What to do after a cesarean section. Recovery after surgery. Pay attention to mood changes

A woman cannot always give birth to a child on her own. There can be many reasons: too large a fetus, full placenta previa, a high degree of myopia, other diseases and features in which only surgical intervention is indicated. But no one takes off the responsibilities of caring for a baby from women's shoulders, so the question of how to quickly get back to normal and recover after surgery worries all patients.

The first days after a cesarean section:

REFERENCE! Caesarean section is a major surgical procedure during which the tissue of a pregnant woman is excised in order to extract the fetus to the outside. It is performed under both general and spinal anesthesia.

- when do you need to get up after surgery?

The patient spends the first day after the operation in the intensive care unit. The first 12 hours she is not allowed to get up, but lying flat in bed is also not recommended. In order for the blood clots to come out and the adhesion process does not start inside, a woman must definitely move - roll over from side to side, move her legs. Try to rest your feet on the bed and slightly lift your hips, swing them back and forth, and then lower them. Then turn the chest, first to the left, then to the right. Do everything smoothly and neatly!

Your doctor will constantly monitor your health: check the pressure and pulse, the amount of secretions, the contractility of the uterus. It depends on these indicators - when you are allowed to get up and sit down.

The first time you will be allowed to get up only in the presence of a nurse. If you feel dizzy, don't worry, this is normal. Sit for a few minutes, breathing deeply. You will not be able to straighten right away, so do not strain. You will have to walk in the first days, bending forward a little, so as not to disturb the seam once again.

ATTENTION! As soon as the woman and the baby are transferred to postpartum and left alone, the mother already has to take care of the baby on her own. Therefore, it will not work out. You should walk more along the corridor (at least for short distances) - this way the uterus will contract faster.

- how much can you push after cesarean?

Every second woman faces such a nuisance as constipation after childbirth. Hemorrhoids often occur (especially in the last stages, when the fetus presses on the rectum with all its mass). It is impossible to push in these cases! First, it is possible to provoke the appearance of cracks in the mucous membrane, bleeding and even prolapse of the rectum. And secondly, due to the strong tension of the muscles of the peritoneum and uterus, the fresh suture may begin to bleed.

IMPORTANT! The stitches after the cesarean are usually well sewn and cannot disperse so easily, but efforts will have a negative effect on healing.

The following helps to avoid constipation:

• Compliance with a special diet with a lot of fresh vegetables and cereals, dairy products, bran bread, a lot of liquid.
• Taking medications: Duphalac, Normase, Portalak (if the mother is breastfeeding); Guttalax, Bisacodyl, Regulax (if the baby is artificially fed). It is allowed to use candles - Calciolax, Ferrolax, Glycelax, candles with sea buckthorn oil.
• Folk recipes: a decoction based on figs, herbal infusions and decoctions of fruits (nettle, valerian roots, fennel, anise, cumin).

- How long does it take to remove the catheter?

A catheter for urine diversion is a must: there is a high risk of damaging the bladder during surgery. Therefore, by monitoring the volume and color of urine, and specifically, whether blood has entered the urine, this risk can be reduced.

After the procedure, the catheter remains in the bladder for a day or two and, in general, it does not cause unpleasant sensations. And the removal is quick and painless: with a deep breath.

Recovery rules after cesarean section:

A woman should be prepared for the fact that recovery after a cesarean section will last longer than after a natural birth.

- normalization of the menstrual cycle after cesarean

The reverse process of internal restructuring starts from the very day when the baby is born, but if during natural childbirth it lasts about six months, then the full recovery of the body after cesarean will occur within 3 years. Menstruation will come much earlier - the normal cycle is restored in 3-4 months.

Do not confuse postpartum spotting - lochia - with menstruation. They are not so abundant, but smearing, day by day they change color from brown to transparent, then disappear altogether. The appearance of lochia is a natural process indicating the healing of the uterine lining.

REFERENCE! Breastfeeding speeds up the recovery of the body and the uterus. It has been found that human milk contains 20 hormones, one of which is prolactin. It has a depressing effect on the production of progesterone, which is responsible for the maturation of the egg and its fixation in the uterus. The more often a woman puts the baby to her breast, the more prolactin is produced, respectively - the usually longer the period of absence of menstruation. Sometimes they don't come for 8-10 months.

- normalization of breastfeeding after surgery

Women who have undergone a cesarean section initially have a number of difficulties with breastfeeding. Early attachment (immediately after childbirth) cannot be carried out, since the mother is quite often in intensive care a day. They do not bring the crumbs there, i.e. there is no feeding for 24 hours. Therefore, milk does not arrive immediately, but after 4-5 days. The baby is given a special mixture from a bottle these days. Since the mechanism of sucking on the nipple and breast is somewhat different, the child has to adapt to the changed conditions. The physical condition of the mother and the hormonal changes in the body that have begun also affect. In addition, droppers often cause swelling, and in the chest too - it swells, becomes hard and painfully reacts to touch.

Therefore, remember a few important rules:

• Be sure to massage your breasts and express milk if it arrives. It is enough to do this every 3-4 hours for 15 minutes for each gland. Do everything carefully and carefully, without squeezing or jerking.
• Place the baby to the breast so that not only him, but also you feel comfortable. You can do this while lying on your side, or by placing the child on your stomach and pressing it tightly.
• You shouldn't feel pain while sucking! If the baby's mouth is wide open, the chin is pressed against your chest, and the lower lip is turned outward - you are doing everything right.
• You need to feed the baby on demand, but if he sleeps for more than 4 hours at night, he should be woken up and fed.

