What to do after a caesarean 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, complete placenta previa, a high degree of myopia, other diseases and features in which only surgical intervention is indicated. But no one removes the responsibility for caring for a baby from women's shoulders, so the question of how to quickly bounce back and recover after surgery worries all patients.

First days after caesarean section:

REFERENCE! A caesarean section is a major surgical operation during which the tissues of a pregnant woman are excised in order to extract the fetus to the outside. It is performed under both general and spinal anesthesia.

When do you have to get up after the operation?

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

Your doctor will constantly monitor your well-being: check the pressure and pulse, the amount of discharge, uterine contractility. It depends on these indicators - when you are allowed to stand up and sit down.

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

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

How long can you push after a caesarean?

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

IMPORTANT! The stitches after caesarean are usually sewn well and cannot open so easily, but attempts to heal will have a negative effect.

The following can help prevent constipation:

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

How long does it take for the catheter to be removed?

A urinary diversion catheter is a necessity: 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 any discomfort. Yes, and the removal is quick and painless: on a deep breath.

Rules for recovery after caesarean section:

A woman should be prepared for the fact that recovery after a caesarean 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 it lasts about six months during natural childbirth, then full recovery body after caesarean section 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 plentiful, but smearing, day by day they change color from brown to transparent, then completely disappear. The appearance of lochia is a natural process that indicates the healing of the uterine mucosa.

REFERENCE! Breastfeeding accelerates the recovery of the body and uterus. It has been established 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 her baby to her breast, the more prolactin is produced, respectively, the usually longer the period of absence of menstruation. Sometimes they do not come for 8-10 months.

- normalization of breastfeeding after surgery

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

Therefore, remember a few important rules:

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

- body restoration

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

• Individual characteristics of the organism. How the operation went, whether there were any complications (suppuration of the sutures or the remains of the placenta in the uterine cavity) - all this does not add positive emotions and delay the healing process. Separately, it is worth mentioning the pain threshold. 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 nature of the woman and her moral condition, but also on the climate in the family, relations with her husband and other close relatives, and attitude towards the newborn.

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

- exercise after cesarean

Already a couple of hours after the operation, you can do self-massage - stroke the stomach in a circular motion from left to right and from top to bottom. Get a tennis ball - write out circles for them, starting from the navel, clockwise.

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

ATTENTION! It is forbidden to use dumbbells and other weighting agents after the operation for a year! Postpone cycling, volleyball, and weightlifting for a while. If during the exercise you feel dizzy, divergence of the seam, discharge from it or the vagina, pain in the abdomen - immediately stop exercising and choose another method in the future.

- hygiene after caesarean section

In the maternity hospital, nurses will handle the stitches. When they are 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 to do at home:

1. Wash hands before each handling.
2. The seam is washed while taking a shower with a special gel and blotted with a disposable paper towel. Terry is better not to use - 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 right size. It should not pull the skin, reap and rub.
5. 2-3 weeks after the cesarean, you can begin to smear the suture with a regenerating gel - it will help the skin return to normal faster.

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

What can not be done in the first time after a cesarean section?

• Carry weights
• The maximum that you can raise is a child. No heavy packages and boxes, especially from the floor.
• Tighten 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.
• Have sex.
  The ban is imposed for 1.5-2 months, but in the presence of complications (internal inflammation, endometriosis, suppuration of the suture, etc.) - until the permission of the gynecologist.

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

Conclusion

Be prepared for certain difficulties after a caesarean 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 result is worth it.

Especially for- Elena Kichak

Every woman who gave birth by caesarean section should understand that her body has undergone a 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 caesarean section, the tissues of the woman in labor, up to the uterus, are cut to safely remove the fetus. For safe conduct, in some cases, only spinal anesthesia is used. The drug is injected into the epidural region of the spine using a catheter.

With spinal anesthesia, only the lower part of the 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 child to her breast.

If it is known that the caesarean section will be carried out 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 caesarean 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 an "emergency caesarean section" and is performed in a slightly different way, in contrast to the planned one.

Consequences and complications

Despite the high level of development of medicine, various 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 severity, they are individual in each individual 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 that occur 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 near the uterus.

