Today, on average, every fifth birth is resolved by caesarean section - for medical reasons or at the request of the expectant mother. In order for the rehabilitation process to take place for the woman in labor as comfortably and quickly as possible, it is necessary to know exactly what measures include a comprehensive recovery after a caesarean section.
A caesarean section is a complete abdominal operation with a transverse incision, performed under anesthesia (local - epidural or spinal).
Indications for it may include:
Regardless of the expectations of the expectant mother, doctors have the right to decide to perform a caesarean section even during natural childbirth right in the hospital. This is justified when there is a real threat to the health of the baby and the woman in labor. Pregnant women should be mentally prepared for this course of events and well informed.
The recovery period after surgery often takes longer than rehabilitation after natural childbirth. If in the second case, nature itself took care of the woman’s easy transition to a new role, then the “revitalization” of the body after a cesarean section can be delayed in some cases for months. It should be comprehensive and include both moral and physical recovery.
It is believed that the first five days after an operative birth are the most difficult for a woman. How do they go?
A day after a caesarean section, a woman in labor spends in the intensive care unit. This is due to the fact that she needs constant medical supervision and qualified help from a nurse. On the first day, the woman is still under a dropper and is incapable of independent hygiene procedures due to the action of anesthesia. The doctor prescribes active antibiotic therapy. Fortunately, antibiotics do not affect the quality of milk, and immediately after waking up from anesthesia, a woman is ready to breastfeed her baby.
If everything goes according to plan, then mom is ready to be transferred to the general maternity ward. The following days - the second and third - are aimed at strengthening the body and walking independently to the women's room. Establishing the work of the excretory organs is usually painful, however, it is necessary immediately after the end of bed rest.
If the recovery after caesarean section goes without complications for the mother and her child, and all possible inflammatory risks are under control, then by the fifth day of the child's life they are already ready for discharge. Often it is still difficult for mothers to even stand on their own, not to mention holding the baby in their arms. Weightless three kilograms for a normal person, feel like a burden for someone who is recovering from surgery. The medical staff always encourages the family to meet the newborn and the mother, if possible.
So, for the first five days after the operation, the woman in labor is surrounded by a doctor and nurses and does not take a single step herself. Her diet is controlled. It is completely excluded on the first day, then the use of non-solid foods (sweet tea, chicken broth, soft meat, rice, potatoes) is allowed. Parents and the baby are released with a whole list of recommendations for continuing rehabilitation at home.
Usually, the list of prohibited items is not limited to vigorous physical activity and the ingestion of unwanted foods. What else should mothers remember at discharge?
After five days of a modest diet, mothers need energy. However, you should be careful when choosing food. The addition of ground products, mashed potatoes, and all kinds of soups to the diet is encouraged. It should be remembered that during lactation, the mother's diet should be checked for the presence of allergens (alcohol, chocolate, citrus fruits and seafood are not allowed in food).
Restriction in activity concerns lifting weights, sudden movements, squats and the “lying on the stomach” position. Exercises to restore the tone of the abdomen are recommended to be left “for later”: the first month is spent on the restoration of muscles damaged after surgery.
It implies gentle cleansing of the body with a soft gel. It is undesirable to wet the suture for a week, therefore, when changing the dressing, it is recommended to use wide waterproof adhesive plasters for sensitive skin. At the same time, they can only be placed on top of a layer of gauze, and in no case directly on the seam: it can become inflamed from simple steaming.
After discharge, the woman in labor will have to go through a difficult stage of returning to “herself”. The first month of this journey is the most difficult. The mother's body adjusts to the schedule of nutrition and sleep of the child, the lack of sleep affects the functioning of the nervous system, the body itself is still under stress after the operation.
What physical features can make their own adjustments to the recovery program of a young mother? This, inevitable after any kind of childbirth, is the restoration of the menstruation cycle, lactation (in cases where the young mother decided to breastfeed the baby) and the healing of the incision. For a smooth transition to normal mode, it is important to pay attention to every detail.
Let us consider in more detail the physiological features of recovery after caesarean section. Restoration of the functioning of female organs and the resumption of the cycle.
Each case is individual. On average, the regeneration of the uterus occurs two months after childbirth, and it does not matter how they happened. The healing of the surface is accompanied by a discharge that is not menstrual. But the restoration of the incision on the walls can take up to two years. The gynecologist closely monitors the process of fusion of skin layers through ultrasound.
Breastfeeding mothers usually wait longer to cycle than non-lactating mothers.
This is due to the hormonal background in the body of a woman.
The following factors also affect the speedy recovery of menstruation:
The normalization of the cycle is considered a signal that a woman has been restored in her childbearing function. Indeed, the possibility of re-pregnancy immediately after the onset of menstruation is great.
Breastfeeding the baby.
