When I got pregnant, I was happy to tell everyone. I was thinking now I can finally go through what every one of my friends told me about - I was only told good things!. I was especially thinking of my cousin who said the birth of her daughter happened in 45 minutes. I immediately thought to myself, we’re related! so the same may happen to me. To my surprise, I was not a candidate for the ‘pushing’ option. I had previously undergone a myomectomy so my OB/GYN informed me my only option was a C-Section. I began reading the next day, no matter how much reading you do nothing can prepare you for the experience.
Here are a few of my surprises:
I’ve been seeing my OB/GYN all 9 months and on the day of my scheduled surgery, she called out. Apparently, she had something more urgent to do than delivering my baby. So instead I got the doctor that was on ‘call’ that day. She tried to re-assure me of how great she was and how everyone would do their best to take care of me. It was not the same, 'who was this woman and why was she talking to me'.
I had my daughter at a teaching hospital, it felt more like a classroom. Peering eyes everywhere, tons of introductions only thing missing was the blackboard.
The after pain when the drugs wore off, hurt like hell. All I did was press that call button all day long. At the onset of any pain, it was on.
I was shaking uncontrollably during surgery. The anesthesiologist said it was totally normal, at one point I felt tears down my face. In fact, it got so bad they had to request a few warm blankets to cover me up.
When I got home I missed the hospital bed - for the 4 days I was in the hospital the bed was positioned perfectly for my maximum comfort. If I wanted my legs high or low; press a button, for my mid-section, that same button, my upper body, you get what I’m saying. Transferring home to my own bed, it was a disaster plus very painful. I tried using pillows to get the same effect, never mind trying to get out of bed.
I was given a blood transfusion. Apparently, after most cesarean surgery your blood count reduces. On day two I was informed by my doc my insurance only covers a maximum of 4 days for C-Section. So I need to have the transfusion today - day two so that they can monitor my levels on day three and fingers crossed release me on day four. Thought about it long and hard, even though I reassured the doctor that I’ll eat lots of iron-fortified foods when I got home, that didn’t fly. You have to leave the hospital with an acceptable level and mine was nowhere near that.
Overall it was a good learning experience for me.
TIPS TO PREPARE FOR YOUR C-SECTION
BEFORE THE BIG DAY
- Maintain a healthy diet throughout pregnancy. Make sure you are getting enough protein each day. You want your body to go into surgery as healthy as possible, and having a good foundation of nutrition is the best way to do that. Being overweight can increase complications during and after surgery.
- Work on gentle core stabilization activities. Find a Physical Therapist who specializes in prenatal strength training so you can properly strengthen the core and decrease your chances of developing diastasis recti.
- Stretch regularly. You will be sore and stiff after surgery. The better you can move around before surgery, the better you will feel after surgery.
- Come up with a birth plan. Just because you don’t have a vaginal birth doesn’t mean you don’t have options when it comes to caring for you and your baby. Who do you want with you in the OR? Do you want a clear drape or an opaque drape? Do you want a mirror to watch the birth? Are you planning to breastfeed? If so, when would you like to start? What are your baby care requests? i.e., delayed cord clamping, holding off on a bath, avoiding a pacifier.
- Prepare your home for your post-op status. You will have lifting and movement restrictions. Before your baby comes, make sure you arrange your home so that it is functional for you. Do you have more than one story in your home? Can you make arrangements for most, if not all, tasks to be completed in the same area? Re-arrange furniture and place items in easy to reach places to avoid excessive reaching and stretching after surgery.
- Meal plan ahead of time. Stock your pantry and fridge with items you will need immediately after coming home from the hospital. Assemble freezer meals for quick and simple meal preparation after birth. Ask local friends to create a meal train to bring prepared food to your home.
- Pack a bag suitable for post-op care. Include high waisted pants and underwear that will sit far above your incision. Pack a couple of nightgowns to avoid having a waistband altogether.
- Enjoy your supper the night before surgery. It will be the last big meal you have for a while. Choose foods that are satisfying and filling. Usually, you won’t be able to eat or drink anything 12 hours before surgery. So, take the time to enjoy your last supper before the operation.
- Wake up 15 minutes before your “no eating or drinking deadline” and have a snack and some water. I wasn’t allowed to eat or drink anything 8 hours before arriving at the hospital, so I got up at 2 am (yes, really) to have a big cup of water and some toast. I knew not eating or drinking for such a long period, as well as being nervous for the surgery, would make me nauseated. So, I had a middle of the night snack to curb it.
- Choose your curtain: clear or opaque. Clear if you want to see the operation. Opaque if you don’t want to know what’s going on behind the curtain. You can ask the doctor to drop the screen when they pull your baby out so you can see your little one as soon as he or she comes out. I always put this in my birth plan that I give to the doctor ahead of time.
- Mentally prepare. Your c-section may be easy, well planned. Your c-section may be last minute, urgent, and scary. Continue to talk positively to yourself and know your body can do this.
THE DAY OF YOUR C-SECTION
- Breathe. This is my #1 tip. Just focus on breathing. Breathe in. Breathe out. Repeat. Smell the roses. Blow out the birthday candles. When you get scared, breathe. When you get nervous, breathe. Focus on your breathing the entire time to help stay relaxed.
- Take pictures. If allowed, and if you want, take pictures in the OR. If you had a vaginal birth in a normal room, you would probably take some pictures. At least a selfie of some sort, right? So, take pictures in the OR to memorialize your special moment.
- Be prepared to enter the OR without your +1. When the nurse came to our pre-op room, to take us to the OR, she instructed my husband to put on scrubs, and she would come back for him. I had to walk from the pre-op room to the OR by myself. I wasn’t prepared for this. In my mind, I thought my husband and I would go in together. I wouldn’t be alone. That didn’t happen. I panicked a little. Were they going to bring him in before they started? Was I going to be alone the whole time? Ask your pre-op care team what the procedure is so that you can be prepared.
