Journalism of Courage
It is no secret that there has been a surge in caesarean section rates. Sedentary lifestyle, change in eating habits, obesity, diabetes and hypertension during pregnancies, increasing IVF pregnancies and twin pregnancies, elderly primigravida, primigravida mother (delivering first time), mothers requesting for caesarean, fear of experiencing labor pain or for auspicious timings are all factors behind it, says Dr Jayashree Nagaraj Bhasgi, senior consultant, obstetrics and gynaecology, Fortis Hospital, Richmond Road, Bengaluru.
“Caesarean delivery is definitely a life-saving procedure when done during a complication encountered during labor. It involves a cut in the abdominal wall and the deeper tissues up to the lower part of the uterus just behind the urinary bladder. The uterus is opened here and the baby is delivered,” she explains.
But, once the baby is out, what happens to the mother and what does the timeline of her recovery look like?
According to the doctor, refined techniques in anaesthesia and surgery along with good quality suture materials, strict aseptic precautions, usage of appropriate antibiotics, availability of blood and blood products have brought down incidences of morbidity and mortality.
“Patients are usually discharged 3-4 days after surgery. Early ambulation is important, specially in obese patients to prevent clots formation in the lower limbs, which can travel to the lung and cause breathlessness. Physical activity is limited initially and plenty of rest is advised,” Dr Bhasgi advises.
Safe pain killer medicines and heat pads to alleviate pain are prescribed. Surgical pain wanes and almost stops in a weeks’ time. Sleeping on the back and sides using a comfortable pillow is advised but not on the abdomen. “As the pain goes away, the patient is advised to increase her activity till she is comfortable — but not to the point of exertion,” she adds.
The doctor also cautions that strenuous activity be avoided for 2 months, till the sutures on the uterus dissolve and the wound is healed completely. “This means little or no house work and no running after the other little one. Usage of tampons and menstrual cups, and sexual activity is discouraged during this time to avoid infections of genital tract.”
If there is an increase in pain, and the patient sees redness in the wound or purulent discharge she should visit the hospital, warns Dr Bhasgi.
Other things to keep in mind:
* Postpartum belly binder can be used after the pain stops.
* Bleeding from the vagina is more in the first 3-4 days after caesarean, but gradually reduces and will continue till 3-6 weeks.
* Any change in the vaginal discharge, heavy bleeding after 7 days, passing clots, foul smell, fever, increase in pain in the abdomen needs attention of the doctor.
* Breastfeeding is initiated immediately after the baby is born. The mother is advised to look for any lumps in the breast. They are formed when the milk stagnates in the breast. To avoid it, remove the excess milk after feeding the baby, basically empty the breast so that fresh milk can be produced.
* Drink a good amount of fluid and eat a balanced diet. Fibre-rich food is a must to prevent constipation after delivery. Increased intake of fluids also prevents urinary infection.
* Returning to activities like exercising, driving, carrying anything heavier than the baby and sex can be started when one feels able and comfortable — ideally after eight weeks.
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