After a caesarean section, the establishment of lactation occurs in a different way than after a natural birth. Due to the fact that the hormonal background of the mother does not detect a surge of the hormone oxytocin, it is specially introduced into the body. He is responsible for a number of maternal reactions that are important at the birth of a baby, including lactation. Introduced artificially, he "belatedly" informs the mother's body about the changes.
So, milk can come on the second or third day after the birth of the baby. This is fine. Delayed lactation can be associated with overwork of the mother herself, and with her modest diet during this special period. In no case should you worry that the child will be hungry: nurses feed newborns with a special milk formula for the smallest. However, despite the fact that the child will not be hungry, it must be applied to the breast regularly. Usually in the maternity ward for this purpose they practice a “visit” by the baby to the nurse every two hours. When milk appears, the need for additional nutrition for the baby disappears.
There are several methods for stimulating milk production in a young mother after a caesarean section:
Seam healing.
The delicate incision area requires special daily care.
When applying a gel or oil to a scar, it is necessary to do a special massage: press on the upper and lower parts of the skin in turn, stimulating the slight movement of its inner layers. The move should resemble "steps" with your fingers along the scar.
Usually, dissatisfaction with the appearance of this zone is associated with a specific relief: the abdomen is smooth above the incision, and there is a static swelling below it. You can minimize it by wearing a bandage and performing special exercises.
It is known that the best way to get in shape after pregnancy is with the help of gymnastics. However, this rule applies to young mothers after cesarean section only in part: with increased sports, there is a risk of divergence of the uterine suture.
Therefore, the exercises should be approached carefully, focusing on a number of simple rules.
It is forbidden to perform any physical training during the first two months of a baby's life.
Carrying a child is the only exception. At the same time, if possible, you need to help yourself: press the child as close to the body as possible or use special devices for wearing (kangaroo, slings, etc.).
After the first two months, the following activities should be included in the daily schedule:
Gymnastics for a young mother includes stretching, breathing exercises and promotes the formation of posture. The balance of a woman's body after the birth of a baby changes, and the musculoskeletal system must be restored in a short time.
As in the case of natural childbirth, proper nutrition of a new mother is designed to help her return to her former forms. Only in the first week after the operation, the diet is different and consists of liquid, sparing food. The classic diet for a young mother provides for a number of restrictions. Follow the basic principles of nutrition
Nutrition should not be low-calorie, in order to avoid a deficiency of the necessary substances for the mother and baby. The amount of food during the day should correspond to the diet of one person. The quality of the food comes to the fore.
If a woman is breastfeeding, a whole list of restrictions is imposed on her diet, which includes:
In addition, it is important to remember the special needs of the child in some periods, for example, with colic, it is necessary to refuse to take gas-forming food, with increased growth of the baby, cottage cheese and yogurt should be added to food.
So, lactation itself contributes to the restoration of the forms of a young woman in labor: the motivation for proper nutrition is much higher when it is designed to give strength to the development of the baby.
The exceptional benefits of goat's milk for babies are known. Its composition includes such valuable elements as vitamins A, B, C and D, fluorine, calcium. With a high content of fatty acids, milk is easily digested and does not cause allergic reactions.
Efforts to return the former figure must be comprehensive. An important component of this system is cosmetic care for problem areas:
They are added to the classic, for women who have recently given birth, problem areas of the hips, buttocks and the so-called lifebuoy (sides).
Attentive attitude to your body after surgery implies the rejection of invasive effects on the injured area of the abdomen: work on volumes will have to be postponed for six months. This is due to the fact that the uterus acquires the same tone within 5-6 months, sometimes more. External influences on this area should be excluded. Only the treatment of the scar with special means, which was mentioned above, is allowed. However, there are no restrictions to maintain the elasticity of the skin of the thighs and buttocks.
Beauty salons today have a whole range of services for getting rid of extra pounds after pregnancy:
These sessions give the desired effect. Their disadvantages include the high cost and the need to plan the time of the visit in advance, which is not easy for a young parent.
At home, it is much easier for a mother to find half an hour of precious time for herself. What actions against cellulite and excess volume are time-tested and beneficial?
Massage and body wraps. The method really brings results. Sequence of steps.
It is important to exclude the contact of the baby with the funds during the procedure. If the time has come to feed the child, do not let his delicate skin touch aggressive cosmetics. Experienced mothers are advised to perform procedures while the newborn is sleeping.
Regular application of oils.
The miraculous power of oils in the fight against extra pounds is known. Moisturizing and nourishing the skin in the morning and before going to bed will improve its quality, and a light massage will reduce the appearance of stretch marks and even out the relief.
Useful oils for this purpose include:
It is important to remember that essential oils must be added to the base (olive, coconut) and in no case should they be used on their own. Taking baths with the addition of 2-3 drops of essential oil also has a beneficial effect on the skin.
The birth of a baby is an incredible joy for a young mother. In order not to be overshadowed by physical ailments, it is important for women to know how to quickly and efficiently restore the body after a cesarean section. With an integrated approach, rehabilitation takes place quickly and does not distract from the long-awaited activities with the child.
