New Idiots guide to Elective C/section

[wiltshire]

As the idiots guide to bringing home baby was so bloody fantastic. I would like to have one for this as well. I will outline what is supposed to happen next week and would love to hear any views/experiences/tips for this as well. Also I know that this has been done before but in my labour bag, do I need to pack my robe/nightie/slippers/baby clothes or not. As I am not doing labour I am not sure and don't want dh taking home bag with stuff in it that I need.

Thursday 25th

Go in to get bloods/general wellbeing for op done

Friday 26th

0800 Go to hosp. Op scheduled for 0930 but I have been warned that any emergencies will precede me (fair enough). I am opting for a spinal anaesthetic.

Thats as far as I get. Will I be on a ward or a room, when will I will be able to get up. Will I be able to hold baby. How long before I am back in my hosp bed. You see, I am going to be in this place for 5 days. What will happen. I hope you are not all too fed up with me to help with this.

Oh and how long can DH stay, are they usually strict with this or not.

Hi, of course you need the same stuff - you are still having a baby

What will happen is that you will probably have to wait quite a while - I waited all day and got very grumpy cos I wasn't allowed to eat.
You will walk into theatre and get up on the bed yourself which feels funny. Then you will have your drips put in and then you will lie on your side as the anaesthetist puts in the needle for the spinal block. This didn't really hurt me a they numb the area first. Just a pricking on the skin - no deep sensation at all for me. Very quickly you will feel an odd sensation heavy, cold, tingling sensation in your legs and lower body and then you will go completely numb. This, for me, was by far the freakiest part of the whole experience as I am slightly phobic about going numb (eg after pins and needles) and then you will be without sensation or movement from the chest down. You will be wedged slightly on your side so you aren't flat on your back, a catheter will be put in (you won't feel or notice this) . Then the team will erect a screen over your body at about chest height so you can't see what's going on. The section will happen when - and only when! - you have no feeling at all. It's incredibly quick. the surgeon will tell you when they are starting teh op and about five or ten minutes later you will see your baby. You can ask for your baby to be delivered on to you, or to be given to you immediately. I wish I'd asked for that but instead he was given a check, a weight and a wipe while I was desperate to hold him. I held him immediately but at first you can't sit up so to get a better look at him I gave him to dh, who held him, while I kissed him and stroked him (baby, not dh! Though I did kiss dh and we both were teary). I was stitched up while this was happening - again, absolutely no feeling. After this - I suppose about half an hour - 45 mins in total, during which you can talk, breastfeed, cuddle your baby etc, you are wheeled into a recovery room. I started to get sensation back in my legs after about an hour from the moment the block went in, but you will still be on drips/catheter etc. A few hours later was wheeled to my room by which time it was about 10pm - this wasn't for medical reasons, more that the room wasn't ready! I think on an NHS unit you are more likely to be allocated a side room if there is one, but it's not guaranteed by any means. The next day you will been checked over same as anyone else and encouraged to get out of bed. You'll be bent double at first, and shuffling, like quasimodo, but you will straighten up pretty quickly. You will still be on a drip or two - I think mine went on day 2/3. You will be given painkillers and you should take them as they will make your recovery much quicker. Take nice toiletries and a bit of makeup to make you feel more human, esp for visitors. Get your dh to bring food! Hospital food is vile. Bring mags, fruit, drinks, a radio with headphones etc along with a few nighties, some thin ultra nighttime towels and enormous soft knickers which won't squash your bump. Make them cheapies so you can chuck them out afterwards without any guilt! I couldn't find a comfy pair of disposables personally. Your milk may take a day or two longer to come in after a section. Your baby will be fine on colostrum - babies are born with fat on board to see them through the first few days. If you are worried ask to see the hospital breastfeeding counsellor rather than be pressed into bottle feeding if this isn't what you want. Five days is nothing - I was in for more than five weeks - though that was before the section rather than after it, I hasten to add. Don't feel you have to stay in for the full five days if you feel really well and are desperate for your own bed. I was fine after three. Take in your own pillow and a breastfeeding pillow if you have one as it will help you get comfy. Hospital pillows are bad things. Make sure you can breastfeed in your nighties - they should be front opening ideally. I had a private room (paid for by insurance) so dh could visit at any time which was just wonderful for me. I think NHS wards are very strict, but others know more than me about visiting post birth.
Any questions, ask away!

er....wow!

Oh, you need to lose the top couple of inches of pubic hair as that's where they make the incision. You have to keep very still when they put in the spinal but that's easy because you aren't in labour.