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

The first days after the operation

The first days after a caesarean section, a woman is obliged to spend in bed, restoring her strength after the operation. After all, even the simplest operations that used to go unnoticed will take away physical strength.

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

During the operation, painkillers 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 is carried out with the help of relatives or nurses. On the first ascent, there may be a slight dizziness of the head and weakness in the whole body. Unpleasant symptoms quickly pass during the recovery period.

First steps

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

• Before sitting on the bed, you need to lie on your side and only after that, hanging your legs, sit down;
• Then you need to gently move your feet, as if sorting through the water;
• When getting up, the feet should rest on the floor, and the back should be straight - so the seam on the stomach will not strain, the woman will feel only a slight tension in the navel;
• Do not rush to go, you need to stand a little, leaning on a bed, cabinet or person;
• And only then start moving 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. You should gradually increase the load every day, but not too much so that the load on the seam is minimal.

Cough control

Some women in labor after a caesarean section are plagued by coughing. 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 is formed because a small amount of mucus accumulates in the lungs when general anesthesia is used. This mucus is named and coughed up after surgery. The first couple of days, the suture when coughing will be very tense and sore. To reduce pain, you need to put your palms on your stomach, holding the area with seams. Optimally - bandage the stomach with a cloth or a terry towel. Cough technique:

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

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

Intestinal gases and urination problems - normal or pathological?

It is worth preparing in advance for the fact that after the operation, the woman will have intestinal gases. This is normal, since surgical intervention in the abdominal region slows down the processes of peristalsis.

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

Less often, women in labor begin to have problems with bladder. Difficulty urinating can cause a catheter used during a caesarean. In order to improve the functioning of the genitourinary system, it is worth trying to drink more fluids.

If a simple method does not help, consult a doctor. Using a catheter to empty the bladder of accumulated fluid will alleviate some of the pain. The main thing is not to gloss over the problem. Further consultation of the nephrologist is necessary.

Rules for eating

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

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

Small portions are calculated in order not to strain the organs gastrointestinal tract. This will speed up recovery after a caesarean section. For the same reasons, food should be easily digestible. Ideally, everything is boiled or steamed. Do not be surprised that the first hard stool is formed only after a week.

Features of feeding the baby

If there are no complications in the first days, a woman will be able to safely ask for a baby to be brought to her for breastfeeding. The baby will stimulate the production 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 independently.

When feeding, it is necessary to keep the child sitting or lying down. Standing seam strains, and the load in the form of a child will only delay the passage of rehabilitation. Depending on the severity of the operation, the ban on keeping the child standing for a long time can stretch for six months.

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

Seam care

As after any other operation, during the rehabilitation period, it is necessary to take care of the sutures. The first days of care is the daily treatment of the wound. The dressing is changed five times a day. You can only shower after the stitches have been 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 act on it once again.

After a caesarean section, the stitches will hurt for several days. To cope with pain, the doctor prescribes painkillers in each individual case. Over time, the pain becomes 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.

A caesarean section is an obstetric operation performed when a woman is unable to give birth naturally. It takes a little longer for women in labor to recover from a caesarean section. In order for a woman to gain strength faster, you need to follow some recommendations.

Postoperative period

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

The first days after caesarean section require 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 administered.

After the operation, the woman may be prescribed painkillers, which are administered within one to three days. During any surgical intervention on the organs abdominal cavity there is a risk of intestinal paresis. To prevent this from happening to a woman, she is prescribed prozerin. To prevent infectious complications, it is prescribed (in some cases, an antibiotic is administered intramuscularly or intravenously before surgery).

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

Nutrition of the woman in labor

On the first day after childbirth, a woman in labor should not eat anything, you 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, a woman in labor should follow a sparing diet, because her intestines are still not able to work to the fullest. You can eat boiled, pureed food. It is allowed to add hatred meat broth, steamed cutlets, low-fat cottage cheese and cheese, mashed potatoes to the diet. Under the ban are products that increase gas formation (legumes, flour products, grapes, etc.). If a woman is worried, you need to stroke your stomach clockwise for a minute.

Already on the fifth day, the menu is gradually expanding. 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 should not eat certain foods that can harm the crumbs.