On the forums, mothers are vigorously discussing the issue of the advisability of a caesarean section. Many are afraid of him, and all because of the long rehabilitation period, as well as the sagging of the abdomen after. Is it really that sad? Let's talk about this in the article "Recovery after a caesarean section."
We are afraid of caesarean section, and this despite the fact that in some countries the percentage of its implementation is close to 90%. Of course, this is a surgical intervention, which is undesirable under normal conditions, but if there is, there is nothing to think about. It is important to save your health, and even your life, and your baby. As times woman, for them, too, in the answer.
By the way, both EP and KS are equally dangerous for women. And there, and there can develop serious complications. The difference is only in the features of the conduct and the recovery period. The latter, by the way, after a caesarean section lasts longer, and there are reasons for that:
But even despite all this, a quick recovery is possible after a CS. Just to feel it for yourself, you need to listen to the advice of a doctor and ensure proper care after surgery.
The cesarean section operation itself lasts no more than 40-60 minutes. After it, the incision is sutured with threads (absorbable or non-absorbable) or staples are placed on it. Sometimes a drain is placed to drain the fluid, which is removed after a couple of days. Stitches, if necessary, are removed on the 5th - 6th day.
Ice is placed on top of the stomach. By the way, it is precisely because of him that women complain about strong cooling after such a delivery.
After the end of the operation, the woman is transferred to the intensive care unit for two hours, and then to the postpartum. And of course, on the first day, she is carefully watched. What do doctors do?
Without fail, she is given nutrient solutions, intravenously, antibiotic therapy is prescribed. And do not be afraid of it, modern antibacterial drugs are quite compatible with breastfeeding.
The child, as a rule, is brought on the second or third day. Anesthetize also up to 2 - 3 days. By the way, women feel best after CS with spinal anesthesia, and not general anesthesia.
Both after a planned CS and after a CS due to a complicated delivery, the care of the uterus falls on the hospital staff. They prescribe drugs to the woman in labor to reduce it (oxytocin), non-narcotic painkillers. To control the process, they monitor the secretions, because in the event of a violation of contractility, bleeding may develop.
Along the way, medical stimulation of the intestine is carried out. This is necessary to remove gases that can not only bring pain, but also provoke the development of adhesions - adhesions between intestinal loops and other organs. Moreover, if the adhesions are strongly pronounced, a second operation may be required.
The seam is washed, treated with antiseptics, for example, brilliant green. If it is not inflamed, for speedy healing, it is recommended to lubricate it with calendula ointment after a couple of days. 
Restoring a cycle after a caesarean section is a separate conversation. Firstly, because each organism is individual, and secondly, the interference in the process of delivery itself is to blame. To minimize possible harm, doctors recommend feeding the baby more often (with breastfeeding, oxytocin is released, which stimulates uterine contractions). Every day, it changes its size, returning to its usual pre-pregnancy and drops by 1 cm. The most interesting thing is that subsequently the uterus can become even smaller than it was before pregnancy.
In the first days, specific discharges appear - lochia. This is the result of bleeding on the surface of the uterus, due to which it heals faster. Duration lochia - 6 - 8 weeks. Moreover, during this period they can change color, smell, intensity of release.
Thanks to them, you can control the recovery time: if they are over, then the body is restored. Sometimes after such a birth, an anovulatory cycle is possible - this is when ovulation does not occur, but here it is necessary to normalize sleep, establish proper nutrition, exclude diseases, and then everything will pass.
As with EP, recovery of periods depends on lactation. The less mother feeds the baby, the faster they will come.
Rehabilitation after a caesarean section is also an individual matter. In general, it lasts up to six months. The woman in labor is discharged on the 6th - 7th day, after which it is recommended to refrain from physical activity for at least 2 or even 4 weeks. It is also impossible to raise the baby, the seam on the stomach may disperse. But this does not mean that it is forbidden to take care of yourself.
The very next day after surgery, if there were no complications, simple exercises are allowed:
This is necessary not so much for the figure, but for the normalization of digestion and speedy recovery. Remedial gymnastics is also indicated, if there are no contraindications:
To restore harmony after a cesarean section, you need. Physical activity is possible only after the seam has healed. Reviews of some mothers indicate that they started exercising as early as 1.5 months after the CS, but you should not blindly follow them. First you need to go to the doctor and make sure that everything is in order.
Running, swimming, moderate (!) loads on the abdominal area are shown, but it is better to perform them with a professional trainer who will select the best ones for you! Classes begin no earlier than 2 months later.
Caesarean section is used in cases of impossibility of independent childbirth for various reasons. After a caesarean section, as well as after other operations, some prohibitions and recommendations are expected in the recovery period. What can not be done after a cesarean and what can be done in the postoperative period should be known to every woman preparing for surgery.
After a caesarean section, the woman is in the intensive care unit. At this time, the woman in labor receives intensive rehabilitation therapy. Depending on the condition of the woman, she may be prescribed drugs to restore lost blood, antibacterial drugs, and drugs that restore bowel function.
