How does the body recover after a caesarean section? Recovery after caesarean section: rehabilitation and reviews. Sex after caesarean section
Caesarean section - operative delivery. Nowadays, this method of childbirth is quite widespread. The increasing number of pregnancy complications, both on the part of the mother and the child, leads to this state of affairs.
How is a caesarean section performed?
The caesarean section is performed only under anesthesia. Nowadays, there is a gradual transition from general anesthesia to spinal anesthesia during these types of operations. The meaning of such anesthesia is to “turn off” the lower half of the body. The woman is conscious, she can take her baby in her arms immediately after removing him from the uterine cavity. In addition, during general anesthesia, the child receives a certain amount of drugs that are administered to the mother and is born slightly “stunned”, while there are no such features when choosing spinal anesthesia.
After anesthesia, an incision is made in the lower abdomen, opening of the uterine cavity and amniotic sac, followed by removal of the child. As in normal childbirth, the umbilical cord is tied and cut. Then, through the surgical incision, the fetal bladder and placenta are removed. The wound is sutured in layers, a sterile dressing is applied. With caesarean section under spinal anesthesia, the child is immediately applied to the mother's breast, with general anesthesia - after a while, the woman needs to get out of anesthesia.
Early postpartum period
The postoperative period after caesarean section does not differ significantly from that period after other abdominal operations. A common practice is early activation of the patient. After 6-8 hours (depending on general condition) a woman is allowed to sit down in bed; after 10-12 hours - get up and walk. This tactic minimizes the risk of developing adhesive complications in the abdominal cavity, congestion in the lungs (especially likely after intubation anesthesia).
If the condition of the mother and newborn does not cause concern to the doctor, then on the second day they are transferred to the ward for joint stay (if such wards are available). A woman, most often, is prescribed antibiotic therapy to prevent infectious complications during the postpartum period, as well as painkillers. During this period, it is worthwhile to warn the young mother against taking care of the baby too actively, frequently lifting it in her arms (especially for large children), and sudden movements. To alleviate discomfort in the area of the postoperative scar, it is recommended to wear a special bandage that supports the abdominal muscles.
The length of the postpartum period
The postpartum period in the case of physiological childbirth lasts 40 days. The postpartum period after caesarean section is up to 60 days. One of the main indicators of the course of the postpartum period is the so-called involution of the uterus: the process of its contraction and epithelialization of the inner surface. During this time, the woman has varying degrees of bleeding from the genital tract (lochia). It should be noted that, as a rule, the intensity of discharge in women delivered by caesarean section is less: after childbirth through the natural birth canal, discharge from the cervix, vagina, injured to one degree or another, is added to the discharge from the uterine cavity.
Since the integrity of the muscle fibers of the uterus, its vessels and nerves was violated during the operation, the rate of uterine involution slows down. If necessary, a woman is prescribed an appropriate drug therapy that stimulates the contractile activity of the muscles of the uterus, reducing bleeding from vessels damaged during incision. Most often, precisely because of the slow decrease in the uterus after childbirth, a mother with a baby after a cesarean section is discharged home a few days later than after a physiological birth.
Nutrition after caesarean section
On the first day after the caesarean section, it is allowed to drink only non-carbonated water, unsweetened tea. From the second day, the diet is gradually approaching the nutrition of the woman who has given birth: starting with the broth, pureed dishes, we gradually move on to a full-fledged diet rich in proteins, vitamins, microelements, which is recommended for a nursing mother.
Hygiene after caesarean section
The hygiene of a woman who has undergone a caesarean section in the first days after the operation must necessarily include a toilet of the external genital organs. Body washing is allowed, excluding the area of the postoperative suture. You can take a shower immediately after discharge from the hospital. The scar area must be washed clean water, very carefully, excluding friction, exposure to detergents. It is recommended to take a bath, swim no earlier than one and a half to two months after childbirth.
Postoperative scar
The postoperative scar will remind of itself for quite a long time: up to six months, in some women - up to a year. This is due to the fact that during the surgical incision, the integrity of the nerve endings was violated, and their recovery is a long process.
Two months after the operation, a woman who has undergone a caesarean section is advised to start exercises to strengthen the abdominal muscles. I would like to note that the better the muscles of this group were developed, the smaller the subcutaneous fat layer, the faster and better the postoperative wound heals. It is not forbidden to use ointments that promote the resorption of scars, although you should not expect a special effect from their use. The course of the healing process is also influenced by the lifestyle that a woman will lead after surgery. A big role in how the postpartum period after cesarean proceeds is the help of relatives and close people to the woman who has given birth. Ideally, one of them should be constantly at home at this time. Any woman after childbirth to ensure the recovery of the body and quality breastfeeding complete rest is required. The recovery postpartum period after caesarean section requires a serious limitation of the weight of the lifted weights. Overstrain of the abdominal muscles can lead to deformities in the area of the postoperative scar, up to the formation of hernias.
Family planning after caesarean section
The resumption of sexual activity after caesarean section is recommended one and a half to two months after the operation. Be sure to visit a gynecologist by this time, make sure that the recovery period runs smoothly, and discuss acceptable methods of contraception. It is better to postpone planning a subsequent pregnancy for two years - this time is enough to restore the strength of the mother's body, the formation of a strong scar on the uterus (ultrasound is performed to determine its quality).
Medical practice is currently moving away from the establishment that a history of caesarean section is a direct contraindication for natural childbirth in future. Quite often, women who have undergone a caesarean section give birth to subsequent children through the natural birth canal.
In this article:
There are situations when a woman cannot give birth to a child in a natural way. The reasons for this can be various factors, for example, the unsatisfactory state of health of the mother or fetus, anatomical features women, incorrect location of the fetus in the uterine cavity and much more. In these cases, a caesarean section is used.
To date, the technology of this operation minimizes the risk to health for both the woman and the child. But, like any operation, caesarean section requires long-term postoperative treatment, which includes various antibiotics, analgesics, and, as a rule, intravenous and intramuscular administration of saline solutions. All this is necessary in order to reduce the risk of infection after surgery, lower the pain threshold and help the woman's body recover as soon as possible.
How is recovery after surgery
For most women, after a caesarean section, the postoperative period is a much greater test than the operation itself.
A woman may experience:
- severe pain in the area of the incision of the abdominal cavity;
- problems with emptying and urination;
- pain in the lower abdomen associated with the accumulation of gases and contraction of the uterus;
- nausea and vomiting during the first days after surgery;
- effects effects of anesthesia, dizziness, blurred memory, hallucinations and more.
Immediately after the operation, an ice pack is placed on the abdomen of the woman in labor and contracting drugs (oxytocin, etc.) are administered. Thus, they accelerate the process of uterine contraction in the first hours after childbirth. For the first 24 hours, the patient is forbidden to get out of bed on her own. Since the risk of divergence of the seams and infection in it when trying to get up increases.
Within 5 days, a course of antibiotics is mandatory to prevent the development of infection. Like any wound, the incision made during the operation will disturb the woman for a long time. She will feel severe pain with any movement. Therefore, narcotic painkillers are prescribed, after which the pain is dulled, but consciousness is clouded. As a result, the woman in labor may experience "symptoms of withdrawal from anesthesia", that is, partial memory lapses, hallucinations, dizziness, vomiting and nausea, disorientation, and sleep disturbance.
If during the operation a tube was inserted into the throat (intubation), through which anesthesia was administered, then the following consequences are possible:
- swelling of the larynx;
- temporary paralysis of the vocal cords;
- spasms of the larynx and bronchi;
- sore throat;
- occurrence inflammatory processes.
