'Enhanced' recovery

[BeanCalledPickle]

Saw the consultant this morning. I have a section booked for 1st may. I've had one before and the two ward days were the worst ever. Sleep deprived, screaming babies. People coming and going throughout the night. However I know that's to be expected. And just assumed it would be the same this time.
So today they told me they now offer enhanced recovery and I could leave after 24 hours all being well. Has anyone else done this? What's enhanced about this recovery? How did you find being at home, stairs etc? I figured if I could get home and up the stairs then I could just stay in bed and feed which is all I'd do in hospital?!

[divingoffthebalcony]

Watching with interest. I barely slept at all during the four nights I stayed with my first baby. It was hell and I was genuinely mad with exhaustion when I was discharged.

Having an ELCS this time (also in May, but I have to go back at 34 weeks to set a date) so I am VERY interested in getting the hell out as soon as it is safe to do so. I'll even discharge myself if I have to.

[LikeSilver]

Also watching with interest. ELCS in
January (no date yet). I too found the maternity ward stay hell and would do anything to avoid it, I'm hoping my hospital offer enhanced recovery too.

[trilbydoll]

I had an emcs on a Mon afternoon and a shower Tuesday lunchtime. I prob could have gone home Tues eve - I think as long as your DH brings you all your meals and recreates hospital for at least 24h it should be fine? I went home Wed morning and stairs were ok, we have sturdy handrails on both sides which helped.

[ZenNudist]

Isn't it just an excuse to ship people out faster and free up a bed. With ds1 (not c-Sec) I spent 5 days in a private room. And it wasn't too bad.

Ds2 born at home so it's not like I'm mad keen on hospitals or anything. But it's nice to get a bit of support with bf and how to bath baby etc. Food is lousy but you won't be that hungry. If you could get a private room I'd stay in...

[divingoffthebalcony]

I WAS in a private room and felt so utterly alone and neglected, I wondered whether the midwives and HCAs knew I was in there at all.

Wasn't quiet either, it was a 1930s hospital with a call button system that sounded like a klaxon blaring up and down the corridor. It was impossible to sleep. It was hideous.

[SocksRock]

I haven't had a section, but I was allowed rapid discharge after my last baby - sat on sofa eating takeaway curry 3.5 hours after she was born in hospital. Bliss. Can totally understand why you want out...

[smogsville]

My section's booked for April. I will be leaving as soon as the catheter's out after last experience of postnatal!

There are rooms at UCH that your partner can stay in but they are £500 a night. Which is obviously ridiculous unless you're really very well off.

[BeanCalledPickle]

If I could have a private room and be spared someone sticking a thermometer in my ear at 2am I would stay another day!

[Greenoes]

No experience of enhanced recovery after CS but I look after other surgical patients on this pathway - usually after major elective abdominal surgery.

It's not just about recreating the hospital at home, but also about early mobilisation. Patients who have 10+ Hours of complex surgery including the deflating of a lung to enable the removal and then rejoining of internal structures are out of bed the following morning.
Adequate pain relief and deep breathing exercises are essential as well as the actual process of getting up and about, for example - walking short distances to reduce the risk of thrombosis.

[WrappedInABlankie]

I had a cat 1 C-Section in April 2012, I was under genera for the birth but had been given gas and air, the injection and a epidural to bring my bp down. went home under 24 hours later with my clexain injections, son had been checked and was all okay and my heart rate had come down from 180 to 80 and my bp was normal again. walked out the hospital whilst my mum carried my son and my hospital bag suitcase

was in asda the next day buying clothes for my son, The first 24 hours on the ward was hideous one woman kept yanking my curtains back so we can "chat" the person across me wouldn't stop talking and her baby did nothing but cry and she'd just ignore, she even put the cot outside the curtain and the person next to her had a husband that called the nurse everytime the mum wanted to do something like feed because "you're not holding the baby at a 75 degree angle like the book tells you to, I'll get the nurse to show you with a angle measure"

Could mentally take it anymore but make sure they don't leave non-disposable stitches in ether side like they did me and not tell you, they get infected and hurt like fuck.

If I have another c-section this time round I'll be going home in the same time frame

[WrappedInABlankie]

Private rooms in my hospital are £80 a night even then I wouldn't stay for 5 days

[HollyJollyXmas]

I wouldnt agree to this. You have no idea how you'll feel.

I agree that this 'enhanced' recovery is a ploy to free up beds. Most other forms of major surgery do not end in the 'patient' going home 24 hours later. 48 hours is the norm for a trouble-free section.

[stargirl1701]

I have to be dragged out of the MLU I love it! It's a brilliant unit - small and friendly. Pool room for the birth then your own en suite room afterwards. Fathers can visit 8am until 10pm. Food is fantastic. All the staff are just so lovely. I go to the bf group at the unit every week. I could happily live there!!

