joy can be signs of postpartum depression. Consult your doctor is you are experiencing these signs.

Follow up

You will come for a postnatal check-up six weeks after the C-section.

This information was kindly supplied by:

Dr K Essel, Gynaecologist and Obstetrician
MBChB (WITS), FCOG (SA), MMED (UCT)
Lenmed Zamokuhle Private Hospital
Tel: +27 11 (0) 923 7804
Email: [email protected]
Website: www.jhbobgyn.co.za