How to quickly get back on your feet after a caesarean. Recovery after caesarean section: rehabilitation and reviews. Placenta previa: the baby's place completely or partially overlaps the cervix

Update: October 2018

A man, especially a woman, is measured by God with many difficulties. Do not treat exceptions as birth process as well as pregnancy. Often there are situations that force the doctor to get the child out of the womb of a woman through caesarean section.

Such termination of pregnancy is considered preferable by many representatives of the weaker sex, as they do not know or forget about the potential consequences after a caesarean section.

And, of course, a woman should remember how long and hard she will have to recover from the operation, how much strength, perseverance and patience she will need. About the consequences of caesarean section and recovery after it - our article.

Negative aspects of abdominal delivery

Undoubtedly, a caesarean section is no longer an operation of despair, when all other possibilities were used to facilitate the birth of a child, and therefore the risk of complications during and after the operation, as well as the consequences, was significantly reduced.

However, it is possible and necessary to prevent the development of potential consequences after the removal of the baby by means of abdominal surgery. Occurrence percentage postoperative consequences directly proportional:

surgical technique
time spent on the operation
antibiotic therapy after caesarean section
suture quality
experience of the surgeon and many other factors influencing the operation and the course of the postoperative period

It is worth noting that any, even a perfectly performed caesarean section, does not pass without a trace for a woman and a child. Only quantitative indicators of consequences vary.

Caesarean section - consequences for the mother

Seam on the anterior abdominal wall

Oh, how many negative emotions carries such a rough and unaesthetic scar on the anterior abdominal wall. I would like this negative moment after the operation, it remained the only thing for the woman, the main thing is not physical beauty, but the health of the young mother and her baby.

Do not be upset about the "disfigured abdomen", currently there are several methods that allow you to take in the skin of the abdomen either with a cosmetic (intradermal) suture, or make a transverse incision in suprapubic region, which will allow a woman to flaunt in an open swimsuit.

The formation of a skin (imperceptible or convex, wide) scar depends on the production of certain enzymes in the body. And, unfortunately, someone produces more of them, and someone less, which leads to the formation of a keloid scar. But even in this case, do not despair, at present there are many ways to get rid of reminders of the operation (for example, “polishing” the scar or laser).

Adhesive disease

Any surgical intervention in abdominal cavity leads to the formation of adhesions in it. Particularly high risk of developing adhesive process when blood and amniotic water enter the abdominal cavity, a rather long and traumatic operation, with a complicated course of the postoperative period (development of endometritis, peritonitis and other purulent-septic diseases).

They pull the intestines, which disrupts its functions, tubes, ovaries and ligaments that hold the uterus. All of this can lead to:

permanent constipation
development of intestinal obstruction
tubal infertility
improper location of the uterus (its bend or bend backwards), which affects menstruation (see).

After the second, third caesarean section, the consequences in the form adhesive disease and its complications are most likely.

Postoperative hernia

Education is excluded postoperative hernia in the area of the scar, which is associated with insufficient comparison of tissues during wound closure (in particular, aponeurosis) and the course of the early postoperative period. In some cases, diastasis (divergence) of the rectus abdominis muscles may be observed, that is, their tone is reduced, and they cannot perform their functions:

as a result, the load is redistributed to other muscles, which is fraught with displacement or),
education umbilical hernia(the umbilical ring is a weak point in the abdominal wall),
digestion is disturbed and pains in the spine appear.

Consequences of anesthesia

The decision on anesthesia during caesarean section is made by the anesthesiologist. It can be either intravenous anesthesia with tracheal intubation or spinal anesthesia. After endotracheal anesthesia, women often complain of coughing, which is associated with microtrauma of the trachea and accumulation of mucus in the bronchopulmonary tract.

Also, after leaving general anesthesia, nausea, less often vomiting, confusion, drowsiness are disturbing. All of these symptoms disappear within a few hours. After spinal anesthesia, headaches may occur, so the patient is advised to remain in horizontal position at least 12 hours.

When performing epidural and spinal anesthesia, damage to the roots is possible spinal cord, which is manifested by weakness and trembling in the limbs, back pain.

Scar on the uterus

The transferred caesarean section will forever leave a memory of itself in the form of a scar on the uterus. The main criterion for the uterine scar is its consistency, which largely depends on the quality of the operation and the course of the postoperative period.

An inconsistent (thinned) scar on the uterus can cause a threat of pregnancy and even rupture of the uterus, not only during next birth but also during pregnancy. That is why doctors recommend sterilization (tubal ligation) to women who are planning a second caesarean section, and insist on this procedure after the third operation.

endometriosis

Endometriosis is characterized by the fact that cells similar in structure to the endometrium are localized in atypical places. Often, after a cesarean section, endometriosis of the scar on the uterus develops, since in the process of suturing the uterine incision, the cells of its mucous membrane can enter, and in the future grow in the muscle and serous layers, that is, endometriosis of the scar occurs.

Problems with lactation

Many women note problems with the formation of lactation after abdominal delivery. This is especially true for those who were taken for a planned caesarean section, that is, before the onset of labor. The flow of milk after natural childbirth and caesarean section in women who were “let” into childbirth occurs on the 3rd-4th day, otherwise the arrival of milk occurs on the 5-9th day.

This is due to the fact that during childbirth, oxytocin is produced, which causes uterine contractions. Oxytocin, in turn, stimulates synthesis, which is responsible for the production and release of milk.

It becomes clear that the woman after the operation is not able to provide the baby with breast milk in the coming days, and he has to be supplemented with mixtures, which is good. Often, after a cesarean section, postpartum women have hypogalactia (insufficient milk production) and even agalactia.

The consequences of a caesarean section for a child

A caesarean section also affects the newborn. Caesarean babies often have breathing problems.