Intubation can lead to the development of pneumonia. To prevent the occurrence of the disease, it is necessary to expand and clear the lungs of the remnants of anesthesia. To do this, a woman should conduct special breathing exercises daily. Performing exercises, the incision must be supported with a pillow.
The contraction of the uterus after a cesarean section is weak in the first days, therefore, reducing drugs are prescribed, due to which the woman feels cramping pain in the lower abdomen, which is complicated by an operating wound and accumulations of gases, which also put pressure on the seam, causing even more pain during uterine contractions. When a woman in labor cannot cope with the accumulated gases on her own, she can be given a gas tube or an enema.
Immediately after the operation, a catheter is inserted into the woman's urethra. After 24 hours, it is removed. It is impossible for the bladder to fill completely, as it puts a lot of pressure on the suture. Therefore, if a woman in labor has problems with urination, it can be put back.
The first 2 to 3 days, food intake is minimized, as there may be severe vomiting and the need to empty, which cannot be allowed these days, since there is a high risk of suture divergence at the slightest tension of the abdominal muscles. During this period, the woman's body is supported by the introduction of liquid with all the necessary minerals and vitamins intravenously.
The risk of infection in the abdominal cavity during the operation is very high. And although it is believed that an increase in body temperature after childbirth is a completely natural phenomenon, in this case it is necessary to carefully monitor its fluctuations. If the fever after caesarean section lasts for more than 2-3 days, there is a possibility that the infection still got into the body and treatment should be started urgently. Untimely treatment can turn out to be fraught with the health of the woman in labor.
Another problem that a woman faces is excessive sweating and the formation of edema after a cesarean section. This is considered a normal condition after childbirth, but it is complicated by the fact that the woman in labor is limited in movement, so it is necessary to deal with edema more intensively. After all, swelling in the legs, they can lead to the formation of varicose veins and thrombophlebitis. Therefore, in the postoperative period, it is recommended to wear stockings. At a consultation with a doctor, a woman will be able to learn how to prevent or reduce swelling.
The sutures are removed approximately 4-5 days later. In rare cases, by 6 - 7. As a rule, after completing a course of taking antibiotics and removing sutures, the woman in labor is discharged and she can safely go home with the baby, of course, only in cases where the condition of both the woman in labor and the child is satisfactory.
Consequences of the operation
After removing the child from the uterine cavity, the woman is sutured both on the abdominal wall and on the walls of the uterus itself. The probability of formation in this case of diastasis (divergence of the edges of the seam between the rectus abdominis muscles) is very high. Here you will need the help of a surgeon. Often, diastasis is treated in combination with special exercises.
So-called keloid scars (red growths) can form above the seam, the treatment of which should be carried out only by a specialist.
If after the operation the seam looks ugly and is very striking, you can use the help of a surgeon or cosmetologist. Today, there are various techniques for correcting the seam, making it more even and almost invisible. For example, grinding a seam, smoothing it or excising it.
But after a caesarean section, the seam on the abdomen should not bother the woman like the seams on the walls of the uterus. After all, it depends on them how the subsequent pregnancy and the birth itself will proceed.
Menstruation after surgery lasts the same period of time as after natural childbirth, approximately 28 to 40 days. If there were complications, then the process of cleansing the uterus can be delayed up to 2 - 2.5 months.
As for breastfeeding, then the operation does not remain without consequences. Milk appears at about the same time as after natural childbirth, about 3-4 days, but feeding is impossible due to antibiotics. Therefore, during this period, the child is fed exclusively from a bottle, after which he gets used to it and does not take the breast.
Prevention of complications
As a prevention of complications in the postoperative period, it is necessary to carefully monitor the state of the body. And first of all, on the seams and on the color and amount of discharge. Avoid stress and heavy lifting, try to lead an active lifestyle, only, of course, in moderation and without fanaticism. Do light gymnastics.
If you find that the color of the discharge has changed, their number has increased or decreased, the divergence of the seams, fever and severe pain in the lower abdomen - contact your doctor immediately! Your body should be examined and, if necessary, treated.
A caesarean section is not a joke, it is a real operation, the consequences of which can be very different.
Establishing breastfeeding
As mentioned earlier, while the woman in labor is undergoing antibiotic treatment, the baby is not applied to the breast and there is a risk that the baby will not take the mother's breast, as he is used to eating from a bottle. But there is another risk of not being able to continue breastfeeding after a caesarean section - lack of milk or lack of it.
To prevent this from happening, a woman in labor must pump every two hours for five minutes. Break at night should not exceed 6 hours. This will generate the tide breast milk.
As for the refusal of the child to breastfeed, then everything depends on you. If you have a sincere desire to breastfeed, then you will definitely succeed. After you are discharged from the hospital, try not to give your baby milk from a bottle. Try to put it on your chest more often. One day, if there is milk, he will still take the breast, and you will be able to continue breastfeeding without any problems!
If you are not sure that you will be able to establish breastfeeding, then visit various forums, read the reviews of those who have already gone through the postoperative period after a cesarean section and have established breastfeeding. You may find a lot of useful information there.
Figure restoration
The process of restoring the figure after a caesarean section takes quite a long time. Firstly, you can start doing physical exercises only after examining a doctor and his approval. Secondly, you need to start with minimal loads on the body, gradually increasing them. Thirdly, you need to improve your diet, add low-calorie foods with a high fiber content to it.
Remember that sports, both after cesarean section and after natural childbirth, have a very strong effect on lactation. The taste of milk may change, after which the baby will be reluctant to breastfeed, or it may disappear completely, and then you will have to transfer the baby to artificial feeding.
The best thing to do is to head to the gym and find a trainer who will create a weight loss and skin tightening program especially for you, taking into account the specifics of your situation. Find out from friends or look at the reviews and recommendations of other women, where in your city you can sign up for individual sessions to a good coach.
Massages using anti-cellulite massages will help get rid of cellulite. Massage can be performed both independently, that is, with your hands, and with the help of a massager. If possible, it is better to use the services of a massage therapist.
Diet
There can be no talk of any diet after a cesarean section! The body is already weakened after the operation, it needs to recover, and besides, the quantity and quality of milk completely depend on the food consumed by the mother.
To lose weight after pregnancy, it is not necessary to "sit" on strict diet, limit yourself in everything and risk losing milk. Gained pounds, in most cases, go away on their own. However, this process takes a long time. But if you want to lose weight much earlier, then you just need to watch your diet.
Exclude flour and confectionery products, fatty and fried foods from the diet. It is worth giving preference to separate meals. Drink one glass of water before meals. This will help to slightly satisfy the hunger.
But keep in mind that the child will "suck" everything from your body. useful material, so if you have a wild desire to eat something, do not deny yourself.
Subsequent births
Doctors say that after a caesarean section, you can have sex only after 7-8 weeks after the operation and only if there were no complications during the operation. Subsequent births are possible only after 2-3 years. During this period, you should be well protected, in addition to mechanical protection, you need to use contraceptives.
In the event of pregnancy during this period, an abortion should be performed, and preferably by medication. Since the abortion procedure depletes the walls of the uterus, which have not yet had time to recover after a caesarean section.
If a woman decides to leave the pregnancy, then the chances of carrying a child until the end of the term are 1:10. Pregnancy should proceed under the strict supervision of a physician.