About the importance of movement after surgery

The first day after a caesarean section, a woman will feel weak, feel pain in her stomach, which is why the woman in labor does not want to move again. In addition, with active movements, a 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 your legs up to your stomach, doing simple physical exercises right in bed (rotation of the feet, hands, flexion and extension of the legs at the knee joint, etc.), and then - and get up (strictly under the supervision of 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 wrapped tightly with a folded sheet).

You need to get out of bed carefully, without straining your abdominal muscles. You need to slightly pull your knees towards you, roll over on 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 wonder when they can start physical activity. In the postpartum period, only simple exercise. More active loads can be started after a month and a half. It can be fitness, yoga, body flex. With exercises for swinging the press, you should wait for six months.

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

Healing of sutures after caesarean section

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

Do not take a shower until the stitches are removed. But you can wash separately parts of the body. 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 bathhouse 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 caesarean section is a large wound surface. Therefore, until it heals, and this happens within one and a half to two months, one 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. That is why you need to use . And, of course, you should not hope that it is impossible to get pregnant during lactation - this is a myth.

The restoration of menstruation depends on whether the mother is breastfeeding the child. 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 commentator

According to statistics, an average of 20-25% of pregnancies end in a caesarean section. This method of delivery is considered relatively safe and gives a minimum of complications. But doctors do not get tired of repeating that caesarean should be a necessity, not a whim of a woman. A caesarean section is performed only according to indications: an anatomically narrow pelvis in the mother, complete placenta previa, 2 or more cesarean sections in history, acute fetal hypoxia, etc. Recovery after cesarean section is longer and more difficult than after natural childbirth.

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

The operation is performed under spinal or epidural anesthesia. The anesthesiologist decides which type of anesthesia to choose, 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 child from the womb.

A catheter is placed in the urinary canal to drain urine. Due to this, the bladder does not put pressure on the uterus, the doctor gets the baby faster. Then the anesthesiologist puts anesthesia, and the woman in labor is fenced off with a screen. During the operation without general anesthesia, the woman is conscious.

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. Cut subcutaneously fatty tissue, muscles, aponeurosis, abdominal wall. Remove the bladder. Then an incision is made in the lower segment of the uterus. In this place, the thinnest muscle layer, during healing, a small scar remains. The amniotic sac is cut open and the baby is removed. In the reverse order, the incision is sutured with silk, self-absorbable threads, or closed with brackets.

Removing the baby during a caesarean section

The operation lasts 30-40 minutes. The child is removed 15-20 minutes after the start of the operation. If the mother is conscious and no endotracheal anesthesia was performed, then the child can be immediately applied to the breast.

Negative consequences of caesarean section

The operation in our time is considered safe, but complications after it are quite common.

The recovery period is complicated by such factors:

• Seam on the stomach. In 90% of cases, a horizontal intradermal or outer seam above the pubis. Only in emergency situations make a vertical seam 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 body. Some have a predisposition to the formation of keloid scars, with the growth of connective tissue fibers of the skin in the area of ​​the scar. You can get rid of a keloid scar with laser resurfacing.
• Stitch on the uterus. Before the onset of the next pregnancy, at least 2-3 years must pass for the scar to heal thoroughly. Otherwise, in childbirth or during pregnancy, there is a risk of uterine rupture along the seam. After three caesarean sections, tubal ligation is indicated.
• Spikes. Surgical intervention almost always leads to the formation of adhesions (fusions of internal organs). They glue the internal organs of the small pelvis, intestinal loops, fallopian tubes like a film. This happens due to inflammation, which provokes contact with the non-sterile air of the operating room, the ingress of blood into an open wound, and even particles of talc from the doctor's gloves. Can lead to infertility, indigestion, constipation, endometriosis. In severe cases, removal of adhesions using laparoscopy is indicated, in mild cases, treatment with physiotherapy.
• The effects of anesthesia. If during the operation general anesthesia is used with the installation of a tube in the trachea, trauma to the mucous membrane occurs. Sputum accumulates, a cough appears, causing tension in the abdominal muscles. Spinal anesthesia leads to microtrauma of the roots of the spinal cord. This causes back pain, dizziness, headaches.
• Delayed start of lactation. After natural childbirth, milk comes in 3-4 days. In case of caesarean section - in 7-9 days. The onset of labor triggers lactation hormones. The operation of caesarean section is carried out, as a rule, as planned, when the body may not yet be ready for childbirth. In this case, lactation hormones are produced with a delay.
• Great loss of blood. During natural childbirth, a woman loses 250-300 ml of blood. The body recovers such blood loss quickly. With CS, blood loss is 500-1000 ml. To maintain the body after surgery, blood-restoring drugs, plasma, and erythrocytes are infused.
• Weak contraction of the uterus. Due to the seam on the anterior wall, the uterus is slightly reduced. To avoid subinvolution, the puerperal is prescribed adjuvant therapy for rapid uterine contraction.

