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 agree with 53rdWay. I also took my own pain relief and then later thought, 'These people honestly don't give a fuck their patients are self-medicating and it's nowhere on their charts because after all, they don't give a fuck enough to give you pain relief at all (I'll be right back! Just need to check something!').'

I'm surprised more women don't die here with the appalling post natal 'care' in many hospitals.

My whole experience with midwives was overwhelmingly negative - in my experience they have lost their humanity.

I feel much the same. I found them terrifying and their reluctance to allow women pain relief which had been prescription for them seemed like a power game with the women caught in the middle. I was in hospital for around a week after both births and both times the doctors were very sympathetic and agreed that more pain relief was needed and then when they disappeared the midwives said 'let's just wait an hour and see how you feel, you might not need it' and that went on over and over and the pain relief never arrived at all.

Was chatting about it to a friend who is a midwife in the same hospital and she said that if someone asks for additional pain relief they are automatically on guard and reluctant to give it in case they are an addict.

@JaneTheVirgin women should be told they can ask for stronger painkillers though. I had no idea I could ask for more tbh, it just didn’t occur to me.

Yep it’s completely out of order. I was sent home 12 hours after my section (fine by me, I hate hospitals) but was only sent home with ibuprofen . I told the midwife who visited at home the following day and she was outraged, made me phone the GP who prescribed something stronger immediately.

Apparently it’s standard now not to offer anything stronger, no idea why and if you’re BFing codeine is no longer allowed (it was when I had my other DC 6/7/9 years ago).

I'm sorry you've had to wait but I'm sure you've noticed the midwives are not only caring for you.

The nurses caring for post-surgical patients on other wards also have multiple patients to care for, and yet the approach to pain management in my experience has been quite different. It's only the c-sections where I was expected as standard to manage on paracetamol as soon as I was out of recovery and had to haggle and beg for anything stronger with the expectation that it would only come intermittently and reluctantly and 5 hours after asking.

You asked for it and have been given it

Aye but time and time again as evidenced by this thread @janethevirgin it’s not asking it’s having to ask and ask and ask and beg and - in my case - shout.

When you’re in that much pain nobody needs to go through that hoopla.

I agree; it shouldn’t be just given out....but making patients aware of the right to request AND delivering it promptly when it’s asked for is not a big ask; it’s the basics.

jane I'm a surgical nurse so what we do is very different from midwives, but if a woman has had paracetamol multiple times and each time it has not had enough effect for her, I would be re-assessing her analgesia and moving onto step two of the pain ladder as standard, adding in an NSAID or adjuvent and if not available, offering the PRN because I know they've demonstrated the para not being enough for them so let's get on top of it. Optimal pain control works on the basis of pain never being allowed to peak because then it's much harder to control. I'm a Pain Link Nurse though (hoping to specialise at some point) so something I'm overly concerned about as a nurse, not a MW.

53rd agree we do seem to handle it very differently.

I was up and about within a couple of hours of each section and never needed any painkillers. I also went home after 12 hours. So I don't have direct experience but our hospital liked to allow women to self medicate. They were given a drug chart and meds relevant to pain levels and shown how to take them and record them. I liked it as an attitude. It took pressure off the staff and allowed women the autonomy of self care. Perhaps explains why the cs patients were all up, coping and pain free when I was in.

It's very strange. I have had several major surgeries on my legs and every time, it was made very clear to me that staying on top of the pain was paramount to recovery - mainly because you cannot mobilise optimally if you're in pain - and then you step down the pain relief gradually. Works a treat mostly, you don't see most post-surgical patients end up on the street begging money for smack afterwards.

The exception seems to be maternity.

Ha @janethevirgin IMe they’re not actually looking after anyone my husband was expected to do all my care.

A family member recently formally complained about her post c section experience in post natal. She said the midwives were doing nothing despite having a small number of patients all in the same medical condition and were in her opinion, lazy.

She’s matron in the emergency medicine department of the same hospital so I tend to trust her perception.

They were given a drug chart and meds relevant to pain levels and shown how to take them and record them. I liked it as an attitude. It took pressure off the staff and allowed women the autonomy of self care. Perhaps explains why the cs patients were all up, coping and pain free when I was in.