- Tell the anesthesiologist if you are nervous. He or she will be at the head of the table during your birth. I told mine I was nervous when I came into the OR. He was able to talk to me during the procedure, regularly check in on me, and continue to reassure me that things looked great. My anesthesiologist was like a little angel on my shoulder.
- If you are claustrophobic, don’t try to wiggle your toes. It will only cause you to freak out. So tell yourself, “I’m fine. I can wiggle my toes, but I am choosing not to.” Trick yourself into forgetting that you won’t be able to move the bottom half of your body.
- You may feel pressure and pull during the procedure. If this makes you freak out, distract yourself. Go back to focusing on your breathing pattern. In and out. In and out.
- You can ask for the skin to skin contact as soon as your baby is born. Depending on the status of your little one when he or she comes out, the OR staff may be able to accommodate this request. Sometimes they need to stabilize the baby before bringing him or her over to you. So, you may have to wait a little bit. Be prepared for that. But, early skin to skin contact will be beneficial for both you and baby.
- If you plan on breastfeeding, ask to breastfeed immediately in the OR. Chulengo latched on while my doctor was sewing me up. I didn’t mentally prepare to breastfeed, so this took me by surprise and was a nice distraction from the doctor sewing me up. Doing this in the OR also set the tone with my care team that I was serious about breastfeeding.
AFTER YOUR C-SECTION
- Stay ahead of your pain. You will be hooked up to a pain pump the first day and then switched to oral pills the second day. The day of surgery, don’t wait for the pain to come on before you push the pain button. You just had major surgery; you are going to be uncomfortable. Click it every 4-6 hours, like your nurse, will probably recommend. Also, try non-medicinal pain control methods like ice, gentle movement, massaging areas away from the site of incision, and breathing patterns.
- Ask questions about the recommended medication. What are the benefits? What are the side effects? Is it safe during breastfeeding? How often should you take it? Your nurse will come in regularly to give medications to you, but don’t be afraid to ask lots of questions. It’s important to know what you are putting in your body.
- Stay hydrated. Drink water and lots of it! The more hydrated you are, the better you will feel. Hopefully, you will love your hospital mug as much as I do and drinking water won’t be a problem.
- Walk, walk, walk. You won’t be able to walk until the next day because the anesthesia has to wear off. But once you get the clearance to get up, do it!
- Stool softeners are your best friend. Your bowel movements may be super uncomfortable. You want to avoid bearing down to pass your stool because that can lead to hemorrhoids, pain, and injury to your rectum. Include natural stool softening foods in your diet like prunes, pears, and soup.
- Request cranberry juice to help avoid UTI from the catheter. Just as a precaution. Because you had a catheter in during the surgery and a little bit of time afterward, there is always a risk for a UTI. Cranberry juice is often recommended when patients have a UTI. Doesn’t hurt to include in your diet to use as a precaution.
- Your postpartum nurse will do regular pushes on your abdomen to help push out blood clots. This can be uncomfortable but it is necessary for your uterus. Breathe through the discomfort.
- You will retain water for at least a couple of days. You will be swollen. Be gentle with yourself. You just gave birth to a baby. The water retention should continue to decrease. Check with your doctor if you notice an increase in fluid retention.
- Wear the abdominal binder. I wore the binder the day I left the hospital and every day for six weeks. If I was up, I was wearing a binder. Transitioning from one position to another was much easier with the binder on. The binder is there to serve as a support for your core muscles that are healing from the trauma of surgery. As a physical therapist, not just a previous patient, I recommend — wear the binder!
- No heavy lifting. You aren’t allowed to lift anything heavier than your baby. So no diaper bag, car seat, laundry baskets…you get the idea. The length of these restrictions depends on your doctor’s recommendation.
- Ask for help. If you have loved ones available to help you, don’t be afraid to ask them for assistance. You just had major surgery. Your body needs to recover. Your baby needs you to recover safely. Let other people help you. Have family come and stay with you. Invite a friend over to help you out. Hire a mother’s helper if you don’t have friends or family available. People don’t always know if you need help, so don’t be afraid to ask.
- Use a step stool at home. Avoid reaching by having a small, lightweight step stool easily accessible. You may not always have someone available to reach up high for you, use the step stool to safely get items from above without reaching.
- Sneezing, laughing, and coughing are uncomfortable. Brace yourself…literally. Hug a pillow when you sneeze, laugh, or cough to make it less painful.
- Don’t sit up using your abs, roll to your side. Sitting straight up from a lying down position requires you to use your rectus abdominis. Your doctor had to really stretch these muscles to get to your uterus. Therefore they are traumatized. Be nice to your abs and give them a break. When lying down, roll to your side and sit up by pushing your upper body into sitting using your arms. And when you need to lie down, sit first, then lower your body, using your arms, into a side-lying position on the bed, then roll onto your back.
- No driving for up to two weeks afterward. I didn’t realize I wouldn’t be able to drive, but it makes sense. Thankfully, my mom was able to drive me to appointments as needed when my husband had to go back to work. Thank goodness for car-sharing apps, online ordering, and food delivery.
- You may experience some swelling around your incision. I remember I had a little pocket of fluid that surrounded my incision. My doctor assured me that it was nothing to worry about but advised me to contact her if it got worse.
- Remember, although your birthing experience was not traditional, it was very real. Just because your experience was different than most, doesn’t mean it wasn’t important or easier. You are a warrior mama; you got this!
I know, I know…it’s a TON of information. But, I want to give you all of the tips I wish I had beforehand. If you think about it, a c-section is a doctor operating on TWO people - you and the baby. The more prepared and calm. you are, the easier the experience.