Dr. Hall-Minnie Talks About Strategies to Enhance Recovery After a Cesarean Delivery

mom and newborn just after deliveryDid you have a hard time when your doctor suggested that a cesarean delivery would be best for you and your baby? You’re not alone. Most expectant mothers are young and have enjoyed good health.  Many have never had any kind of surgery. Moms recall feeling disappointed and sometimes fearful.

Knowing what to expect will ease your concerns. I’d like to offer some reassurance and a few tips for our OB patients, whether you are expecting a c-section or just know it’s a possibility. Women who have had a previous c-section may also find this information helpful when thinking about future pregnancies.

After a cesarean delivery, you must balance your baby’s care needs and your needs as you recover from a major surgical procedure. This can be very stressful. During my residency training, I became interested in helping my patients over this hurdle. I participated in a project at Baylor Scott & White to involve our entire care team in helping women recover from surgery.

Enhanced Recovery After Surgery

Enhanced Recover After Surgery (ERAS) is an approach to helping patients prepare and recover better.  Originally developed for colon surgery patients, it has been adapted to gynecologic surgery and now to obstetrics for cesarean deliveries. The goal of ERAS is to help your body prepare for and better manage the stress of surgery. As with most of life’s stressful events, planning ahead is key. ERAS strategies start before your surgery (preoperative) and continue during (intraoperative) and after your surgery (postoperative).

Before surgery, we make sure that your body is as physically ready as possible. We check your blood count to make sure you are not anemic. Anemia is the condition of not having enough red blood cells to carry the oxygen your body needs to feel well and to heal. You will lose some blood during surgery (or even during a vaginal delivery). We remind you that a well-balanced diet will supply the nutrients your body needs for healing. Getting back to normal is also easier if you have stayed active throughout your pregnancy.

When it is time for your delivery, our strategies focus on keeping you comfortable and preventing complications from surgery that will slow your recovery. You can read about anesthesia for your cesarean delivery here. We give you antibiotics to prevent infection and place inflatable compression sleeves on your legs to prevent blood clots. Preventing blood clots is a high priority after any surgery. All women are at higher risk for a blood clot during pregnancy and for about one to three months after their delivery.

After your delivery, we use multiples types of pain medications that work together to manage your pain depending on your needs (multi-modal analgesia). You will be able to eat as soon as your digestive system is active; that is usually as soon as you feel like eating. Getting up and walking is your best strategy to get your bowel function back to normal and to prevent blood clots.

Your emotional recovery is very important too. We want your first hours with your newborn, your bonding experience, to be as normal as possible. Unless you or your baby needs medical attention, the nurses will help you to see, touch, and have skin-to-skin contact with your baby in the delivery room. Brookwood’s special BabyCam will allow you to watch those precious first moments of your baby’s life even as your doctor finishes your c-section. We feel that moms who are given immediate bonding opportunities have less discomfort and anxiety.  Our lactation consultants will suggest comfortable positions to help you start breastfeeding.

Preparing to Go Home

As you transition to recovery at home, your care team will offer lots of tips to help you through these first days. A healthy, high-fiber diet with plenty of water will promote healing and help avoid constipation. If you are still taking pain medicine, you are more likely to have problems with constipation. Besides diet and water, an over-the-counter stool softener will help. You can use an abdominal binder or heating pad in short increments to help with discomfort. Follow the instructions for taking pain medicine that your nurse provided before you left the hospital.

So, following the ERAS plan really means paying attention to dozens of small details. As we started introduced more of the ERAS concepts into patient care, I realized it was making a difference for women having surgeries, including cesarean deliveries. My patients were having a more positive overall experience. We also believe that attention to detail reduces the risk of complications that could delay your going home.

I appreciate the way ERAS focuses on helping you understand what to expect, so you can participate in your care. At Sparks and Favor, we provide Birmingham moms with an individual Birth Planning program. It consists of two sessions your nurse, one at an early prenatal visit and another around 28 weeks of pregnancy. You are welcome to ask questions then or at any of your obstetric visits. You will receive more detailed information about preparing for a cesarean delivery at your Birth Planning appointment. You can also find it here.

As you adjust to your new role, care for yourself too! Accept help from family and friends. You’ll need a little extra recovery time after a cesarean delivery. Please do call our office if you are concerned about a problem. We look forward to seeing you at your postpartum visit.