WHAT IS A CESAREAN BIRTH?
A Cesarean Section is a birth through a surgical incision in the mother's abdominal wall. Cesareans are performed when a vaginal delivery is not possible or when there is concern for the mother's health or the baby's well-being.
During this surgery several layers of tissue are incised and then after the baby is delivered, the layers are sewn back together. This can cause a great deal of discomfort in the postpartum period. Also, the uterus, now having a row of stitches in this muscles, will be contracting to return to its pre-pregnant state.
PAIN RELIEF AFTER SURGERY
Immediately after surgery, if you have had regional anesthesia, you may continue to be numb for an hour or two while you recover. During the immediate postpartum period, after the regional anesthesia has worn off, there are several ways your pain can be managed and different women will have different levels of pain from a Cesarean Section. For some women pain can be managed with oral pain medication or medication taken by injections. Because these medications often include narcotics, they may make you drowsy. Most of the time narcotic medications cannot be dispensed routinely around the clock, but must be dispensed "as needed", or when you ask for them, at predetermined intervals. Don't wait until your pain is unbearable to ask for pain medication. The sooner you ask for pain medication, that is, the lower your pain level, the less medication it will take to control your pain.
Sometimes your pain may be controlled by a continuous, patient controlled pump. If you had an epidural for your Cesarean Section, it may be left in place and a narcotic used in the epidural catheter to provide pain relief. A small amount of medication is injected continuously and when you need additional medication you would push a button to give yourself another dose. The pump is pre-programmed so that you cannot give yourself too much medication. A similar pump can be used which is connected to your IV if you did not have an epidural. With both patient-controlled pain pumps, the most important thing to remember is that you should be the only one to push the button to give yourself a dose of medication. If you are dozing or sleeping, no one else should be pressing the button to give you additional medication. This could result in a level of sedation that could interfere with breathing.
CAN I TAKE PAIN MEDICATION IF I AM BREASTFEEDING?
According to The American Academy of Pediatrics, not only is it safe for breastfeeding mothers to use pain medications prescribed by their doctors, it is important for mothers to have proper pain management so they you can care for and feed their baby. You will not build up a significant amount of narcotic in your breastmilk to affect your baby at this point.
NON-PHARMACOLOGICAL METHODS FOR PAIN MANAGEMENT
When a person has had surgery, our natural first thought for pain management is for medication, but there are non-pharmacological methods and factors to be considered as well. Whoever will be with you during your recovery can help you to create a "culture of comfort" in your room. This will aid any other pain management that you currently have in place. Some things to think about:
- Is your clothing comfortable? Wear loose, non-binding clothing in the hospital.
- Is the temperature of the room comfortable for you? You don't need to keep your hospital room warmer for the baby. In fact, most pediatricians recommended a cooler temperature for babies rather than a warmer one to help prevent infection. If they room is too warm for you, or too cold, you will not feel comfortable enough to sleep and rest. Do not keep the room warmer or cooler than you would like for the sake of your visitors.
- Is there too much light for you? If there are shades or curtains in the room, they can be pulled shut and lights and be turned off. Do not keep lights on in the room for visitors at the sake of your own comfort and rest. You are the one who has had surgery and you are the one who needs to recover.
- Are you hungry? If you are allowed to eat and you are hungry, ask your nurse if there is something on the unit you can eat, or if your family is allowed to bring you any food. Often on the first day after surgery patients are only allowed to drink liquids and eat things they can see through such as jello, broth and popsicles.
- Are the sounds of the hospital waking you? Most hospitals will allow you to bring CD players or MP3 players. Bring the music of your own choice so that you can drown out any sounds from the hallways or intercoms.
- Are you having too many visitors? Often it is difficult to tell your visitors you would like to rest and sleep. Ask your nurse to place a sign on your door that says, "Check with nurse before entering". This will often stop many visitors. The nurse can explain that you have requested to rest and she will be glad to convey any message to you they would like to leave.
One of the best ways, when your physician allows, is to get out of bed and walk. Walking will help to stretch and strengthen your muscles and will make you feel much better. Take a minute or two the first thing each morning as you get out of bed and straighten all the way up (you may feel as if your intestines will fall out of your abdomen the first time you do this, but they won't!) That will help prevent much of the soreness for the rest of the day.
Remember, the first day after your surgery is the most difficult day. Every day after that will get easier and easier. You will find that each day you will need less and less pain medication and you will feel better and better. If you do too much in your recovery period, however, you may find yourself especially fatigued. Limit yourself to those activities allowed by your physician and try to rest as much as you can when your baby rests.
