To think the pain relief should be comparable

[BurnoutGP]

20 years ago I had a caesarian section. I had some paracetamol and was in hospital for 2 nights. Was sent home with a newborn and a 6yr old with no pain relief. I was pretty much a single parent.
Yesterday I had a full hysterectomy through my old section scar. I have a catheter, 2 drips, PCA fentanyl and IV paracetamol. I haven't been allowed out of bed yet and have been asked a number of times who is at home to look after me.
Yes im 20 years older (but otherwise fit and healthy mid 50s). Yes medicine has changed in 20 years. Anyone had a recent section? What pain relief did you have?
Because these are essentially the same surgery and the difference is quite staggering. And this time I have no small children to look after or really anything to do at all.

Absolutely there should be more care and pain relief post C-section. I've had two elective sections and was only offered paracetamol after both and looked at like an addict when I asked for co-codamol. I'm going in for my third section in January and I'm packing my own pain relief in my hospital bag so I don't have to ask (I've taken it through with the midwife, she's supportive as a lot of women have reported not being given anything and knows exactly what I'm taking. I do think pain associated with childbirth is minimised and dismissed.

Having said that, my mum has had two C-sections and a hysterectomy and she said there was no comparison, she went into the hysterectomy thinking it wouldn't be that bad and was absolutely floored. So I'm not sure of compare the two.

There is a lot more trauma to your body internally when you have a hysterectomy as opposed to a caesarean. You will need more pain relief so comparing the two is unreasonable

However, I do think there is a discussion to be had around the way women are treated when they have gynae procedures.

Also different people feel pain and react to pain relief in different ways. People with ginger hair for example feel pain differently

I was terrified when I was told I would need a c-section, I'd had a cyst removed a few years earlier and the pain and difficulty moving for weeks afterwards had been horrible. The c-section was a walk in the park by comparison.

Was that laparoscopically? If it was, that would be the belly button incision. I said earlier that the belly is a lot more sensitive higher up. And that’s why doctors developed c-section cuts to bikini line.

To add to the ginger hair comment, I read on Mn that people of Asian origin can feel pain more acutely apparently. And then there are people with collagen issues (may not be diagnosed), who need pain relief administered further in advance. I had egg removal from one ovary before the pain relief had kicked in. I nearly passed out with the pain. And have now been told this is related to collagen.

I think it should be patient centric. I had two c sections 20’years ago, discharged after 1 night with just paracetamol- but I didn’t need anything stronger. Others need more and should be given whatever is appropriate for them whatever the operation

I have had neither a c-section nor a hysterectomy but I think there’s a sort of machismo about pain tolerance in maternity medicine which is at the root of this. Medicine that relates to reproduction and childbirth seems to be approached differently.

I had a “normal” but very long and painful labour but I remember really clearly having to literally beg at the top of my lungs for gas and air and later for an epidural. The whole mindset among the nurses and midwives was more or less “suck it up, millions of women do this every day, you’re not special”.

There’s long been a problem with the way medical science approaches women and in maternity care this attitude is overlaid with this unpleasant stiff upper lip mentality.

A baby may be meant to exit the body, but not via the abdomen. It's not the removal of a baby that's the issue, it's the cutting and tearing of the woman's body in order to reach what is being removed (and quite possibly, the diastesi recti adding further complication).

I've had a section and a VBAC. The pain from the section was horrendous (and due to what happened during it - and some rather dubious/non existent care that included the wound opening up two days later because nobody was going to bother with little things like post operative care - I have experienced pain from it for the subsequent 34 years - the endometrial tissue that ended up inside it means that even an abdominal scan this year was incredibly painful).

When I had my other child, other than the episiotomy site being tender (forceps delivery), there was no pain at all and I could do whatever I wanted as long as any sitting down afterwards was done a little more carefully than usual.

Post operative pain relief should be available to women with all procedures - to decide 'oh, well, the baby came out fairly easily so the surgical bit doesn't count and, anyhow, you have to breastfeed and look after the baby, so your pain doesn't count either (and is probably all in your head in any case)' is textbook medical misogyny.

I’ve had 2 c sections and a hysterectomy
First c section I was in unbelievable agony and needed a morphine drip
Second c section was an absolute breeze happily managing on paracetamol
Hysterectomy was somewhere between the 2, I don’t like strong painkillers so had IV paracetamol

But that's short term use which is different because you're in hospital with your baby being monitored and it's very short term.
OP is talking about pain relief she was sent home on with a small baby she was feeding.

I was given codeine and even some liquid morphine on my c sections!!

A lot of mothers aren’t being offered this. The answer then, would to be to go back to funding better maternity care and not kicking them out 5 minutes post c-section.

I’ve had 2 c sections. Minimal pain easily dealt with using paracetamol and ibuprofen both times.