[divingoffthebalcony]

Of course it's a ploy to free up beds. So is letting fathers stay on the wards until midnight (like my local hospital does) because it frees up staff time.

But unless you've experienced the hell of a noisy, badly staffed postnatal ward, I don't think you can fully appreciate how impossible it is to sleep and rest and recuperate after surgery. It's not like other surgeries where you're actually cared for, and might have meals brought to you. On postnatal wards you have to care for the baby round the clock and collect your own food (and if you're otherwise engaged with the baby, tough, no food). I know I would get much better rest and care at home.

[WrappedInABlankie]

That was the cherry on top for me actually.

She asked what I wanted for breakfast and I said toast. She brought me some bread on a plate and told me to walk to the toaster which was on the floor below but i couldn't take my son my mum brought my a m&s sandwich instead

[Kristingle]

I had a emergency CS with my last baby and came home the next day , 24 hours after leaving theatre

I though the post natal ward was terrible too . No care at all, I couldnt get them to give me the baby for feeding, I was getting dehydrated as the drip didnt work and they woudnt give me enough water to drink, the food was inadequate and inappropriate and the drugs were given out late .

I couldn't WAIT to get home to privacy, my own shower which I could bleed over without being shouted at, someone to watch the baby when I went to the loo, meds on time, plenty food and water, my own TV, no visitors, having the baby right beside me and being allowed to feed him as often as I wanted , quiet nights ( apart from baby of course ) .

I CANNNOT IMAGINE why anyone would want to stay in hospital unless they were ill AND getting adequate care

[divingoffthebalcony]

And, er, dare I say it stargirl, your comment was completely irrelevant to this thread because if you gave birth in a MLU you obviously didn't have a CS.

(Incidentally I gave birth to my first child in a MLU and it was great, but due to complications I had to be moved on to theatre and then the standard postnatal ward. How I wish I could have stayed on the MLU...)

[HollyJollyXmas]

I suppose ot really depends on your birth experience and the hosputal you give north in.

My child was a c-section. I had a private room purely because the wards were full. It wasnt a good experience. The midwives basically forgot about me. Forgot me at meal times, forgot to change my bloody sheets, forgot y anti-d injection .

Second section in a different hospital and was on the postnatal ward. They had separate wards for c-section mums, though. It was a bit noisy at times, but the care was very good. I was turfed out 48 hours post birth to the minute. Would have liked an extra day or two to be honest!

[Roonerspism]

I have just has my third baby but my first csection.

My postnatal care was excellent - and I say this as someone who has experienced the complete opposite. I was in no rush to leave hospital. Food was brought to me, cups of tea and biscuits, the cleaners made me laugh, the midwives were lovely.

Yep - it was noisy at night, but I wasn't sleeping much anyway with a hungry newborn.

I would have stayed longer if I could! It's all very well with number one, if you have a devoted DH to care for you. But if you have other kids at home and a work exhausted DH, hospital is the only recuperation you will get!

Just the other side of the coin...

[HollyJollyXmas]

Oh god excuse typos...eating and Mning not a good combo

[pinkr]

I had baby at 11 pm by section and we were discharged to the local mlu about half an hour drive away the next day. I much preferred the mlu as it was so quiet and we had one on one help with feeding etc.
I was a bit when they said i had to go to the unit in my husbands car considering it was only 17 hours after delivery.

[Elletorrito]

H bean, I think it isn't a one size fits all job. My elcs was "enhanced". The op itself was fantastic, calm and I felt very secure with the surgeon.

However my op was a Friday and my hospital closed the ward on the Saturday night on the assumption that everyone would be going home. It was very stressful. They tried to guilt me into leaving.

I think I have a particularly low pain threshold and I was still on morphine! No way was I going home with a codeine prescription, I wanted access to the stronger stuff. Had to fight my corner, as did my mum and my dh. They were not nice about me staying. Had some really nasty comments.

I fainted a couple of times (low bp and anaemia - had been unwell all through pregnancy) and suddenly treated differently.

I requested seeing a physio before I left and that was really helpful so I recommend doing that.

I don't know whether I have the emotional strength to make a complaint but I feel I really ought to.

Be very clear about what you want, get dh etc on board and stick to the plan. It helped to emphasise to them that I was keen to avoid having to return to a and e; re-admission rates make them look bad internally so it is an effective negotiating tactic.

[BeanCalledPickle]

The range of experiences are really interesting. I remember sitting there crying at 2am on night two as the woman in the bay next to me had just had a takeaway brought in and I had to listen to her and her partner talking and eating loudly. I would do anything to avoid this happening again. Was just so awful. I asked to go and was told no but by then I could walk, had showered etc. I contemplated just leaving but the paperwork wasn't done.

I think if I am Ill in someway or the baby isn't fit to go home then I would of course say but I'd hope that I'd be off the ward and in a private room in such circumstances.

I'd hate to feel pushed out but if I'm ready then I want to go!!