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- Cesarean RecoveryLast Updated: 9/24/2011
Healing in the hospital:
· Ask for assistance when you need it and keep the nurse’s call button within easy reach.
· If possible, obtain a private room so that a family member may remain with you.
· Take pain medication as needed for comfort. Many mothers have found that narcotics (like codeine) can manage pain very well but can also cause constipation. Ask your doctor about using a stool softener.
· Use pillows to support your stomach when turning, standing, coughing, and nursing.
· Rest as much as possible and limit visitors. Sleep when the baby sleeps.
· When you are ready, take short walks to prevent blood clots. If you cannot walk have someone massage your legs and ankles in bed, and keep your feet raised on a pillow. Also consider using medical support leg hose to prevent clotting if you cannot move or have to travel within six weeks of the cesarean.
· Eat healthy food and drink plenty of fluids. Avoid soda and drinking with a straw since that can make you swallow air and cause gas.
· Remember to urinate at least every 3 to 4 hours. This helps avoid or reduce the bladder pain that some mothers have after the surgery.
· If you are planning to breastfeed, talk to your nurse or a lactation consultant about positioning that will be comfortable around your incision. While some women experience a delay in their breast milk production after a cesarean, extra support will help you get a good start.
Healing at home:
· Take care of yourself and your baby only.
· Remember not to lift anything heavier than your baby for four to six weeks after surgery.
· Have a list of tasks ready for when people offer to help and don’t be shy to ask people for help.
· Let others do household chores like cooking, cleaning, and laundry. Have frozen meals prepared.
· If you have other children, ask a family member or friend to help you with their daily routine.
· Consider enlisting the help of a postpartum doula or other support person for your recovery.
· Have several diapering areas so you can change your baby easily.
· Clothe yourself based on what you need. Staying in your pajamas can remind people that you are still recovering from birth and need extra help. On the other hand, taking a shower and getting dressed can help you feel refreshed and recharged.
· Keep the baby near you at night so you do not have to get up.
· Fill a basket full of little useful things that you can carry with you. Items can include healthy snacks, your medications, a book, lotion, or a cordless phone.
· Eat well and drink plenty of fluids. Have a pitcher of water or juice near you.
· Increase activity slowly.
Call your doctor if you have any of the following symptoms:
· Any bleeding in your incision. It can mean the surgical stitches have separated.
· Unrelieved pain, or if the pain has increased.
· Pus, leaking, redness and swelling in your incision, which can indicate an infection.
· A fever can also suggest an infection, most likely in your incision.
· Pain or cramping in your arms or legs that will not go away is a serious symptom and can suggest the presence of a blood clot. Other symptoms can include sudden swelling in the arm or leg, red or discolored skin, and skin that is warm to the touch.
· Continuous headaches, dizziness or back pain could suggest after-effects of the anesthesia used during surgery.
· Symptoms of postpartum depression can include tearfulness, anxiety, appetite changes, sleep problems, extreme fatigue, and difficulty focusing your thoughts, among others.
· Keep your baby near you as much as possible.
· Vitamin E capsules can improve the skin on the cesarean scar. Wait until the scar has healed, open a capsule, pour the oil on the scar and rub slowly.
· Share your feelings with others who understand how you feel and talk about your experience as much as you feel necessary.
· Write the story of your experience, with as much detail as possible.
· Seek support from available resources including breastfeeding, parenting, and cesarean support groups like ICAN. Look for an ICAN chapter near you or join the online ICAN community.
For more support:
Call ICAN toll-free: 1(800)866-ICAN(4226)
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Many mothers who have had a cesarean tend to initiate breastfeeding less often than mothers who have had a vaginal birth. The stress, physical pain and emotional roller-coaster force many to change their mind. Bottle feeding "seems” to be easier for a myriad of reasons, not the least of which is that someone else could be doing it.
Mothers giving birth by cesarean have delayed access to their baby and it can cause marked differences in their hormone levels and milk supply. Supplemental feedings sabotage many mothers by their interference in that supply/demand.
Cesareans increase the risk of postpartum depression and PTSD (Post Traumatic Stress Disorder). Women (and/or their partners) should seek further help from a therapist who is skilled in dealing with birth trauma if you suspect you fall into that category.
You have the right to mourn your birth and your trauma while celebrating your child. These are two different events in your life, even if they are happening simultaneously.
Post partum depression symptoms are unpleasant, but manageable. They often start around the third to fourth day after delivery and last for a week or two. A woman often experiences a sense of disorientation. Highs are followed by lows. Gather your support around you. Share your feeling with your partner, another mother, or a professional. If the symptoms persist and interferes with your ability to care for yourself or your baby, then you may have postpartum depression. Postpartum Depression affects at least one in ten new mothers. Some within days of delivery, for other moms the symptoms come on gradually, even up to a year or more later.
