Recovering From a Cesarean Birth: Tips on Healing

Cesarean birth is major abdominal surgery. New mothers need and deserve to have extra support during this special time of birth and healing. Women who have experienced either a planned or an unplanned cesarean section react to the surgery in very individual ways. Some women physically heal very quickly; others report that recovery took several weeks or even months. Avoid putting time limits on yourself. Emotionally, women’s feelings about their cesarean sections vary in range from acceptance, to disappointment, to devastation. Some women need as much emotional support as physical support for a healthy recovery. Each woman heals and grows into her new role of motherhood at her own pace. In time, you will regain your energy level and sense of well being.

To Relieve Pain and Assist Physical Healing:

At hospital:

* Ask for physical assistance, and keep nurses’ call button within easy reach.
* Take pain medication as needed for comfort. Try to avoid pain medications containing codeine as they cause constipation, making it hard to void after cesarean surgery.
* If possible, obtain a private room so that a family member may remain with you.
* Use pillows to support your abdomen when turning, standing, coughing, and when feeding the baby.
* Rest as much as possible and limit visitors. Sleep when baby sleeps.
* Rock in a rocking chair as soon as possible after surgery to speed recovery and reduce gas.
* Take short walks.
* Eat nutritious food and drink plenty of fluids. Avoid cold and carbonated beverages.
* The surgery will slow down your digestive tract, to help with constipation, try an over-the-counter stool softener, NOT a laxative.
* Each time you stand after the surgery stretch up to uncramp stomach muscles and reduce adhesions.

At home:

* Have several diapering stations so you can change baby easily.
* Let others do household chores like cooking, cleaning, and laundry.
* Check the incision daily, or have someone check it for redness, which can be a sign of infection.
* Have a list to things that need done, so when people ask, you can remember what needs done.
* Take care of yourself and your baby only.
* Remember not to lift anything heavier than your baby.
* Stay in your pajamas, so people remember you are recovering from birth and surgery.
* On the other hand, sometimes taking a shower and getting dressed really does wonders psychologically. Even in the hospital, it can help to put on your OWN clothes.
* Keep the baby near you at night so you do not have to get up.
* Have a basket that you can carry easily with nutritious snacks, fingernail clippers, lotion, a book, and other little necessary things in it.
* Eat well and drink water freely. Have a pitcher of water or juice near you.
* If you have other children, secure assistance in caring for them from family and friends.
* Consider hiring a postpartum doula.
* Increase activity gradually.

To Promote Emotional Healing:

* Keep your baby near you as much as possible and get to know your new baby.
* Breastfeed your baby to promote bonding, and release beneficial mothering hormones.
* Share your feelings with others and talk about your experience as much as you feel necessary.
* It is normal to experience a wide range of emotions including relief, happiness, sadness, anger, and feelings of loss and failure.
* Write your baby’s birth story.
* Write letters to the hospital and your doctor, explaining what you did and did not like about your birth- you can mail them, or not, but it is beneficial to write your thoughts down.
* Seek support from available resources including breastfeeding, parental, and cesarean support groups.

Read books on natural childbirth, cesarean birth, and vaginal birth after cesarean (VBAC). There are many varied reasons why a birth may have ended in a cesarean section. If you plan to have any more children, it is important for you to know that it is very likely you can have a vaginal birth next time. When you are ready to learn about VBAC, ICAN can help you find the information and support you need.

This may be copied and distributed with retained copyright.
© International Cesarean Awareness Network, Inc. All Rights Reserved

What is a doula’s role?

1.    A doula’s main role is to help her client have (as much as possible) the kind of birth she desires.
2.    A doula does not take over the role of the birth partner (usually the husband), but supports them both in whatever ways they need.
3.    A doula can give the partner a break if necessary.
4.    A doula helps the couple to apply what they have learned in childbirth classes.
5.    A doula helps with suggesting many different comfort measures during labor.
6.    A doula will advocate between the client and caregiver to help her to have the kind of birth she desires.  A doula will NOT make decisions for the client, but rather make sure they are informed of their options.
7.    A doula will encourage the client to help her reach her goals of a natural birth (if that is the goal).
8.    A doula will explain the stages of labor, help the client understand the various options she has in a difficult situation, and support her completely in whatever she ultimately chooses.
9.    A doula will be constantly present for support, not coming and going like many other caregivers do.

