Caesarean section requires a longer recovery time after childbirth. The operation is serious, abdominal, and therefore the process of rehabilitation after it proceeds completely differently than after natural childbirth.
In this article, we will tell you how long after the operation a woman will have to stay in the hospital, on what day the mother and baby are usually discharged from the hospital after a cesarean, and what can affect these terms.
How is it done?
In natural childbirth, the baby leaves the womb through the genital tract. This is a long and laborious process, largely regulated not by doctors, not by a woman in labor, but by Mother Nature. For a mother and child, birth can be long and difficult, but the recovery process is also more natural, physiological.
Caesarean section is done when natural childbirth for certain reasons is not possible or can be very dangerous for the life and health of the woman and her baby. In this case, the child is removed not through the genital tract, but through an incision made by the surgeon in the uterus and the anterior abdominal wall.
The reasons why a woman is advised to have surgery can vary. Some become apparent even during the period of gestation, and then a planned cesarean is prescribed, others appear suddenly already in the process of childbirth, and then an emergency operation is performed.
For elective surgical delivery, the reasons are most often:
- large fruit sizes;
- discrepancy between the size of the pelvis and the size of the fetus;
- pronounced polyhydramnios or low water;
- placenta previa with overlapping internal os;
- tumor neoplasms in the uterus;
- postoperative scars on the uterus;
- pelvic or transverse position of the fetus towards the end of pregnancy;
- genital infections in a woman;
- gestosis;
- diseases of the heart and blood vessels in a woman, renal failure, myopia and a history of retinal detachment.
For emergency surgery, the indications are completely different. Most often, the need for surgical completion of labor arises with the development of primary or secondary weakness of the birth.
Weak contractions that do not lead to the opening of the cervix to the desired size, stopped attempts, a long anhydrous period, the lack of effect from drug stimulation, signs of fetal hypoxia, massive bleeding in the mother - all these are grounds for transferring a woman in labor from the delivery room to the operating room.
If the operation is planned, the woman goes to the hospital in advance, without waiting for the contractions to begin or the water to drain.
Most often, it is prescribed to go to the hospital at 38-39 weeks of pregnancy, and if the operation is not done for the first time, then about a week earlier.
For several days, the woman is examined, tests are done, a control ultrasound is performed, the method of anesthesia is chosen - epidural (spinal) anesthesia, in which the woman will be conscious during the entire operation, or general anesthesia, in which the woman in labor will sleep soundly with medication.
On the day of the operation, in the morning, the woman is given an enema, her pubis is shaved, her pressure and body temperature are measured. They are brought to the operating room on a gurney and, first of all, anesthesia is performed. After the anesthesia is introduced, the doctors mark the incision lines, treat the abdomen and perineum with an alcohol solution or iodine solution, and proceed to the operation.
It lasts from 20 to 40 minutes. During this time, the surgeon cuts the abdominal wall, removes the muscles and bladder aside. If the operation is planned, a horizontal incision is made in the lower segment of the uterus. Then an incision is made in the uterus, the fetal bladder is perforated, the amniotic fluid is drained and the baby is taken out. The moment the baby is born into the world, a woman can hear his first cry only if she chose an epidural anesthesia. In a state of general anesthesia, the woman in labor will not be able to survive these moments.
The baby is transferred to the neonatologist or nurse of the pediatric department. While the umbilical cord is being processed, the baby is weighed and evaluated on the Apgar scale, the surgeon manually separates the placenta from the uterine wall and sutures the reproductive organ. Then the muscle tissue and bladder are returned to their place and external sutures are applied.
If the operation is emergency, then the incision can be vertical, but it is resorted to only when there is a vital need to remove the child as soon as possible due to the risk of his death in the womb.
In case of repeated birth by KS, the operation may take longer than during the first operation, this is due to the necessary time costs for excision of the old scar, which must be performed, because each time a woman is operated on strictly according to the old scar.
Rehabilitation
From the operating room, the woman is transferred to the intensive care unit, and the baby is transferred to the children's department. The newly made mother will have to spend several hours in intensive care under the vigilant supervision of doctors. They will monitor the level of blood pressure, body temperature, heart rate. All this is very important for assessing the condition of a woman, for assessing the quality of her exit from the state of anesthesia, whatever it may be.
Sometimes drip injections of saline with the addition of vitamins are prescribed. But recently, doctors are increasingly refusing intravenous injections if there is no heavy bleeding, so as not to cause intestinal edema in a woman. From the very first hours, the young mother is injected with reducing drugs and pain relievers. The uterus with a scar shrinks much more slowly and worse than the uterus of a woman who has given birth by natural means, so you cannot do without appropriate medications.
After about five hours, the woman, if she feels well, is transported to the postpartum ward, where she will have to spend the rest of the time until she is discharged from the hospital.
After about 6-8 hours, doctors strongly recommend starting to be active. This will be the best prevention of inflammation, infection, congestion and adhesions.