First, if the operation was performed under intravenous anesthesia, then part narcotic drugs enters the child's bloodstream, which causes depression respiratory center and may cause asphyxia. In addition, in the first days and weeks after birth, the mother notes that the child is lethargic and passive, does not take the breast well.
Secondly, mucus and fluid remain in the lungs of children born through surgery, which are pushed out of the lungs as the fetus passes through birth canal. In the future, the remaining fluid is absorbed into the lung tissue, which leads to the development of hyaline membrane disease. The remaining mucus and fluid are an excellent breeding ground for pathogens, which subsequently leads to pneumonia and other respiratory disorders.

During natural childbirth, the child is in a state of hypernation (that is, sleep). In a dream physiological processes proceed more slowly, which is necessary to protect the baby from sharp drop pressure at birth.

With a caesarean section, the child is removed immediately after the uterus is cut, the baby is not prepared for a sharp change in pressure, which leads to the formation of microbleeds in the brain (it is believed that in an adult such a pressure drop would cause pain shock and death).

Caesarean children adapt much longer and worse in the external environment, because they did not experience birth stress while passing through the birth canal and they did not produce catecholamines - hormones that are responsible for adapting to new conditions of existence.

To long-term consequences can be attributed:

poor weight gain
hyperactivity and hyperexcitability of cesarean children
frequent development of food allergies

There are problems with breastfeeding the baby. The child who was fed artificial mixtures all the time while the woman was recovering from anesthesia and taking a course of antibiotics, there is no motivation to breastfeeding, he is reluctant to take the breast and does not want to exert force to receive mother's milk from the chest (from the nipple is much easier).

It is also believed that between mother and child after a caesarean section there is no psychological connection, which is formed during natural childbirth and is fixed by early (immediately after birth and crossing the umbilical cord) attachment to the chest.

Recovery after caesarean section

Immediately after the operation, the woman is transferred to the ward intensive care, where she is under the vigilant attention of medical personnel during the day. At this time, ice on the abdomen and painkillers are needed. After a caesarean section, recovery of the body must begin immediately:

Physical activity

The sooner the new mother starts moving after the operation, the sooner she can return to her usual rhythm of life.

The first day, especially after spinal anesthesia, the woman should be in bed, which does not exclude the possibility of moving.
You can and should turn from side to side in bed, do leg exercises:
- stretching your fingers
- foot rotations in different directions
- tighten and relax the buttocks
- press your knees together and relax them
- alternately bend first one leg in knee joint and straighten, then another
Each exercise should be performed 10 times.
It is also necessary to immediately start doing Kegel exercises (periodically compress and relax the muscles of the vagina), which strengthen the muscles pelvic floor and prevent urinary problems.
When can I sit down after a caesarean section? Getting out of bed is allowed after the first day. To do this, turn on your side and lower your legs off the bed, then, resting your hands, lift upper end torso and sit.
After a while, you should rise to your feet (you can hold on to the back of the bed), stand for a while, and then take a few steps, trying to keep your back straight.
Getting out of bed should be under the supervision of the sister. Early physical activity stimulates intestinal peristalsis and prevents the formation of adhesions.

seams

Skin sutures are treated daily with antiseptic solutions (70% alcohol, brilliant green, potassium permanganate), and the dressing is changed. The sutures are removed on the 7th - 10th day after the operation (an exception is an intradermal suture, which dissolves after 2 - 2.5 months on its own).

For better resorption skin scar and prevent the formation of keloid, it is recommended to lubricate the seams with gels (Curiosin, Contractubex). You can take a shower after the skin scar has healed and the stitches have been removed, that is, for about 7-8 days (avoid rubbing the seam with a washcloth), and taking a bath and visiting the bathhouse are postponed for 2 months (until the scar on the uterus heals and suckers stop).

Urination, intestinal gases

The passage of intestinal gases is of no small importance for the restoration of bowel function. Many women are very afraid to release gases. You should not keep them in yourself, to facilitate the discharge of gases, you need to stroke your stomach in a clockwise direction, then turn on your side and raise your leg and relieve yourself. If constipation occurs, you can take Lactulose (Duphalac) this is the most safe remedy for constipation or use glycerin suppositories (see), which can be used by nursing women.

Often after the operation there are problems with urination. As a rule, this is due to the catheter standing in the bladder for the first day (no more). After the catheter is removed, there are difficulties with urination: retention or pain during urination. You should not be afraid of pain, they will disappear in 2 - 3 days on their own, and pain syndrome due to mucosal irritation urethra. But long delay urine (more than 4 hours) scares moms. Be sure to tell your doctor about this, but you yourself need to take action - drink more fluids. And, of course, after a caesarean section, even if there are no problems with urination, you should go to the toilet as often as possible (every 2 hours). This is because a full bladder will put pressure on the uterus, preventing it from contracting.

Food

Nutrition after caesarean section is given Special attention, because it abdominal operation, that is, on the abdominal cavity:

First day

It is allowed to drink mineral water without gas, which can be acidified lemon juice. Even if relatives brought “mineral water with gas”, the nurse will definitely open it and leave it in such a way that the gas disappears. In principle, on the first day, you don’t particularly want to eat, but you shouldn’t worry that you are starving, that’s all. nutrients come through the "droppers", which will be prescribed after the operation.

Second day

The mother is transferred from the intensive care unit to the postpartum ward. The diet is expanding. Only liquid foods are allowed, such as low-fat chicken bouillon or meat (water after boiling is drained and filled with new), kefir, yogurt (without pieces of fruit).

Third day

The diet is getting richer. You can use twisted lean boiled meat (beef, veal, rabbit meat), meat or fish soufflé, cottage cheese processed in a blender. Also on the menu are viscous cereals (wheat, rice), cooked in milk with water in a ratio of 1/1. All food is served boiled and pureed, room temperature. Food intake is fractional and is 5-6 times a day in small portions.

From drinks, you can use weak black tea with lemon, compotes, kissels, fruit drinks, and others. herbal teas. Do not get involved in juices. Drink them should be diluted boiled water (1/1).