- body restoration

Remember - the recovery period lasts for each woman differently. It depends on several factors:

• Individual characteristics of the organism. How was the operation, whether there were any complications (suppuration of sutures or remnants of the placenta in the uterine cavity) - all this does not add positive emotions and delays the healing process. The pain threshold is also worth mentioning. This indicator is different for each person: someone forgets about the pain after a couple of days or does not pay attention to it, and someone is not able to fully sleep and take care of themselves, not to mention the child.
• Psychological condition. It depends not only on the character of the woman and her moral state, but also on the climate in the family, relations with her spouse and other close relatives, and attitude towards the newborn.

The more active the mother is, the faster she will recover from the operation. However, it is important not to harm and do only what the doctor will allow! Moderation is the main condition. A large belly affects posture and gait. The abdominal muscles lose their tone, the gait becomes duck-like. All this can be dealt with, but not immediately, but gradually. Athletics are allowed 10 weeks after surgery. Yoga and swimming are allowed. Walk as much as possible, wear a corset and low heels. A back and neck massage gives a good relaxing effect.

- playing sports after cesarean

Already a couple of hours after the operation, you can do self-massage - stroking the abdomen in circular motions from left to right and from top to bottom. Get a tennis ball - write circles with it, starting from the navel, clockwise.

6-8 months after the cesarean, you can do exercises to strengthen the muscles of the thighs, abdomen and waist, starting with the lightest. Pilates, water aerobics, dancing, running are allowed.

ATTENTION! It is forbidden to use dumbbells and other weights after surgery for a year! Put off cycling, volleyball, and weightlifting for a while. If during the exercise you feel dizziness, divergence of the seam, discharge from it or the vagina, pain in the abdomen, stop practicing immediately and choose another method in the future.

- hygiene after cesarean

In the maternity hospital, the nurses will deal with the treatment of the suture. When will they be removed (after 5-8 days - you will have to do it yourself. Pain at the incision site for the first 3-4 days is normal. It is important to wear a postpartum bandage and go to the toilet on time. Sometimes painkillers may be required, this is also not deviation.

What you need to do at home:

1. Wash hands before each treatment.
2. The seam is washed while taking a shower with a special gel and blotted with a disposable paper towel. It is better not to use terry cloth - microbes can accumulate in its folds.
3. After bathing, the damaged area is treated with chlorhexidine, diluted salicylic acid or another disinfectant.
4. Wear cotton underwear of the correct size. It should not tighten the skin, press and rub.
5. 2-3 weeks after the cesarean suture, you can start smearing the regenerating gel - it will help the skin to return to normal faster.

IMPORTANT! The first bath - not earlier than a week after the operation!

What should not be done during the first time after a cesarean section?

• Carry weights
• The most you can lift is a child. No heavy bags and boxes, especially from the floor.
• Strain the press and make sharp movements (tilts, turns).
• Rub the seam with a washcloth.
• Eat fatty, sweet and fried foods. Legumes, cabbage, canned foods and white bread are prohibited.
• Having sex.
  The ban is imposed for 1.5-2 months, but in the presence of complications (internal inflammation, endometriosis, suture suppuration, etc.) - until the permission of the gynecologist.

REFERENCE! Plan your next conception no earlier than 3 years after cesarean. Let the seam heal completely, and the body to recover.

Conclusion

Be prepared for certain difficulties after a cesarean section, but do not shake with fear, but meet them fully armed. By following all the recommendations, you can bounce back pretty quickly, as well as avoid unpleasant complications. It takes effort, but the results are worth it.

Specially for- Elena Kichak

Every woman who gave birth by cesarean section should understand that her body has undergone serious surgical intervention, after which it is necessary to restore her body for some time.

The main thing that should be done during the recovery period after a cesarean section is to follow the instructions of doctors in order to avoid the occurrence and development of complications.

How is the operation going?

During a cesarean section, the woman's tissues are cut, right down to the uterus, for safe removal of the fetus. For safe conduct, in some cases, only spinal anesthesia is used. The medication is injected into the epidural area of ​​the spine using a catheter.

With spinal anesthesia, only the lower body is anesthetized, from the lower back to the heels. In this case, immediately after childbirth, the woman in labor is able to independently attach the baby to her breast.

If it is known that the caesarean section will be performed in advance, the operation is called "planned". Indeed, in some cases, a woman in labor is not able to give birth on her own. Such cases include:

• Complete presentation of placental tissue;
• Some dangerous diseases;
• Features of the location of the child in the uterus;
• The discrepancy between the size of the child and the birth canal of the mother and much more.

The operation is prescribed to avoid possible complications for both the child and the mother herself. Also, a cesarean section is performed when complications arise during natural childbirth and the woman in labor is not able to cope on her own. Such an operation is called "emergency caesarean section" and is performed in slightly different ways than planned.

Consequences and complications

Despite the high level of development of medicine, a variety of complications after the operation occur in almost 35% of women in labor. In the first place, according to the complications that arise, it is worth highlighting a variety of inflammations. It is difficult to predict the place of localization and the degree of severity, they are individual in each case.

Among the main causes of complications, it is worth highlighting infections and some mistakes that were made during the caesarean section.

Women in labor are most often worried about:

• Infections arising in wounds;
• Endometritis;
• Inflammation of the seams;
• Unpleasant discharge from the birth canal;
• Sepsis;
• Peritonitis.