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, whether postpartum antibiotic therapy was used.

Recovery in the first days after cesarean

The first days after the operation are the most difficult. Most women complain that the seam hurts. Some suffer from the effects of anesthesia.

The first day after the operation, the woman spends in the intensive care unit under the supervision of medical personnel. They measure her blood pressure, restore blood loss, give painkillers. A heating pad with ice is placed on the stomach so that the uterus contracts more intensively. If there are indications, antibiotic therapy is carried out. It all depends on how the operation went. On the second day, the woman is transferred to the postpartum ward, where she can, if desired, take care of the child herself.

1. It is allowed to sit on the bed on the second day after the caesarean section. You need to sit down carefully, first lower your legs off the bed, then, relying on your arm, 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. To relieve the soreness of the seam, use.
2. Urinary retention often occurs after a caesarean section. During the operation, a catheter is inserted into the urinary canal, after a day it is removed. But damage to the nerve endings, microtrauma of the mucous membrane cause pain, which disappears after 1-2 days. Even if there is no urge to urinate, you need to urinate every 2-3 hours. Otherwise, a full bladder will put pressure on the uterus and prevent it from contracting.
3. Every day, the seam 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 discharge from the hospital and removal of 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 medications that are safe for the breastfed baby.
4. If a woman suffers from a cough after general anesthesia, then do 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 as you exhale, release the air slowly but strongly with a sound.
5. In the first days after cesarean, you need to improve the work of the digestive tract. Due to the operation on the abdominal cavity, intestinal motility is weak, the first stool appears on the 3rd-4th day. Constipation should not be allowed, because strong straining can lead to a divergence of the seam. The first day after the operation, it is only allowed to drink non-carbonated water. Nutrition 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:

• Sip socks on yourself, away from you;
• Bend your knees;
• Squeeze the buttocks;
• Squeeze the muscles of the pelvic floor for 5-10 seconds;
• Rotate the body from side to side.

Bandage after caesarean helps relieve pain during movement

They are discharged from the maternity hospital on the 7th-8th day after the stitches are removed, 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 caesarean continues after discharge from the hospital. Mom needs house helpers. The most important thing is to rest more and establish breastfeeding.

• Whether a mother will be able to breastfeed after a cesarean depends only on how often she puts 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.
• 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 child.
• It is allowed to start playing sports no earlier than a month after the birth, when the lochia runs out and the seam heals. We wrote about exercises allowed after cesarean.
• You can return to sexual activity in 1.5-2 months, when the postpartum discharge ends. Contraception after CS is a matter of first necessity. 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 divergence of the seam during pregnancy or childbirth. A condom is the most appropriate method of contraception after childbirth.
• Menstruation resumes after 2-3 months if the mother is not breastfeeding, and within 1-2 years if she is breastfeeding.

Video: how to establish GV after cesarean section

Recovery after caesarean takes more than long time than after natural childbirth. But the more actively the mother begins to move immediately after the operation, the faster the process of healing of the sutures and involution of the uterus proceeds.

Surgical intervention in obstetric practice allows you to save the health and life of the mother and child in the event of a difficult course of pregnancy, the presence of contraindications for natural childbirth or the development of unforeseen complications already in their process. Many women consider this method of delivery to be more gentle, since it is not associated with the need for a long experience of contractions and possible breaks. All that is required of the mother in such cases is to be an outside observer of the work of doctors busy extracting the child. However, despite the seeming harmlessness of operational childbirth compared to natural, this path is no less dangerous. Caesarean section is an open abdominal operation requiring anesthesia, associated with extensive tissue injury and massive bleeding.