The doctor's story about the difficulties after the operation
The doctor talks about the serious consequences of caesarean
Not always a woman can give birth to a child natural way. In some cases, doctors have no other choice but to help the baby be born through surgery. A caesarean section is a full-fledged abdominal operation, so a young mother needs more time to recover from delivery than women who have given birth to children in a natural way. Obstetrician-gynecologists warn that various complications may develop after CS, so a young mother needs to carefully monitor her condition and follow all the doctor's recommendations in order to reduce the risk of negative consequences after surgical delivery.
The first days after a cesarean section: how to behave as a young mother
Caesarean section in modern obstetrics is the most common operation. If the expectant mother has direct indications for delivery by surgical intervention or there is a threat to the health and life of the woman and child, doctors urgently perform a CS. Before helping the baby to be born, doctors administer to the woman in labor a special drug that affects the body and future mom does not feel pain. Today, CS is performed under general anesthesia (the woman falls asleep and wakes up after delivery is completed) and epidural anesthesia (the anesthetist injects an anesthetic into the spinal canal in the lumbar region, the expectant mother remains conscious, but does not feel her body below the waist).
Today, a pregnant woman who is scheduled for a planned CS can independently choose the type of anesthesia. Many mothers-to-be choose to have an epidural in order to be awake and see their baby being born.
Doctors always warn a young mother about the possibility of complications after the operation, so they give recommendations and monitor the woman's condition for several days from the moment of birth. To reduce the risk of negative consequences, you must follow all the advice of a gynecologist and do not rush to take care of the baby yourself. The process of her recovery largely depends on how a woman behaves after a cesarean section. It is necessary to give the body a rest and gather strength.
After a caesarean section, a young mother will spend at least five to seven days in the hospital
If the operation took place under general anesthesia, then the young mother will come to her senses thirty to sixty minutes after the end of the CS. With spinal anesthesia, the restoration of full body sensation depends on the individual characteristics of the body: some women can control the lower body almost immediately after childbirth, others take a little longer.
Based on the experience of women and doctors, after epidural anesthesia, a young mother feels much better than after general anesthesia.
Immediately after the CS, the woman is transferred to the intensive care unit. The medical staff constantly monitors the condition of the mother: monitors the pressure and body temperature, checks whether the uterus is contracting, whether bleeding has opened. Doctors also inject drugs into the body that help the reproductive organ contract, antibiotics to prevent infection after surgical delivery, painkillers and other drugs necessary to maintain the body after surgery.
Motor activity after operative delivery
Much attention is paid to physical activity, which is mandatory for women who have given birth to babies by caesarean section:
- two to four hours after the operation, the young mother should begin to move her arms and legs. Of course, it all depends on the woman's well-being, but careful movements are required: it is allowed to work with your toes (sip them on yourself), strain and relax gluteal muscles, rotate the feet and hands in one direction and the other;
If the operation went without complications and nothing threatens the mother’s life, she recovered from anesthesia easily, then a little motor activity of her arms and legs will only benefit her.
- it is recommended to perform Kegel exercises: compress and relax the muscles of the vagina. This is an excellent prevention of urinary problems, and exercises help strengthen the muscles of the pelvic floor;
- on the first day, doctors advise women to roll over from one side to the other. Movements should not be abrupt, everything should be done gradually, not in a hurry, so as not to provoke severe pain in the suture area;
- in most cases, doctors are not allowed to get up during the first day after the operation. This is especially true for young mothers who underwent epidural anesthesia: in this case, bed rest should be at least twelve hours from the moment of delivery. After general anesthesia, many women also spend twelve to twenty-four hours in bed;
However, some new mothers are allowed by gynecologists to get up as early as eight to ten hours after CS. It all depends on the condition of the woman and the complexity of delivery. Early physical activity is an excellent prevention of the formation of adhesions.
- getting out of bed for the first time should be supervised and assisted by a nurse. A young mother needs to turn on her side, gently lower both legs from the bed. Then, leaning on the back of the bed or on the hand of the medical staff, you need to slowly rise to your feet, take a few steps with support;
- it is allowed to sit down only on the third day after the operation;
If there are complications after the operation or the young mother is having a hard time recovering from anesthesia, she can only sit down on the fourth day after the birth. The decision is made by the doctor depending on the condition of the woman.
- you should know that bending over and squatting after the CS is prohibited so that the seams do not come apart. Before discharge from the hospital, the doctor will definitely tell you when it will be possible to perform these actions. It all depends on the process of tissue regeneration: the faster the seam heals, the faster the young mother will be able to return to an active pace.
After a caesarean section, in most cases, getting up is allowed only on the second day after delivery.
Video: obstetrician-gynecologist about physical activity
Features of the condition of a young mother in the first days after CS
In many ways, the condition of the mother after operative delivery depends on the individual characteristics of the organism. According to the experience of doctors, some women ask for permission to get up and look at the baby after eight to ten hours, while others spend two or three days in bed, are in no hurry to show physical activity and do not feel the desire to return to an active rhythm of life.
Doctors explain: a small physical activity after the COP is mandatory. In this case, the body recovers faster and the risk of negative postoperative consequences is reduced. Therefore, young mothers should follow all the recommendations of specialists.
In the first few days, mothers experience a feeling of weakness, as well as severe pain in the suture area. To relieve pain, they must be injected with painkillers. Also, women feel pain while walking - this is normal, because the operation was performed and the body needs time to restore and regenerate tissues. The nurse treats the wound every day, making sure that there is no infection and the stitches do not come apart. Before discharge from the maternity hospital, the doctor will definitely tell you what can be done and what is a contraindication for a young mother for a certain period of time.
Separately, the doctor will inform the woman about postpartum spotting- goofy. Some new mothers think that lochia only appears after vaginal delivery. However, this is a misconception: spotting is a sign of the normal process of recovery of the uterus after childbirth, regardless of the method of delivery. Normally, lochia lasts about six to eight weeks: the color and intensity of the discharge gradually changes.
If a young mother notices an increase in spotting (one pad is enough for forty to sixty minutes), then you should immediately consult a doctor, perhaps this is a sign of uterine bleeding. Also, a doctor's consultation is necessary in the case when the lochia stops abruptly. This situation is not a variant of the norm and may signal the accumulation of blood clots in the uterine cavity.
Contraindications in the first months
For six to seven days, the woman and the baby are in maternity hospital. The doctor carefully monitors the condition of the suture, and the nurse processes the incision area once a day. On the fifth day, an ultrasound scan of the pelvic organs is necessarily performed to see how the uterus contracts, if there are any complications. If everything is in order, then on the fifth or sixth day after the operation, the stitches are removed for the young mother and they begin to prepare her for discharge.
Of course, a young mother strives to get home with the baby faster and start caring for the baby, giving him love and care. However, you should not forget about your health either. Do not overexert yourself, lift weights and do all the household chores on your own. After the CS, it is necessary to give the body time and the opportunity to recover, and care for the newborn and household chores can be shared with the husband or nanny.
After a caesarean section, a woman should not carry a baby in her arms for a long time
What physical activity is prohibited for a young mother
Many women do not imagine that someone will do all the housework and also look after the baby while they are recovering from operative delivery. Doctors explain: physical activity and caring for a newborn are not completely forbidden to a young mother, they are even useful, but you need to know a sense of proportion and give the body a rest. Gynecologists share a list of recommendations that a woman needs to follow after a cesarean section:
- for three months, a young mother is forbidden to lift weights weighing more than three to four kilograms;
In most cases, this is the weight of a newborn baby. However, this does not mean that a woman can constantly carry a crumb in her arms or in a sling. Doctors allow you to take the baby in your arms and put it in a crib or stroller, feed the baby, but do not carry it in your arms for a long time.