On the first day after the operation, you can not eat. You can drink water with lemon juice. It is also not recommended to sit down on the first day. In the first 24 hours after a caesarean section, a woman receives all nutrients intravenously in the form of droppers.
If the operation went without complications and the condition of the woman in labor is stable, the young mother is transferred to the postpartum therapy ward on the second day. Every woman who has undergone surgery is advised about the therapeutic methods of postoperative treatment. Seams after caesarean section are treated 2 times a day.
Antibacterial therapy continues. Prohibitions at this time become less strict. The ban on solid food remains. Mom can already eat broths, natural yogurt, boiled meat, chopped in a blender. You can also drink tea, compotes and fruit drinks. Food should be limited. You need to eat small portions 5 - 6 times a day.
Starting from the second day, you must begin to move independently. However, getting out of bed abruptly is not recommended. You need to get up carefully, turning on your side and lowering your legs to the floor. It will be difficult in the first days, but motor activity after the operation is very important for the speedy recovery of all body functions.
When can I start visiting a bath or sauna after a cesarean section
In addition, starting from the second day after the operation, it is necessary to apply the newborn to the breast as often as possible. You need to lift the child carefully, without straining the abdominal muscles. This will help to establish lactation and contribute to the rapid contraction of the uterus.
On the third day after caesarean section, the ban on solid food remains. You can gradually include porridge, low-fat cottage cheese, low-fat kefir, steam cutlets, vegetable or fruit puree in the diet. There is a ban on overeating. You need to eat often, but in small doses.
You still can’t get out of bed abruptly and strain your abdominal muscles. Until the postoperative suture is tightened with a scar, you can not take a shower. The first careful bathing can be carried out no earlier than the 7th day after the operation. In this case, you can not rub the seam with a washcloth. You can lightly lather it with soap and rinse with warm water. It is important to thoroughly blot the seam after bathing with a soft towel. Make sure the seam is dry. On the recommendation of doctors, if necessary, the seam should be treated with antiseptic solutions.
Depending on the suture material that was used during the operation, the sutures may or may not be absorbable. Today, in most cases, surgeons use sutures that do not need to be removed after surgery.
The threads dissolve within 2 months after surgery or remain in the patient's body and do not require removal. With proper care and compliance with all recommendations, the seam is quickly tightened and becomes almost invisible after 3-6 months after the intervention.
In order to avoid problems with the seams, you can not remove the bandage yourself. It is necessary to strictly follow all the recommendations of doctors and follow the instructions of specialists. In the normal state of the seams, the woman is discharged home on the 7th - 10th day after the caesarean section.
Symptoms and causes of adhesions after caesarean section
Despite the fact that the woman returned home, she must strictly follow the recommendations of the doctors in the first weeks after the operation. You can not abruptly raise the child, it is better if you feed him. No need to do hard work and overwork.
Doctors do not recommend lifting weights and insist that the only thing a woman can lift in the postoperative period can be a newborn baby. The rest of the housework associated with lifting weights must be entrusted to family and friends.
The diet is gradually returning to the dishes familiar to women. However, the ban on sweet, fried, fatty remains. Also, throughout the entire postoperative period, it is forbidden to eat legumes, cabbage, citrus fruits, sausages, canned foods and bakery products.
Later, when the woman has fully recovered from the operation, these products can be introduced into the diet, carefully observing the reaction of the newborn. If the baby reacts with allergic reactions or an upset stomach, some food restrictions may continue throughout the duration of breastfeeding.
Depending on the condition of the woman, the ban on sexual activity can vary from 1.5 to 2 months after a cesarean section. This issue should be decided by the attending physician, based on the examination and the dynamics of recovery in the postoperative period.
If complications arise, such as infection of the suture, inflammation of the uterus, endometriosis, etc., the ban on intimate relationships can be extended until complete recovery. In any case, intimate life can be resumed only after the discharge has stopped and the sutures have completely healed.
Many women are interested in the question of when it is possible to start physical exercises to restore the figure. If women who have given birth on their own can start playing sports immediately after being discharged from the hospital, then with women who have undergone a caesarean section, everything is completely different.
Is it possible to put a spiral on women after a caesarean section
After the operation, it is necessary to withstand at least 1.5 months before starting physical exercises. It is necessary to start classes with minimal loads, gradually increasing the number and pace of exercises.
You can do exercises to strengthen the muscles of the press only after the permission of the attending physician.
Before that, you can do light gymnastics, which is aimed at raising vitality and mood.
Women who have given birth with the help of surgery are highly discouraged from planning a pregnancy earlier than 2 years after the surgery. During this time, the scar on the uterus will completely heal and will not be able to adversely affect a subsequent pregnancy.