The main difficulties for women arise in the postoperative period. Recovery after caesarean lasts several months, the most unpleasant is the first day. At the same time, during the entire rehabilitation period, no one releases the young mother from the responsibility of caring for the newborn.

Recovery after anesthesia

Like any traumatic procedure, surgery to remove a baby requires the use of anesthesia. With a planned intervention, its type is prescribed taking into account the state of health of the woman. 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 response to drugs can be the most unpredictable.

Immediately after the operation and for the next 6-8 hours, the woman is forbidden to get out of bed and roll over on her side. Depending on the complications, blood transfusion, infusion therapy containing nutritional and rehydration solutions may be required during the operation. Then movement becomes a necessity. In order to recover faster and get rid of the effects of drugs, it is recommended to slowly sit down, lower your legs from the bed. You are allowed to get up the next day. You should not be afraid of the divergence of the seams, since they are fastened until complete healing. Much more trouble is brought by the consequences of anesthesia.

General

The advantage of this method of anesthesia is considered by many 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.

Endotracheal procedure with provision of artificial lung ventilation entails a decrease in blood pressure and slowing of cardiac activity within 40–60 minutes - while the operation lasts. During this time, doses of drugs are administered intravenously into the body. When all manipulations are over, the supply of drugs is stopped. Their anesthetic effect stops almost immediately. Consciousness gradually returns to the woman in labor after a few minutes. Severe pain sets in almost immediately.

Within 30–60 minutes, residual effects of drugs are observed, hallucinations, hysterical states, deafness, perceptual disturbance, and 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. It involves a single injection of painkillers into the narrow subarachnoid space that separates the spinal cord and arachnoid. The injection is placed in the region of the spine between the 4th and 5th vertebrae. Active ingredients almost instantly block the nerve endings, anesthesia fully anesthetizes after 15 minutes. The lack of sensation in the lower body allows the operation to be performed while the patient remains conscious.

spinal anesthesia

Body features, nationality or type of appearance also do not affect the time of the return of menstruation.

The physiological processes that occur in a woman's body after the birth of a child ensure a prolonged absence of menstruation. If a young mother is breastfeeding, 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 state provided by nature. This is a period of a kind of rest of the reproductive system after childbirth. Most women do not have periods until lactation ends on its own or artificially. The recovery period of the cycle in this case is from one to five months from the date of the end of feeding.

Don't expect your next period to be regular. In the first 2-3 cycles, more scanty or abundant than usual discharge with the presence of blood clots is likely. 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 changes in the uterus and the endocrine system. Within a few months, the hormonal level fluctuates, which affects the thickness of the endometrium.

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

In almost 10% of young mothers who traditionally breastfeed their children, menstruation appears 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 bioadditives.

In cases where circumstances force from the first days to feed the child with artificial mixtures, and there is no need for lactation, recovery monthly cycle you can wait for 1-3 months from 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 nerve endings were damaged during the operation to remove the child, the seam became inflamed, other health disorders appeared, it will be possible to return to intimate life no earlier than in 3-4 months.

Full recovery of tissues after childbirth by caesarean section occurs within a few years. Despite the fact that a woman can start doing household chores, sports, work, and lead an active image much earlier, the next pregnancy is possible only after two years. Otherwise, one cannot hope for its successful outcome: there may be a violation of the integrity of the uterus, its divergence along the seam, incorrect location of the fetus, detachment placenta or the germination of its tissues through the scar into 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 desirable to use not one method, but several. It is usually recommended to combine barrier protection and oral contraceptives. The former block the penetration of spermatozoa, 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 medically insignificant. Their effectiveness is no more than 40-50%, since ovulation tends to come on suddenly. Put your health at risk premature pregnancy after a caesarean, a woman cannot.