- fulfill homework, especially washing the floor, dusting, washing by hand (those processes where you need to bend over or squat) should be entrusted to the husband or housekeeper, relatives. Within a month or two, the mother should take care of herself and not overstrain. Only after the permission of the doctor can a woman return to doing housework;
- play sports or do physical exercises prohibited for two months;
Of course, all young mothers strive to get in shape as soon as possible, but after the operation it is necessary to wait a while.
Diet and food of a young mother
In order for the recovery process to go faster and without complications, a woman must eat right. Very often, young mothers experience problems with the functioning of the gastrointestinal tract: most have constipation, pain during bowel movements. Therefore, doctors recommend adhering to a special diet, especially in the first week after delivery.
A balanced diet, excluding all harmful foods and dishes, a woman needs at least two to three months after surgery. And the ideal solution would be proper nutrition on an ongoing basis.
All dishes should be steamed, fried or baked. It is strictly forbidden to eat fatty, spicy, fried, smoked or pickled dishes and foodstuffs. Also, a young mother is not recommended to eat fatty meats (pork) and fish. It is necessary to exclude sweets, muffins, pastries and confectionery from the diet. Vegetables and fruits should be eaten only those that are not strong allergens. And also after the COP, it is not recommended to include dishes in the menu that contribute to constipation. It is better to diversify the diet with dairy products and fresh vegetables.
Table: what you can eat in the first week after CS
Day after surgery | Approximate menu |
The first |
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Second |
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Third |
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Fourth |
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Fifth |
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Sixth | |
Seventh |
A woman after a caesarean section must follow a diet
How long can you not have sex
Gynecologists allow sexual contacts to be resumed after the complete cessation of lochia. This usually happens two months after the birth of the baby. However, before having sex, you should consult a doctor. At the appointment, the gynecologist will conduct an examination with the help of mirrors, take tests and do an ultrasound. If, according to the results of the examination, the young mother does not reveal inflammatory processes or infection of the uterus and genital organs, the doctor will allow sexual intercourse.
Some couples ignore the prohibitions of doctors and resume intimate relationship much earlier. This threatens the development of severe inflammation, as well as infection on the wound surface of the uterus. Therefore, doctors recommend not to risk health and wait two months before having sex.
Full recovery of the body from the moment of surgical intervention takes from three to six months, depending on how the operation went, whether there were complications, and the individual characteristics of the woman, for example, the rate of tissue regeneration, also have a great influence. In most cases, three months after CS, a young mother is allowed to play sports and do exercises to restore her figure. However, gynecologists explain that much more time is needed to restore the muscles of the uterus: by four months, the suture on the wall of the reproductive organ is scarred, but it takes about two to three years to strengthen it. Therefore, it is recommended to plan another pregnancy no earlier than twenty-four months after a cesarean section.
Even if the baby is breastfed, young parents should think about contraceptive methods in advance and choose the most suitable one for both partners. It is not worth risking the health and life of a woman, because early pregnancy after a CS can cause a rupture of the wall of the reproductive organ.
General recommendations for recovery in the first six to eight weeks
First of all, a woman must follow all the doctor's recommendations. In this case, many problems will be avoided and the rehabilitation process after surgery will go much faster. Doctors advise to adhere to the following rules:
- take a shower at least twice a day. You can wet the suture only with the permission of the doctor, not earlier, so as not to infect the wound or damage the suture area;
- you can not rub the seam with a washcloth;
- for personal hygiene, use only hypoallergenic cosmetics, which do not contain components harmful and hazardous to health;
- refuse to take a bath for two months after the CS. At this time, only a warm shower is allowed;
- before discharge, the doctor will definitely give recommendations about the treatment of the suture. The prescription indicates the necessary drugs (Miramistin, Levomekol ointment and others). A woman must necessarily treat the wound once or twice a day according to the scheme prescribed by the gynecologist;
- to maintain the strength of the body, doctors advise taking special vitamin and mineral complexes for pregnant and lactating mothers, for example, Elevit Pronatal, Complivit, Pregnacare and others;
- eat small meals five to six times a day;
- be sure to walk in the fresh air, it is advisable to walk. But it is worth remembering that you should not overexert yourself;
- use a bandage to tighten the abdomen. However, after the CS, it must be remembered that it is forbidden to wear this product at all times. You need to take a break every three to four hours. If you do not remove the bandage, this can cause infection of the seam;
- recharge with positive emotions: spend more time with the baby, relax and tune in to a speedy recovery. Psychologists have proven that the ability of the body to quickly return to shape largely depends on the mood of the woman herself.
From the experience of young mothers: how was the recovery
Until six months, I only walked briskly with the child, this was my only exercise, and after that I started doing yoga again and pumping the press, though without fanaticism.
Budoshka
Diet, sports, long walks with a stroller - and it became better than it was) The only thing is that I had to wait 1.5 months with exercises for the press, but everything else is possible.
Just a dreamer
https://deti.mail.ru/forum/zdorove/zdorove_krasota_diety/vosstanovlenie_posle_kesareva_sechenija/
Everything went back to normal, within 6 months the weight was gone. Light gymnastics from 6 months. Well, once every 3 months, a massage of the cervical-collar zone for general well-being and positive.
Mother of Friendly Fox and Cool
https://deti.mail.ru/forum/zdorove/zdorove_krasota_diety/vosstanovlenie_posle_kesareva_sechenija/
After the operation, they raised me to my feet after 6 hours, it was hard to lean on my legs and felt very sick, but after a couple of hours I was already walking along the corridor by myself. The child was given 15 minutes after the operation and then all the time he stayed with me. I took a separate room, where either my husband or my mother spent the night with me and helped with the baby. The recovery lasted about a month, and then she didn’t even remember about the operation, the seam healed, the stomach was completely gone, and when the baby was 3 months old, she was already running to training.
Karina
After the CS, she wore a bandage, everything healed well. Then I decided that I needed to get rid of the scar somehow and started smearing it with Contractubex. The gel did a great job of smoothing out the seam. Now only a thin light strip remains from the operation. And my son is already 3, we are growing slowly.
Marina
https://www.baby.ru/community/view/44187/forum/post/9763217/?page=3
Physical activity after caesarean section
After pregnancy and the birth of a child, many young mothers are in a hurry to get back in shape, because extra pounds, stretch marks on the stomach are not at all encouraging. However, after a caesarean section, doctors prohibit physical exercise at least two months, and in some cases this period is extended. As soon as the doctor allows sports, a woman can plan her time and set aside an hour or more for exercises aimed at improving her figure.
A caesarean section is an operation to deliver a fetus by removing the abdominal wall and uterus through an incision. The postpartum uterus returns to its original state within 6-8 weeks.
Traumatization of the uterus during surgery, swelling, the presence of hemorrhages in the suture area, a large number of suture material slow down the involution of the uterus and predispose to the occurrence of postoperative purulent-septic complications in the pelvic area with involvement of the uterus and appendages in the process. These complications after caesarean section are 8-10 times more common than after vaginal delivery. Complications such as endometritis (inflammation of the inner layer of the uterus), adnexitis (inflammation of the appendages), parametritis (inflammation of the periuterine tissue), further affect the reproductive function of a woman, because. can lead to menstrual irregularities, pelvic pain syndrome, miscarriage, and infertility.
The initial state of a woman's health, the choice of a rational method and technique for performing the operation, the quality of the suture material and antibiotic therapy, as well as the rational management of the postoperative period, the prevention and treatment of complications associated with operative delivery, determine the favorable results of the operation.