Recovery after caesarean - this is how motherhood begins in women who, for medical reasons, had to give up the prospect of natural childbirth. This difficult process requires patience and increased attention to one's own health - it is possible to return to full-fledged physical activity only after 2 months, during which it is necessary to put up with prohibitions and work on oneself in order to ensure the full healing of internal and external seams.
Indications for caesarean section (CS) are absolute, in which the exit of the fetus through the birth canal is impossible, and relative, when the natural course of childbirth is accompanied by risks. It should be noted that with the development of medicine, the list of indications is becoming wider: a number of diagnoses in which caesarean section was considered one of the alternatives are now transferred to the category of absolute ones.
There is also the possibility of conducting a CS at the will of a woman, without medical indications. How justified is this choice? Experts give arguments for and against based on theory, their own experience and statistical research, but their beliefs on this issue can lead to diametrically opposite conclusions: some campaign for natural childbirth, others talk about the benefits of surgery. At the same time, modern medical technologies are being improved in both directions.
Cesarean section is carried out in a planned or emergency order. In cases where the decision on surgical intervention is made before the onset of labor, the patient can receive detailed information from the doctor about the methods of anesthesia, tissue dissection and suturing. The technique is chosen depending on the state of health of the mother and fetus, the anatomical location of the internal organs, the characteristics of the tissues of the abdominal wall and uterus, as well as the professional skills of the surgeon.
The incision of the abdominal wall can be:
There are a number of techniques for dissecting the uterus, the use of which does not depend on the method of opening the abdominal wall, but in practice, each surgeon has his own well-developed technique. The choice of method of anesthesia (epidural, spinal anesthesia or general anesthesia) depends on the decision of the anesthesiologist. With partial anesthesia, if there is no need for resuscitation, the child is given to the mother's arms immediately after extraction. Synthetic absorbable materials are used for suturing.
Stages of a caesarean section:
Hospitalization before surgery (from 1 day to 2 weeks) depends on medical indications for monitoring the condition of the mother and child, supporting and diagnostic procedures, the decision on discharge is made according to the same parameters. Inpatient postoperative treatment in the maternity hospital lasts an average of 5-7 days.
The use of caesarean section is the main factor in reducing the statistics of neonatal mortality, but surgery also affects them:
A woman in labor may experience the following complications:
Unfortunately, both the natural course of childbirth and surgical intervention are not immune from unforeseen circumstances. In the case of a caesarean section, we can talk about a common set of risks inherent in all abdominal operations that arise due to reactions to anesthesia, heavy blood loss, blood clots.
To prevent risks, the main role is played by:
After a cesarean section, time is needed for the healing of injured tissues and postpartum hormonal changes. You have to stay for a week in the hospital, then endure constant aching pains that keep you in suspense and limit movement, establish a regimen and nutrition, and at the same time get used to maternal duties. Communication with the child and the support of loved ones greatly facilitate the situation, but even in this case, the desire to recover quickly often leads to overload, which only prolongs the painful period.
A specially designed bandage fixes the abdominal organs, helps to prevent their prolapse and alleviates pain. Its wearing is possible only with a good condition of the seam and normal bowel function. In the first 4 weeks after the operation, the bandage is put on for 3-4 hours a day, especially when you need to get up, sit and walk. After it, you can switch to wearing tight underwear.
Postpartum bandage The selection of the diet is aimed at replenishing iron deficiency, restoring digestion and water metabolism, and ensuring lactation. During the period when you still have to lie down for a long time, you need to consume more fiber to prevent constipation. General recommendations relate to the exclusion of fried, salty, smoked foods, the need for fractional nutrition. It is recommended to individually exclude products that cause gas formation. You can drink a special course of vitamins for nursing mothers.
Regardless of physical fitness, a return to usual sports is possible only 6 months after the operation. Overload, as well as excessive restriction of movement, can complicate the healing process. Special gentle exercises aimed at preventing varicose veins and thrombophlebitis, working out the pelvic muscles should be performed daily with a gradual increase in multiplicity.
The suture in the maternity hospital is cared for by the medical staff, and by the day of discharge, the discharge from the wound stops, the sutures are removed or dissolve. At home, it is necessary to ensure sterility and protection of the affected area from mechanical damage. Disinfectants and healing agents are used. The cosmetic appearance of the scar depends on the characteristics of the organism. Corrective measures (laser resurfacing, photo-correction) should be postponed for at least a year.
The process of physiological and psychological recovery is individual, but in any case, the mother should spend as much time with the child as possible, and at the same time she needs to sleep as needed.
At first, loved ones should protect her from intermittent sleep at night and assist in any activity that requires physical exertion, for example, bathing the baby or rocking him in her arms. A gradual transition from bed to normal mode is carried out by performing exercises in walking and sitting several times a day.
Lactation may start late, and there is also a certain risk of lack or shortage of breast milk, so supplementation with mixtures is inevitable. Doctors advise not to leave attempts to accustom the child to, take him in his arms more often and apply to the chest not according to the schedule, but on demand. If the baby is already accustomed to the nipple, you need to express milk and try to maintain lactation even in small volumes.
