c-sections

[Lilsquish]

Currently in hospital having underwent a section yesterday.

AIBU to expect/request stronger pain relief other than two paracetamol??

i mean, for christ sake, 16 hours after major surgery they are requesting that i get out of bed and shower with 2 paracetamol for pain relief???? why??

its not like you cant have anything stronger, they even have it stored on their little drug trolleys, so why not offer it? or better still, when i say im really struggling with the pain, offer the bloody morphine without insinuating that its a major deal!!!

Any midwives/doctors shed some light on this?

im getting a bit fucked off feeling like i need to beg/justify reasons for getting stronger pain relief every 4 hours.........

I was told in recovery “we’ve written you up for decent pain relief, make sure you take what you need”. But once up on the postnatal ward it was paracetamol and ibuprofen. I asked and asked and asked for something stronger and eventually got one dose of oramorph, then later after more begging some dihydrocodeine. Was sent home with paracetamol and told that they wouldn’t ever give more than 3 days worth of anything stronger anyway and I needed to see GP if paracetamol wasn’t cutting it.

My first section was a really easy recovery and very low pain levels. The second was 10x worse. I really badly needed the pain relief and couldn’t understand (still can’t) why they were being so stingy about it.

In the hospital I work in you have to bring your own paracetamol and ibuprofen for post (planned) c section pain relief! (Obviously to save costs)
In the hospital I gave birth in they provide in hospital pain relief and send you home with a three day supply of oramorph.
It IS better to be up and moving within 12 hours of so post c section but only if you feel able to. It's really all a double edged sword but please just tell them you need some oramorph.

OP, I'm really sorry you're not getting what you need. Keep pressing the buzzer for more. In the middle of the night. That usually works, they give you whatever just to shut you up.

It's a shame you're having this experience because with mine I had the opposite. I was given Tramadol regularly and they didn't make me get up out of bed until they knew I wouldn't pass out. They did have to test my iron levels though because I was losing a lot of blood after my second.

I’m sorry you are having this. As a midwife this isn’t normal. Yes getting you up and out of bed quickly is normal and that’s done to prevent blood clots forming in your legs as pregnancy alone makes this higher risk and a caesarean even more so. There is no reason why you are not being given proper pain relief however. Where I work paracetamol, ibuprofen and oramorph is standard, some who need more also have tramadol. Paracetamol alone isn’t enough. Please ask for better pain relief and ask why if they are not giving it to you. Ask them to document the refusal to give you pain relief and their reason why. This isn’t good enough.

I'm confused. On the first post you act like you're only being offered paracetamol but the second sounds like you were already given oramorph?

Drugs that strong are not generally given as 'regular' - oramorph works as a breakthrough pain reliever, not first line, and will therefore be on the PRN (as needeed) part of your drug chart. All that means is you take the regular analgesics, in this case paracetamol, and if you are unable to manage afterwards you ask for the oramorph. It's not going to be given every few hours even if you don't need it because of the many problems opioids cause. Just ask.

And to correct the person earlier, you absolutely cannot take codeine if you are breastfeeding. It has been proven to cause breathing difficulties and abnormal heart rates in newborns when exposed to it. Morphine is fine.

I'm pretty sure that within. 24 hrs of both my sections in was paracetamol & codeine only - insisted on the lactulose 2nd time - to constipation is horrific.
Would have been out of hospital within 24hrs both times although exceptional circumstances meant I was still in, however the pain relief was the same.
Even after a secondary PPH 2 nd time round - I blame the MW for that though.

Although I was given adequate pain relief after my second section, I’m still angry and baffled at my midwifes refusal to give me my anti sickness meds that the amazing anaesthetist had prescribed.

I’d vomited after my first section and it was torture. Told anaesthetist who prescribed specific meds and told me to ask for them the minute I felt sick. I did so and she told me NO as I wasn’t actually being sick....

I was too ill to push the point with her. I’m still angry now. I truly think she just couldn’t be bothered

Agree it's not good enough that women are left in pain, but routinely giving more wd be wrong too. All drugs have risks.

EMCS with DD aftercare was bad but pretty sure I was ok with just paracetamol within a few days (spent a week on ward 😖)

Long labour blasted my pain tolerance levels I think and I had such a cocktail of crap in labour/CS I didn't want more.

Care sd be attentive enough to tailor pain meds according to need.

@Jane - Im not 'acting' like anything

my point is why are you routinely given and expected to take paracetamol but not the oramorph. when its stored on their drug cart and they can hand it out without dr permission whether breastfeeding or not!!

i only knew the oramorph was a possibility due to taking unwell and the doctor coming to see me - and ultimately saying to the MW 'can you get this lady some oramorph'

Not reading all the replies but my mum smuggled me codine in, I just took that very 4 hours, compared to all the other mums I was right as rain. My mum was a district nurse and she was appalled at the pain relief options. Hope things are better for you now. It’s horrible isn’t it!

Make sure you buy the codine mix with caffeine and paratomol, I used it while breast feeding and my baby is fine. I figured I’d been on much stronger pain relief. She’s 5 months now and thriving, I’ve had wine and nights out too. It doesn’t have to stop your freedom.

Oh worth noting too I didn’t make big song and dance about pain relief, just really sweetly asked. And I often got that strong liquid one, get the nurses on side, one Mum there kept going on and moaning about pain and they never gave her anything strong. I think it can set off their drug addicts suspicions. I over heard them talking about her resquesting the strong drugs ect. Play it down, but get your own snuggled in.