A transverse incision in the lower segment of the uterus is made parallel to the circular muscle fibers, in a place where there are almost no blood vessels. Therefore, it injures the anatomical structures of the uterus less, and therefore, to a lesser extent disrupts the course of healing processes in the operating area, and the use of modern synthetic absorbable threads contributes to long-term retention of the wound edges on the uterus, which leads to an optimal healing process and the formation of a rich scar on the uterus, which very important for subsequent pregnancies and childbirth.
Prevention of complications
Currently, in order to prevent maternal morbidity after cesarean section, modern highly effective broad-spectrum antibiotics are used, since microbial associations, viruses, mycoplasmas, chlamydia, etc. play a large role in the development of infection. reduce their negative impact on the child. In the postoperative period, preference is given to short courses of antibiotic therapy in order to reduce the flow of drugs to the child through mother's milk; with a favorable course of caesarean section after surgery, antibiotics are not administered at all.
On the first day after the caesarean section, the puerperal is in the intensive care unit under the close supervision of medical personnel, while monitoring the activity of her entire body. Algorithms for the management of puerperas after caesarean section have been developed: adequate replacement of blood loss, anesthesia, maintenance of the cardiovascular, respiratory and other body systems. It is very important in the first hours after the operation to monitor the discharge from the genital tract, because. there is a high risk of uterine bleeding due to impaired uterine contractility caused by surgical trauma and the action of drugs. In the first 2 hours after the operation, a constant intravenous drip of drugs that reduce the uterus is carried out: oxytocin, methylergometrine, an ice pack is placed on the lower abdomen.
After general anesthesia, there may be pain and sore throat, nausea and vomiting.
Removing pain after surgery is of great importance. After 2-3 hours, non-narcotic analgesics are prescribed, after 2-3 days after the operation, anesthesia is carried out according to indications.
Surgical injury, entry into the abdominal cavity during the operation of the contents of the uterus ( amniotic fluid, blood) cause a decrease in intestinal motility, paresis develops - bloating, gas retention, which can lead to infection of the peritoneum, sutures on the uterus, adhesions. An increase in blood viscosity during and after surgery contributes to the formation of blood clots and their possible blockage of various vessels.
In order to prevent intestinal paresis, thromboembolic complications, improve peripheral circulation, eliminate congestion in the lungs after artificial ventilation, early activation of the puerperal in bed is important.
After the operation, it is desirable to turn in bed from side to side; by the end of the first day, it is recommended to get up early: first you need to sit in bed, lower your legs, and then start getting up and walking a little. You need to get up only with the help or under the supervision of medical staff: after a sufficiently long lying down, dizziness and a fall are possible.
Not later than the first day after the operation, it is necessary to start medical stimulation of the stomach and intestines. To do this, prozerin, cerucal or ubretid is used, in addition, an enema is made. With an uncomplicated course of the postoperative period, intestinal motility is activated on the second day after the operation, the gases leave on their own, and on the third day, as a rule, there is an independent stool.
On the 1st day, the puerperal is allowed to drink mineral water without gases, tea without sugar with lemon in small portions. On the 2nd day, a low-calorie diet is prescribed: liquid cereals, meat broth, soft-boiled eggs. From 3-4 days after an independent stool, the puerperal is transferred to a general diet. It is not recommended to take too hot and too cold food, solid foods should be introduced into your diet gradually.
On the 5-6th day, ultrasound examinations of the uterus are carried out in order to clarify its timely contraction.
In the postoperative period, the dressing is changed daily, examination and treatment of postoperative sutures with one of the antiseptics (70% ethyl alcohol, 2% iodine tincture, 5% potassium permanganate solution). The sutures from the anterior abdominal wall are removed on the 5-7th day, after which the issue of discharge home is decided. It happens that the wound on the anterior abdominal wall is sutured with an intradermal "cosmetic" suture with absorbable suture material; in such cases, there are no external removable seams. Extraction is usually carried out on the 7-8th day.
Establishing breastfeeding
Breastfeeding is often difficult after a caesarean section. They are due to a number of reasons, including pain and weakness after surgery, drowsiness of the child against the background of the use of painkillers or impaired adaptation of the newborn during operative delivery, the use of mixtures to give the mother "rest". These factors make it difficult to establish breastfeeding. Due to the need for a low-calorie diet for 4 days, the formation of lactation occurs against the background of a deficiency in the diet of a nursing woman of macro- and microelements, which affects not only the quantity, but also the quality of milk. Thus, the daily secretion of milk after cesarean section is almost 2 times lower compared to spontaneous childbirth; milk has a low content of the main ingredients.
It is important to ensure that the baby is attached to the breast in the first 2 hours after the operation. At present, most obstetric institutions operate on the principle of joint stay of mother and child.
Therefore, if everything went without complications, you can express a wish to leave the baby next to you and start breastfeeding under the supervision of the staff, as soon as the anesthesia wears off and you have the strength to take your baby in your arms (approximately 6 hours after the operation). Women in childbirth who, for various reasons, postpone feeding to a later date (the birth of children requiring special treatment, the occurrence of complications in the mother), should resort to expressing milk during feeding hours to stimulate lactation.
One of the main conditions for successful breastfeeding after caesarean section is to find a position in which a woman is comfortable to feed her baby. On the first day after surgery, it is easier to feed lying on your side. Some women find this position uncomfortable because this causes the seams to stretch, so you can feed while sitting and holding the baby under your arm (“soccer ball from under your arm” and “lying across the bed”). In these poses, pillows are placed on the knees, the child lies on them in the correct position, while the load is removed from the area of \u200b\u200bthe seams. As the mother recovers in the future, the mother can feed the baby while lying down, and sitting, and standing.
In order to stimulate lactation, physiotherapeutic methods of stimulating lactation are used (UVR of the mammary glands, UHF, vibration massage, ultrasound exposure, sound "bioacoustic" stimulation), herbal medicine: a decoction of cumin, dill, oregano, anise, etc. To improve the quality of breast milk, it is necessary to introduce in the diet of a nursing mother, food supplements (specialized protein and vitamin products): "Femilak-2", "Milky Way", "Mama Plus", "Enfimama". All these activities have a positive impact on the performance physical development children during their stay in the maternity hospital, and the mother is discharged with well-established lactation.
Restoration of the physical form
Warm dousing of the body in parts from the shower is possible already from the 2nd day after the operation, but you can take a shower completely after discharge from the maternity hospital. When washing the seam, it is better to use fragrance-free soap so as not to injure the crust. You can immerse yourself in the bath not earlier than 6-8 weeks after the operation, because. by this time, the inner surface of the uterus completely heals and the uterus returns to its normal state. A trip to the bath is possible only 2 months after the doctor's examination.
In order for the postoperative scar to resolve faster, it can be lubricated with prednisolone ointment or contractubex gel. Numbness may be felt in the area of the scar for up to 3 months until the nerves cut during the operation are restored.
Of no small importance is the restoration of physical fitness after a caesarean section. From the first day, it is recommended to wear a postpartum bandage. The bandage relieves lower back pain, helps to maintain the correct posture, accelerates the restoration of muscle and skin elasticity, protects the seams from divergence, helping to heal the postoperative wound. However, it is undesirable to wear it for a long time, because. muscles have to work, contract. As a rule, the bandage is worn for several weeks after childbirth, focusing on the condition of the abdominal muscles and general well-being. Therapeutic gymnastics should be started 6 hours after the operation, gradually increasing its intensity. After removing the sutures and consulting a doctor, you can begin to perform exercises to strengthen the muscles of the pelvic floor and muscles of the anterior abdominal wall (Kegel exercise - compression and relaxation of the pelvic floor with a gradual increase in duration up to 20 seconds, retraction of the abdomen, lifting the pelvis and other exercises), which causes a rush of blood to the pelvic organs and accelerates recovery. When performing exercises, not only the physical form is restored, but also endorphins are released - biologically active substances that improve the psychological state of a woman, reduce stress, feelings of depression, low self-esteem.