They try to attach the baby to the breast as early as possible in order to accelerate the process of contraction of the uterine muscles and stimulate lactation, which can be established at a slower pace after surgery.
Joint stay with the baby is usually allowed already on the second day, provided that the woman got up, began to walk, that she can take care of the baby on her own.
To recover faster, it is recommended to start moving, but do it in stages.
First, master the turns from the back to the right and left sides with the support of the seam area with your hand. Then learn to lie on your side confidently. Lying on your side, you can feed your baby to avoid unnecessary lifting of weights, which is absolutely contraindicated after surgery.
After that, the woman can lower her legs and sit down. It is better to get up and walk after the operation with support or support on a bed or a wall, since dizziness will accompany the new mother for at least several more days.
When are they discharged?
Even 15-20 years ago, after a cesarean section, a woman could get home under the most favorable circumstances for only 10 days.
On the 7-8th day after the surgical delivery, the stitches were removed, a control ultrasound was done, for a couple of days they were watching how she was feeling, and only then was she allowed to be discharged home. Antibiotics were usually given for 10 days to rule out the possibility of infection, even in theory.
In recent years, maternity hospitals have a completely different approach to caesarean section and rehabilitation issues after it. Antibiotics are now prescribed only to those women who have signs of early inflammation, the rest of the antibiotic therapy is not carried out, limited to the introduction of pain relievers and reducing drugs (oxytocin) during the first three to four days after surgery.
This approach forced to reconsider the terms of discharge. There is no longer any need to keep a woman in the hospital for 10 days. After a cesarean section, they are now discharged on the fifth day, and after a natural birth - on the third.
A woman will be able to get home with a baby in five days only if there are no complications.
Naturally, the stitches are not removed on the fifth day. That is, mom is discharged home with external seams.
The internal ones dissolve on their own. The external ones will have to be removed, but already in the antenatal clinic at the place of residence on the 7-8 days after the operation, sometimes it is recommended to remove the stitches no earlier than 9-10 days. Individual advice on timing is usually given by a doctor at the hospital before discharge.
Reasons for changing dates
What factors can affect the length of stay in the maternity hospital? Let's say right away, ahead of the questions of the most impatient, that it will not be possible to leave the hospital before the fifth day. Not a single doctor, in any clinic or maternity hospital in Russia, will take responsibility for the possible death of a woman or baby.
Five days is the minimum period for monitoring them, and therefore you do not even need to try to persuade the attending physician to let them go home early.
A woman who has shown signs of an inflammatory process can be detained in a maternity hospital - her body temperature is elevated, pressure jumps, episodes of breakthrough bleeding from the genitals are observed.
According to the results of an ultrasound scan, it may be found that the uterus has contracted poorly or fragments of the placenta remain in it (which is very rare). In this case, the woman in labor is delayed for at least 2-4 days. Then there can be two options - either she will be discharged home, or transferred to a gynecological hospital for further treatment. The child will be sent home with his father and close relatives.
The second reason for the doctor's refusal to discharge on the fifth day is the baby's health problems. They can be very different.
In the first 3-4 days of life, the baby is carefully examined, various tests are taken from him, and functional tests are performed. If a pathology is found, the child can be left in the hospital for a few more days, after which he will either be sent home with his mother, or both will be transferred to the children's hospital in the early childhood department for subsequent treatment. Transportation is carried out by special medical vehicles.
Useful Tips
Discharge after a cesarean section has several features that a woman needs to know about in advance and warn her family and friends. Our tips will help you check out with the greatest comfort and safety.
- It is categorically impossible for a woman to hold a baby in her arms, lifting weights over 3 kilograms in weight - the strictest ban for the next six months. You should especially carefully follow this rule in the first days and weeks after the operation. Therefore, any of the relatives can pose in their arms with a baby on a ceremonial discharge, but not the newly-made mother herself.
- Ask your relatives to bring you a dress to the hospital for discharge. Free is best. Trousers, jeans, breeches and other waistcoats will cause a lot of inconvenience, because the seams have not yet been removed, besides, pressure on the seam of the zippers and buttons should be completely eliminated for at least 3 weeks until the outer seam is completely healed. A tight dress will not look very aesthetically pleasing, because even in thin women after a cesarean section, the stomach sags and retracts much longer than the tummy after natural childbirth.
- Ask family or friends to arrange for a separate rear seat in the car beforehand, in which the woman will go home. It is rather difficult to sit for a long time after the operation - the stitches are pulling, the lower back hurts, the woman may need to lie down or take a half-sitting position. If there are a couple more people in the car in the seat, besides her, the newly-made mother will not be able to do this purely physically. The child must be held by another adult on the way home.
- It is better to temporarily refuse from the table in honor of discharge and collect relatives in 2-3 weeks, since the woman is shown to be at rest, in addition, strangers can be a source of infection.
The famous pediatrician Yevgeny Komarovsky presents his view of the cesarean section in the following video.