Author: Brenda Minica, CD (CBI) – All Rights Reserved

1.    First of all, make sure you are drinking PLENTY of fluids to maximize the amount of amniotic fluid in the uterus. This helps the baby have more room to turn.
2.    Visualize your baby turning into the correct position. Talk to your baby. Prayer, communication with your baby and positive thinking can do wonders!
3.    Postural inversion, lie on a slanted board or with pillows under your hips for about 20 minutes, three times a day. You want your hips to be elevated 12-18 inches higher than your head.
4.    If you have access to a warm pool, do a headstand in the pool with someone there to help you. Do this several times and on several occasions if possible.
5.    Shine a bright flashlight onto your belly directly above the pubic bone. Put the flashlight directly on your skin!
6.    Put a frozen bag of peas (or another ice pack) at the top of your uterus, directly on the baby’s head if possible. You can do this at the same time as when you’re using the flashlight. Babies tend to move away from cold things and toward light.
7.    Another idea is to have Daddy talk to the baby with his mouth down in the same place where the flashlight is. Or put a small radio with music right in that spot. Any combination of these things can be done at the same time to maximize the effect.
8.    If the above tricks don’t work with Mom lying comfortably, try doing them with Mom on her hands and knees. Do the “pelvic rock” while in this position as well. This brings the baby up and out of the pelvis, giving it more room to turn.
9.    Find a chiropractor experienced in “The Webster Technique” for turning breech babies. I can recommend a good chiropractor if you’re interested.
10.    Ask your doctor about doing an external version if the baby is still breech at 36 weeks. Ask what his/her success rate is with this procedure.
11.    If you are successful in turning your baby to the correct position, keep it that way by sitting tailor style on the floor as much as possible from then on. Avoid sitting in lazyboy type chairs – you always want to keep your knees below your hips. This sitting position is a good idea to encourage baby to turn also.

*This is my midwife’s advice: Chiropractor first, then if that doesn’t work, use the slant board, swimming, and pulsatilla (homeopathic remedy.)

*This information is for informational purposes only. Contact your medical caregiver for diagnosis and treatment.

Author: Brenda Minica, CD (CBI)  – All rights reserved.

Click here to read more from this author – a mom of 3 boys and birth doula in California.

As an educator, I am pretty easy-going.  My main goal is to offer accurate, evidence-based information and trust the expectant family to make the decisions they feel are right for their situation.  I don’t give a lot of “you should do this” kind of advice — it’s just not my style, and I don’t think it lends well to a woman learning to trust her inner wisdom.

One place where I throw this out the window, though, is when it comes to “rules” a partner absolutely must follow.  These rules are not covered in a particular class, rather they come up according to what topics we happen to be discussing.  In class last week we happened to touch upon quite a few of these rules, and I told my families, “I should write these down.”  Enter, the blog!

These are for partners, so the “you” in the sentence is not the woman who is pregnant, but her direct support person…I think you know who you are.

1.  You are not allowed to have bad breath.  Her breath will probably be less-than-optimal — she is working hard, breathing through her mouth, it could have been hours since she last brushed her teeth, or she may have thrown up her last snack.  None of this matters.  She needs support, often in a very close, in-your-personal-space kind of way.  If her breath causes you to recoil, you can muster up your strength and remind yourself of the awesome events unfolding within her body.  If your breath causes her to recoil, she may, very bluntly, tell you so, or maybe she will just involuntarily vomit in your lap.  You have been warned.  No chili cheese fries with extra garlic for you, partner.  Breath mints, gum, and mouthwash are your friends.

2.  You are not allowed to comment about anything else that might come out of her that is NOT a baby.  It is very common for a woman to have a bowel movement during the second stage of birth — it is actually a good thing — not only does it provide extra space for a baby, it also shows she knows how to push.  If a woman asks later, “Did I poop?” be careful, this question can be as loaded as, “Do I look fat?”  My best answers to this question:  “Hmm, I don’t remember,” or a solid, “No.”  One situation, kids, where honesty doesn’t pay.