I absolutely love the idea of this. We allow very little self administration here, its disappointing because we could better optimise pain control and save nurse time if we did.

@jane

its not the having to ask/wait. its the attitude, more like 'why would you possibly need extra pain relief after major surgery'??

I think the main problem here is not individual nurses, midwives or wards... It's that maternity related pain is treated fundamentally differently to other post op pain relief. As if it's a special branch of pain management that requires more caution or addiction prevention, way beyond what would be a responsible reaction to breastfeeding mothers (which not every woman can or chooses to so that's not even the reason!).

The only explanation that makes sense to me from this thread and hearing that this isn't an isolated incident/one off bad luck of poor care is that it's just ingrained mysogony.

Women's pain doesn't matter.

They were so shit with the drugs trolly after mine - staff were stretched yes but I was in huge pain and had lost 4 pints of blood on operating table!
I started to self medicate with nurofen I had with me- that made them freak and they were good for the next few hours then it fell apart I asked to be discharged and continued to self medicate. They seriously underestimate how painful it is.

God I wish I was given something stronger than paracetamol on the odd occasion they remembered. I was immobilized for a day and had the catheter in for 2 days. I was recovering from a life threatening illness and major surgury and couldn't be given anything stronger. I was in agony when I had to move but it does get better.
Don't let them fob you off if you are in pain but I second moving around as it massively helps

Seriously people if you don’t know what you are talking about STOP giving medical advice! Especially when it’s DANGEROUS!

I repeat YOU CANNOT TAKE CODEINE WHILE BREASTFEEDING! Google it, look in the BNF, look on breastfeeding network. It causes breathing and heart rate problems in babies. It’s dangerous.

Telling the OP to sneak it in is bloody awful! So then if her baby has a problem due to the codeine the neonatal staff won’t even know what they are treating as she’s been sneaking the codeine. Did you not consider how DANGEROUS your advice is?

You took codeine while breastfeeding and your baby was fine? Fabulous lucky you! My auntie smoked 40 a day and lived until she was 92. Does that mean I should tell people it’s safe to smoke?

When I say they were shit they were coming round every 7 to 8 hours not 4!

I had an EMCS a few weeks ago and was lucky with the aftercare but I wish I’d known you could be discharged with oramorph because I was specifically told if I needed I “wasn’t managing my pain” and couldn’t be discharged till I’d had a day without it.

Also chuckling wryly at anyone saying getting up and walking around afterwards is down to your pain threshold. I had my section under a general, got hacked from hip to hip, also had two internal incisions, bp was 80/40 for most of the following day and my oxygen was hovering around 85 so I was stuck lying down as I couldn’t even sit up properly. I asked to get up and walk the next evening, catheter bag if hand, and they were reluctant as didn’t want me to push myself too hard.

I have to admit it's usually super rare to be discharged with oromorph and it would require a lot of pushing but it can be done. Especially as it's a controlled drug but if women need it they need it, surely. Its only short term.

@CatchingBabies more accurately you can take codeine whilst breastfeeding (and stronger opiates) but the dose needs to be titrated carefully and the baby observed closely for any signs of respiratory depression. It shouldn’t be done except on advice from a doctor or midwife but it’s not absolutely contraindicated by any means.

I had a vaginal birth after being induced, so not exactly the same. My baby was born at 4:23pm, and I was given absolutely no pain relief until the next day. And then it was just paracetamol. I was in so much pain from the stitches and apparently I was supposed to have had a suppository but did not. I was eventually given a second lot of paracetamol and then told I could not have any other medication.

You do need to get up, I know it’s so hard but it will aid your recovery. My mother in law smuggled in her tramadol to give my after my section. Would not have managed without it. I got turfed out after one night too but then at least I could take whatever painkillers I wanted at home. Silver lining and all that. for you and congratulations on your baby

I had 2 sections and paracetemol was all I got - I think it was about not passing stuff on in your milk?

Crikey. I was given oramorph and paracetamol in hospital. Sent home with codeine and diclofenac

And I was bfing