These complications bring discomfort to a woman's life, but with timely treatment they will be quickly eliminated. But, it is also worth highlighting a group of diseases that can lead to death, infertility, constant pain:

• Inflammation of the appendages;
• Inflammation of the inner layer of the uterine tissue;
• Inflammation of the tissue around the uterus.

To avoid the appearance of these diseases, it is necessary to provide the woman in labor with the necessary care and regular examination from doctors.

The first days after the operation

The first days after a cesarean section, a woman is obliged to spend in bed, recovering her strength after the operation. After all, even the simplest operations, which previously took place imperceptibly, will take away physical strength.

Women in labor spend the first day in the intensive care unit, under the supervision of nurses. Temperature, blood pressure and pulse are checked regularly. Along with this, the intensity of vaginal discharge and uterine contraction is checked. Particular attention is paid to the seam, on which the dressings are changed every few hours, the condition of the seam itself is checked. To avoid stretching, the woman in labor is in bed for the first day.

During the operation, pain relievers are used, the woman should not even sit on the bed for the first 15 hours. It will be possible to get up only after three days under the strict supervision of medical personnel.

All movements should be done slowly, getting out of bed with the help of relatives or nurses. On the first rise, there may be slight dizziness and weakness throughout the body. The unpleasant symptoms will go away quickly during the recovery period.

The first steps

Depending on how the woman in labor will behave, it depends on how the rehabilitation period will go. When you first try to get out of bed, you must adhere to some rules:

• Before sitting on the bed, you need to lie on your side and only then sit down with your legs dangling;
• Then you need to slightly move your feet, as if fingering the water;
• Getting up, the feet should rest on the floor, and the back should be straight - so the seam on the abdomen will not strain, the woman will feel only a slight tension in the navel;
• You should not rush to go, you need to stand a little, leaning on a bed, a curbstone or a person;
• And only then begin to move with light, small steps.

It is this instruction that should be followed in the first days after the operation. If everything is done correctly, after a couple of days, the walking process will bring less discomfort. The load should be gradually increased every day, but not too much so that the load on the seam is minimal.

Fighting cough

Some women in labor after a caesarean section are annoyed by a cough. To reduce the load on the abdomen, and, accordingly, the postoperative suture, it is necessary to learn how to cough correctly so as not to strain the sutures.

A cough occurs because a small amount of mucus builds up in the lungs when using general anesthesia. Names this mucus and coughs up after surgery. The first couple of days, the seam when coughing will be very tense and painful. To reduce pain, you need to place your palms on your stomach, holding the area with sutures. Optimally, bandage the abdomen with a cloth or a terry towel. Cough technique:

• Take a full chest of air;
• Exhale sharply;
• At the same time, keep the abdomen pulled in.

Subject to all the conventions, the cough will resemble the barking of a dog.

Intestinal gas and urinary problems - normal or abnormal?

It is worth preparing in advance for the fact that after the operation, the woman will have intestinal gases. This is normal because abdominal surgery slows down the peristalsis process.

It is impossible to completely eliminate the formation of gases in the first days. Refusal of food forming attacks of flatulence, the technique of deep breathing and rocking in a chair will help to solve the problem.

Less commonly, women in labor develop bladder problems. Difficulty urinating can be caused by a catheter used for a caesarean. In order to establish the work of the genitourinary system, it is worth trying to drink more fluids.

If a simple method does not help, see your doctor. Using a catheter to empty the accumulated fluid in the bladder will relieve some of the suffering. The main thing is not to hush up the problem. In the future, a consultation with a nephrologist is required.

Eating rules

For the first two days, all nutrients to support the life of the woman in labor are administered intravenously. This is necessary so that all internal organs can rest after the operation. Only clear non-carbonated water is allowed, with a small slice of lemon.

And only on the third day, the use of chicken broth is allowed. This nutritious meal will help you gain strength quickly. After a couple of days, liquid porridge, chopped meat, all liquid food are allowed. Regardless of the product, its volume should not exceed one hundred grams (milliliters).

Small portions are calculated so as not to strain the organs of the gastrointestinal tract. This will speed up recovery from a cesarean section. For the same reasons, food should be digestible. Ideally, everything is cooked or steamed. It should not be surprising that the first hard stool is formed only after a week.

Features of feeding the baby

If in the first days there are no complications, a woman can safely ask to bring her a baby for breastfeeding. The baby will stimulate the formation of milk in the breast.

If, for various reasons, the baby is not brought for feeding (for example, in case of complications), milk must be expressed on its own.

When feeding, keep the baby sitting or lying down. While standing, the seam is strained, and the load in the form of a child will only delay the rehabilitation. Depending on the severity of the operation, the prohibition on keeping the child standing for a long time can last for six months.

When feeding, it is better to sit not upright, but lean your back on a few pillows. At this moment, relatives or medical personnel should be nearby. They will take the baby so that the woman can go back to bed.

Seam care

As with any other operation, the stitches must be taken care of during the rehabilitation period. The first days of care consists in daily treatment of the wound. The dressing is changed five times a day. The shower can only be taken after the stitches are removed. But, even when taking a shower, you should forget about the washcloth, despite the fact that the scar has already formed. The tissue on the scar is still very delicate, you should not influence it once again.

After a caesarean section, the stitches will hurt for several days. To cope with pain, the doctor prescribes pain medications for each individual case. Over time, the pain becomes less and less, the dose of the drug decreases. Bandages are needed to support the abdomen. For at least two months, women who have undergone surgery should not understand things whose weight exceeds two kilograms.

Caesarean section is an obstetric operation performed when a woman cannot give birth naturally. Women in labor take a little longer to recover from a caesarean section. In order for a woman to gain strength faster, you need to adhere to some recommendations.

