My Body After a Cesarean Birth - Assignment Example

Cesareans I. Introduction: About cesareans: Cesarean is a process for delivery of a baby through surgical incision in the mother’s abdomen and uterus. Cesarean can be planned and unplanned. Unplanned cesareans are carried out through unforeseen circumstances after development of complications. In medical terminology cesarean is named as cesarean section or c-section. Cesarean is a major abdominal surgery and is dangerous than the vaginal delivery. Mothers who underwent for cesareans are more probably to face an infection, excessive bleeding, blood clots, postpartum pain, longer hospital stay , and longer recovery period. In addition, if a mother plans for more children, every cesarean increases future risks for these complications and development of other symptoms. It is advised cesarean should be avoided but in certain circumstances, it becomes necessary for the welfare and safety of the mother and the baby or both. Why cesareans are necessary? Nothing can be definitely said during pregnancy or labor and surprises may occur. Vaginal deliveries may not be possible in many cases for more reasons and the practitioner then prefers for a cesarean birth. The following reasons are included which may apply for planned cesarean births. 1. The mother has pre-mature labor 2. The labor is not progressing. 3. The mother already has had either a cesarean in vertical uterine incision or more than one cesareans. 4. The mother has had other type of uterine surgery. 5. The mother has more than one baby. 6. The mother expects a large baby. 7. The baby suffers from any illness or disease that can make vaginal delivery dangerous. 8. The head of the baby is not coming first i.e. breech baby where bottom comes first. 9. The mother has placenta previa i.e. where the placenta lies across the internal opening of the cervix. 10. Any infectious in birth canal. Page 2 The reasons included for necessity of an emergency cesarean i.e. unplanned cesarean are: 1. The heart beat of the baby is not adequate 2. Any fatal distress as indicated through ultrasounds or monitoring 3. Illness of the mother. 4. If prolapsed cord slips which may cut off oxygen to the baby. Procedure of a cesarean: The following steps are applicable for preparations of a cesarean birth: 1. The practitioner will explain the mother for the necessity of the cesarean birth. 2. The hospital will send the instructions how to get ready for surgery or a nurse may call her before surgery. As per hospital procedure the mother will be asked to sign the consent form. 3. The mother’s husband or partner may be allowed to stay during preparations for cesarean birth as well as in operating room. 4. An anesthesiologist will examine various points of the body of the mother for any pain and other symptoms. Now-a-days a general anesthesia is hardly given to make the mother unconscious except in some special circumstances or the local pain relief is not possible for any reason. 5. An epidural is administered by an anesthesiologist which will numb the abdomen area of the mother but keep her in sense for the birth of the baby. 6. No further epidural is required for cesarean if it is already given for pain relief during labor. 7. Other medications may be given to ascertain that the abdomen area has become completely numb. 8. The nurse will insert the catheter into the bladder to drain out the urine during and after surgery. 9. The nurse will clean the area of the surgery, wash the abdomen area fully with an anti-biological solutions and shave the upper pubic hair. 10. The blood pressure, heart rate, blood oxygen etc. of the mother are closely monitored before , during and after completion of the surgery of the mother. A dose of antibiotics will also be given to prevent any infectious after delivery. 11. The mother will then be moved to the operating room Page 3 12. The anesthesia will be administered and a curtain will be hung across the chest of the mother to avoid watching the surgery. How a cesarean is done? The following steps are taken to carry out the cesarean process: 1. Oxygen tubes will remain inserted into the nose during the surgery 2. When the anesthesia takes effect, the attending doctor will make a small horizontal cut in skin above pubic bone. 3. The doctor will then make the cesarean incision slowly through the lower abdomen and uterus. 4. The doctor will separate and expose abdominal muscles manually to examine what is there. She will later make horizontal cut in the lower section of uterus. 5. The doctor will put her hands in and pull out the baby. The baby is immediately cleaned , checked, weighed and wrapped in a blanket. 6. The doctor will show the baby to the mother. 8. The doctor will deliver the baby to the pediatrician or nurse to examine the newly born for various examinations. 9. The doctor will remove the placenta and will close up the surgery area with stitches or staples. Closing of uterus and belly take longer time around thirty minutes. The placenta will be delivered to the mother. 10. The newly born baby may be delivered to the mother ‘s husband or partner after examinations to kiss and admire. 11. The mother is moved to the recovery room after completion of surgery process and would be monitored closely. 12. The mother may be given the newly born baby for breastfeed. 