3.  You are not allowed to try and have a conversation with her during a contraction.  Commonly, partners pick this one up pretty quickly, so it is kind of a freebie.  But, there is a second part:  While this seems like a simple idea to you, others coming and going may not remember to “respect the contraction.”  Your job is to run interference so the laboring woman can focus — remember her contractions are her body’s little bursts of working energy, and her concentration is needed.  If a nurse or friend tries to talk to her at this point, not only can it be a source of irritation to her, it can actually impede her body’s ability to unroll the red carpet that is the birth process.  “Let’s wait and ask her when the contraction is over.”

4.  You are not allowed to suffer in silence if there are people in the room that your partner is obviously not comfortable with.  This includes friends and family as well as hospital staff.  If the person(s) happen to be friends or family, and they just won’t listen to your kind requests of removal, enlist help from your doula or nurse or practitioner.  Get one of these fine folks alone in the hall and let her know your company has gotten out of control, and to save yourself the potential grudge at the 4th of July party and forever, could she please help you out?  These professionals have mouths like magic wands and they can easily clear a room with smiles on their faces and official-ness in their voices.  Your guests will never know what was at the root of their departure, and you have helped protect your partner and the space she needs to un-focus for birth.

If the unwanted guest happens to be working at the hospital, it is perfectly acceptable to ask for a replacement or a removal.  If you feel there is a bad connection with your nurse, you can talk to her about it, talk to the nurse manager about it, or talk to your practitioner about it, and see if the situation can be changed for the better, either with improved communication, or with a new nurse who better fits your philosophy and birthing plans.  If a nurse walks in with a group of students and your birthing partner does not want to be on the observation deck, this is a situation where you can ask for removal, in a nice way, of course.  “My-partner-the-laboring-woman and I discussed this beforehand, and she is not comfortable having students present.”

5.  You are not allowed to get upset if you catch the brunt of some unseemly comments.  When a woman is having a baby, some odd things happen in her brain and she may not be in the “polite” part of her mind – that filter of sorts – that “nice-izes” the things we say.  Imagine this:  your eyes are closed and you are listening to something you know is very important, but it is lightly garbled and it runs together.  Your job is to pick out the words and phrases and construct some logical instructions out of it.  The words are being whispered, and you are concentrating hard, trying to understand them.  At the same time, you are aware of a fly buzzing around your face.  You don’t know how long the fly has been there, but suddenly it seems like forever, and in a nanosecond, the idea of that fly just consumes you, and you pop open your eyes and start flailing your arms around like crazy, surprised by how you went from zero to medieval in no time flat.  That’s kind of what it’s like in your head when you are absorbed in having a baby.

6.  You are not allowed to complain about being tired, hungry, sick, or sore.  That just kind of goes without saying.  If you feel you might need someone to help you help your partner if one of these four physical conditions should arise, consider hiring a doula.  Not only does she help the laboring mother, she also ensures the birth partner is doing well, gets to eat, gets to rest, gets a shoulder rub, etc.

To sum up:  Labor and birth are intense times.  There is so much going on that it can be hard to know how to help.  A woman must go through this process herself – no one can do it for her.  But that doesn’t mean she has to be alone while she is doing it.  The most important rule a partner should remember is to be with her and remind her of the wonderful job she and her baby are doing together, and that she has your support, your heart, and your presence during the process.

Author: Stacie Bingham. Printed with permission.

Lara with Baby #2 immediately after birth

After two frustrating and traumatic experiences with giving birth in hospital settings, I knew that there had to be a better way to give birth.  While pregnant with my first baby, Isabella, I sought traditional medical help—an OB in a large practice.  I read everything I could get my hands on about birth, and my research told me that having a natural childbirth was best for both mother and baby.  I bought a birth ball, did a hypno-therapy program for birth preparation, and wrote a birth plan.  However, when I got to the hospital, once labor became challenging, I was offered an epidural which I agreed to.  There were no other comfort measures offered to me, and since I had no experience with labor and birth, I thought that the pain I was feeling was a failure on my part to not relax properly—something that my hypno-therapy course led me to believe would eliminate the pain.  I felt unprepared and scared that the pain would become unmanageable.