Fourth day

To fourth day, as a rule, there is an independent chair. Therefore, you can eat sparse vegetable soups with pureed meat, potato and others vegetable puree, boiled fish, lean bird. You can eat 2 - 3 small pieces of dried or yesterday's rye bread. All pastries and confectionery are excluded. Foods that stimulate gas formation are also prohibited: peas and all legumes, cabbage and others. Fruits are introduced into the diet with caution and only those that are not prohibited by the pediatrician (so as not to cause allergies in the child). You can 1 banana, chopped, peeled green apple, kiwi.

Fifth day and beyond

Meals are normal, but taking into account the products allowed by pediatricians. You can’t have any nuts (although they stimulate lactation, but they are very allergens for a newborn), honey in in large numbers, various confectionery creams, chocolate, red fruits. Emphasis should be placed on protein food(meat, fish, poultry) dairy products and fresh vegetables.

All fatty and fried foods, marinades and pickles, canned food, fast food and fast food are prohibited.

Food is boiled, steamed, stewed or baked, but without a crust. Meals remain fractional, up to 5 times a day and still in small portions.

Bandage

Wearing a bandage will greatly facilitate life, especially in the first days after the operation. However, do not abuse this device, for a full and quick recovery muscle tone of the anterior abdominal wall, the bandage must be periodically removed, gradually lengthening the “bandage-free” periods.

Cough

After a caesarean section, a woman is often worried about coughing, especially after endotracheal anesthesia. However, the fear of rupture of the seams during coughing inhibits the desire to cough. To strengthen the seams, you can press a pillow to your stomach (an excellent replacement is a bandage or bandaging with a towel), then inhale deeply and then exhale completely, but gently, making a sound like: “woof”.

Physical activity and restoration of abdominal elasticity

After a caesarean section, weight lifting is limited to no more than 3-4 kg for at least three months. Raising a child and caring for him is not prohibited and even encouraged. All household work, especially those related to bending and squatting (washing floors, washing) should be entrusted to another family member.

One month after the operation, you can start light exercise gymnastic exercises. After a cesarean section, to restore the abdomen, you can start pumping the press no earlier than six months later. In principle, a sagging belly will return to normal after 6-12 months (skin and muscles will gain elasticity, their tone will be restored).

To restore the figure after a caesarean section, sports (fitness, aerobics, body flex, yoga) must be carried out according to an individual program with an instructor and only after consulting a gynecologist (not earlier than six months after the operation). Bodyflex classes 15 minutes a day perfectly help to restore the figure and tighten the stomach.

Gymnastics after caesarean section

Gymnastics will help you get in shape. In the second week, after the stitches are removed, you should walk as much as possible (slow, alley step). Do not overexert yourself, as you feel tired, stop walking and return home. Also, within these periods, it is allowed to perform simple exercises to support the abdominal muscles. One of the exercises - retraction of the abdomen, is performed in sitting position with a bent back. You need to retract the stomach on the exhale, and relax on the inhale. Repeat no more than 15 - 20 times at a time, and perform the exercise 2 times a day. Also, don't forget about Kegel exercises for the pelvic floor muscles.

A month after the operation, it is allowed to perform simple exercises aimed at restoring posture.

1 exercise

Sitting on a chair with a straight back and separated shoulders, put your feet shoulder-width apart. After 0.5 minutes, try to reach your toes with your hands while tilting and relax. Repeat 6-12 times.

2 exercise

Press firmly against the wall, touching it with the back of your head, shoulder blades, calves and heels. Fix the position for 3 minutes, and then step back 2 steps and hold out in this position for another 3 minutes.

3 exercise

Feet shoulder-width apart, then bend your knees slightly and try to lean forward. Keep your hands on your hips, and straighten your shoulders and bring your shoulder blades together. Repeat 30 times three times a day.

4 exercise

Standing on all fours, alternately raise the right straight leg with right hand, then lower and repeat with the left limbs. Perform 10 - 15 times on each side.

5 exercise

Standing on all fours, straighten one leg and bend at the knee at an angle of 90 degrees. At this time, strain the buttocks. Lower your leg and repeat the exercise with the other. Perform 10 - 15 times with each leg.

Lactation

Currently, early attachment to the breast is encouraged, that is, immediately after childbirth. Unfortunately, not many maternity hospitals put the baby to the breast immediately after it is removed during the operation, and most often this happens on the 2nd or 3rd day, when the mother is transferred to the postpartum ward. It is better to arrange in advance with the doctor so that the child is not just shown to the mother during the operation, but is attached to the breast (if the operation is not performed under endotracheal anesthesia). It is also appropriate to require that the baby be brought to the intensive care unit during feeding. The first 4 - 5 days after a cesarean section, the mother still does not have milk (after an independent birth, a rush of milk occurs on 3 - 4 days). This is not a reason for despair, and, moreover, refusal to breastfeed. By rubbing the nipple, the baby not only stimulates the flow of milk, but also helps the production of oxytocin, which contributes to the contraction of the uterus.

Positions that mothers prefer for breastfeeding after surgery are lying on their side or sitting on a chair. To stimulate lactation of the baby, it is better to untie and attach to the bare chest. Also, during feeding, both mammary glands should be involved (first feed one, then attach to the other). This method stimulates milk production. It is not necessary to remind that after feeding it is necessary to express and treat the nipples, for example, with sea buckthorn oil.

If in the maternity hospital feeding was carried out strictly by the hour, then after discharge it is advisable to adhere to free feeding or feeding on demand (but not less than every 3 hours). This not only contributes to better saturation of the child, but also the production of milk, as well as oxytocin.

sex life

Resume intimate relationship it is possible in 1.5 - 2 months after abdominal delivery (the same period after independent birth). This period of abstinence is necessary for healing wound surface in the uterus (place of attachment of the placenta) and the uterine suture.

It is important to attend to the issue of contraception even before the onset of sexual activity. Every woman who has undergone surgery should remember that intrauterine device can be installed only 6 months after cesarean, a) it is strictly contraindicated, as they injure the suture on the uterus and can cause scar failure.