Well good for you. But that is often not enough for other women and the fact they are not offered more or shamed for needing more is my issue.

It’s not just that mothers are sent home with minimal pain relief post c section, it’s the lack of rest too. How can your body heal well when you get so little sleep? Women used to be in hospital for 10 days post birth with nurses on hand to help look after the babies precisely to allow women to rest fully before going home. When and why did that change?

I can't remember my c section pain relief, 30+ years ago now but it was an emergency and done under a general anaesthetic and not something that sticks in my mine.

But, few years ago I had to have a hysteroscopy, no pain relief advice given before, during or after.
It was one of the worst procedures I've had to go through and the pain for me was literally off the scale.

I don't think that's been the case since my brother was born in the early/mid 70s.

Prior to that when my mum was a midwife in the 60s many, many women had home births.

I think the golden age of post birth hospital convalescense was very, very short lived.

I had an 8hr laparoscopy with 7 incisions and wasn’t given/offered pain relief. My friend got given oramorph to take home so it seems to really vary

I absolutely agree that women's medicine is a shit show in general in terms of pain. I had a hysteroscopy without the offer of painkillers/sedation and it was monstrous. I was also told to 'pop in tomorrow and we'll put a little stitch in' when pregnant with a short cervix. Turned out to be full surgical thing involving a spinal block and a night in hospital, so it wasn't painful but I was hugely unprepared.

After a crash C-section I had to send DP hunting for a nurse for pain relief (eventually got some morphine after I burst into tears at the offer of paracetamol). At a planned C-section, though, they did a suppository which was OK with subsequent paracetamol. I think if it was completely pain free, I'd have done more getting up and doing stuff than I should have, though. No one should be left in pain unnecessarily, of course, but for me it did work as an early warning system not to overdo stuff too early.

Pain relief after 2 c-sections - first, just paracetamol, second they gave me some diclofenac, which was a lot easier as you only took one every 12 hours, but TBH I was better after a couple of days anyway, oh, and I was home in under 24 hours (basically as soon as rounds could get to me and discharge me)

I recently had a hysteroscopy with ablation though, and was told not to do anything for 24hrs, and given a big box of codeine, so TBH, pretty similar treatment (although I have plenty to say about my second c-section and the appalling lack of care throughout, they did at least give me that little bag of pain relief)

But you did have a newborn that needed you to care for them, thats the nature of childbirth, what are they supposed to do about the fact your newborn needs you every 90 minutes at night?

Im sure your friend had to have support to have 6 weeks rest, the NHS wasnt providing that. Its required by law you have 6 weeks off work post childbirth as a minimum, your family/child's father can provide support. Its fairly equivalent.

The support you get post either procedure is going to be dependent on your support at home.

No it wasn't. That was why I was comparing my two surgeries with very similar operations scars, but very different effects internally.

I had oramorph but I made a point of asking for it

I’m not saying the NHS should keep mothers in for 6 weeks post a c section. What I am asking is, if mothers recovering from a c section can cope without 6 weeks’ rest, why is this recommended for patients recovering from other similar ops? Having a new born to look after does not magically speed up the healing process!

I do hope you're not implying that I said that pain relief should be rationed in any way, because I didn't. I was voicing the view that a c section birth is not at all the same as removing the uterus via the abdomen (old scar or not), just that same as removing my uterus via my vagina was not the same as giving birth to my baby, vaginally, although I did have a tear with both things. Ultimately, babies are designed to be removable; wombs are very definitely not. The fact that you had problems is regrettable but doesn't change my argument. Things can and do go wrong (and you speak of poor after care) with any surgery but it doesn't sound like it did for the OP.

Its an interesting discussion. I have had excellent care for my hysterectomy. A wonderful female anaesthetist who listened to my worries and gave me a spinal block before the GA, then a fentanyl PCA, I've also had IV paracetamol and lovely nurses offering and asking me about pain. Its made my recovery so much better (all NHS).
I cant help feeling so sad for the 35yr old me who sobbed on the hell of the postnatal ward with no pain relief being told off by the midwife for falling asleep with my baby but I literally could not put her back in the crib and no our answered the bell.
I was clearly so traumatised by it that I have brought my own little bag of painkillers in with me which I obviously haven't needed. But why was that 35yr old treated so badly.

6 weeks rest means 6 weeks off work, which everyone giving birth already has. It doesnt mean 6 weeks in bed. You are recommended to avoid heavy lifting for 6 weeks, avoid strenuous excercise, not drive, you are advised to "take it easy" post C section, but they cant exactly advise you dont care for your newborn baby.

What are the NHS supposed to say "sleep all night to recover, dont worry about feeding your newborn baby at night". Someone with a newborn and coincidental fibroid removal would be told to rest but isnt getting it, the NHS isnt facilitating their rest anymore than post Csection.