Reception of analgesics is stopped even in the maternity hospital, and doctors do not advise stopping pain, using them as an indicator of physical activity. Painful sensations allow you to dose physical exercises, tell you how to get out of bed correctly, how much time to spend on your feet or in a sitting position.
The consequence of anesthesia may be a paroxysmal cough caused by the accumulation of mucus in the bronchi. To avoid divergence of the seams, you need to control this process by holding the place of the seam with your palms and coughing on a strong exhalation.
Life after a caesarean section gets better only with time, and the rehabilitation process is not only extended in time, but also cannot be clearly predicted. It is important to understand that prohibitions are measures to prevent complications that allow you to shorten the recovery period and spend it at home, next to the child.
The first item on the list of restrictions is a ban on lifting weights more than 3 kg until complete scarring of the uterine tissue occurs. During this period, you should also not make sudden movements, such as pulling up or bending over. In the first months after the operation, you should not take hot baths.
It is important to move away from the stereotype that restrictions can be lifted if the pain has stopped and the stitch on the abdomen has tightened. Complications from internal inflammatory processes and abnormal scarring of the uterus can be hidden, so it is important not to ignore the alarm signals and not violate the prohibitions that the doctor has imposed based on the individual characteristics of the patient.
Depending on the intensity of the symptoms, you should call an ambulance or contact your doctor if:
Lack of stool and problems with urination are also an alarm signal that requires specialist advice. Complications after CS can also appear after the recovery period, even years after the operation. Regardless of how you feel, you need to undergo examinations by a gynecologist every six months and seek medical help for pain in the abdominal cavity and menstrual irregularities.
This is how our world works, that a person must overcome many difficulties during his life, especially this applies to the weaker sex. Tests such as pregnancy and childbirth cannot be ruled out. Quite often, situations arise when a child needs to be “extracted” from a woman’s womb by means of a caesarean section.
Many representatives of the weaker sex consider this termination of pregnancy to be more preferable, since they either do not know or forget about the potential threat of complications after cesarean section.
Of course, a woman should also remember how difficult and long postoperative rehabilitation will be, how much patience, perseverance and strength will be required.
Undoubtedly, abdominal delivery is no longer an operation of desperation, when all possible techniques were resorted to to facilitate the appearance of a child. Accordingly, the risk of postoperative complications, complications during the operation itself and during rehabilitation has also decreased.
However, it is not only possible, but necessary, to prevent various hypothetical consequences after surgical delivery. The percentage of consequences after the operation is directly proportional to:
the method of performing the operation;
the time spent on the operation;
antibiotic therapy after surgery;
the quality of the suture material;
qualifications of the surgeon and other factors that may affect the operation in the postoperative period.
It is worth noting that any caesarean section (even if it is performed perfectly) cannot pass without a trace for the child and mother. Only quantitative indicators of consequences vary.
Suture on the anterior abdominal wall.
The presence of an unaesthetic and rough scar on the anterior abdominal wall carries a lot of negative emotions. I would like such a negative moment to be the only one for a woman, because the main goal is not physical beauty, but a healthy mother and baby in the end.
You should not be upset about the “disfigured abdomen”, because today there are methods by which you can make an intradermal suture (suturing the skin) or make an incision in the suprapubic region (transverse incision), which will allow a woman to wear even a bathing suit without fear.
The formation of a skin (wide, convex or inconspicuous) scar depends on the secretion of certain enzymes by the body. Unfortunately, some people produce more of them, while others have less, as a result of which a keloid scar is formed. But even in this case, there is no need to be upset, because modern medicine offers a lot of ways to get rid of the scar (for example, laser correction, “polishing” of the scar).
Adhesive disease.
After any surgical intervention in the abdominal cavity, adhesions form. A particularly high risk of developing an adhesive process in case of amniotic water and blood entering the abdomen, during traumatic and long operations, as well as complications during the rehabilitation period (purulent-septic diseases, peritonitis, endometritis development).
Connective tissue adhesions and strands lead to tugging of the intestine, as a result of which its functionality is disturbed, and the ligaments that hold the uterus, ovaries, and tubes also suffer. All this can be the reason:
improper location of the uterus (back bend or bend), this affects the menstrual cycle;
tubal infertility;
the development of intestinal obstruction;
permanent constipation.
After performing 2, 3 caesarean sections, the consequences in the form of the adhesive disease itself and its complications are more likely.
Postoperative hernia.
The formation of a postoperative hernia in the area of the surgical scar is also possible, which is associated with insufficient comparison of tissues during wound closure (aponeurosis) and during the early period after surgery. Sometimes there may be a divergence (diastasis) of the rectus abdominis muscles, a decrease in their tone and loss of functionality:
digestion is disturbed and pain appears in the spine;
an umbilical hernia is formed (the umbilical ring is the weakest point in the abdominal wall);
as a result of the redistribution of the load on the remaining muscles, the internal organs (vagina, uterus) can shift or fall.