Menstrual cycle

Differences in recovery menstrual cycle after abdominal delivery and independent childbirth no. In the case of breastfeeding, menstruation may begin six months after childbirth or later. In the absence of lactation, menstruation begins after 2 months.

Next pregnancy

Obstetricians recommend to refrain from new pregnancy after surgery for at least 2 years (optimally 3). This time period allows a woman not only to recover physically and psychologically, but is also necessary for the full healing of the suture on the uterus.

Observation at the gynecologist

All women who have had a caesarean section are registered in antenatal clinic where observed for two years. The first visit after the operation should be no later than 10 days, with the obligatory ultrasound of the uterus. Then, after the end of the lochia (6-8 weeks), and in half a year, in order to assess the condition of the scar on the uterus, then a visit to the gynecologist at least once every six months.

Question answer

What day are you discharged after a caesarean section?

Normally, they are discharged on the 8th day, when the stitches are removed. It is also possible to remove the stitches earlier (on the 7th day), and discharge on the 6th or 7th day, but this is welcome in large cities.

How long does the stomach hurt after surgery and what should I do?

If the operation went without complications, then the pain syndrome is very intense only on the first day after cesarean section. During this period, a woman must be prescribed analgesics that are safe for the child (ketorol). But at very severe pain it is possible to prescribe narcotic painkillers (promedol). In terms of pain, the first day is the most difficult, then pain gradually disappear, especially with vigorous activity.

Is it possible to do without a bandage after the operation?

Of course you can, and some doctors are generally against this device. But in the first three days it is easier to move around and endure pain still with a bandage.

When can I shower and bathe?

A shower can be taken immediately after discharge, that is, on the 7th - 8th day, provided that the stitches are removed and there is no suppuration postoperative scar. And taking a bath will have to wait, it is allowed only after the cessation of lochia, about 1.5 months after the operation. Moreover, you should monitor the temperature of the water, it should be warm, but not hot (you can provoke later bleeding).

Is it possible to visit the pool after a caesarean section?

Yes, swimming lessons are welcome after childbirth, especially after abdominal delivery, but are allowed only after the end of lochia, that is, 6-8 weeks after childbirth. Swimming successfully restores the figure, affects the abdominal muscles and improves overall tone.

How to protect yourself after surgery?

This question is of interest to all women, no matter what the birth was, independent or operational. In the first six months, you can use the method of lactational amenorrhea, but subject to conditions. Breastfeeding should be every three hours, including at night. The child is not supplemented with mixtures. But this method not particularly reliable, so you can take mini-pill tablets (when breastfeeding) or combined oral contraceptives if the mother is not lactating. It is optimal to insert an intrauterine device, but after a cesarean section, it is administered no earlier than after 6 months.

Can I sleep on my stomach after a caesarean section?

It is possible and necessary. But only on the first day, the mother will be on her back (administration of intravenous solutions and drugs, monitoring blood pressure, pulse and respiration). After the puerperal woman began to get up and move around on her own, lying on her stomach is not only not prohibited, but also welcomed (it helps to contract the uterus). You should not be afraid of the divergence of the seams, if the seams are well-founded, they will not disperse.

After a cesarean section, as after any operation, you need to move. It is better to wear a postpartum bandage - it is easier to walk with it, it will help to quickly return the previous tone to the abdominal muscles, fix it correctly postoperative suture takes the load off the spine. However, his prolonged wear undesirable, because the muscles still have to work themselves.

The first hours after cesarean mom spends in intensive care or intensive care unit under the close supervision of doctors. After six hours, with the permission of the doctor, she can already get up, on the second day she can walk and feed the baby.

So that the postoperative suture does not become inflamed, you can lubricate it 1-2 times a day with lavender oil or tea tree, after dissolving them vegetable oil in a ratio of 1:10. Suitable and pharmacy ointment from calendula.

Exercises you can do the day after surgery

Starting position sitting with support on the back. Perform slowly with repetition up to 10 times.

Pull the socks towards you, then away from you at an average pace.
Rotation of the feet inward, then outward.
Press your knees together, then release.
Tighten the gluteal muscles, then relax.
Bend one leg and stretch forward, lower, then the other.

Repeat all exercises up to 10 times, then rest.

Also helpful exercise for the muscles of the perineum and pelvic floor.

Kegel Exercises: Squeeze your perineal muscles as if you were trying to hold back a stream of urine. Hold tight for a few seconds, then relax. Do 10-20 repetitions at a fast pace 3-4 times a day. Increase the voltage time by 1 second each time, gradually reaching 20 seconds or more.

Regular performance of this exercise helps to avoid problems with urinary incontinence.

Once you have been allowed to walk, you should use it to improve your condition. Spend as little time in bed as possible, walking helps you recover from surgery and prevent constipation.

Important! Until the stitches have completely healed, try to get out of bed correctly! You can not raise your head and rise while lying on your back, this strains the abdominal muscles and can cause the seams to diverge.

To get out of bed, you need to turn on your side, lower your legs and slowly sit down, pushing with your hands, without straining your abdominal muscles.

After suture removal with the permission of the doctor, you can start light exercises for the abdominal muscles:

Retraction of the abdomen. Sitting position with back slightly bent. Inhale, then exhale and as you exhale draw in your stomach. Hold this position for 1 second, then relax your stomach and inhale. Perform 10-15 repetitions several times a day.
Lifting the pelvis. Lying on your back on a hard surface, legs bent at the knees. Raise the pelvis up, without lifting the lower back, lower it. Perform 15 - 20 repetitions several times a day.

Intensive physical exercise and swimming should be started no earlier than a month and a half later. The same is with sexual life, but here the recommendations of doctors differ: from 2 weeks to 2 months, depending on individual characteristics.

In this, a cesarean section has one of the few advantages over natural childbirth: the vagina does not stretch, there are no tears and stitches on the perineum, so there are no problems with sexual activity.