Sexual relations can be resumed 6-8 weeks after the operation, by visiting a gynecologist and consulting about the method of contraception.
Subsequent births
The gradual restoration of muscle tissue in the area of the scar on the uterus occurs within 1-2 years after the operation. About 30% of women after a caesarean section plan to have more children in the future. It is believed that the period 2-3 years after the caesarean section is more favorable for the onset of pregnancy and childbirth. The thesis "after caesarean section, childbirth through the birth canal is impossible" is now becoming irrelevant. For a number of reasons, many women attempt vaginal delivery after a caesarean section. In some institutions, the percentage of natural deliveries with a uterine scar after caesarean section is 40-60%.
We start with gymnastics
6 hours after the operation, you can start the simplest therapeutic exercises and massage of the chest and abdomen. You can perform them without an instructor, lying in bed with your knees slightly bent:
* circular strokes with the palm over the entire surface of the abdomen clockwise from right to left, up and down along the rectus abdominis muscles, from bottom to top and from top to bottom obliquely - along the oblique abdominal muscles - for 2-3 minutes;
* stroking the anterior and lateral surface of the chest from the bottom up to the axillary region, left-hand side massaged with the right hand, the right - with the left;
* hands are wound behind the back and the lumbar region is stroked with the back and palmar surfaces of the hands in the direction from top to bottom and to the sides;
* deep chest breathing, to control the palms are placed on top of the chest: at the expense of 1-2, a deep breath is taken with the chest (the chest rises), at the expense of 3-4, a deep exhalation, while lightly pressing on the chest with palms;
* deep breathing with the stomach, palms, holding the area of \u200b\u200bthe seams, inhale at the expense of 1-2, inflating the stomach, exhale at the expense of 3-4, drawing in the stomach as much as possible;
* rotation of the feet, without lifting the heels from the bed, alternately in one direction and the other, describing the largest possible circle, bending the feet towards and away from oneself;
* alternating flexion and extension of the left and right legs, the heel slides along the bed;
* coughing, supporting the area of \u200b\u200bsutures with the palms.
Repeat exercises 2-3 times a day.
Ludmila Petrova,
Obstetrician-gynecologist of the highest qualification category, head of the maternity department of the maternity hospital N 16, St. Petersburg, Article from the magazine "9 months" N12 2006
A caesarean section is surgery, in which the fetus and placenta are removed through an incision in the abdominal wall and uterus. There are many indications for caesarean section. They may be related to the initial health of the mother, problems during pregnancy and childbirth, and the condition of the fetus. We won't stop at detailed description indications for caesarean section, as a separate article was already devoted to this in the first issue of the journal in 2002.
In various maternity hospitals, the frequency of caesarean sections ranges from 12 to 27% of all births.
Caesarean section can be planned and emergency. A planned caesarean section is considered when the indications for it are established during pregnancy.
Who decides whether a woman can give birth herself or whether she needs to have a caesarean section? This issue is preliminarily resolved in antenatal clinic or a medical center where the pregnancy and the patient's condition are monitored. The examination is carried out not only by an obstetrician-gynecologist, but also by doctors of other specialties: therapist, oculist, endocrinologist, if necessary, surgeon, neuropathologist, orthopedist. In the presence of any diseases, these specialists give their recommendations on the management of pregnancy and a conclusion on the method of delivery. The final decision on the need for a caesarean section and the timing of its implementation is made by doctors in the maternity hospital. Each maternity hospital has its own characteristics of the operation itself, anesthesia, and postoperative management. Therefore, it is better to choose a maternity hospital in advance and ask the doctor all the questions that concern you.
The question is often asked: Is it possible to do a caesarean section at will, without medical indications? We believe that caesarean section can be performed only in cases where delivery through the natural birth canal is impossible or dangerous to the life of the mother or fetus. The patient, not having professional knowledge about the dangers of surgery, cannot make such decisions.
When to go to the hospital? Most often, doctors from the antenatal clinic are sent to the maternity hospital 1-2 weeks before the proposed operation. Conducted in the hospital additional examination female patients. If necessary, medical correction of the identified deviations in the state of health. The condition of the fetus is also assessed: cardiotocography, ultrasound, dopplerometry in the vessels of the mother-placenta-fetus system are performed. If the maternity hospital is chosen in advance and a decision is made on the need for a caesarean section, then all consultations and examinations can be completed before hospitalization. And for a caesarean section, come right on the day of the operation, having done the necessary preparation at home. However, this is possible only in the absence of severe complications of pregnancy and the normal condition of the fetus.
Speaking about the preparation for a planned caesarean section, one cannot fail to mention the possibility, and even the need, of the so-called autologous plasma donation. After 20 weeks of pregnancy, a patient can donate 300 ml of her own plasma (the liquid part of the blood), which will be stored in a special freezer for a long time. And if a transfusion of blood products is required during the operation, then not someone else's (even if examined), but one's own plasma will be transfused. This eliminates the possibility of infection with various infections, including HIV, hepatitis B and C. Autoplasma donation is carried out in maternity hospitals that have their own blood transfusion department. The procedure does not negative influence neither on the state of the mother, nor on the state of the fetus, and the lost plasma is restored in the body within 2-3 days.
How is the transaction date determined? The condition of the patient and the fetus is assessed, the date of delivery is specified by the date of the last menstruation, by the expected day of conception, by the first ultrasound examination, and, if possible, the day closest to the date of birth is selected. In this case, the wishes of the patient herself must be taken into account. The patient expresses her consent to the operation and anesthesia in writing.
Now let's talk directly about preoperative preparation for a planned caesarean section. On the eve it is necessary to take a hygienic shower. It's important to get a good night's sleep, so to help manage understandable anxiety, it's best to take something calming at night (as recommended by your doctor). Dinner the night before should be light. And on the day of the operation in the morning you can not drink or eat. A cleansing enema is performed 2 hours before the operation. Immediately before the start of the operation, a catheter is inserted into the bladder, which is removed only a few hours after the operation. These measures will help prevent serious complications from the kidneys.
What are the methods of anesthesia for caesarean section? The most modern and safe method of anesthesia for both mother and fetus is regional (epidural or spinal) anesthesia. In this case, only the site of the operation and the lower part of the body are anesthetized. The patient is conscious and can hear and see her baby immediately after birth, attach it to the chest. In modern clinics, more than 95% of the operation is performed with this kind of anesthesia. General anesthesia is used much less frequently.
How is a caesarean section performed? After anesthesia, the woman's stomach is washed with a special antiseptic and covered with sterile sheets. A barrier is placed at chest level so that the patient cannot see the operation site. An incision is made in the abdominal wall. In the vast majority of cases, this is a transverse incision above the womb, extremely rarely - a longitudinal incision from the womb to the navel. Then the muscles are moved apart, an incision is made on the uterus (more often - transverse, less often - longitudinal), the fetal bladder is opened. The doctor inserts a hand into the uterine cavity and removes the baby. The umbilical cord is cut, the baby is handed over to the midwife. Then the placenta is removed by hand, and the incision on the uterus is sutured with a special thread, which dissolves after 3-4 months. The abdominal wall is also restored. Brackets or sutures are applied to the skin, and a sterile bandage is placed on top. Depending on the technique and complexity of the operation, its duration is on average 20-40 minutes.