The effects of anesthesia.
The decision on the need for anesthesia during caesarean section is made by the anesthetist. Anesthesia can be either intravenous using tracheal intubation or spinal anesthesia. Among the frequent complaints when using endotracheal anesthesia, cough and sore throat are noted, which are explained by the accumulation of mucus in the bronchopulmonary tract and microtrauma of the trachea.
Also, the exit from general anesthesia is often accompanied by drowsiness, confusion, vomiting (rarely), nausea. These symptoms disappear within a few hours. Spinal anesthesia can cause headaches, therefore, after such anesthesia, patients are recommended to be in a horizontal position for 12 hours.
With spinal and epidural anesthesia, damage to the roots of the spinal cord can occur, this manifests itself in the form of back pain, trembling and weakness in the limbs.
Scar on the uterus.
After delivery by caesarean section, a scar remains forever on the uterus. The main criterion for the uterine scar is its consistency, which largely depends on the course of the postoperative period and the quality of the operation.
A thinned (incompetent) scar on the uterus can cause a threat of premature termination of pregnancy, and in some cases even rupture of the uterus, not only during childbirth, but also during pregnancy. That is why doctors advise women who are planning a second birth by caesarean section to perform sterilization. At the third operation, tubal ligation is insisted.
Endometriosis.
Endometriosis is characterized by the fact that there is an accumulation of cells similar in structure to the endometrium in places that are not typical for them. Quite often, after a cesarean section, endometriosis appears on the uterine scar, because in the process of suturing the incision of the uterus, cells from its mucous membrane can get to the outer side, in the future they begin to grow into the muscle and serous layers, endometriosis of the scar appears.
Cases of development of endometriosis of the skin suture are known.
Endometriosis can cause future infertility, but the disease develops years later.
Women suffer from constant pain in the lower abdomen, the strength of which depends on the phase of the cycle (during menstruation, the pain usually increases).
Problems with lactation.
Many patients after surgery experience problems with the process of lactation. This is especially true for those who had a planned caesarean, before the onset of childbirth. The flow of milk to the glands after caesarean in women who had a natural birth and gave birth naturally occurs on the 3rd-4th day, otherwise it happens on the 5th-9th day.
This is due to the fact that during childbirth, the body synthesizes oxytocin, leading to uterine contractions. This component is also responsible for the production of prolactin, which, in turn, is responsible for the synthesis and release of milk.
It becomes clear that a woman after a planned operation cannot provide the child with milk on her own, she has to supplement the newborn with mixtures, and this is not very good. Often, women after caesarean section develop hypogalactia (lack of milk production) or even agalactia.
A caesarean section also affects the baby. “Caesarites” quite often have breathing problems.
Firstly, if the operation was performed under intravenous anesthesia, then a certain part of the narcotic drugs penetrates into the child's bloodstream with the bloodstream, the respiratory center is inhibited, which can lead to asphyxia. In addition, in the first days and weeks, mothers note lethargy and passivity of the baby, the child does not take the breast well.
Secondly, in the lungs of children who were born by caesarean section, fluid and mucus remain, which are normally pushed out during the passage of the fetus through the birth canal. In the future, the remnants of the fluid are absorbed into the lung tissue, and this is the cause of the development of hyaline-membrane disease. Remaining fluid and mucus are an excellent substrate for the reproduction of pathogenic microorganisms, which later leads to respiratory disorders or pneumonia.
During natural delivery, the baby is in a state of sleep. With hypernation, physiological processes slow down, which serves to protect the newborn from pressure drops at the time of birth.
With a caesarean section, the baby immediately enters the external environment from an incision in the uterus, he is not prepared for this pressure drop, as a result - microbleeds in the brain (experts believe that such a pressure drop in an adult would result in pain shock and death).
"Caesarites" adapt much longer and worse to environmental conditions, because they do not experience stress during passage through the birth canal, they do not produce catecholamines - hormones responsible for adapting to completely new conditions of existence.
Long-term effects include:
frequent development of food allergies;
increased excitability and hyperactivity of cesarean children;
poor weight gain.
There are problems with breastfeeding the baby. A child who was fed artificial mixtures while the woman was recovering from anesthesia, underwent a course of antibiotic therapy, becomes unmotivated to breastfeed, he sluggishly takes the breast and does not want to make an effort to get mother's milk from the breast (sucking from a bottle is much easier).
The specialist also believes that after a cesarean section there is no psychological connection between the child and the mother, which is normally formed during the natural birth process and is fixed during early attachment to the breast (immediately after birth and dissection of the umbilical cord).
Immediately after the operation, the woman is transferred to the intensive care unit, where she stays for a day under the close supervision of medical personnel. At this time, it is required to apply ice to the abdomen and inject painkillers. After a caesarean section, the recovery of the body should begin immediately:
Physical activity.
The sooner a newly-made mother restores physical activity after the operation, the sooner her usual rhythm of life will be restored.