Figure restoration

The extra pounds gained during pregnancy and the stretched protruding belly do little to please the young mother. Annoyance after the operation is added by the need to spare one's health, avoiding tension in the first months. Restoration of the figure after a caesarean section, indeed, fades into the background. Compared with 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 characteristic after multiple pregnancies or for women who have never played sports before. With such problems, harmony can be restored only with the help of plastic surgery. In all other cases, you need to be patient.

Diet

In the first days after caesarean 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 regular or mineral water with a little fruit juice. Over the next four days, the menu is gradually expanded, gradually introducing broths, juices, dairy products, liquid cereals and pureed soups into it.

For several weeks after discharge from the hospital, it is recommended to observe special diet for surgical patients. All dishes must be cooked without frying: steamed or baked, do not contain hard crusts, a lot 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 not 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;
• products made from white flour: cookies, gingerbread, buns, pies;
• sweets: chocolate, sweets.

It is necessary to completely exclude various delicacies and heavy foods from the menu:

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

New mothers who are breastfeeding need to adhere to stricter restrictions. Often, their diet in the first weeks consists only of cereals on the water, pureed meat and vegetable stew.

Usually within 3-4 months proper nutrition most of the extra pounds accumulated during pregnancy gradually disappear. More drastic measures: various express diets and fasting days You can practice not earlier than the end of the lactation period.

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

Fitness

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

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

Performing physical exercises aimed at strengthening the press should be regular, and the load should increase gradually. It is better to do it in the gym under the guidance of a coach, it disciplines. If this is not possible, a place should be equipped at home.

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

Yoga

Of the Eastern practices, strengthening the press after a cesarean section is helped by breathing, static exercises, movements to stretch the muscles. They need to be performed in a calm environment, in the morning or evening, preferably daily. Many yoga exercises are great as a warm-up or the final step in fitness.

Exercise at home

For homework, you can purchase a stepper or treadmill. As auxiliary projectiles, room furniture is suitable: a chair or a sofa. In order for the stomach to tighten after a cesarean section, it is useful to perform twisting exercises, imitation of cycling from a prone position, pulling the legs to the chest, and rocking the press. At home, it is desirable 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 the birth.

An earlier visit should be made if warning signs appear:

• 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 healing of the stitches;
• the appearance of swelling, redness, itching or suppuration in the suture area;
• absence of menstruation for five or more months from the date of cessation of lactation.

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

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

What are the possible complications

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

Most often, these are various infectious processes, pathologies vascular system and hematopoietic functions.

Common complications:

• inflammation or divergence 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, when figuring out how to recover from a C-section, it's important not to overdo it. With strange changes in well-being 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.

Doctors' opinion

A caesarean section is a complex surgical operation. She is prescribed to women in labor not out of 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 of maternity hospitals refuse to perform this procedure for patients at will, without any reason. After all, natural childbirth is a painful, but less dangerous process if we are talking about completely healthy women. After a natural delivery, the mother can get up in a few hours and gradually return to ordinary life. Caesarean section 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 births in the same way. Although over time, the place of the incision of the muscles and the wall of the uterus is reliably overgrown, the structure of the tissues in the area of ​​​​the suture is inelastic. A woman can give birth naturally after a caesarean, but only if she is less than 30 years old and more than three years have passed since the operation.

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

A condition for the successful restoration of health after a cesarean is compliance with all medical prescriptions. The first few days are especially difficult. The young mother suffers from pain, residual effects of anesthesia. Almost everyone develops intestinal atony, so you can not eat solid food.

Staying in bed is not recommended. Already a few hours after the withdrawal of anesthesia, it is desirable to move your arms and legs, start turning. On the second day, the work of the intestines should be activated: rumbling appears in the stomach, gases begin to leave. In the absence of signs of intestinal activity, stimulation with drugs 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't load yourself physical work, walk for a long time, carrying the baby in her arms, lift the stroller up the stairs. To maintain the muscular corset, it is useful to wear a bandage. It is necessary to select not squeezing the sides, but a comfortable elastic model. The design 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 draw in the abdomen for too long will lead to the opposite effect - the muscles will weaken and become flabby.

To do fitness to return harmony, you need to be careful. In the first few weeks, the daily load 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 to exclude possible contraindications.

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