The decision to have the epidural caused me to not feel anything at all when I was told to push, and it also made my daughter drowsy.  Since I was confined to the bed on my back, I felt completely powerless and when the staff took my baby to the “well baby” nursery for “observation”–I was helpless to do anything about it.  I was told my blood pressure spiked dangerously after the birth, so I was unable to leave the delivery room for 8 hours.  I did not even get to hold my baby before they took her!  Needless to say, this was a complete nightmare.  I did not get that precious hour after birth to bond with my baby, and this negatively effected breastfeeding.  I was completely stressed out and upset—not anything like I pictured giving birth to my baby would be.

When I became pregnant with my second baby, Andrew, I knew that I did not want a repeat experience.  I had read a lot of natural birth stories that included a doula, and since I could not afford to have a birth at a birth center with midwives (our insurance did not cover any of the over $3000 cost), I felt that having a doula in the hospital would be my best chance to have a natural birth.  That’s when I met Brenda!  I felt instantly comfortable with her, and she really got to know me and my desires for a natural birth.  We went over my birth plan that I wanted—to see the placenta before it was taken away, and to hold my baby immediately after birth, my desire for a natural birth and no separation of baby.  I encountered a combative doctor, and without Brenda there advocating for me, it would have been a totally negative experience.

With my third pregnancy, I started researching how to have a birth without bending to the hospital staff’s rules for their own convenience—and I found that it is very difficult to have a hospital birth the way I wanted it—freedom to move around in labor, choosing the birth post ion—and in San Antonio there is no way to have a water birth—something that I intuitively felt I wanted.  I read everything I could get my hands on about Unassisted Childbirth (UC), and I made the decision to have this baby at home with my husband.  It turned out to be the best experience!  I bought an inflatable kiddie pool so I could have a water birth—something I’d always wanted.  I had all my supplies set up, and spoke to Brenda often about the birth. My husband was with my 2 other young children at his parents’ home when I stared having cramping and mild contractions—very mild and nothing like the labor contractions I’d felt with my other two babies.  I was feeling uncomfortable and irritable, so I got into the bathtub.  I started having more of what I thought were Braxton-Hicks contractions, and then things started moving.  I knew that I was going to give birth in the tub!  Since I had watched so many births on DVD and on YouTube, I had a good idea what was happening as it happened.  I gave birth to my beautiful daughter, Liliana, in our bathtub.  She latched onto my breast right away, and I delivered the placenta soon afterwards.  I was too shaky to get out of the tub, so I kept draining and refilling the tub with warm water.  Needless to say my husband was shocked to come home to mother AND baby!

Liliana is such a calm, happy baby—she got to bond with her mommy immediately after birth—not with an OB nurse.  My recovery was phenomenal—such a big difference from my 2 hospital birth experiences.

Lara with her 3 beautiful children

If the mother is to be conscious, an anesthesiologist will inject spinal or epidural anesthesia (usually fentanyl, a derivative from the opium family; and bupivicane, a derivative from the cocaine family) into the mother’s back or epidural space (between the vertebra) via a thin catheter. Vomiting and/or dry heaves may occur as a reaction from the narcotics, as may uncontrollable shivering. A catheter is inserted into her urethra to allow urine to be eliminated.

In a sterile operating room, with a surgical team in “scrubs”, masks, hair net, and gloves, preparation continues with strapping the mother’s arms, crucifix-style, to an operating table. A nurse starts an IV with fluid and/or narcotics (usually demerol or stadol, a derivative of the morphine family), and an anesthesiologist applies oxygen and/or general anesthesia. A curtain is hung between the mother and her lower body to prevent her from seeing the surgery. Her belly is laid bare and she is completely naked, save for a hospital gown that is now pulled up to her neck or just below her breasts. Her belly and pubic area are rubbed with a 10% Povidone-Iodine solution (a.k.a. “Betadine”) and her pubic hair is shaved. A sticky plastic drape is laid over her belly to stabilize her skin.