Postoperative period

If the operation took place without complications and the child is healthy, the woman with the baby is transferred to the joint ward after 2 hours. In order to prevent the development of complications, it is necessary to constantly monitor the state of vital organs. For this, the medical staff measures the pulse of the woman in labor, blood pressure, temperature, assesses the tone of the uterus, the nature of the discharge. Also, the doctor assesses the state of urinary function and, if it is impossible to urinate, a urinary catheter is installed for the woman.

The first day after cesarean section requires active drug treatment. The operation is inevitably associated with blood loss. To restore the volume of circulating blood and increase the rheological properties of the woman in labor, rheopolyglucin, solutions of sodium chloride and glucose are administered. In case of massive blood loss, blood components are injected.

After the operation, the woman may be prescribed pain relievers, which are administered within one to three days. When carrying out any surgical intervention on the abdominal organs, there is a risk of developing intestinal paresis. To prevent this from happening to a woman, she is prescribed proserin. To prevent infectious complications, they are prescribed (in some cases, the antibiotic is administered intramuscularly or intravenously before the operation).

A woman is in the hospital for 4 - 5 days or more in case of complications.

Mother's nutrition

On the first day after giving birth, a woman in labor can not eat anything, she can only drink non-carbonated water. But do not worry, the woman will not be hungry. All necessary nutrients will be replenished with drips.

On the second or fourth day, the woman in labor needs to follow a sparing diet, because her intestines are still not able to work fully. You can eat boiled, pureed food. It is allowed to add hated meat broth, steamed cutlets, low-fat cottage cheese and cheese, mashed potatoes to the diet. Products that increase gas formation (legumes, flour products, grapes, etc.) are prohibited. If a woman is worried, you need to stroke the stomach in a clockwise direction for a minute.

Already on the fifth day, the menu is gradually expanded. But this does not mean that you can eat absolutely everything. Now a woman needs to constantly remember that everything eaten can affect the condition of the baby. Therefore, during the period of breastfeeding, you cannot eat certain foods that can harm the baby.

The importance of movement after surgery

The first day after the cesarean section, the woman will feel weak, feel pain in the abdomen, which is why the woman in labor does not want to move again. In addition, with active movements, divergence of the seams may occur. However, already 6 hours after the operation, doctors advise starting to roll over from side to side, slightly pulling up the legs to the stomach, performing simple physical exercises right in bed (rotation of the feet, hands, flexion and extension of the legs in the knee joint, etc.), and then - and get up (strictly under the supervision of the medical staff).

Important: you can sit down and get up only after the woman puts on a special postpartum bandage (in many maternity hospitals, women in labor are first tightly wrapped with a folded sheet).

Get out of bed carefully, without straining your abdominal muscles. You need to pull your knees towards you a little, roll over onto your side, and then, leaning on your hands, take a sitting position. By the end of the first day, a woman can already get out of bed and walk a little.

Many mothers are worried about being overweight and wondering when to start exercising. In the postpartum period, only simple physical exercises are allowed. You can start more active loads after a month and a half. It can be fitness, yoga, body flex. It is worth postponing with exercises for swinging the press for six months.

After discharge from the hospital, the woman in labor will be warned that in the near future she cannot lift weights over three to four kilograms, that is, no more than the weight of the child.

Suture healing after cesarean section

During the stay of a woman in labor in the hospital, the nurse regularly treats the seam with antiseptics (brilliant green, potassium permanganate solution), and changes the bandage. The stitches are removed approximately on the seventh to tenth day. Skin healing usually occurs quickly. The seam is initially very visible, red or purple. As time passes, it will become less and less noticeable. For the speedy resorption of the scar, you can take special ointments, for example, contractubex.

Do not shower completely until the stitches are removed. But you can wash parts of the body separately. It will be possible to take a full shower only after the stitches are removed, but, of course, you should not actively rub the scar. But visiting the bath and bathing in the bath should be postponed for two months until the seam on the uterus is completely tightened.

Intimate life

The uterus after a cesarean section is a large wound surface. Therefore, until it heals, and this happens within one and a half to two months, you should refrain from sexual intercourse.

The uterine suture heals completely within two to three years. If a woman plans to become pregnant in the future, she should become pregnant no earlier than after the specified period. This is why you need to use. And, of course, you should not hope that it is impossible to become pregnant during lactation - this is a myth.

Menstruation recovery depends on whether the mother is breastfeeding. So, if a woman does not breastfeed, the menstrual cycle resumes after two months, if she feeds - after six months or more.

Grigorova Valeria, medical columnist

According to statistics, an average of 20 -25% of pregnancies end with a caesarean section. This method of delivery is considered relatively safe and gives a minimum of complications. But doctors never tire of repeating that Caesarean should be a necessity, not a woman's whim. Caesarean section operation is carried out only according to indications: anatomically narrow pelvis in the mother, full placenta previa, 2 or more cesarean sections in history, acute fetal hypoxia, etc. Recovery after cesarean section takes longer and harder than after natural childbirth.

In this article, we talk about recovery after a cesarean section: what difficulties can arise in the first days and weeks after childbirth, and how to cope with them.

The operation is performed under spinal or epidural anesthesia. What type of pain relief is chosen by the anesthesiologist, based on the situation and the health of the mother. General anesthesia is given in some emergency cases when you need to quickly remove the baby from the mother's womb.

A catheter is placed in the urinary tract to drain urine. Thanks to this, the bladder does not press on the uterus, the doctor takes out the child faster. Then the anesthesiologist puts on anesthesia, and the woman in labor is fenced off with a screen. During the operation without general anesthesia, the woman is awake.

