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.........

Directly ask them for stronger pain relief than paracetamol. Buzzer again and again. Maternity recovery is pants ime but a midwife in mine told me after my emc that unless you directly ask them for something (be it pain relief, formula if you are having trouble breastfeeding etc) they were under orders to ignore you because you hadn't really asked for it if you said something like ”I think I need xyz”. You have to say ”I want you to give me pain relief because...”

It's utter crap because in other wards they hand out the oramorph like sweeties even if you don't want it.

I had oramorph twice after mine and I was breastfeeding but I had to ask for it. I had better painkillers when I had a tooth out.

I think this varies massively depending on area/hospital. For my EMCS with DS1, I found the after care horrendous. Like you OP, only paracetemol and ibuprofen. Every time I requested something stronger they took hours to appear with it and often didn't bring what I asked for. I got in to trouble for getting out of bed on my own 24 hours after my section (apparently I was meant to wait for a midwife to help me but no one had came to help and my baby was in NICU that I hadn't bloody seen!). No one to help me try and breastfeed or show me how to use their hospital pump. Often brought me the wrong formula.
My EMCS with DS2 I was in a different hospital and they were great. Wheeled me over to NICU in my bed just after having DS to see him. Brought me paracetamol, ibuprofen, diclofenac, and anything else I asked for as soon as I asked. Helped me up out of bed after 6 hours. Tried to make time to take me over to NICU, which was the other side of the maternity unit, in a wheelchair and always told me to get the staff at NICU to call them when I got there if I was walking over. Total support for breastfeeding.

Keep on at them OP. Be a nuisance if you have to be. Buzz and buzz until someone actually comes. They might be pissed off, but you need pain relief and that shouldn't be ignored. Nor should anything else you might need. Hope you get home to recover soon.

The first CS I had I was given paracetamol and oramorph as standard across the first 12 hrs but after that no more oramorph without request. IIRC I was ok but my first CS went like dream and I was up and about quick so I was lucky.

The second one: GOD NO. Paracetamol only as they’d “changed policy” on oramorph, I’m allergic to NSAIDS and they wanted to give ibuprofen and the afterpains the second time were shocking. I was on a big ward and had to shout right out at 0100 after 3 hours of being told “it’ll be with you in a tick after I check something”.

It was awful.

Not as bad as the wait for it when I was in hospital having a m/c. I was so bad I remember looking at the open window wondering if I should jump. It was honestly that bad.

Same trust, two CS’ one MC. The same person can have vastly different experiences.

My hospital is great for postnatal care in general but still rubbish at the pain relief side.

Their drugs rounds are based on people being asleep at night, so nothing between 10-6, even though people obviously don't sleep all night with a baby.

The drugs round was often late, and often you were just given paracetamol, and then nothing for 6-7 hours, by which time it had run out ages before, so no chance of keeping on top of things.

Middle of the night ibuprofen was available, but only in request - as was oramorph, but they didn't tell you this, so you never knew to ask.

Oh, and if you asked for oramoroh after midnight (which is likely given the 10pm paracetamol drugs round), then their policy was that you'd have to stay in the following night too, as clearly your pain wasn't under control.

It was much easier to take painkillers regularly and keep pain under control when at home, than in hospital.

On the plus side though, they let us get up when we felt ready, were helpful and attentive, and aside from the pain relief side (which is quite a big thing admittedly) they were fab.

There just seems to be some policy of trying to minimise pain relief given to women on postnatal.

Hmm it’s strange the Mum who was begging they really didn’t want to help I found. I’d smuggled my own in but I didn’t have an issue. I quietly said “I’m not coping please can you help” and I got strong pain relief when needed. I got so much help with my breast feeding too, my area was a meeting area for student midwives wanting to help. I got extra toast when I asked, I let any midwife cuddle my baby and when she was screaming they took her away for me so I could rest. I didn’t really bond until I got home, it was all over whelming for me. I’m so glad I had my own pain relief too. None of the other mums were in a good way. Please make sure someone gets you bits op.

I was fine with paracetamol and ibruprofen and didn’t have anything stronger after I was out of theatre.

But it depends on your pain threshold. I have a feeling paracetamol has a cumulative effect too - the longer you’re taking it, the better it works because of what’s already in your system.

I asked (firmly, politely, brooking no dissent) for oramorph (one dose) straight after and cocodamol (continued dosing including prescription for when I went home). I knew what I was talking about and explained I was in pain.

Get your partner to bring you ibruprofen. Take 2 paracetamol 4 times a day and 2 ibruprofen 3 times a day at the same time (ie, say, breakfast, lunch, bedtime, while paracetamol breakfast lunch dinner and bedtime). I’ve had two sections, this seems to be the standard medication bar some diclofenac early on and I’ve found it’s okay. I’m not denying there’s SOME pain on top of that but you should be able to get up and move about a bit. Take it regularly - don’t stop doses just because you think you might be feeling better - as the relief is cumulative. Hope you feel better soon xx

Yeah I got paracetamol and ibuprofen- it's major surgery not a headache!

It must depend on the hospital as I was given tramsdol after a forceps and episiotomy delivery - I wasn't keen on it though so I just had diclofenic (I think)

It's a crap policy if you have to specifically ask for the drug you feel you need. When I had my C-sections I had never heard of oramorph. Because I had never been in contact with anyone who was in enough pain to need oramorph. I know about it now because I have nursed a parent through terminal cancer. But there was no way I could have asked for a dose of oramorph because I didn't know it existed. I just kept asking for stronger pain relief and not getting any.

I was on Oramorph after my c section and breastfeeding twins. There is some great drug information on breastfeeding network website on exactly what drugs you can take when breastfeeding.