A horizontal incision is made with a scalpel, just above the pubic bone where the pubic hair begins, slicing through five layers of skin, tissue, and muscle: 1) the derma, or outer layer of skin and 2) fat; 3) the fascia, the tough, thin layer that supports the muscle; 4) the rectus muscle, which is manually separated with the fingers down to the pubic bone; and 5) the peritoneum, the shiny layer that encases the entire abdominal cavity. Suction is applied to absorb excess blood. A metal “spatula” known as a bladder blade is inserted to pull back and protect the bladder. Another “spatula” known as a retractor is inserted at the top of the incision and/or on the sides, and are pulled back tightly to enlarge the incision, usually by two surgical assistants. Another incision is made into a sixth layer, the uterine lining, taking care not to cut the bladder, causing infection. Suction is again applied. Sponges and gauze are used to blot blood and fluid pooling in the abdominal cavity.

The mother may feel intense pulling and tugging to dislodge the baby’s head from the pelvis. If vertex, the baby is pulled by the neck backwards out of the pelvis and then by the head through the incision in the uterus. The baby’s nose and mouth are then suctioned to remove any amniotic fluid, mucous and/or meconium from the airway. The remainder of the baby’s body is pulled from the mother’s uterus through the abdominal incision, taking care not to tear the uterine or abdominal incision wider.

The umbilicus is clamped and cut immediately and the child may be held up over the curtain for the mother to see before being taken to a warm table to be suctioned further, toweled off, footprinted, weighed, measured, tagged and wrapped in a blanket and hat. Pitocin and/or methergine is immediately injected into the mother’s IV to begin contractions of the uterus to aid in the removal of the placenta. The remaining umbilicus is then pulled and the placenta is scraped off the uterine wall by hand to tear away the placenta from the uterine wall. The placenta is removed and examined to ensure all pieces are intact. The uterus is then removed from the mother’s body and placed on her stomach for the incision repair. One set of stitches is made in the wall of the uterus, then a second layer of stitches in the outer lining. The uterus is then pushed back through the abdominal incision and into the mother’s body. Sponges and gauze are counted to ensure none are left in the surgical cavity. The abdominal cavity is irrigated with water to flush out bacteria (to prevent infection) and check for bleeding.

Approximately 1000cc of blood is lost during the procedure. A layer of absorbable stitches are made in the rectus muscle, another layer of sutures are made in the fascia. The plastic drape is pulled away from around the abdominal incision and another set of absorbable sutures or staples may be used for the outer layer, usually removed three to five days later by a nurse. A second dose of demerol may be injected into the mother’s IV to aid in relaxation as she is wheeled into recovery to hold her child when the physician allows it. Again, the mother may experience dry heaves and/or uncontrollable shivering and chills.

Within 24 hours, the urine catheter is removed and she is allowed to stand and perhaps walk to the bathroom or shower. Within three to five days she is discharged and permitted to return home, with a check of her incision in two weeks. If infection or seeping occurs, antibiotics may be prescribed. Incision pain may occur constantly or intermittently for up to a year. Feeling may be regained on the incision site, or nerve damage may result in permanent lack of sensation. Her ability to birth normally in the future may be called into question.

For video of a cesarean section, contact The Learning Channel at (800) 544-1717 and request a copy of the video, “The Operation: Cesarean Section.”

This may be copied and distributed with retained copyright.
© International Cesarean Awareness Network, Inc. All Rights Reserved.

*Printed with permission from Birthing with Guinever. This is an awesome site with several great articles about pregnancy and birth.

So you’re pregnant, and you think you might want to have a natural birth. Having had 5 natural births myself, I’d like to offer what I feel are a few of the most important things to do in order to achieve a drug-free birth.

1. Going natural is a mindset. Make the commitment during pregnancy that drugs are not an option for labor. Believe that you can do it, and you will. If you have the feeling that you’d like to try it to see how it goes, but you’re open to getting an epidural, I guarantee you that you will have the epidural. Labor is hard work and to get through it, you can’t be wishy washy going into it. One medical intervention leads to another.

2. Surround yourself with friends and family who believe that you can have a natural birth, who assume that you can do it. Tune out the negative birth stories that some girlfriends might tell you about how awful labor was until the epidural took effect. Instead, seek out labor stories from women who have had natural birth and you’ll hear how awesome the birth was, how the baby latched on right away, how the nurses kept making comments that the baby was so alert. You’ll hear how proud her husband was, what a great help to her he was during labor, and that the birth was an empowering, amazing experience.