The surgeon cuts the abdominal wall. If there is already a scar on the uterus, then another one is made in the same place, after cutting off the old one. Subcutaneous fatty tissue, muscles, aponeurosis, abdominal wall are cut. The bladder is removed. Then an incision is made in the lower segment of the uterus. In this place, the thinnest muscle layer, a small scar remains during healing. The fetal bladder is cut and the child is removed. In reverse order, the incision is sutured with silk, self-absorbable sutures, or closed with staples.

Removing the baby during a cesarean section

The operation takes 30-40 minutes. The child is removed 15-20 minutes after the start of the operation. If the mother is conscious and has received non-endotracheal anesthesia, the baby may be immediately attached to the breast.

Negative consequences of a cesarean section

The operation is now considered safe, but complications after it are quite common.

The recovery period is complicated by the following factors:

• Stitch on the abdomen. In 90% of cases, a horizontal intradermal or external suture is made above the pubis. Only in emergency situations is a vertical seam made when there is a risk to the life of the mother and child. How quickly the scar heals depends on the individual characteristics of the organism. Some have a predisposition to the formation of keloid scars, with the proliferation of connective tissue fibers of the skin in the area of ​​the scar. You can get rid of a keloid scar using laser resurfacing.
• Suture on the uterus. Before the onset of the next pregnancy, at least 2-3 years must pass for the scar to heal thoroughly. Otherwise, during childbirth or during pregnancy, there is a risk of rupture of the uterus along the seam. After three cesarean section operations, tubal ligation is indicated.
• Adhesions. Surgery almost always leads to the formation of adhesions (fusion of internal organs). They glue together like a film the internal organs of the small pelvis, bowel loops, fallopian tubes. This happens due to inflammation, which provokes contact with non-sterile air of the operating room, blood entering the open wound and even talcum powder from the doctor's gloves. It can lead to infertility, indigestion, constipation, endometriosis. In severe cases, removal of adhesions using laparoscopy is indicated, in mild cases - treatment with physiotherapy.
• Consequences of anesthesia. If general anesthesia is used during the operation with a tube inserted into the trachea, mucosal injury occurs. Sputum accumulates, a cough appears, causing tension in the abdominal muscles. Spinal anesthesia leads to microtrauma to the roots of the spinal cord. From this back pain, dizziness, headaches.
• Delayed onset of lactation. After natural childbirth, milk comes in 3-4 days. In case of caesarean section - after 7-9 days. The onset of labor triggers lactation hormones. The caesarean section is usually performed on a planned basis, when the body may not yet be ready for childbirth. In this case, lactation hormones are produced with a delay.
• Great blood loss. During natural childbirth, a woman loses 250-300 ml of blood. The body quickly recovers such blood loss. With CS, blood loss is 500 - 1000 ml. To maintain the body after the operation, blood-replenishing drugs, plasma, erythrocytes are injected.
• Weak contraction of the uterus. Due to the seam on the anterior wall, the uterus contracts slightly. To avoid subinvolution, the postpartum woman is prescribed auxiliary therapy for the rapid contraction of the uterus.

External and cosmetic seam

The well-being of the operation depends on the experience of the surgeon, how quickly and efficiently the operation was performed, the quality of the suture material, and whether postpartum antibiotic therapy was used.

Recovery in the first days after cesarean

The first days after the operation become the most difficult. Most women complain that the seam hurts. Some people are tormented by the effects of anesthesia.

The first day after the operation, the woman spends in the intensive care unit under the supervision of medical personnel. Her blood pressure is measured, blood loss is restored, and she is given pain relievers. A heating pad with ice is placed on the stomach so that the uterus contracts more intensively. If there are indications, antibiotic therapy is performed. It all depends on how the operation went. On the second day, the woman is transferred to the postpartum ward, where she, if desired, can take care of the child herself.

1. Sitting on the bed is allowed on the second day after the cesarean section. You need to sit down carefully, first lower your legs from the bed, then, with support on your hand, rise to a sitting position. Before getting up, you need to sit for a while, and get up for the first time with the help of a nurse, or at least leaning on the back of a chair. Use to relieve soreness of the seam.
2. After a cesarean section, urinary retention is common. During the operation, a catheter is inserted into the urinary canal, and after a day it is removed. But damage to the nerve endings, microtrauma of the mucous membrane cause pain, which disappears in 1-2 days. Even if there is no urge to urinate, you need to urinate every 2-3 hours. Otherwise, the overflowing bladder will press on the uterus and prevent it from contracting.
3. Every day, the suture on the abdomen is treated with an antiseptic solution and the bandage is changed. It is impossible to wet the seam for the first 7-8 days until the seams are removed. It is allowed to take a shower after leaving the hospital and removing the stitches. And take a bath only after 1-2 months, when the seam heals. The bath should not be hot. The first 2 days the seam hurts very much. The doctor prescribes pain relievers that are safe for a breastfed baby.
4. If a woman after general anesthesia is tormented by a cough, then you should not be afraid to cough. The accumulated sputum in the trachea after anesthesia should come out. During a coughing fit, place a pillow or palm on your stomach. Inhale deeply and exhale slowly, but strongly, with a sound, release the air.
5. In the first days after cesarean, you need to establish the work of the gastrointestinal tract. Due to the operation on the abdominal cavity, intestinal motility is weak, the first stool appears on the 3-4th day. Constipation should not be allowed, because strong straining can lead to seam divergence. The first day after the operation is allowed only to drink non-carbonated water. Food enters the body through a dropper. From the second day, easily digestible food is introduced, gently starting the work of the intestines. We wrote more about nutrition after cesarean section.
6. To stimulate intestinal motility and blood circulation in the pelvic organs, you need to move as much as possible. On the first day after the operation, you can do gymnastics in a supine position.