13. The mother may be discharged after three or four days from the hospital. I did search and found out an appropriate site covering your points (baby center) II. Body: After cesarean birth the body of the mother takes a path of recovery and she feels for rebuilding of her body. In fact the recovery process starts immediately after the baby is delivered. The other areas of the body which remain untouched during surgery will require re-functioning because of pause for a while. Some minor side effects and major complications may develop after cesarean but they have both easy and reasonable solutions. Before discharge from the hospital the mother has to pass through several examinations during stay: Breastfeeding: 1. After delivery the uterus starts shrinking and the breast starts producing colostrums which is called first milk. 2. The mother can breastfeed as soon as the surgery is completed 3. The mother has to hold the baby in a right position in the arms for breastfeeding and the hospital nurse may help. 4. Should the baby is sleepy for anesthesia’s effect and does not accept breastfeeding, the mother may attempt at every three or four hours and the baby will start breastfeeding. 5. Should the mother feels breastfeed painful, she should consult the hospital expert for remedial ways. Constant urination: Constant urination may be one of the side effects after surgery. This could be for bladder trauma during surgery which becomes unavoidable in some cases and is not a long term effect. This will heel itself in few months. The mother is advised: to use sanitary pads to absorb leakages to go to restroom often to avoid filling of bladder to limit intake of caffeine which helps. To do some exercises suggested medically To sit crossing the legs and tighten the pelvic muscles. Page 2 The leakage will discontinue itself in few months. Should the mother feels burning during discharge of urine and the constant urination continues beyond few months she may take advice from the doctor. Bowel function: Bowel function should be normal even after surgery to defecate. Regular constipation may cause malfunctioning of bowel and the mother is advised to take iron supplements because of loss of blood during surgery. Sometimes intake of narcotics to ease pain plays an important role to stop defecate. Walking, drinking of more water, intake of stool softeners etc. are suggested ways to follow for relief. If the problem continues for malfunctioning of bowel beyond few days the mother is advised to take help from nurse and the nurse may prefer for enema which may give some relief. Gas and back pain: After surgery the stomach gets filled with much gas which causes back pain. The pressure of the gas pushes spinal cord resulting pain in lower back, shoulders and neck. As soon as the gas is passed out, the mother can take solid food again. Passing out of gas indicates that the digestive system starts functioning but this process can take few days. In many occasions the gas pain becomes more acute for the mother to bear. The mother may get relief if she does: Hold breath 5-10 seconds for every few hours. Go to short walk. Rotate in the revolving chair Take hot tea. Should the above tips do not help, the nurse may be consulted. She may give some medicines which may allow gas to pass slowly and may make the mother to feel comfortable. Page 3 Menstrual period: After cesarean the body of the mother starts to flush out from uterus. The nurse will provide suitable heavy pads to absorb bleeding. The color of the blood will go on changing with the days from bright red, pinkish / brownish, and then yellowish during discharge. This may take few weeks. If there is abnormality in the bleeding , the doctor may be consulted. After discharge from the hospital, no measure should be used for birth control for few weeks. Sex should be avoided and take consent from the doctor before restart of sex. The doctor may also give some tips while recovery at home. The body requires rest after surgery. Longer effects: Like other surgeries there may be some long term side effects after cesarean birth. The mother may complain for loosing of sensation feelings around incision or vagina. This may be caused because of damage of nerves during pregnancy, baby’s head wedged in the pelvic bone or during actual surgery process. The doctor may be consulted and probably these sensations may return to normal. In case these sensations do not return, several tests may be conducted and suitable treatment may be suggested to follow. The other long term effect may be increase risk of uterus rapture because the wall of the uterus may have become thin during previous cesareans which may have cut the thick muscular part of the uterus. The doctor may be aware about this rapture risk and may schedule the cesarean even before the labor starts. Such mothers should avoid future children After cesarean the body of the mother starts regaining naturally for pre-pregnancy existence and for normal functions in a month or two. I did search and found an appropriate site. (The Essential Infant Resource for Moms - My Body After A Cesarean Birth) III. Conclusion: Facts about cesareans: Despite surgery being harmful cesarean should be used judiciously for birth of babies. Some facts about cesareans: 1. Cesarean rate reaches all time high of 31.1% in U.S. in 2007. It was around 6% in 1970, 17% in 1980, 23% in 1990 and 29% in 2004. 2. As per Consumer report cesarean is included in ’10 overused tests and treatments’ in U.S. 3. World Health Organization (WHO) reports show that the death of mothers is higher in U.S. than 40 other countries of the world despite the women in U.S. think that they are getting top care. 4. As Per World Health Organization (WHO) more than half of all cesareans in U.S. could be avoided. 