The first day, especially if spinal anesthesia was used, the woman must observe bed rest, but it is less strict and you can move.
You need to roll over from one side to another right in bed, do leg exercises:
alternately bend the legs at the knee joint, and then straighten it;
press your knees to each other, and then relax them;
perform rotational movements with the feet in different directions;
pull your toes towards you.
Each exercise should be performed at least 10 times.
Immediately you need to start performing Kegel exercises (periodic contraction and relaxation of the muscles of the vagina), they help strengthen the muscular system of the pelvic floor and are the prevention of possible problems with urination.
You can get out of bed after a day. To perform the lift, you need to turn on your side, lower your legs off the bed, then, resting your arms, lift the upper body and sit down.
Get out of bed only under the supervision of a nurse. Early motor activity has a stimulating effect on intestinal motility, thereby preventing the formation of adhesions.
Skin sutures are treated daily with antiseptic solutions (potassium permanganate, brilliant green, 70% alcohol), the dressing is changed. Removal of sutures is performed on the 7-10th day after caesarean section (an exception is the intradermal suture, which dissolves on its own after 2-2.5 months).
In order for the scar to dissolve better and avoid keloid, doctors recommend treating the sutures with gels (Kontraktubeks, Curiosin). You can take a shower after removing the stitches and healing the skin scar, after about 7-8 days (it is forbidden to rub the seam with a washcloth), baths and baths should be postponed for 2 months (until the uterine scar heals).
Nutrition and intestinal gases.
The passage of gases is one of the important elements in the restoration of bowel functions. After a caesarean section, you should follow a certain diet. On the first day, only mineral water without gases or water with lemon juice is allowed. On the second day, you can take chicken or meat broth, kefir, rolled meat, low-fat cottage cheese.
After self-emptying of the intestines, usually this happens on the 4-5th day, the woman is transferred to a normal diet. You should not hold back gases, for their easier discharge, you need to perform stroking movements in a clockwise direction, then roll over on your side, take your leg and relieve yourself. If constipation occurs, you can resort to using Microlax or glycerin suppositories, they should be allowed for use during lactation and breastfeeding.
Bandage.
Wearing a bandage will greatly facilitate the life of a woman in the first days after a cesarean section. But it is not necessary to abuse this device, in order for the restoration of the muscle tone of the anterior abdominal wall to pass quickly and fully, the bandage must be periodically removed and the periods of being without this device gradually lengthened.
Cough.
After surgery, women often suffer from coughing, especially if endotracheal anesthesia was used. At the same time, the fear that the stitches will open during a cough makes many hold back. In order to strengthen the seams, you can press a pillow against them or perform a dressing with a towel, then take a deep breath and exhale completely, making a sound similar to “woof”.
Physical activity and restoration of elasticity of the anterior abdominal wall.
After delivery by caesarean section, the patient is limited to lifting weights to the limits of 3-4 kg for 3 months. Raising and caring for a child is not prohibited, but rather welcomed. At the same time, all household work that is associated with squats, bends, should be entrusted to another family member.
A month after the caesarean section, you can start physical exercises with light gymnastic exercises. After the operation to restore the abdomen, you can start pumping the press no earlier than six months later. By and large, a sagging belly will return to normal after 6-12 months (muscles and skin will become elastic, and their tone will be restored).
Sports in order to restore the figure after surgery (yoga, body flex, aerobics, fitness) should be carried out only after consulting a doctor and only under the supervision of an instructor, not earlier than after 6 months. Bodyflex exercises do an excellent job of restoring the figure and abdomen, 15 minutes a day is enough.
Sex life.
You can resume sexual intercourse 1.5-2 months after the operation (the period is the same as during natural childbirth). Such a period of abstinence is required for the healing of the site of attachment of the placenta to the uterus and the uterine suture.
It is important to think about contraception even before the start of an active sexual life. After the operation, the intrauterine device can be installed only after 6 months from the moment of the operation, while performing an abortion is the strictest contraindication, since the scar is re-traumatized and its failure may develop.
Menstrual cycle.
There are no differences in the restoration of the cycle after caesarean section and childbirth in a natural way. If a newborn is breastfed, menstruation may begin 6 months after birth or even later. If there is no lactation, the menstrual cycle is restored after 2 months.
next pregnancy.
Obstetricians recommend refraining from a new pregnancy for at least two years, and preferably at least three. During this time period, a woman manages to fully recover both psychologically and physically. Complete healing of the scar on the uterus is also necessary.
Observation at the gynecologist.
All women after caesarean section are mandatory registered in the antenatal clinic, the observation is carried out for 2 years. The first visit after a caesarean section must be performed no later than 10 days later. An ultrasound of the uterus is required. After the end of lochia (6-8 weeks), a second visit is performed. A six-month visit is necessary to assess the healing of the scar on the uterus, subsequent visits to the gynecologist should be carried out at least once every six months.