Exercises can be as follows:

• Pull the socks towards yourself, away from yourself;
• Bend your knees;
• Squeeze the buttocks;
• Squeeze the pelvic floor muscles for 5-10 seconds;
• Turn the body from side to side.

A post-cesarean bandage helps relieve pain during movement

They are discharged from the maternity hospital 7-8 days after the removal of the stitches, having previously done an ultrasound of the uterus to make sure that the involution occurs at a normal pace.

What happens to the body after discharge from the hospital

The recovery period after cesarean continues after discharge from the hospital. Mom needs au pair. Most important is getting more rest and breastfeeding.

• Whether a mother can breastfeed after a cesarean depends only on how often she lays the baby to her breast. Feeding on demand is the right decision. Then oxytocin and prolactin, which are responsible for milk production, will be produced. Lactation hormones also cause uterine contractions.
• For the first three months after childbirth, lifting weights weighing more than 4 kg is not allowed. The maximum that a mother can afford is to carry her baby.
• It is allowed to start playing sports no earlier than a month after giving birth, when the lochia ends and the suture heals. We wrote about the exercises allowed after cesarean.
• You can return to sexual activity in 1.5-2 months, when postpartum discharge ends. Post-COP contraception is a must. You need to wait a break of at least 2-2.5 years. During this time, the suture on the uterus will heal. If you hurry, then there is a risk of suture divergence during pregnancy or childbirth. A condom is the most suitable method of contraception after childbirth.
• Menstruation resumes in 2-3 months if the mother is not breastfeeding, and within 1-2 years if the baby is breastfeeding.

Video: how to establish hepatitis B after cesarean section

Recovery after a cesarean takes a longer time than after a natural birth. But the more actively the mother begins to move immediately after the operation, the faster the process of healing of sutures and involution of the uterus proceeds.

Surgical intervention in obstetric practice allows you to preserve the health and life of the mother and child in the event of a difficult pregnancy, the presence of contraindications to natural childbirth or the development of unforeseen complications already in their process. Many women consider this method of delivery more sparing, since it is not associated with the need for prolonged experience of contractions and possible ruptures. All that is required of the mother in such cases is to be an outside observer of the work of the doctors involved in the extraction of the child. However, in spite of the seeming harmlessness of operative labor in comparison with natural labor, this way is no less dangerous. Caesarean section is an open abdominal operation requiring anesthesia, associated with extensive tissue trauma and massive bleeding.

The main difficulties for a woman arise in the postoperative period. Recovery after cesarean lasts several months, the first day being the most unpleasant. At the same time, during the entire rehabilitation period, no one relieves the young mother from the duties of caring for the newborn.

Recovery after anesthesia

As with any traumatic procedure, surgery to retrieve a child requires anesthesia. With a planned intervention, its type is assigned taking into account the state of the woman's health. Emergency surgery is often performed under spinal anesthesia. Recovery after cesarean, physical well-being and emotional state in the first days is directly related to the anesthesia used. The body's reaction to drugs can be the most unpredictable.

Immediately after the operation and for the next 6-8 hours, a woman is forbidden to get out of bed and turn over on her side. Depending on the complications, blood transfusion, infusion therapy containing nutrient and rehydration solutions may be required during the operation. Then movement becomes a necessity. To quickly recover and get rid of the effects of drugs, it is recommended to sit down slowly, lower your legs out of bed. The next day it is allowed to get up. You should not be afraid of the divergence of the seams, since they are held together until complete healing. The consequences of anesthesia are much more troublesome.

General

Many consider the advantage of this method of anesthesia to be a complete loss of consciousness and the absence of the need to monitor the progress of the operation. However, for both doctors and patients, this type of anesthesia is associated with great risks.

An endotracheal procedure with artificial ventilation of the lungs leads to a decrease in blood pressure and a slowdown in cardiac activity for 40-60 minutes - while the operation lasts. During this time, doses of medicinal substances are administered intravenously inside the body. When all manipulations are over, the supply of drugs is stopped. Their anesthetic effect ceases almost immediately. Consciousness gradually returns to the woman in labor after a few minutes. Severe pain begins almost immediately.

Within 30-60 minutes, residual effects of the drugs are observed, hallucinations, hysterical states, stunnedness, perception disorder, speech impairment are possible.

To relieve pain after general anesthesia, a woman in labor needs analgesic drugs for several days.

Spinal

One of the easiest anesthesia techniques to use. Provides a single injection of anesthetic drugs into the narrow subarachnoid space that separates the spinal cord and the arachnoid membrane. The injection is placed in the area of ​​the spine between the 4th and 5th vertebrae. The active ingredients almost instantly block the nerve endings, anesthesia fully relieves pain in 15 minutes. The lack of sensitivity in the lower part of the body allows the operation to be performed while maintaining the patient's consciousness.

Spinal anesthesia

Physique features, nationality or type of appearance also do not affect the time of return of menstruation in any way.

Physiological processes occurring in a woman's body after the birth of a child ensure the prolonged absence of menstruation. If a young mother is breastfeeding her baby, large doses are regularly released into her blood. oxytocin and prolactin... These hormones are natural estrogen antagonists responsible for ovulation... Lactational amenorrhea is a normal condition provided by nature. This is a period of a kind of rest of the reproductive system after childbirth. For most women, menstruation is absent until lactation is completed on its own or artificially. The cycle recovery period in this case is from one to five months from the date of the end of the feedings.