Aloha you should write an idiots guide to babies
Impressed

I had an elective section on the NHS a couple of months ago and it was pretty much as Aloha described ie loads of hanging about beforehand (so nervous I could hardly breathe even though it was my second section!) then the op and some time in recovery before being taken to the ward. Don't be alarmed if you look down at some stage after the op and see that you are wearing a huge pair of inflating wellies - they keep your circulation going post-op and are the business for squeezing fluid retention out of puffy pregnancy ankles.

With both my sections I found the aenesthetist (sorry, spelling) pretty invaluable - not just for giving the spinal but for keeping me informed about what was going on down below (s/he is usually standing by your shoulder and can provide a running commentary! ). If your partner isn't squeemish he might want to watch the op over the top of the screen - it's not for the faint hearted but I would have loved my dh to be able to see our children emerging into the world - so I could pester him to describe it to me for years to come .

I don't know if it was just the policy of my hospital but DH was allowed to come and go as he pleased all day (and I was in a ward not a single room) but there was an unwritten rule about partners going home around 11pm, although I didn't see any partners being asked to leave. The same rule applied to any siblings - as long as they weren't making too much mayhem while other women were trying to rest.

Totally second what aloha says about painkillers and big knickers - and for an NHS ward you might want to add earplugs to your list - those wards can be bloody noisy even in the dead of night.

Finally - when they try to make you get up for the first time you will probably feel terrified (oh my God - what if my stitches pop and my stomach bursts open and spills its contents onto the floor????) but you will feel SOOOOOO much better once you are out of that bed. Also - learn to love your catheter and beg to keep it in for as long as possible - after nine months of continuous peeing it is a complete joy to have your bladder emptied by artifical means. I would have gone home with that catheter still up me if I had been given any choice in the matter

I can't possibly compete with aloha's very comprehensive posting, but just thought I'd add that some of the things she described were different for me, just in case you get worried that it's not all happening exactly like that. For example, I didn't have to wait, went straight in at 9 am (though obviously that was just chance), and had my spinal block sitting up in the room just outside the theatre, not lying down. I also had to take some pills the night before, something to do with digestion.
I was made to get up the next morning, it was pretty sore. I had patient-controlled analgesia (morphine drip that I could administer myself) for 24 hours, and then just the usual ibuprofen/paracetamol. I've said this before on another thread, but when you finally get something to eat, take it slowly! Do not do as I did and wolf down an enormous breakfast, I had more pain from that (trapped wind) than the operation itself
Good luck and let us know how it goes!

I had an elective cs nearly 2 years ago. Mine was also very similar to alohas, but a few things were done differently, guess it depends on the hospital.

My catheter was put in before I went to theatre and therefore I went on a trolley, I didn't walk. The anaesthetist was great and really put me at ease and it was pretty painless having the spinal block done. At our hospital your dh/p isn't allowed into the theatre until the block is done.

I don't remember being told when the cs had started and my dp watched it over the screen as he loves a bit of blood and guts. My dd was taken to the resuscitation table immediately after the birth for her checks but then handed to me. Like aloha, I couldn't see dd properly, so dp took her.

Went to the recovery room and had the first breast feed. I wasn't in there that long and then went straight to the ward. All the cs babies on my ward had little electric heaters over the top of their cribs to keep them warm, which looked pretty strange.

Everything else was pretty much as said before. I didn't want to get out of bed at all and would have kept my catheter in as long as possible. It is so much easier not having to go to the loo.

Which reminds me, the nurses used to come round and give you a quick clean up with a jeyes cloth and stick a pad between your legs. Wasn't as embarrasing as I feared though.

Hope it all goes well for you.

Oh yes, I had forgotten about the wind, complete nightmare, if you get offered some peppermint stuff to drink, take it.

Also I had a pessary inserted in theatre for pain relief and then another one given to me by the nurse.

Thank you for all of your postings. Very very informative. Aloha, you said don't worry about asking so at what point do you change into your own stuff. This is where I get confused. Should I just take everything in or what. I have a small labour bag, but a bloody huge suitcase & v.pillow as well. This probably sounds a bit pedantic, but as I now feel fully informed about the rest of it, this is just the last bit. As I have so much, I don't want to put DH through removals as such.

I am happy that you don't feel the catheter as that was going to be my next question. It does actually sound that the whole thing is pretty painless until of course you try to get up. I had an ectopic pregnancy 10 years ago and they removed my tube. I had to have a drain etc and I am assuming that the pain will be similar. Standing up & feeling your guts go. does this ring any bells?