Smuggled lol it’s too early. Also take codine home with you, that will change your life. Buy ones that dissolve in water. Beware of addiction and you shouldn’t take longer than 4 days in a row without a break but you will need. The pain doesn’t go away after hospital stay, I couldn’t walk I was in so much pain for few weeks. :( but once strong pain killers took hold I was right as rain. X

OP I see the issue here. (Am a midwife.) Paracetamol is a drug that will have been written up to be given on a regular schedule, hence the midwives handing it over each time. Usually it would be written up alongside ibuprofen or diclofenac (once your suppository has worn off), so the pain is kept under control. Oramorph is a PRN or "as needed" prescription. It is to be given as the patient requests it. Have you not been asking for it when the midwives come round? Have they been denying you it? It would not be prudent to "expect" women to take oramorph regularly as it is a stronger drug with some side effects- not everyone will want to take it and not everyone will need it either.

I was given paracetamol and ibuprofen, and a personal supply of oramorf (a small bottle) to use when needed. I only took it a couple of times a day so it lasted a while - I think the last time I took it was a week after surgery, when I forgot to take my regular drugs and couldn't get on top of the pain.

I'm pretty sure I had to ask for the oramorf at first as the basic stuff wasn't cutting it, but after that they were fine.

I was made to get up seven hours after my section, they made it clear it wasn't an option not to.

I was told I needed to move after my section. Problem was I couldn't feel my legs. Two nurses carried me to the shower and washed me on a chair, and massaged my legs. I was given morphine.

I had exactly the same when I had a emergency section 2 months ago. I kept being sick for the first 12 hours so brought all paracetemol back up. Got it through a drip around 14 hours after surgery and that was my pain relief.
Got offered something stronger (can't remember for the life of me what it is) and then they said I couldn't have more even though they said I could as I only had 1 tablet to begin with to see how my nausea would be. I was so disappointed and upset as I felt I just got left, and pretty much made to get out of bed even though I had next to no pain relief in my body. I left the following evening as I couldn't do it any longer, I managed my own pain relief at home much better

Can’t comment on level of pain relief after c section. But my dad has had several major surgeries and they are very keen to get people up and about and walking after surgery. Apparently it’s good for recovery and helping with fluid drainage from the drain pipes and reduces risk of dvt and other benefits.

Paracetamol, ibuprofen and codeine are standard where I work. We’ll do our best to space them out so that you are always covered which might be why you have only been given paractemol at this particular drug round? We wouldn’t give oramorph routinely as it can make you feel a bit rough/spacey/constipated but it’s written up as an option (it’s also a controlled drug and much harder to give because you need so members of staff and have to sign it out of a safe, which given shitty staffing is bloody impossible on a night shift).

FWIW the sooner you get moving, the less crap you seem to feel IME. After my section I was up and about by about 5 hours and never had any morphine. I know everyone reacts differently (trust me, I’ve seen the whole range) but you do seem to get more stiff and uncomfortable the longer you lie still.

I got tramadol, nurofen and paracetamol. Paracetamol on its own is nowhere near enough.

Paracetamol can be effective and comes with less side effects that other painkillers (such as stomach issues with NSAIDS and constipation with codeine). Its best to take it every 4 hours as a background painkiller and then if about 30mins/1hour after that buzz the midwife and say the pain relief is not enough and you need something stronger. I am 100 percent sure you will have been prescribed a couple of stronger pain killers (usually oral morphine solution and diclofenac) on a 'when required' basis so you absolutely can request them and if you havent exceeded your dose for the day you will get them. These analgesics do come with side effects so it is best not to take them when required but if your pain is not controlled and its affecting your mobility and therefore your recovery then you absolutely need them.

I’m likely to be having a section, I’ve heard about the issues in some hospitals with pain relief-for this reason I’ll be packing my own paracetamol, codeine and ibuprofen in my bag. Bugger having to beg!
I can be a massive pain in the arse when required though so they won’t get away with leaving me to suffer- if it comes to it I’ll make an enormous fuss.
Make a complaint, use PALS.

My c sections were quite a while ago now and I still break out in a cold sweat when I think of the pain I was in afterwards.

I am unable to take diclofenac so I got paracetamol and...that was it. Couldn't even get ibuprofen. I wanted to get up and moving but I was in so much pain and so weak that I didn't have the strength to sit up without help. But of course, no one would help me because 'you have to learn to do it yourself'. I would have done it myself if I had been allowed sufficient pain relief, but when you are on the verge of passing out from pain it's hard to do anything yourself. I was in tears with the pain and I begged for help and a midwife (who in fairness was lovely) said she'd get me something. She came back with peppermint oil mixed with water. That was my additional pain relief.

I had terrible post natal anxiety from which I have never fully recovered (thirteen years and counting) and I am certain that the trauma of the post natal ward (where I was kept for a week each time) contributed to it. When I mentioned it to my GP recently (because I'm still having complications from my C-sections) he said that he has a lot of patients who feel the same.

I live in terror of having an unplanned pregnancy. My husband had a vasectomy and I'm still terrified every month until my period comes. The horrors of the post natal ward will never leave me.

Conversely, I had abdominal surgery a few months after one of my C-sections and kept declining pain relief because I didn't need it, even though the staff were keen for me to take it. So I am very far from having a low pain threshold and being too quick to turn to pain relief.

It’s all fine and well to say that there’s stronger pain relief available and you only need to ask, but the reality for many of us is that asking doesn’t actually mean you get the decent pain relief. I was asking for hours, literally, and I got one dose of oramorph in the whole 2-day stay and only got dihydrocodeine towards the end because I begged.

A little while before my section, my mum had a hysterectomy. She for a PCA pump for pain relief. I had two non-maternity surgeries before this section that were much less major and I got stronger pain relief with those when needed. If we can treat most surgical patients this way, why are women who’ve just given birth via major surgery expected to be content with paracetamol and a pep-talk about getting up and about?