Do not expect that your next periods will be regular. In the first 2–3 cycles, a more scanty or more abundant than usual discharge with the presence of blood clots is likely. The breaks between them can vary from 21 to 50 days, the duration can be from 2 to 7 days, which is also not a sign of violations. All these phenomena are due to the changes that have occurred in the uterus and the endocrine system. For several months, hormonal levels fluctuate, which affects the thickness of the endometrium.

In some cases, pain during menstruation in women who have suffered previously algomenorrhea, after childbirth, they may weaken or disappear altogether. This is due to changes in the shape and location of the uterus.

Almost 10% of young mothers who traditionally breastfeed their babies have menstruation before six months after childbirth: in the second or third month. Such a surprise is associated with hormonal disorders, insufficient milk production, long breaks in feeding. Sometimes this is an individual feature of the organism. It is not necessary to curtail lactation in such a situation, but then the mother will have to deal with the increased load: reconsider nutrition and rest a lot. The diet must contain animal proteins, carbohydrates, a sufficient amount of fat, foods rich in calcium, iron, vitamins E, D, A, ascorbic and folic acids. It is necessary to supplement the menu with special complexes and dietary supplements.

In those cases when circumstances force from the first days to feed the baby with artificial mixtures, and there is no need for lactation, the restoration of the monthly cycle can be expected within 1-3 months from the date of the end of the postpartum period. Usually, for mothers who are not breastfeeding, the first menstruation occurs 6-8 weeks after the end of the lochia.

Intimate life

Having sex after surgical delivery should be postponed until the end of the postpartum period and the formation of a dense postoperative scar. The minimum period is about 2 months in the absence of any complications. If, during the operation to remove the child, nerve endings were damaged, the seam became inflamed, other health problems appeared, it will be possible to return to intimate life no earlier than in 3-4 months.

Complete restoration of tissues after childbirth by the method of caesarean section occurs within several years. Despite the fact that a woman can start doing household chores, sports, work, and an active image much earlier, the next pregnancy is possible only after two years. Otherwise, one cannot hope for its successful outcome: a violation of the integrity of the uterus, its divergence along the seam, improper placement of the fetus, detachment placenta or the germination of its tissues through the scar into the adjacent organs.

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The danger of an early onset of the next pregnancy makes contraception after a caesarean section more relevant than ever. For safety net, it is advisable to use more than one method, but several. A combination of barrier protection and oral contraceptives is usually recommended. The former block the penetration of sperm, but are not reliable enough. Hormonal agents have an almost 100% effect, but do not exclude the so-called "breakthrough" ovulation. The combination of several methods practically guarantees safety.

Hopes for the calendar method or lactational amenorrhea are not serious from a medical point of view. Their effectiveness is no more than 40-50%, since ovulation tends to occur suddenly. It is impossible for a woman to expose her health to the risk of premature pregnancy after a cesarean.

Figure restoration

The extra pounds gained during pregnancy and the stretched protruding belly do little to please the young mother. The annoyance after the operation is added by the need to spare your health, avoiding stress in the first months. The restoration of the figure after a cesarean section really fades into the background. Compared to the need for proper care of the baby and control of one's own well-being, this aspect can be considered unimportant.

It is not always possible to return an elastic flat stomach and a thin waist after a cesarean section. The reason for this is overstretching of the skin and diastasis - the divergence of the abdominal muscles. This problem is especially typical after multiple pregnancies or for women who have never played sports before. With such problems, slenderness can only be restored with the help of plastic surgery. In all other cases, you need to be patient.

Diet

In the first days after a cesarean section - the use of only light liquid food. During the day, the intestine is unable to function, as it is under the influence of anesthesia. It is allowed to drink plain or mineral water with a small amount of fruit juice. In the next four days, the menu is gradually expanded, gradually introducing broths, juices, dairy products, liquid cereals and mashed soups into it.

A special diet for surgical patients is recommended for several weeks after discharge from the hospital. All dishes should be cooked without frying: steamed or baked, do not contain hard crusts, a large amount of salt, spices, animal fats, artificial colors.

• lean meats and fish: turkey, skinless chicken, veal, cod, chum salmon, horse mackerel;
• cottage cheese and kefir with a fat content of no more than 5%;
• chopped vegetables: first stewed, and then raw;
• berries, fruits;
• whole wheat bread.

Dishes high in starch and sugar should be limited. These include:

• potato;
• pasta;
• semolina;
• polished rice;
• white flour products: cookies, gingerbread, buns, pies;
• sweets: chocolate, candy.

Various delicacies and heavy foods must be completely excluded from the menu:

• Salo;
• sausages;
• fast food;
• ham;
• margarine.

New mothers who are breastfeeding are required to adhere to stricter restrictions. Often, their diet in the first weeks consists only of porridge in water, mashed meat and vegetable stew.

Usually within 3-4 months with proper nutrition, most of the extra pounds accumulated during pregnancy gradually disappears. More radical measures: various express diets and fasting days can be practiced not earlier than the end of the lactation period.

Mothers whose children are bottle-fed, in search of how to quickly recover from a cesarean, are also not recommended to torture themselves with a hungry diet. The energy value of the daily menu to preserve all the functions of the body must be at least 1500 kcal. For full healing of tissues, it is recommended to use meat products, aspic, fruit jelly, chicken eggs.