I can only agree with everything Aloha said. Only difference was I preferred pyjamas as it saved you flashing everything when you struggle to get up ( and no-one can see that your legs are hairy!)

I had an emergency caesar ... so can't comment on the 'elective bit ... but I think Aloha's account was excellent.
Just a couple of bits ... I think it depends on the hospital where you have your baby whether some things happen or not ...
For example ... East Surrey Hospital in Redhill, where I had my baby, was very very strict about visiting hours ... even for daddies. It was the worst bit about being in hospital ... he could only come from 10am to noon, 3pm - 5pm and then 7.30 - 9pm. The 10am to noon slot was for partners only ...
No one suggested I breastfed my baby whilst being stitched up ... in fact he was so wrapped up in blankets that I could hardly even see the top of his head ... if I have a c/s next time it will be very different!
I was not allowed to hold my baby straight after delivery ... again next time it will be different!
I was allowed to have my drips taken out quite quickly ... I hated them and hated the patient controlled morphine and what it was doing to my head! I think they were out by 9am (DS was born at 4am)
I was allowed to get up really early aswell ... was up and about as soon as the drips were out ...
Oh ... and I was a bit surprised at the fact that I still bled a lot from my 'bits' after the c/s ... for some reason that had not occurred to me ... derrrrrr!!! When I first got up I had quite a scary looking flood but the m/w said it was normal and she was ever so kind in cleaning me up ... (not the most dignified thing in my life!!)
Some hospitals give individual rooms for c/s's (even on NHS) but some don't ... I was in a ward with 8 other beds ... only one occupied for the first 2 nights and then on the third day all the 'electives' came in and we were packed in like sardines ... (they squeezed in another 2 beds) ... so after a night of no sleep as there was too much going on I decided to leave!!!

Ghosty, did you discharge yourself. Although it is an elective cesarean, that just means that on my doctors advice I have agreed to one. That word 'elective' sounds awful. It sounds like the person having the baby has asked for it. To posh to push and all that. Mind you after reading loads on mumsnet, I am quite glad I am having one.

Take arnica on the lead-up to the section to help with the bruising.
Most theatres will let you bring your own music in so pack a few CDs of your fave stuff.
Be sure to let the anaesthetist know straight away if you feel at all sick during the op as they can help try to avoid you being sick by increasing your oxygen.
Don't bother with disposable pants - the elastic waist is the same level as your scar - ouch!
Take your big black pregnancy pants (lots of them) and stick a san towel on the inside of your pants to cushion your wound!
IME you can change into your own stuff when you first get up, after you've had your shower, possibly the next day, depending on what time of day you have your section. Try to do your hair and put a bit of lippy on - you'll feel better!
Don't struggle to get up too soon - it will HURT! Take advantage of the fact you are being waited on hand, foot and finger - cos you certainly won't be soon after!
Accept - readily - all pain relief offered after the spinal block wears off.
Hope this helps. Good luck!

God, almost forgot - you must still do your pelvic floor exercises. Guess who thought she didn't have to because she'd had a section, and then wee'd herself jumping on a bouncy castle 6 months later?

Wiltshire, I've had two electives on the NHS and my experiences were pretty similar to Aloha's and Tamum's. You will go to theatre in a hospital gown and if I were you, although they are loathesome polyester, I'd stick with a gown for the first 24 hours after your op because you are less mobile than usual and a nightie might get irretrievably stained.
Agree with whoever said to cultivate the anaesthetist - these people stay by your head throughout the op and if you have a rapport it is great. The spinal does not hurt but as Aloha said, is a very WEIRD experience.
Definitely recommend peppermint oil for trapped wind and if they are prepared to accept patient requests for painkillers I found voltarol (by pessary) great for the first 24 hours and then co-proxamol for the next couple of days did the trick for me. I am sure my recovery second time round was better because I took 200 potency Arnica for five days prior to surgery and a week after.
Would also recommend you get a midwife to show you the right technique for getting yourself into a sitting position and getting in and out of bed post-operatively. Obviously you have help for the first 24 hours but you have to do it for yourself after that.
Hospital policies about being on a ward/in a side room after a c-section vary. Mine insisted on ward care post-op for 24 hours so you were all together and it was easier for them to do their obs. If you can possibly get a side room thereafter, DO. It is quieter/more private and you may find your dp can stay when ward visitors have been banished.
Good luck, remember it is a very safe procedure!