· Sadness, depression, hopelessness
· Sluggishness, fatigue, exhaustion
· Poor concentration, confusion
· Appetite and sleep disturbances
· High anxiety levels
· Memory loss
· Over concern for the baby
· Uncontrollable crying, irritability
· Lack of interest in the baby
· Feelings of guilt, inadequacy, worthlessness
· Fear of harming yourself
· Fear of harming the baby
· Exaggerated highs and/or lows
· Lack of interest in sex
Most women are unprepared and feel bewildered when these symptoms are experienced. PPD does not take the same form for every woman. If you have several of these symptoms, ranging from mild to severe, you could have postpartum depression. You may have alternating "good" and "bad" days. Any of these symptoms can be reason to seek professional help.
Some women may not feel depressed, but instead may feel anxious. Postpartum anxiety or panic disorder is characterized by:
· Intense anxiety and/or fear
· Rapid breathing
· Fast heart rate
· Sense of doom
· Hot or cold flashes
· Chest pain
· Shaking, dizziness
Postpartum distress may include obsessive-compulsive symptoms; such as:
· Intrusive, repetitive thoughts
· Repeated thoughts of harming baby
· Anxiety, depression
These thoughts are scary and out of character for the woman experiencing them.
Post Traumatic Stress Disorder
Post Traumatic Stress Disorder is a severe anxiety reaction to a traumatic event that occurs outside the range of usual human experience.
PTSD can occur as an acute disorder soon after the trauma, or have a delayed onset in which the symptoms occur more than six months after the trauma. It can occur at any age and can follow a natural disaster such as flood or fire, a man-made disaster such as war or imprisonment, rape, or assault (such as a traumatic birth experience, often without acceptable informed consent). Such events produce stress in anyone, but not everyone will develop PTSD. The cause is not known, but psychological, genetic, physical, and social factors may contribute to it. In studies of Vietnam war veterans, those with strong support systems were less likely to develop PTSD than those without support systems. People with PTSD persistently re-experience the event in at least one of several ways: recurrent distressing dreams; recurrent recollections of the event; a sense of reliving the experience (flashbacks); and intense distress at events that symbolize an aspect of the event (such as anniversaries).
Post Traumatic Stress Disorder symptoms include:
· Recurrent distressing memories of the event
· Recurrent dreams of the event
· Flashback episodes
· Inability to recall aspects of the trauma
· Lack of interest in activities
· Feelings of detachment
· Sense of foreshortened future
· Sleeping difficulties
· Irritability or outbursts of anger
· Difficulty concentrating
· Exaggerated startle response
· Sense of guilt about the event
· Excessive sweating
· Paleness; headache
· Heartbeat sensations
· Fever; fainting; dizziness
· Agitation; phobia
· Anxiety, stress, and tension
· Alcohol and/or drug abuse
It might be helpful in preventing PTSD for those who have experienced extremely stressful situations to seek counseling or other psychiatric intervention as soon after the event as possible. Characteristic symptoms that persist after a history of unusual trauma lead to the diagnosis of PTSD. A psychiatric examination is often done.
The aim of treatment is to reduce the symptoms by encouraging the affected person to express grief and complete the mourning process (a very important first step). Support groups are effective at providing a setting where people who have had similar experiences can share feelings. Treatment for depression, alcohol use or substance abuse, or associated medical conditions may need to take place before psychological problems can be effectively addressed. Behavior therapy can be used to treat avoidance symptoms. Behavior techniques used include the graded exposure and flooding technique (frequent exposure to an object that triggers symptoms). Anti-depressive and anti-anxiety medications are sometimes used. These medications act on the central nervous system to reduce the feelings of anxiety and associated symptoms.
The best prognosis (probable outcome) is associated with symptoms that develop soon after the trauma, and with early diagnosis and treatment. Go to the emergency room or call the local emergency number (such as 911) if you are feeling overwhelmed by guilt, if you are impulsive and unable to contain you behavior, or if you are experiencing other symptoms of PTSD. Know that you are not alone- that there are people who understand and who can help.
Any woman who is pregnant, had a baby, miscarried, or even recently weaned a child from breast-feeding can be affected, regardless of how many previously uncomplicated pregnancies or postpartum adjustments she has made. There are contributing risk factors; biological, psychological, and in your relationships, that might predispose you to suffering in your postpartum period. These include:
· History of personal or family depression, anxiety, panic, mania, obsessive thoughts, or behavior
· Feelings of inadequacy; low self-esteem
· Martial conflict; Single parent
· Lack of support
· Super woman syndrome
· Hormonal risks; thyroid imbalance, PMS
· Physical exhaustion; lack of sleep
If you (or your partner) recognize yourself in any of these descriptions, please get help right away. If you email me, I will help you locate someone capable of assisting you with diagnosis/recovery.
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