Fitness

Any physical activity associated with the tension of the abdominal muscles after a cesarean section is allowed no earlier than 4 months later. Until the expiration of this period, only walking is allowed.

In the first month, support for the press and pain relief during the daytime is necessary. It is desirable to wear it for several hours a day.

Doing physical exercises aimed at strengthening the press should be regular, and the load should increase gradually. It is better to work out in the gym under the guidance of a trainer, it is disciplined. If this is not possible, you should equip the place at home.

Additionally, you can go swimming, skiing, cycling. These exercises gently stimulate the tone of the abdominal muscles and help tighten the abdomen.

Yoga

Of the eastern practices, breathing, static exercises, and muscle stretching movements help to strengthen the press after a cesarean section. They are required to be performed in a calm atmosphere, in the morning or evening hours, preferably daily. Many yoga exercises are great as a warm-up or finishing exercise.

Exercise at home

For home activities, you can purchase a stepper or treadmill. Indoor furniture is suitable as auxiliary shells: a chair or a sofa. So that after a cesarean section, the abdomen begins to tighten, it is useful to perform twisting exercises, imitation of cycling from a prone position, pulling the legs to the chest, swinging the press. At home, it is advisable to practice daily, for 30-40 minutes. In the absence of time, instead of a full-fledged complex, you can perform several approaches at different periods, if possible.

When to see a doctor

If the recovery process after surgery is successful, you can come to the next medical examination to the gynecologist six months after childbirth.

An earlier visit should be made if warning signs appear:

• a change in the nature of lochia before the end of the postpartum period: the appearance of impurities of pus, a heavy odor;
• the occurrence of frequent cramps or sudden cutting pains in the abdomen after the stitches have healed;
• the appearance of swelling, redness, itching or suppuration in the seam area;
• absence of menstruation for five or more months from the date of cessation of lactation.

Additional medical examination is also necessary in case of a sharp change in the menstrual cycle: the release of blood or pus before or after menstruation, constant internal pain, attacks of weakness or dizziness.

When a woman is in the hospital, her condition can be relatively stable, and complications after surgery develop later.

What complications can there be?

In approximately 20% of cases of caesarean section, women in labor experience various kinds of complications. Basically, they are associated with existing systemic diseases, circumstances that arose during the operation or during the period of early recovery.

Most often these are various infectious processes, pathologies of the vascular system and the functions of hematopoiesis.

Common complications:

• inflammation or dehiscence of the postoperative suture, the formation of hernias;
• accession of a secondary infection: the development of an inflammatory process in the uterine cavity, adjacent pelvic tissue or in the appendages;
: during the operation, patients inevitably lose blood, on average, about 500-600 ml.

Depending on the physical condition of each woman, other complications are possible. For these reasons, it's important not to overdo it when figuring out how to recover from a cesarean section. In case of strange changes in the state of health or a change in the appearance of the seam, the appearance of redness, burning or severe itching in this area, you should consult a doctor.

Opinion of doctors

Caesarean section is a complex surgical procedure. It is prescribed to women in labor not on a whim, but for serious medical reasons, when there is a real threat to the health of the expectant mother or her child. It is no coincidence that doctors at maternity hospitals refuse to provide patients with this procedure at will, without any grounds. After all, natural childbirth is, albeit a painful, but less dangerous process when it comes to completely healthy women. After a natural delivery, the mother can get up in a few hours and gradually return to normal life. Caesarean, however, requires a long recovery, sometimes lasting more than six months.

It is important that the first such operation is an almost unconditional reason for subsequent artificial childbirth in the same way. Although over time the site of the incision of the muscles and the wall of the uterus is reliably overgrown, the structure of the tissues in the suture area is inelastic. A woman can naturally give birth after a cesarean, but only if she is less than 30 years old and more than three years have passed after the operation.

With a second surgical intervention, the surgeon makes the incision on the previous suture, which significantly slows down the subsequent healing and increases the risk of complications. The permissible number of safe cesareans that one woman can tolerate is no more than four. In practice, a successful and relatively quick recovery from a caesarean section occurs only after the first two procedures. Of course, each case is individual, there are mothers who were born in this way for 5 or more children, but these are exceptions.

Compliance with all medical prescriptions is a condition for the successful restoration of health after a cesarean. The first few days are especially hard to bear. The young mother suffers from pain, residual effects of anesthesia. Almost everyone develops intestinal atony, so solid food should not be consumed.

Lying in bed is not recommended. Within a few hours after the release of anesthesia, it is advisable to move your arms and legs, start turning. On the second day, the work of the intestines should be activated: a rumbling appears in the stomach, gases begin to escape. In the absence of signs of intestinal activity, drug stimulation is necessary.

Milk from such women comes with a slight delay - after 3-4 days. During this period, the child has to be supplemented with mixtures.

After discharge, the recovery process continues. You can not burden yourself with physical work, walk for a long time, carrying a baby in your arms, lift a stroller up the stairs. It is helpful to wear a bandage to maintain the muscle corset. It is necessary to select not squeezing sides, but a comfortable elastic model. The construction should be worn no more than 6-8 hours a day and only for two months after the operation. The habit of sleeping in a bandage or using it to suck in the abdomen for too long will have the opposite effect - the muscles will weaken and become flabby.

Doing fitness to regain harmony must be done carefully. In the first few weeks, the daily activity should not exceed 20-30 minutes. In this case, you can not use weights or do exercises that strongly strain the press. Before starting classes, you must consult a supervising doctor in order to exclude possible contraindications.

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