3. Take a private, independent childbirth class. (in other words, don’t take the birthing classes offered by the hospital.) If this isn’t possible, prepare yourself by reading several pregnancy books and learning labor coping techniques. Consider my list of recommended books.

4. Choose your doctor or midwife carefully. If you don’t know where to start looking for a care provider, ask your local childbirth educators and doulas for ideas. Ask lots of questions in your first few pre-natal visits so there aren’t any surprises later on. Be wary when the answer is always, “I only do that when its medically necessary.” You need to ask them, “How often do you feel its medically necessary?” (to do inductions, planned cesareans, episiotomies, etc) You want to find someone with a low induction, low cesarean, low episiotomy (and low tear) rate. Don’t be afraid to switch doctors or hospitals no matter how late it is in your pregnancy. Remember, it is your birth, and you are hiring them to work for you. There should be a mutual respect.

5. During labor, just take one contraction at a time. Don’t worry about the length of labor–how long it has been or how much longer it might be. Women talk about their long labors, but remember, its not as if they were in constant pain for 18 hours. Contractions only last for about a minute (longer during later labor) and you get breaks in between. Don’t let anyone tell you that your body isn’t working if your labor slows down. That is just the body’s way of giving you a rest. Be thankful for the break because labor will pick up soon enough.

*To read points #6-10,  visit Birthing with Guinever’s website here. You can also read many other articles including several positive and encouraging birth stories. Click here to read the small but growing collection of birth stories on this website.

The best ways to take advantage of everything your doula has to offer.

During Pregnancy:
During your pregnancy you may have a lot of non-medical questions that you may not necessarily remember to ask your health care providers. This is when you can consult your doula. Your doula is like pregnancy Google. If she doesn’t know the answer, she’ll find it or give you the resources to do it yourself.
During prenatal visit’s, your doula gets to know you and your hopes for birth. What makes your doula special, is that she takes on the same amount of enthusiasm about your birth plan as you and your partner. Your birth is taken as seriously as her own.

During Labor:
During your labor, you should consider your doula an extension of yourself. Chances are, if your thinking it, she should know it. Fears and inhibitions can hinder labor progress. This is the reason it is important to choose the right doula for you. You should feel like you can tell her anything. A doula is a professional and she does not judge.

Postpartum:
After your baby is born, your doula can help you in a number of ways. She helps with basic breastfeeding issues. She can entertain older siblings. Your doula is a calming presence in your home while you make the transition with your new baby. To best use your doula, you cannot be shy about telling her what you need or don’t need. She is there to help. How she helps is custom to YOUR needs.
Your doula is aware of all of your local resources. Whether it’s breastfeeding support, local mom groups, or government assistance. She wants to make sure you have everything you need to mother with confidence.

Author: Kim Stewart, Just Yours Birth Service

Used with permission.

Here is the program that Dr.Gary Young, founder of Young Living Essential Oils created for his wife Mary Young  (told by Gary Young himself during a talk in July, 2000 at The Farm, Mona, Utah):

YL Essential Oils:
Valor 2 times a day – tummy, back, hips – AM and PM.
Gentle Baby AM & PM for 30 days; then 1-2 times a week
By using Valor on the tummy, at 7 months she has no stretch marks or blemishes.  The doctors are amazed.
Brain Power on tummy, ears, neck once a day.  Baby knows Morse Code.
Her mind is much more clear.
Gary massages her legs at night with Valor and Cypress, sometimes Aroma Siez.
Frankincense each day protects baby.
He tests her weekly.
 
Supplements:
Multigreen – 8-12 a day.
Be Fit – 4 a day
Power Meal – 2 scoops in AM
Super Cal – 4 a day
Master Formula Hers – 6 a day
Body Balance – 1 scoop a day
Comfortone – 2 a day
Sulfurzyme – 2 tbs. a day
ICP – 2-3 times a week
Boswella Crème – 1 time a day on top of oils

*Note from Brenda – I personally use and recommend Young Living Essential Oils. The above recommendations are not intended for use with other types of oils, because essential oils are made very differently. Click here to visit my essential oils website and learn much more, or contact me if you have specific questions about my own experiences with essential oils, pregnancy, and birth.