You can also have dihydrocodeine in addition to the oramorph and paracetamol. They can alternate them every few hours. Don't let them fob you off op. Good luck.

How are you today?

Thanks for everyones responses. Its been interesting to see how experiences have differed.

Lots of posts about the getting up and moving around, i wasnt annoyed at this, i know its extremely important. i was getting at it being unreasonable to be expected to do it with virtually no pain relief.

the midwives and doctors are lovely here and have been overall helpful amd friendly. its just this one issue. and i dont understand it.

can anyone actually explain why the pain relief for a section is so mimimal but for other similar surgeries plentiful and actually helpful?

@octo

not great. was nearly in tears earlier trying to change my babies dirty nappy......nearly 10 hours after last pain relief of paracetamol!!

since the fainting episode yesterday iv had 2 lots of oramorph - where iv had to specifically ask for it (despite the doctor telling one of the midwives my pain needs managed better as BP is on the floor)

both times i have asked for it its been met with a stare, followed by 'you got morphine slow release after the surgery'.....i then respond, 'im asking for the liquid oramorph thats in the drawer in ur trolley'. its then been given to me and no more said.

iv just asked for it again there, but the internet is down so mw is away to check if i can have it......bet i dont see her again.

That just isn't good enough, although if your BP is low there is reluctance to give opiates.

You can have paracetamol every 4 hours 4 times in 24 hours. Every time this is given you can have oromorph - or you can have it in between - in fact oromorph can be give 2 hourly, even 1 at a push if the patient isn't opiate naive - doctors don't usually presrube it this way but it can be done. I did explain earlier than paracetamol will be a regular drug whereas oromorph is PRN so you will have to ask for it, so ask for it as soon as they come with the paracetamol (they work well together so I do prefer giving them both together if I know the paracetamol isn't going to be enough), plus they'll have your drug chart then and there and won't have to fanny around making you wait. Here, if a person is left to wait for over 30 mins for analgesia it's classed as a nursing red flag and an incident report is supposed to go in. But even when I have 13 acutely unwell people and running the ward, we still manage to not let people suffer so if I were you I would speak to PALs either now or later on (if you feel up to it) because it isn't good enough and is impeding your recovery which they should know could then have effect on bonding.

I hope you feel better soon and get some stronger drugs.
I was told that since my first c section (when I had lots of diclofenac(?) that they now don't give strong drugs due to breast feeding and traces being in the breast milk.

I really feel for you as having had 2 sections, I don't ever remember being in pain after my first, but the recovery from my second was really painful.

The moving and walking dues help, but you're right, it's not easy or comfortable and it bloody hurts.

A doctor friend who also had a c section described it as having major abdominal surgery then starting a new job the next day.

Keep asking for whatever you can get and if it's really bad when you go home then make an appt with your GP, they might be more understanding.

You ask ‘can anyone actually explain why the pain relief for a section is so mimimal but for other similar surgeries plentiful and actually helpful’?

Answer: the patriarchy, specifically patriarchal views about women’s physical needs, feelings of pain, right to choose etc etc.

Imagine if a man underwent some similar operation without adequate pain relief and was expected to put up and shut up. Or had to undergo a vasectomy with no pain relief because first the anaesthetist was occupied elsewhere (because of nhs cuts) and when they were available it was too late - BUT hey, no worries: ‘congratulations you did it the natural way Dave! It may have hurt to god and you desperately wanted pain relief but you’ve got a healthy willy and that’s what counts! You should feel empowered!’

(This is by no means an indictment of anyone who wanted to give birth with no or fewer drugs, that’s their choice - but my point is too many women don’t get to choose. They often would have chosen an epidural/strong painkillers but can’t access it for reasons that could be avoided including just being subtly steered away from it.)

but is it really down to men?

all the midwives iv asked for more pain relief from are females.

or are you saying its come from men in general and now is just standard practice? (albeit not everywhere)

can anyone actually explain why the pain relief for a section is so mimimal but for other similar surgeries plentiful and actually helpful?

You’re correct and the answer is simple - because “you’re a mother now” and you’re expected to care for a newborn with virtually no help, with no consideration for how bad a state you may be in. It’s scandalous really. On any other hospital department, where patients have had major surgery, they’re actually nursed. Postnatal women don’t even get their meals brought to the bedside.

Its interesting to me because we get the early preggers on my ward and they're given more analgesia here for relatively minor things(in comparison to a section) than the women on the labour ward who have given birth or had a section. Its not over medication either, the women genuinely need it.

After undergoing both a section and a further op to contain a massive bleed I was in the High dependency unit - woke up in loads of pain, had to ask for more morphine (my drip couldn't be self administered and the midwife told me I wasn't done for anymore pain relief and I wasn't getting. My obstetrician visited me on her ward round about half an hour later - she asked how I was and I just sobbed and told her I was in agony and wasn't allowed any pain relief - she was really upset for me, said the midwife had no authority to make that decision and assigned me my very own anesthetist to look after my pain levels while in the hospital - he was German and he said he didn't understand the British attitude to this - woman in Germany get the pain relief they need. My whole experience with midwives was overwhelmingly negative - in my experience they have lost their humanity.
Ask and demand what you need while in hospital otherwise you won't get anything - it's the way it is.

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 explained why. Just because you don't agree doesn't make it any less valid. Oramorph is for BREAKTHROUGH pain. The pain that is still there AFTER you've taken your regular pain medication. And not everyone needs it, as evidenced by this thread. So why would they hand it out as regular when it's not a regular pain medication and is not intended to be used as such? Opioids are a huge issue and not without side effects.

You asked for it and have been given it. Which is exactly how it should work. I'm sorry you've had to wait but I'm sure you've noticed the midwives are not only caring for you.