The first day after caesarean section, the patient is usually in the postoperative ward or intensive care unit, where her condition is monitored around the clock: general well-being, blood pressure, pulse, respiratory rate, size and tone of the uterus, amount of discharge, function Bladder. At the end of the operation, an ice pack is placed on the lower abdomen for 1.5-2 hours, which helps to contract the uterus and reduce blood loss. What drugs are usually administered in the postoperative period? Anesthesia is mandatory, the frequency of administration of these drugs depends on the intensity of pain. Usually anesthesia is required in the first 2-3 days, in the future it is gradually abandoned. In addition, drugs are prescribed that promote uterine contraction, and drugs that normalize the function of the gastrointestinal tract. Physiological saline is also administered intravenously to replace fluid loss. The issue of prescribing antibiotics is decided by the operating physician in relation to each patient individually. Most elective caesarean sections do not require antibiotic therapy.
When can you get up? The first time we help the patient to get up is 6 hours after the operation. First you need to sit, and then stand a little. This is enough to get started. A more active motor mode begins after transfer from the intensive care unit. It is better to take care of purchasing a special postoperative bandage in advance, which will greatly facilitate movement in the first few days after a cesarean section. Already from the first day, you can begin to perform minimal physical exercises, which contribute to a more favorable course of the postoperative period. Transfer to the postpartum department is possible 12-24 hours after the operation. The child at this time is in the children's department. In the postpartum department, the woman herself will be able to start caring for the child, breastfeeding and swaddling. But in the first few days, help from doctors and relatives will be required (if visits are allowed in the maternity hospital).
Diet. On the first day after the operation, it is allowed to drink mineral water without gas. You can add lemon juice to it. On the second day, the diet expands - you can eat cereals, low-fat broth, boiled meat, sweet tea. From the third day, full nutrition is possible - only foods that are not recommended for breastfeeding are excluded from the diet. Usually, a cleansing enema is prescribed to normalize bowel function about a day after the operation.
When you can go home, the attending physician decides. Usually, on the 5th day after the operation, an ultrasound examination of the uterus is performed, and on the 6th day, the staples or sutures are removed. With a successful course of the postoperative period, discharge is possible on the 6-7th day after cesarean section.
When you go home, try to get as much rest as possible. It will require special attention and assistance from family members who can take on part of the household chores. Indeed, for some time after the operation, weakness, increased fatigue, and pain in the suture area will persist. What regimen should be observed at home? Nutrition is normal - taking into account breastfeeding. With "water procedures" you will have to confine yourself to a shower. You can take baths and swim only 1.5 months after the operation. Full physical activity - two months after cesarean section. Sexual intercourse can be resumed 6 weeks after the operation. Pre-visit a doctor, he will be able to assess how well the postoperative period proceeds. Be sure to consider contraception. You can choose the most suitable method for you by consulting with your doctor.
The next pregnancy after a caesarean section is best planned after 2 years. During this time, your body will have time to fully recover from the previous pregnancy and surgery. You should know that if during the next pregnancy you have no indications for a caesarean section, then you have every chance of giving birth on your own without resorting to surgical intervention.
A caesarean section is an operation to deliver a fetus by removing the abdominal wall and uterus through an incision. The postpartum uterus returns to its original state within 6-8 weeks. Traumatization of the uterus during surgery, edema,
the presence of hemorrhages in the suture area, a large amount of suture material slow down the involution of the uterus and predispose to the occurrence of postoperative purulent-septic complications in the pelvic area with involvement of the uterus and appendages in the process. These complications after caesarean section are 8-10 times more common than after vaginal delivery. Complications such as endometritis (inflammation of the inner layer of the uterus), adnexitis (inflammation of the appendages), parametritis (inflammation of the periuterine tissue), further affect the reproductive function of a woman, because. can lead to menstrual irregularities, pelvic pain syndrome, miscarriage, and infertility.
The initial state of women's health, the choice of a rational method and technique for performing the operation, the quality of the suture material and antibiotic therapy, as well as the rational management of the postoperative period, the prevention and treatment of complications associated with operative delivery, determine the favorable outcome of the operation.
A transverse incision in the lower segment of the uterus is made parallel to the circular muscle fibers, in a place where there are almost no blood vessels. Therefore, it least of all injures the anatomical structures of the uterus, and therefore, to a lesser extent disrupts the course of healing processes in the operating area. The use of modern synthetic absorbable sutures contributes to long-term retention of the wound edges on the uterus, which leads to an optimal healing process and the formation of a prosperous scar on the uterus, which is extremely important for subsequent pregnancies and childbirth.
Prevention of complications after caesarean section
Currently, in order to prevent maternal morbidity after cesarean section, modern highly effective broad-spectrum antibiotics are used, since microbial associations, viruses, mycoplasmas, chlamydia, etc. play a large role in the development of infection. reduce their negative impact on the child. In the postoperative period, preference is given to short courses of antibiotic therapy in order to reduce the flow of drugs to the child through mother's milk; with a favorable course of caesarean section after surgery, antibiotics are not administered at all.
On the first day after the caesarean section, the puerperal is in the intensive care unit under the close supervision of medical personnel, while monitoring the activity of her entire body. Algorithms for the management of puerperas after caesarean section have been developed: adequate replacement of blood loss, anesthesia, maintenance of the cardiovascular, respiratory and other body systems. It is very important in the first hours after the operation to monitor the discharge from the genital tract, because. there is a high risk of uterine bleeding due to impaired uterine contractility caused by surgical trauma and the action of drugs. In the first 2 hours after the operation, a constant intravenous drip of drugs that reduce the uterus is carried out: OXYTOCIN, METHYLERGOMETRIN, an ice pack is placed on the lower abdomen.
After general anesthesia, there may be pain and sore throat, nausea and vomiting.
Removing pain after surgery is of great importance. After 2-3 hours, non-narcotic analgesics are prescribed, after 2-3 days after the operation, anesthesia is carried out according to indications.
Surgical trauma, entry into the abdominal cavity during the operation of the contents of the uterus (amniotic fluid, blood) cause a decrease in intestinal motility, paresis develops - bloating, gas retention, which can lead to infection of the peritoneum, sutures on the uterus, adhesions. An increase in blood viscosity during and after surgery contributes to the formation of blood clots and their possible blockage of various vessels.
In order to prevent intestinal paresis, thromboembolic complications, improve peripheral circulation, eliminate congestion in the lungs after artificial ventilation, early activation of the puerperal in bed is important.
After the operation, it is desirable to turn in bed from side to side; by the end of the first day, it is recommended to get up early: first you need to sit in bed, lower your legs, and then start getting up and walking a little. You need to get up only with the help or under the supervision of medical staff: after a sufficiently long lying down, dizziness and a fall are possible.
Not later than the first day after the operation, it is necessary to start medical stimulation of the stomach and intestines. For this, PROZERIN, CERUKAL or UBRETID is used, in addition, an enema is made. With an uncomplicated course of the postoperative period, intestinal motility is activated on the second day after the operation, the gases leave on their own, and on the third day, as a rule, there is an independent stool.
On the 1st day, the puerperal is allowed to drink mineral water without gases, tea without sugar with lemon in small portions. On the 2nd day, a low-calorie diet is prescribed: liquid cereals, meat broth, soft-boiled eggs. From 3-4 days after an independent stool, the puerperal is transferred to a general diet. It is not recommended to take too hot and too cold food, solid foods should be introduced into your diet gradually.