When you go home you'll be told you can't drive for 6 weeks - that may not worry you but for me it was a real problem - anyway it's not strictly true - if you feel up to it and you get the nod from your GP you can drive before then, as most car insurance companies are pretty laid back about caesarian sections now

The only thing I would add (just so that you are ware of the eventuality) is that in some cases you will hold your baby very quickly after the birth but I have been in theater 7 times (as a doula) and on a few occasions (3 times I think) it was a wee while before mum was handed her baby.... so be prepared for that too. They often have to give the babies a wiff of oxygen or clear their nose and mouth.... and they do this in the theater in what they call a rescusitaire. Your DH can watch of course.

Pupuce is the resusitaire the thing that looks like a grill? I made my m/w laugh when I asked if they had put DS under the grill!!

Wiltshire ... I didn't discharge myself ... but the wards were so full (they had closed Crawley maternity unit for some reason and had sent billions of labouring women to ESH) that the midwives were desperate to get rid of some of us so they came and asked me if I felt up to going home. Physically I could have done with another night but mentally I was desperate to get away from the madhouse of 9 other women and 9 screaming babies and back to my own house and bed.

Re: disposable pants ... I used them for a week or so ... they didn't rub on my scar at all ...

Oh ... a good friend of ours who is one of the funniest men on the planet came to visit on day 2 and made me laugh so much I had to send him away. I was convinced I was going to split my stitches

Can't add anything on the advice front, just made me remember how fantastic it was to see this little purple baby, arms and legs outstretched like a starfish, yelling her head off being held up for me to see. Then our 3 heads together on the pillow as we said hello. Fantastic. All the best.

You do need to ask if you want to hold the baby straight away. remeber it's still your birth - you can ask for the things you want (music etc). After my spinal block I started shaking violently and uncontrollably. Apparently a fairly common side effect of the blood pressure fluctuations, but if they don't warn you it can be very scary. I also threw up (well retched) - which is extremely difficult to do when you have no muscle contol below your boobs.
Take your babies first outfit + nappy (babygro is best) into theatre - they got my dd dressed in there whilst waiting, but because we didn't have any clothes ready dh had to dash back to the ward.
Discuss the stitches with the consultant. I had a continuous stitch that went under the skin and just stuck out at either end - this is much better than multiple stitches. And it is quite normal to not have a drain. You do not want to have a drain.

I'll second about being definite on what you want to happen with your baby. I knew it was a while before I saw anyone post-CS but it was only when I got my notes that I found that it was 1.5 hours between when my baby was born and I was returned to the ward, where I met up with her again. I hadn't held her in all that time and she hadn't even been near me - had been with my DH who was waiting in the delivery room (he hadn't wanted to come into the theatre) - rather than all of us being together in recovery.

Agree with making friends with the anaesthetist - I insisted mine tell me jokes as I was a bit nervous. My dh was with me every second of the time from going into theatre to going back to my room. I would be very insistent on that - bugger hospital policy! I really felt I needed him with me. Also, if you want your baby right away, make this very clear to the whole team before the op begins. Also, once I had my baby, they couldn't prise him away from me! The amount of pain you will be will vary a lot from person to person. It does feel a bit as if you've been kicked in the stomach, usually, at least for a day or two. And yes, you will bleed for a while, but I think it is lighter than with a normal birth as you get 'cleaned up' internally when they do the cs. I found Always Ultra Nightime press on towels were easily absorbent enough.
I changed into my clothes the day after the op - I think...funny how the memory fades - just a very loose skirt and t-shirt. Walking was a bit of a shock but got much easier quickly. I found co-proxamol made me dizzy and disoriented when I had previous surgery so didn't have it for the cs. Most people are absolutely fine on it. You won't need lots of changes of outfits - I promise! I had one skirt, one pair of drawstring waist trousers and a couple of t-shirts - and I'd already been in for weeks and weeks. Don't take in a huge suitcase as your dh will be visiting every day so he can take dirty stuff home and bring you new, clean stuff as you need it. the less you have to bring home the better as you won't want to be carrying anything heavy and you will have the additional baby and the car seat to transport home as well, remember Before you have your op get (or get your dh to get) a phone card that lets you use the bedside phone in your ward. You will NOT want to get up and walk down the corridor every time you want a chat with your mum/friends etc.
Good luck. I'm getting excited for you now!

You have to wear hideous white elastic stockings after the op for a couple of days to prevent blood clots while you are less mobile - they are not a fashion item. I kept taking mine off because they were so hideous (and I am so vain) and got told off. I don't recommend this