You're holding your newborn baby in your arms and as you gaze at her angelic face, all the aches and pains of the months gone by are rapidly forgotten—all except one. If you've delivered your baby via a caesarean section, do keep in mind that while it is a rather common procedure these days, it still is a major surgery.
Unlike mothers who deliver naturally and recover immediately after birth, the circumstances are different for you because the pain is just beginning. Catering to the physical demands of being a new mother—breast feeding, changing diapers, the nightly routines—it can all get rather overwhelming.
Caesarean to the rescue
Timely C-sections have saved many lives. "Regular antenatal check-ups, close monitoring using sonography and colour Doppler can detect abnormalities at an early stage. Conditions such as intrauterine growth retardation [where the baby's growth isn't adequate], reduced [amniotic] fluid [oligohydramnious], reduction in blood flow to the baby warrant caesarean delivery to ensure safety of the baby," explains Rishma Pai, consultant gynaecologist at Jaslok and Lilavati hospitals in Mumbai.
Also, problems, which can be risky to the mother and baby such as placenta previa, abruptio placentae [where the placenta separates from the uterus], pregnancy-induced hypertension, and gestational diabetes require a C-section. "Close monitoring in labour identifies when foetal distress occurs, requiring urgent C-section," adds Pai. Delivery of twins and older women getting pregnant too contribute to increase in caesarean deliveries.
Things you can do
If you're opting for a C-section, or are at risk for one, here's what you need to know for a speedy recovery.
Deal with post-surgical pain: A C-section can be done under two conditions. You will either be given a spinal block [epidural] that will numb the lower portion of your body [you are conscious throughout the procedure]. Or, you will be provided with general anaesthesia. With the latter, you will be unconscious for the duration of the surgery. In both cases, once the procedure is over, you will have to deal with intense pain. Be prepared for a great discomfort post-surgery despite taking pain killers.
"I couldn't sleep most of the night, despite the sedatives," recalls Sharadha Manohar, a Chennai-based teacher. "I had difficulty emptying my bladder the next day and had tremendous stomach ache because of trapped gas. I made the mistake of refusing to walk for a few days after surgery, since it was painful around my stitches, but the delay just worsened the cramps and pain. It was a week before I could move normally and months before I fully recovered," she says.
Today, doctors agree that as hard as it may seem, taking those first few steps the day after your C-section can set you on the road to rapid recovery. "Due to the type of sutures used and universally followed procedure of lower segment caesarean section [with the stitches on the lower part of the abdomen in a horizontal line], the risk of the scar on the uterus or the abdomen giving way is low. As a result, the patient is out of bed, the day following surgery and is encouraged to be active," says Pai.
Establish a feeding routine: Breast feeding while dealing with the pain can be very daunting, unless you're adequately prepared. Clogged ducts, sore nipples or leaking breasts pose a challenge.
"I breast-fed for one hour 40 minutes after birth," says Mangala Ramprakash, a Bangalore-based housewife. "A nurse had to help me breast-feed as I couldn't sit up."
Establish a feeding ritual as soon as possible. This will ensure that your baby gets the nourishing colostrums—the first life-giving milk that builds up a healthy immune system for life—and also prevent clogged milk ducts that could add to your discomfort.
Make breast feeding easier: "Buy a feeding pillow that can be clipped to your waist," advises Delhi-based Kimberline Arora, who has had two C-sections. "After my first delivery, I knew the second one too could be a caesarean. So I focused on feeding essentials in my prenatal classes. The pillow turned out to be a boon; I could rest the baby on it without hurting my scar," she adds.
"Breast feeding may be tried in the lying down position if pain is experienced while sitting and feeding. Applying nipple cream or application of the hind milk help to minimise soreness and cracking. As far as possible, try to reduce the strain on the abdomen," advises Basab Mukherjee, a Kolkata-based gynaecologist.
Eat the right kind of food: Since you're feeding and recovering from major surgery, your diet becomes important. Avoid spicy foods and excessive caffeine. Eat calcium-rich foods, fresh fruits and vegetables. "The need for calories during breast feeding is more than that during pregnancy. A good diet helps improve health and heal the scar," says Mukherjee.
Take care of your body"Avoid exertion, lifting heavy weights, or exposure to crowded places to prevent infection," advises Pai. "You can start back-strengthening exercises soon after. Continue iron and calcium supplements for a few months."
Keep travel plans on hold : Wait for at least two weeks after the operation to travel. "Wear comfortable shoes, stay well-hydrated, get up intermittently to stretch your legs during travel," says Pai. This is applicable only if you have an uneventful recovery from caesarean delivery. In case of complications such as pregnancy-induced hypertension, diabetes, heavy bleeding during delivery or an infection in the post-operative period, avoid travelling for at least a month.
Care for the scar: Ensure that your caesarean scar doesn't get infected. Since most stitches are dissolvable, most of the healing is internal. So, avoid activities that may strain your abdomen. Don't carry anything heavier than your baby and avoid frequent climbing of stairs. Immediately report itchiness, redness or swelling along your scar tissue to your doctor. Keep the scar area dry and clean and don't wear tight-fitting clothes. When you cough, sneeze, or laugh, support your incision using your hands or a pillow.
Don't be too eager to exercise: You might be eager to get back to your pre-pregnant figure as soon as possible. However, slipping back into an exercise schedule too soon could lead to several complications. Give your body time to heal; be patient.
"I generally advise women to take it easy after C-sections and ask that they limit all strenuous activity," says Mukherjee. You may start light walks a week or two after the procedure. However, wait for at least six weeks after delivery to begin a full-fledged exercise programme. This gives the sutures inside the body time to get completely absorbed, minimising the risk of hernia."
Seek emotional and spiritual relief : Go beyond just the physical and ensure that you heal on a mental and spiritual plane as well. "I started yoga about a year after my C-section and it helped enormously," says Ramprakash. "I finally began to feel like I 'possessed' my body in its entirety again... that feeling of wholeness and wellbeing that yoga gave me was a big gift." Make use of every minute your baby sleeps to pencil in time for yourself. Exercise, meditate, pray, chant—do anything that will allow you to connect with your inner self.
And remember, it took nearly a year for your body to create the miracle—your baby. It will take just as long for you to regain your original strength and fitness. Give yourself time and care; as you nurture your baby, you too should be back to the pink of health soon.
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