On the 5-6th day, ultrasound examinations of the uterus are carried out in order to clarify its timely contraction.
In the postoperative period, the dressing is changed daily, examination and treatment of postoperative sutures with one of the antiseptics (70% ethyl alcohol, 2% iodine tincture, 5% potassium permanganate solution). The sutures from the anterior abdominal wall are removed on the 5-7th day, after which the issue of discharge home is decided. It happens that a wound on the anterior abdominal wall is sutured with an intradermal "cosmetic" suture with absorbable suture material; in such cases, there are no external removable seams. Extraction is usually carried out on the 7-8th day.
Establishing breastfeeding after cesarean
Breastfeeding is often difficult after a caesarean section. They are due to a number of reasons, including pain and weakness after surgery, drowsiness of the child against the background of the use of painkillers or impaired adaptation of the newborn during operative delivery, the use of mixtures to give the mother "rest". These factors make it difficult to establish breastfeeding. Due to the need for a low-calorie diet for 4 days, the formation of lactation occurs against the background of a deficiency in the diet of a nursing woman of macro- and microelements, which affects not only the quantity, but also the quality of milk. Thus, the daily secretion of milk after cesarean section is almost 2 times lower compared to spontaneous childbirth; milk has a low content of the main ingredients.
It is important to ensure that the baby is attached to the breast in the first 2 hours after the operation. At present, most obstetric institutions operate on the principle of joint stay of mother and child.
Therefore, if everything went without complications, you can express a wish to leave the baby next to you and start breastfeeding under the supervision of the staff, as soon as the anesthesia wears off and you have the strength to take your baby in your arms (approximately 6 hours after the operation). Women in childbirth who, for various reasons, postpone feeding to a later date (the birth of children requiring special treatment, the occurrence of complications in the mother), should resort to expressing milk during feeding hours to stimulate lactation.
One of the main conditions for successful breastfeeding after caesarean section is to find a position in which a woman is comfortable to feed her baby. On the first day after surgery, it is easier to feed lying on your side. Some women find this position uncomfortable because at the same time, the seams are stretched, so you can feed while sitting and holding the baby under your arm (“soccer ball from under your arm” and “lying across the bed”). In these poses, pillows are placed on the knees, the child lies on them in the correct position, while the load is removed from the area of \u200b\u200bthe seams. As the mother recovers in the future, the mother can feed the baby while lying down, and sitting, and standing.
In order to stimulate lactation, physiotherapeutic methods of stimulating lactation are used (UVR of the mammary glands, UHF, vibration massage, ultrasound, sound "bioacoustic" stimulation), herbal medicine: a decoction of cumin, dill, oregano, anise, etc. To improve the quality of breast milk, it is necessary to introduce in the diet of a nursing mother, nutritional supplements (specialized protein and vitamin products): Femilak-2, Milky Way, Mom Plus, Enfimama. All these activities have a beneficial effect on the indicators of the physical development of children during their stay in the maternity hospital, and the mother is discharged with well-established lactation.
Gymnastics after cesarean
6 hours after the operation, you can start the simplest therapeutic exercises and massage of the chest and abdomen. You can perform them without an instructor, lying in bed with your knees slightly bent:
- circular stroking with the palm of the hand over the entire surface of the abdomen clockwise from right to left, up and down along the rectus abdominis muscles, from bottom to top and from top to bottom obliquely - along the oblique abdominal muscles - for 2-3 minutes;
- stroking the anterior and lateral surfaces of the chest from the bottom up to the axillary region, the left side is massaged with the right hand, the right side with the left;
- hands are wound behind the back and the lumbar region is stroked with the back and palmar surfaces of the hands in the direction from top to bottom and to the sides;
- deep chest breathing, to control the palms are placed on top of the chest: at the expense of 1-2, a deep breath is taken with the chest (the chest rises), at the expense of 3-4, a deep exhalation, while lightly pressing on the chest with palms;
- deep breathing with the stomach, palms, holding the area of \u200b\u200bthe seams, inhale at the expense of 1-2, inflating the stomach, exhale at the expense of 3-4, drawing in the stomach as much as possible;
- rotation of the feet, without lifting the heels from the bed, alternately in one direction and the other, describing the largest possible circle, bending the feet towards and away from oneself;
- alternate flexion and extension of the left and right legs, the heel slides along the bed;
- coughing, supporting the area of \u200b\u200bthe seams with the palms.
Repeat exercises 2-3 times a day.
Getting back in shape after a caesarean
Warm dousing of the body in parts from the shower is possible already from the 2nd day after the operation, but you can take a shower completely after discharge from the maternity hospital. When washing the seam, it is better to use fragrance-free soap so as not to injure the crust. You can immerse yourself in the bath not earlier than 6-8 weeks after the operation, because. by this time, the inner surface of the uterus completely heals and the uterus returns to its normal state. A trip to the bath is possible only 2 months after the doctor's examination.
In order for the postoperative scar to dissolve faster, it can be lubricated with prednisolone ointment or CONTRACTUBEX gel. Numbness may be felt in the area of the scar for up to 3 months until the nerves cut during the operation are restored.
Of no small importance is the restoration of physical fitness after a caesarean section. From the first day, it is recommended to wear a postpartum bandage. The bandage relieves lower back pain, helps to maintain the correct posture, accelerates the restoration of muscle and skin elasticity, protects the seams from divergence, helping to heal the postoperative wound. However, it is undesirable to wear it for a long time, because. muscles have to work, contract. As a rule, the bandage is worn for several weeks after childbirth, focusing on the condition of the abdominal muscles and general well-being. Therapeutic exercises should be started 6 hours after the operation, gradually increasing its intensity. After removing the sutures and consulting a doctor, you can begin to perform exercises to strengthen the muscles of the pelvic floor and muscles of the anterior abdominal wall (Kegel exercise - compression and relaxation of the pelvic floor with a gradual increase in duration up to 20 seconds, retraction of the abdomen, lifting the pelvis and other exercises), which causes a rush of blood to the pelvic organs and accelerates recovery. When performing exercises, not only the physical form is restored, but also endorphins are released - biologically active substances that improve the psychological state of a woman, reduce stress, feelings of depression, low self-esteem.
After the operation, it is not recommended to lift weights of more than 3-4 kg for 1.5-2 months. You can start more active activities 6 weeks after giving birth, taking into account the level of your physical fitness before pregnancy. The load is increased gradually, avoiding strength exercises on the upper body, because. this may reduce lactation. Active types of aerobics and running are not recommended. In the future, if possible, it is advisable to engage in an individual program with a trainer. After high-intensity training, lactic acid levels can increase, and as a result, the taste of milk deteriorates: it becomes sour, and the baby refuses the breast. Therefore, engaging in any kind of sport for a nursing woman is possible only at the end of breastfeeding, and not for lactating women - after the restoration of the menstrual cycle.
Sexual relations can be resumed 6-8 weeks after the operation, by visiting a gynecologist and consulting about the method of contraception.
Second and third births after cesarean
The gradual restoration of muscle tissue in the area of the scar on the uterus occurs within 1-2 years after the operation. About 30% of women after a caesarean section plan to have more children in the future. It is believed that the period 2-3 years after the caesarean section is more favorable for the onset of pregnancy and childbirth. The thesis “after caesarean section, childbirth through the birth canal is impossible” is now becoming irrelevant. For a number of reasons, many women attempt vaginal delivery after a caesarean section. In some institutions, the percentage of natural deliveries with a uterine scar after caesarean section is 40-60%.