5. Cesareans are being overused in U.S. 6. More than 300 hospitals around U.S. have banned women for vaginal birth after cesarean (VBAC) to press them for unnecessary surgery which increases the rate of cesareans. VBAC is being considered as a safe option for baby birth in U.S. ICAN has released a guide to help women to understand their rights as patients who oppose VBAC ban. The guide can be found at http://www.ican-online.net/resources/white_papers/wp_vbacbanqa.pdf. 7. Recent studies show that cesarean causes risks to the mothers and babies. More mothers and babies are paying high cost of complications from these cesareans. Cesarean should be used as a life saving measure when there is a real threat to the mother and baby or both for any complications. 8. The mothers with prior cesareans are at great risks for miscarriage, infertility and complications in future pregnancies. Besides, the future birth options can be very limited. 9. Report from Center for Disease Control and Prevention shows increasing trend of deaths of women in baby births in surgery. Page 2 10. Casual use of cesarean can led to both short and long term effects to healthy women and babies. (Well Preserved – Cesarean Rate Hits a New High) Factors for higher rate of cesareans: 1. Increasing attitude of the mothers for safe option of VBAC. 2. Mothers are driven casually for cesarean without considering its need and complications when other options may be available to avoid them. 3. Practicing doctor adopts safe way and sometimes she is pressed for VBAC by the mother. 4. Previous cesarean when no chance of VBAC. 5. Side effects of medical interventions during pregnancy including in take of medicines, fatal electronic monitoring etc. 6. Avoiding of due care suggested by the doctor to the mother which increases chances for natural labor. 7. Abnormal condition of baby as well as mother like illness etc. How to avoid unnecessary cesareans? (1) Before labor If proper cares are taken during pregnancy, labor and delivery unnecessary cesareans could be avoided and the mother can have both healthy and positive experiences. Following cares can work: 1. Attend pregnancy classes and workshops both inside and outside hospital to get aware. 2. Discuss and prepare the birth plan with the doctor and a copy of the plan may be given to the hospital, doctor and labor support person for future follow up. 3. Discuss important points with more than one doctor and evaluate their different information and take decision in the best interest. 4. Ask for any set time limit for labor and discuss if anything can disturb normal process of labor. 5. Visit few medical facility centers and collect all details like charges , facilities available, VBAC instructions , convenience etc. and choose the best center. 6. Get information for the rights as pregnant woman. ICAN guide can help which discusses the principles of consent and rights of every patient to refuse an unwanted medical procedure Page 3 7. Interview few support persons and select a right one who has experience for more births both in normal and abnormal conditions. A recent medical journal informs that a female labor support would be much helpful to prevent cesareans. 8. A well-balanced diet as suggested by the doctor would ensure for healthy baby and the mother . Protein, vitamins and minerals oriented foods would help to avoid complications in pregnancy. Salt foods may be taken. 9. Get the suggested medical exercises from the doctor to turn the baby if the baby is breech. Consult another doctor for double check. 10. Consider VBAC. More women with previous cesareans delivered subsequent babies vaginally. During labor 1. Stay at home as more as possible. Walking and some suggested light exercises to change positions would be helpful. Suitable position provides comfort to the labor. Avoid to lay flat during labor or birth which may cause slow down blood supply and oxygen to the baby. 2. Take suggested light food and drink for proper functioning of uterus. 3. Prefer to use nipple stimulation for progressive labor 4. Consult the doctor if the bag of water breaks for necessary instructions. Never allow any one to do vaginal examination to prevent any risk for infectious. Take instructions from the doctor to monitor symptoms of infection. 5. Request to avoid for frequent electronic fetal monitoring which increases risks for cesareans. 6. Avoid using epidurals and other anesthesia because they can lower down labor and may create complications. 7. Reach the hospital at schedule time and avoid to reach early. Take some walk and rest at home. 8. Get the information for harms and benefits for normal and emergency procedures. If any one applies, ask the doctor for reasons, short and long terms effects on the baby and any other options available. 9. Remain strong and trust your requests and decisions. Woks cited: Sources: 1. baby center: http://www.babycenter.com/0_giving-birth-by-cesarean-section_160.bc?articleId=160&showAll=true 2. The Essential Infant Resource for Moms - My Body After A Cesarean Birth: http://www.the-essential-infant-resource-for-moms.com/Body-After-A-Cesarean.html 3. Well Preserved – Cesarean Rate Hits a New High: http://wellpreserved.wordpress.com/2007/12/06/cesarean-rate-hits-a-new-high/ References: Citations: (1) 19 Ways to Avoid an Unnecessary Cesarean http://parenting.ivillage.com/pregnancy/plabor/0,,47mt,00.html (2). WebMD- health & baby : Cesarean Section- How a Cesarean Section is Done: http://www.webmd.com/baby/tc/cesarean-section-how-a-cesarean-section-is-done Read More