Sometimes after childbirth, some women become depressed. In the case of a caesarean section, this can be exacerbated by the disappointment of a missed delivery. It must be understood that all these sensations are normal and characteristic of many women, and in case of severe emotional state turn to a psychologist for help.

Quite often, expectant mothers are interested in a caesarean section (hereinafter referred to as CS). Reading various heartbreaking stories about natural childbirth, women think that the operation is The best way. However, in reality recovery after cesarean proceeds at a slower pace. The operation is abdominal, which means that you will need to prepare for it in advance. There are times when KS- only decision.

When is a caesarean section necessary?

The procedure itself is relatively simple and frequent. - This is an incision (dissection) of the walls of the uterus. It is necessary in several cases: when natural childbirth poses a threat to the life of mother and baby, with high pressure, the presence of a narrow pelvis, the gluteal position of the fetus, abruption or placenta previa, diabetes, heart defects, operations on the uterus, a high degree of myopia. In such cases, childbirth naturally can provide Negative influence on the mother's body. At such moments, a planned operation is shown.

An emergency operation is performed with weak labor activity, prolonged unsuccessful contractions, the threat of fetal hypoxia, and a sudden change in the position of the fetus.

How is a cesarean section performed?

If you have been told that you cannot do without a cesarean section, then you should find out in advance how the operation itself goes, as well as how to quickly recover from a cesarean section afterwards.

The operation can be carried out as epidural anesthesia(planned), and under general anesthesia(emergency and planned).

Stages of a caesarean section

With general anesthesia, you are placed on a couch and the pubic area is treated with brilliant green, and a urinary tube is also placed. Then the pressure is measured and anesthesia is injected into the vein on the arm, after putting on a mask. You don't feel like falling asleep. The surgeon then makes a thin transverse incision, removes the baby and then the placenta. The incision is then sutured layer by layer. bioresorbable or non-absorbable threads. Parentheses can be used instead of threads. The stitches are removed for 6-7 day. If the threads were self-absorbable, then they gradually disappear without a trace, and "tails" fall off on their own after a few weeks.

The cut can be either vertical or horizontal. AT recent times incisions for caesarean section are made horizontal. When healed, such a seam becomes almost invisible and allows you to flaunt in a swimsuit and underwear. But the most important thing is that such an incision allows a woman to give birth naturally in the future (if there are no additional contraindications).

What are the possible complications?

Sometimes there are complications after a caesarean section. Woman loses 3 times more blood than in natural childbirth. To restore severe blood loss, through droppers, plasma or other blood substitutes are injected. The number of droppers is proportional to the amount of blood lost.

Sometimes there may be adhesions in the intestines(as a result of the cut). This does not always happen and is cured by physiotherapy procedures. AT last resort, adhesions are removed surgically.

Also, after the operation, the uterus contracts much worse than after natural childbirth. To improve the contraction, oxytocin is injected or the uterus is massaged for 1-2 days, which can be painful after surgery. In this case, you just need to be patient. At the same time, antibiotics will be dripped through the dropper to prevent infection of the uterine cavity.

Recovery after surgery

How to recover quickly after a caesarean section? Doctors will take you to intensive care and will carefully monitor your condition. Immediately after the operation, an ice pack is placed on the abdomen. This procedure is accompanied by measurements of pulse and pressure. Doctors will observe how well the uterus contracts after a caesarean section, as well as monitor the discharge. In the first hours after the operation, you will have a urinary catheter placed.

Withdrawal from anesthesia- an unpleasant thing. Your stomach will hurt and you will be thirsty. You just need to get through this time. Don't worry, the nurses will administer pain medication to help relieve the pain. These drugs are not canceled within 1-3 days.

Do not be surprised if you are forced to move after 6-8 hours. This is very important for a quick recovery. After the intensive care unit (usually the next day), you may be transferred to the postpartum ward, where you will continue to receive intravenous and intramuscular drugs, be told to move more, and begin to process the suture. Processing is usually done with green paint. Then the seam is sealed with a special tape. Later you will process it yourself.

In order not to touch the already painful seam, wear panties with a low waist made of natural fabrics. After the crust falls off on its own, you do not have to stick the tape, but you should not forget about processing either.

The shower is allowed to take on the 7th day. In this case, the seam cannot be affected. An extract after a caesarean section is carried out on the 7-10th day. Perhaps at first it will be difficult for you to unbend, a feeling of tightness will appear. This is normal and such discomfort will disappear with time.

After the operation, abundant lochia (bloody discharge) also appears. You should not be afraid of them, just stock up on absorbent pads. Gradually, the lochia will begin to decrease and disappear completely. During this period, be sure to wash yourself without affecting the area of \u200b\u200bthe seam.

Possible problems after surgery

Uterus. This hollow organ after natural childbirth or caesarean section should be reduced. Contractions are necessary to return the uterus to its natural state. Hormone released during breastfeeding oxytocin and this allows the uterus to contract faster. You may feel pain in the lower abdomen as soon as you attach the crumb to your chest. This is absolutely normal and necessary. Also, contractions are necessary to prevent the accumulation of blood and the inflammatory process. To make the process less painful, the woman is prescribed painkillers.

Bowel emptying. This becomes difficult after abdominal surgery. Therefore, immediately after the COP, an enema is given. Further, in the maternity hospital, a woman is shown a diet that helps get rid of processed food and prevent. Dairy products are shown. Fiber (pasta, bread) and raw fruits/vegetables should be avoided. The fact is that they cause the accumulation of gases in mom and baby. Increased gas formation for mom postoperative period may be painful. The drug Lactusan, which softens in the intestines, has proven itself well stool and helps to get rid of them. In addition, this drug has a bactericidal effect, which is necessary after surgery.

Abdominal muscles. After the operation, they should not be loaded to avoid divergence of the sutures. At such a moment, a woman should wear a bandage, which will gradually bring the abdominal muscles back to normal and will fix the seam.

