Pregnancy, Cesarean Section, Discharge Information

What is a cesarean section?

A cesarean section, also called a C-section, is an operation done to deliver your baby through your abdomen (belly). It may be done when delivery through the birth canal (vagina) is not possible or safe for you or the baby. The cuts made in the abdomen and the uterus to deliver the baby are usually horizontal, or across. This allows the muscles in the uterus to safely stretch for future childbirth. Many women are able to deliver the next baby through the birth canal. Sometimes the cut in the abdomen may be vertical, or from below the belly button down to just above the pubic bone.

A C-section may be performed before labor begins if there are medical reasons for not having labor or a vaginal delivery, including:

• You have severe preeclampsia (high blood pressure caused by pregnancy)
• You have primary high blood pressure (also called essential hypertension) that existed before getting pregnant
• The placenta may be partially or completely covering the opening of the cervix (called placenta previa)
• You have a scar on your uterus caused by a previous operation on your uterus, such as certain types of C-sections or surgery to remove fibroids (myomectomy). Because scar tissue is weaker than normal uterus muscle, the scar from your previous operation might open during labor, especially if the cut went through the inside lining of your uterus.

A C-section may also be done after labor begins, if certain problems occur, including:

• The baby may be in a breech position, which means the bottom, knees, or feet will come out before the head in a delivery through the vagina (birth canal)
• Your cervix may not fully dilate for the baby to pass through
• The baby may be too large for your birth canal
• The baby may have an abnormal fetal heart rate during labor (the heartbeat is too fast, too slow, or irregular)

How can I take care of myself when I go home?

Postpartum is the time after the birth of your baby when your body is changing back to normal. It lasts about 6 weeks or until your uterus returns to its normal size. If you are not breast-feeding, you may start having menstrual periods 3 to 10 weeks after delivery. If you are breast-feeding, you may not get your period again until you stop breast-feeding. During this time, you will need to take steps to recover from surgery and adjust to your body’s changes and life with a new baby.

Management

• Your provider will give you a list of your medicines when you leave the hospital.
  • Know your medicines. Know what they look like, how much you are to take each time, how often you are to take them, and why you take each one.
  • Take your medicines exactly as your provider tells you to.
  • Carry a list of your medicines in your wallet or purse. Include any nonprescription medicines and supplements on the list.
  • Talk to your provider before you use any other medicines, including nonprescription medicines.
• Your provider may prescribe medicine to:
  • Treat pain
  • Treat or prevent an infection
  • Soften your bowel movement and reduce straining
• Your provider may recommend other types of therapy to help relieve pain, other symptoms, or side effects of treatment.
• To care for your surgical wound:
  • Keep your surgical wound clean.
  • If you are told to change the dressing, wash your hands before changing the dressing and after disposing of the dressing.
• To relieve tension headaches that many women develop in the first few weeks after delivering their baby, lie down with a cool damp cloth on your forehead or try relaxation techniques, such as meditation.
• To relieve breast pain and discomfort after your milk comes in (2 to 4 days after childbirth):
  • Wear a well-fitting support bra
  • If you are breastfeeding, maintain a regular breastfeeding schedule
  • If you are not breast-feeding, put ice packs on your breasts and do not stimulate your nipples
• Follow activity restrictions, such as not driving or operating machinery, as recommended by your healthcare provider or pharmacist, especially if you are taking pain medicines.
• Talk to your provider about methods of birth control you can use after the birth of your baby. You may still be able to get pregnant even if you do not have a period.
• Do not put anything in your vagina, including tampons, or have sex until your provider says it is okay.
• Do not do any heavy lifting or otherwise strain your belly muscles for 4 to 6 weeks.
• Take care of your health. Try to get at least 7 to 9 hours of sleep each night. Eat a healthy diet and try to keep a healthy weight. Learn ways to manage stress. Exercise according to your healthcare provider's instructions.

Appointments

• Follow your provider's instructions for follow-up appointments for you and the baby.
• Keep appointments for any testing you or the baby may need.

Talk with your provider about any questions or concerns you have.

Call emergency medical services or 911 if you have new or worsening:

• Severe vaginal bleeding (soaking a pad every hour for more than 2 hours) with:
  • Weakness
  • Dizziness or lightheadedness
• Have a severe headache with:
  • Changes in your eyesight such as difficulty focusing or blurred vision
  • Nausea or vomiting
  • Weakness in any part of your body
• Feel like you want to hurt yourself or the baby

If you have any of these symptoms, do not drive yourself.

Call your healthcare provider if you have new or worsening:

• Chest pain
• Belly pain
• Shortness of breath
• Vaginal bleeding with blood clots the size of a plum or larger
• Vaginal discharge with a bad odor or itching
• Depressed, sad, anxious, afraid, or confused feelings for more than 2 to 3 days
• Swelling, redness or pain in your breasts
• Unusual discharge from the nipples
• Trouble emptying your bladder
• Pain or burning with urination
• Swelling, redness, or pain in your legs
• Diarrhea, constipation, or other intestinal problems
• Signs of infection around your surgical wound. These include:
  • The area around the wound is more red or painful
  • The wound area is very warm to touch
  • You have blood, pus, or other fluid coming from the wound area
  • You have a fever higher than 101.5° F (38.6° C)
  • You have chills or muscle aches