Caesarean aftercare and advice - what was your experience?

[HayMax]

I recently had an ELCS for a breech baby . The pre-op appointment was brilliant and really informative about what to expect during the c section, and the birth itself was a lovely calm experience. BUT I found the after care and advice in hospital pretty disappointing, and was just wondering if my experience was typical?

It wasn't the post natal ward or midwives as such - they were good in general despite being busy. It was the specifically c-section related care/policies - for example:

• Given pretty low levels of pain relief (paracetamol and tiny dose of diclofenac - less than standard ibuprofen) unless I specifically asked for more after the first 12 hours or so. Nothing for at home - just told to buy paracetamol and ibuprofen.
• I got horrendous skin burns from the outer dressing they used on the incision and was told by several people that this was 'very common' - why do they not use a different one?
• Very very little info on wound care - what to look out for in case of infection, what is normal, how best to keep it clean/dry etc.

Does this sound standard? I am thinking of giving the hospital some feedback - it wasn't a terrible experience I just thought the lack of info on c-section recovery and the meagre pain relief was quite surprising. I would have felt better about going home if I'd had more information - and more painkillers! I also wonder how this compares to the advice and pain relief given to other people who go through major abdominal surgery...

Hi HayMax, my ELCS was 9 weeks ago and fairly similar to yours. I was on some terrific painkillers though and hardly felt a thing, co-dydromol if my memory serves me rightly. I was sent home with a whole load of drugs to last me for the next 3 weeks and can honestly say they worked a treat, my recovery has been really good.

As for aftercare advice I got given a workshop from the hospital physio the day after surgery with a few other women. We were told the best ways to move, get in and out of bed and do simple exercises to help. It was really helpful.

So sorry Haymax - maybe you should make a complaint.

I was sent home with a medicine kit of paracetemol and diclefenac - enough for 2 weeks (I didn't bother finishing them as I wasn't in pain!).
The dressing was removed the day after the birth and the wound was incredibly clean and looked well-healed.

I had daily midwife visits for 10 days. The stitch was removed on day 5.

I was also invited to a couple of physio sessions at the hospital.

A month after the birth, I had a routine phone call from the hospital to check on my wound. I didn't have enything to report - I felt great, and by then couldn't believe I'd had a c-sec.

Your experience doesn't sound good......hope you're OK now.

haymax congratulations on your baby!

My story is similar to yours. I was actually written up for stronger pain killers, but they said I wasn't when I asked. When challenged on this, I was told it was because I was BFing. It should have been up to me to decide. They had not right. They also gave me the PCM and ibuprofen every 4 hours, then told me I could not have anything else for 8 hours or so, and the pain got to a point it was hard to get on top of again. I will be more in control this time!

Did you get much shoulder pain? Mine was worse than the wound pain, and when I asked for something for it, they had no idea. I will take my own peppermint in this time.

Apart from pain relief, the care was pretty good. I thought getting me to shower myself and change my own dressing from the following morning was a bit mean, but I managed it, and this gave me confidence.

Hi Seoladair,
Your experience sounds great. Congratulations on your baby! I may be having an CS, and just wondered were you stitches not dissolvable and did the removal hurt? Was there anything in particular you think that you did that helped make your recovery easier? Im particularly worried about how i'll be able to avoid using stomach muscles when moving / getting out of bed & off the sofa etc..Did you make a conscious effort to relax as much as possible?
x

I'm thinking about a stretchy tube bandage or a corset type thing to support my stomach this time around. Laughing and sneezing post op hurt more than the actual immediate post op ouch. A friend gave me a stretchy tube bandage after a few weeks and it seemed to really help especially when lying down to feed as my flabby/empty but still distended stomach was flopping around and dragging slightly at my stomach muscles. Trying to arrange a baby and a supporting pillow into the right position was a real faff so it was a godsend.
Post op I became anaemic (normal blood loss, nothing dramatic) so I recommend having the liquid iron supplements in the house. Stick it in some orange juice and you can barely taste it.
raphbec it was handy to have a higher chair/chair with a cushion so you are not heaving yourself out of a low chair. If you are v late pregnancy now, it will be as difficult post op to get up as it will be now. The key thing is to settle yourself into something comfy (esp if bfing) as bolt upright as possible before someone hands you your baby. It's v easy to slide down into a more comfy position but excruciating to try to engage your stomach muscles to lever yourself more upright with a child in one arm.
Get everything you need together before sitting down to feed. Glass of water, snack, remote control, book/kindle, telephone and mobile, sign on the front door to say to give you some extra time to get there. I bought packs of sports cap bottles and just stashed them everywhere I sat down to breastfeed, so I always had some water available.

Hi Raphbec
I was given a choice about the stitches. I chose one long stitch held in by prolene beads. (I can't remember what the other option was - possibly dissolving stitches?)
In general, a planned c-sec is much easier than an emergency, so that's probably why I had such a good experience.
Getting in and out of bed was uncomfortable for a few days, and I found it better not to turn over in bed. I lay on my side, partly on a pillow. The midwives can demonstrate the best way to get in and out of bed.
That was the only discomfort I felt really, and it passes after a few days.
Best of luck!

My previous c sections were 8 and 6 years ago so my memory is pretty hazy. However, I do remember being given cocodamol on disharge. Pain relief in hospital was generally ok. Although I do remember killer afterpains with my 2nd. Painkillers didn't touch that. Also missed out on last dosage as they couldn't give me anything as my file was at pharmacy. Going to take some paracetomal with me in case that happens again.
I too was only given very little advice re wound care or anything csection related.
With my 2nd I was even told where the sheets were if I needed to change them!!!! Although since I spent only about 32 hours on the ward this didn't really matter.