Recovery after caesarean section - step by step

1. With a planned caesarean section, you can not drink and eat for exactly a day.

2. Recovery after caesarean section includes good hygiene. You need to wash yourself 2 times a day.

3. The bandage will help you reduce pain and recover faster after a caesarean section. Put it on as soon as you shower. He will help you lie down and get up.

How to wear a postpartum bandage after a caesarean section

4. Ask you to bring your baby not the next day, but the same day. Attach the crumb to the chest. You will feel pain in the uterus, but such contractions are necessary for a speedy recovery. In addition, you will establish faster contact with the child.

5. Insert glycerin suppositories into the anus to facilitate bowel movements. In a few days the stool will improve.

6. Apply ice wrapped in a handkerchief. This will help relieve pain and induce contractions.

7. Drink more fluids and go to the toilet more often in a small way.

At the hospital after surgery

Help. Ask a family member to be with you in the postpartum room. For this, a paid ward is usually ordered in advance. With a loved one, you can recover very quickly after a caesarean section, both physically and mentally. In addition, they will help you with the child.

Traffic. No matter how painful it is after a caesarean section, you absolutely need to move. Remember: the more you move, the sooner it will become painless.

Communication. Don't be afraid to ask staff questions about how to recover from a caesarean section and breastfeed your baby. You will be told and taught everything. Often, after the first feeding, the nipples begin to hurt from the habit. In this case, you will need Bepanthen cream or special pads.

Baby care. Always wash your hands before changing a diaper or touching your baby at all! To recover from a cesarean section, you need to be more distracted from heavy thoughts about your stomach pain and take care of the baby.

Home after surgery

On account. As soon as you are discharged, you will need to register the crumbs with the pediatrician at the place of residence within a week.

Dream. Sleep as much as possible and in any free minute. How long does it take for the body to recover after a caesarean section? This may take several months. But if you rest more, then recovery will go faster.

Drink. After the operation, you should drink as much water as possible. Water helps replenish the fluid lost in the body after a caesarean section.

Food. Eat more lungs and low-fat foods to recover from a caesarean section. Boiled poultry, steam rice, kefir or yogurt are suitable.

Traffic. Avoid squats sudden movements, bending over, lifting weights, pressure on the abdomen and excessive load so that the seam does not begin to diverge after a caesarean section.

Scar. Take good care of the suture after a caesarean section - wash it with soap and treat it several times a day with brilliant green.

Sex. Do not engage in intimate caresses for 3 weeks or more after surgery.

Hygiene products. Use only pads and forget about tampons for a while.

Breastfeeding after caesarean section

After a caesarean section, the baby can be brought the next day or the second day. You also need to start feeding the baby as soon as possible so that he receives a portion of valuable colostrum. In addition, breastfeeding will help you recover faster after a caesarean section.

Life after a caesarean section

To quickly recover mom after a cesarean section, you need to remember that you can’t lift weights. Now your most valuable and permitted cargo is a child. But not more!

Also, do not think about the figure yet. To recover from caesarean section, time needs to pass. Light physical activity is allowed for 2-3 months after the operation. However, you will have to forget about exercises for the press for a long time. If you find it difficult to lift the stroller - ask one of the relatives to accompany you on a walk, or after a cesarean section, walk with a crumb in your arms.

Carefully monitor the seam after cesarean section, avoid overwork and overstrain, monitor the condition mental health and walk more fresh air. This will help the body recover quickly after a cesarean section and focus on the baby.

Cesarean Section - Doctor Komarovsky's School (video):

Personal experience of how to survive a caesarean section (video):

The woman is transferred to the postoperative ward (intensive care unit), where, under the supervision of a nurse, an anesthesiologist, she will spend from several hours to a day. During this time, monitoring general well-being, the amount of discharge, for how the uterus contracts.

The first few hours after the operation, the young mother lies, she is prescribed anesthesia (the area of the seam is quite painful and requires medical anesthesia, the frequency of drug administration depends on the intensity of pain), drugs that reduce the uterus and drugs that normalize the function gastrointestinal tract. Also administered intravenously saline to replace fluid loss. Antibiotics are given as needed to prevent possible complications. On the lower section an ice pack is placed in the abdomen for 20 minutes, which helps to contract the uterus and reduce blood loss.

Possible symptoms after a cesarean sections: chills, thirst, severe fatigue, pain at the site of the seam, due to dehydration, a slight fever. After general anesthesia, there may be pain, sore throat, nausea and vomiting.

When can I get up after a caesarean section?

On the first day after surgery appointed bed rest, but the woman should roll over from side to side.

Getting up and walking after surgery (usually possible after 6-8 hours) some mothers have to learn almost all over again, but despite the pain, getting up early is very useful. This is the prevention of intestinal paresis (violation motor function intestines), the formation of adhesions.

You need to get up gradually, slowly, without sudden movements, and at first it is necessary in the presence of medical staff or relatives. To get out of bed, first move closer to the edge, turn on your side, lower your legs to the floor, lean on the bed with one hand, and support the seam area with the other. Sit down slowly, sit for a while (possible weakness and slight dizziness). Regardless of whether the general anesthesia or spinal anaesthesia, a feeling of weakness on the first rises is unavoidable. Then you need to try, leaning on the bed to get up and stand a little, trying to keep your back straight, without slouching. This is enough to get started. In the future, you can take a few steps, gradually increasing physical activity. On the second day, in the absence of complications, the woman should already move independently.

Sometimes, relief in moving in the first few days brings wearing postpartum bandage or a tight diaper bandage. In the future, it is better to refuse to wear a bandage, since the muscles need to be given a load, and they must work.

Nutrition after caesarean section

First day after surgery. Table 0: still mineral water, optional with lemon, sugar-free juices. Forbidden: milk, dense food products even in puree form.

Second day after surgery. Table 1. Very thin porridge, low-fat broth, pureed soups from cereals and soups-puree from boiled vegetables (with the exception of cabbage), as well as milk soup with vermicelli; can i have a piece boiled meat, sweet tea.

Third day after surgery. maybe good nutrition- only foods that are not recommended for breastfeeding are excluded from the diet.

Postoperative procedures

Careful monitoring of the condition of the postoperative suture is very important. The nurse in the first 2-3 days daily processes the postoperative suture antiseptic solutions(for example, 5% potassium permanganate solution), change the dressing, and inspect the scar to identify areas of suppuration. If the sutures are applied with non-absorbable material or staples, then the threads or metal staples are removed on the 6th day before discharge. With an uncomplicated course of the postoperative period, it takes about two to three weeks to form a scar on the uterus.

In the postoperative period, it is necessary to carefully monitor the function Bladder and intestines. On the 2nd day of the postoperative period, stimulation and unloading of the intestine is carried out, for which sodium chloride is injected intravenously, a hypertonic (salt) enema is placed. This is necessary to restore intestinal motility. The first independent stool should be on the 3-5th day after the operation, so it is necessary to exclude products that cause increased gas formation and constipation: White bread, buns, semolina, rice porridge etc. One of the most important observations in the immediate postoperative period is the measurement of the volume of urine excreted, so it is necessary to drink, especially in the first days after the operation.

For amplification contractile activity uterus and with insufficient release of lochia in the postoperative period, oxytocin is administered.

take clinical analysis blood and urinalysis.

On the 4-5th day, an ultrasound scan is performed to clarify the condition of the postoperative scar on the uterus, the uterus itself is examined, the condition of the uterine appendages and adjacent organs (bladder) is assessed.

Breastfeeding after caesarean section

In the absence of contraindications from the mother and child, feeding is allowed as soon as the woman comes to her senses after the operation.

The use of antibiotics does not require abandonment of breastfeeding (probiotics such as bifidum-bacterin, normoflorin, linex are prescribed for mother and baby.

After a caesarean section, milk can come in the same way as after a natural birth - on the third day, or the formation of lactation can occur more later deadlines, hypogalactia (insufficient milk production) may develop. Therefore, early attachment to the breast in this situation is even more important than in natural childbirth - for normal contraction uterus and formations enough milk. Moreover, it is desirable to feed the child not on a schedule, but on demand.

After a caesarean section, the most comfortable position in which a woman is comfortable to feed a child is a pose - lying down on the side: on the hand when the mother holds the baby with her hand or on the pillow when the baby lies on a pillow and milk comes from the upper breast.

You can also feed your baby while sitting out of hand when he lies across the bed. In this position, the load is removed from the area of the seams and milk is well removed from the lower and lateral lobes of the breast, i.e. emptying takes place in problem areas where stagnation of milk is often possible. For feeding in this position, a pillow (or pillows) is placed, the baby's legs go behind the mother's back, the tummy is turned to the mother's side, the head is at the chest, the baby's mouth is at the level of the mother's nipple (if you do not observe this condition, in a bent position, the mother will quickly get tired).

As the mother recovers in the future, the mother can feed the child in other positions: lying, sitting, standing.

After discharge from maternity hospital

After being released from maternity hospital(in the absence of any complications, the woman is discharged on the 5-7th day, after removing the sutures or staples, if self-absorbable materials were not used), the suture area will need to be treated for another 1-2 weeks with one of the antiseptics, it is better if it is 5% -ny solution of potassium permanganate (concentrated dark solution of potassium permanganate). Do not allow wet and dirty dressings to be worn; as they get wet or dirty, they must be changed to dry ones.

An unusually painful or sensitive wound is usually infected. Therefore, if you feel unwell, you should consult a doctor.

Not later than two months after the operation, it is necessary to visit a antenatal clinic, whose doctors should give recommendations on prevention and treatment. inflammatory processes, regulation menstrual function choosing an acceptable contraceptive. With the appearance of irregular spotting spotting from the genital tract 3-6 months after the operation, ultrasound is indicated for intrauterine diagnosis and correction of the identified pathology.

What not to do after a caesarean section

Take a bath, swim for 1.5 months after the operation. During this period, a woman needs to confine herself to a shower.
Active physical activity for 2 months. To work on abdominals can be no earlier than a month after childbirth.
Lift weights greater than the child's weight.
Have sex for 1.5-2 months. Since the early resumption of sexual activity after surgery can lead to the development of bleeding and inflammation in the uterine cavity.

Who decides whether a woman can give birth herself or whether she needs to have a caesarean section? Previously, this issue is resolved in the antenatal clinic or medical center, where the monitoring of the course of pregnancy and the patient's condition is carried out. The examination is carried out not only by an obstetrician-gynecologist, but also by doctors of other specialties: therapist, oculist, endocrinologist, if necessary, surgeon, neuropathologist, orthopedist. In the presence of any diseases, these specialists give their recommendations on the management of pregnancy and a conclusion on the method of delivery. The final decision on the need for a caesarean section and the timing of its implementation is made by doctors in the maternity hospital. Each maternity hospital has its own characteristics of the operation itself, anesthesia, and postoperative management. Therefore, it is better to choose a maternity hospital in advance and ask the doctor all the questions that concern you.

The question is often asked: is it possible to do C-section optional, without medical indications? We believe that C-section can be performed only in cases where delivery through the natural birth canal is impossible or dangerous to the life of the mother or fetus. Patient without professional knowledge of the danger surgical intervention cannot make such decisions.

When to go to the hospital? Most often, doctors from the antenatal clinic are sent to the maternity hospital 1-2 weeks before the proposed operation. Conducted in the hospital additional examination female patients. If necessary, medical correction of the identified deviations in the state of health. The condition of the fetus is also assessed: cardiotocography is performed, ultrasound procedure, dopplerometry in the vessels of the "mother-placenta-fetus" system. If the maternity hospital is chosen in advance and a decision is made on the need for a caesarean section, then all consultations and examinations can be completed before hospitalization. And for a caesarean section, come right on the day of the operation, after necessary training at home. However, this is only possible if there is no severe complications pregnancy and normal condition fetus.

Speaking about preparation for a planned caesarean section, one cannot fail to mention the possibility, and even the need, of the so-called autologous plasma donation. A patient after 20 weeks of pregnancy can donate 300 ml of her own plasma ( liquid part blood), which will be stored in a special freezer for a long time. And if a transfusion of blood products is required during the operation, then not someone else's (even if examined), but one's own plasma will be transfused. This eliminates the possibility of infection various infections, including HIV, hepatitis B and C. Autoplasma donation is carried out in maternity hospitals that have own department blood transfusion. The procedure does not negative influence neither on the state of the mother, nor on the state of the fetus, and the lost plasma is restored in the body within 2-3 days.

How is the transaction date determined? The condition of the patient and the fetus is assessed, the term of delivery is specified by date last menstrual period, according to the expected day of conception, according to the first ultrasound examination and, if possible, the day closest to the due date is selected. In this case, the wishes of the patient herself must be taken into account. The patient expresses her consent to the operation and anesthesia in writing.

Now let's talk directly about preoperative preparation with planned caesarean section. On the eve it is necessary to take a hygienic shower. It's important to get a good night's sleep, so to help manage understandable anxiety, it's best to take something calming at night (as recommended by your doctor). Dinner the night before should be light. And on the day of the operation in the morning you can not drink or eat. 2 hours before the operation is carried out cleansing enema. Immediately before the start of the operation, a catheter is inserted into the bladder, which is removed only a few hours after the operation. These measures will help prevent serious complications from the kidneys.

What are the methods anesthesia at caesarean section? The most modern and safe method anesthesia for both mother and fetus is regional (epidural or spinal) anesthesia. In this case, only the site of the operation is anesthetized and Bottom part torso. The patient is conscious and can hear and see her baby immediately after birth, attach it to the chest. In modern clinics, more than 95% of the operation is performed with this kind of anesthesia. General anesthesia is used much less frequently.

How to perform C-section? After anesthesia, the woman is washing her stomach special antiseptic and covered with sterile sheets. A barrier is placed at chest level so that the patient cannot see the operation site. An incision is made in the abdominal wall. In the vast majority of cases, this is a transverse incision above the womb, extremely rarely - a longitudinal incision from the womb to the navel. Then the muscles are moved apart, an incision is made on the uterus (more often - transverse, less often - longitudinal), opened amniotic sac. The doctor inserts a hand into the uterine cavity and removes the baby. The umbilical cord is cut, the baby is handed over to the midwife. Then the placenta is removed by hand, and the incision on the uterus is sutured with a special thread, which dissolves after 3-4 months. Also restored and abdominal wall. Brackets or sutures are applied to the skin, and a sterile bandage is placed on top. Depending on the technique and complexity of the operation, its duration is on average 20-40 minutes.

First day after caesarean section the patient is usually in the postoperative ward or intensive care unit, where round-the-clock monitoring of her condition is carried out: general well-being, blood pressure, pulse, respiratory rate, size and tone of the uterus, amount of discharge, bladder function. At the end of the operation, an ice pack is placed on the lower abdomen for 1.5-2 hours, which helps to contract the uterus and reduce blood loss. What drugs are usually administered in the postoperative period? AT without fail anesthesia is prescribed, the frequency of administration of these drugs depends on the intensity of pain. Usually anesthesia is required in the first 2-3 days, in the future it is gradually abandoned. In addition, drugs are prescribed that promote uterine contraction, and drugs that normalize the function of the gastrointestinal tract. Physiological saline is also administered intravenously to replace fluid loss. The issue of prescribing antibiotics is decided by the operating physician in relation to each patient individually. Most elective caesarean sections do not require antibiotic therapy.

When can you get up? The first time we help the patient to get up is 6 hours after the operation. First you need to sit, and then stand a little. This is enough to get started. A more active motor mode begins after transfer from the intensive care unit. It is better to take care of purchasing a special postoperative bandage, which will greatly facilitate movement in the first few days after a cesarean section. Already from the first day you can start to fulfill the minimum physical exercises that contribute to more favorable course postoperative period. Transfer to the postpartum department is possible 12-24 hours after the operation. The child is currently in children's department. In the postpartum department, the woman herself will be able to start caring for the child, breastfeeding and swaddling. But in the first few days, help from doctors and relatives will be required (if visits are allowed in the maternity hospital).

Diet. On the first day after the operation, it is allowed to drink mineral water without gas. You can add lemon juice to it. On the second day, the diet expands - you can eat cereals, low-fat broth, boiled meat, sweet tea. From the third day, full nutrition is possible - only foods that are not recommended for breastfeeding are excluded from the diet. Usually, a cleansing enema is prescribed to normalize bowel function about a day after the operation.

When can I go home decided by the attending physician. Usually, on the 5th day after the operation, an ultrasound examination of the uterus is performed, and on the 6th day, the staples or sutures are removed. With a successful course of the postoperative period, discharge is possible on the 6-7th day after cesarean section.

Discharged home try to get as much rest as possible. It will require special attention and assistance from family members who can take on part of the household chores. After all, weakness will persist for some time after the operation, fatigue, pain in the suture area. What regimen should be observed at home? Nutrition is normal - taking into account breastfeeding. At " water procedures” will have to confine to a shower. You can take baths and swim only 1.5 months after the operation. Full physical activity - two months after cesarean section. Sexual intercourse can be resumed 6 weeks after the operation. Pre-visit a doctor, he will be able to assess how well the postoperative period proceeds. Be sure to consider contraception. You can choose the most suitable method for you by consulting with your doctor.

Next pregnancy after caesarean section better to plan in 2 years. During this time, your body will have time to fully recover from the previous pregnancy and surgery. You should know that if during next pregnancy if you have no indications for a caesarean section, then you have every chance of giving birth on your own without resorting to surgical intervention.