When can I start after a caesarean section? If I had a caesarean section, is it possible to give birth naturally? Intestinal gases and urinary problems - normal or pathological

Content

If a natural delivery is impossible for a woman for a number of reasons, the doctor prescribes a caesarean section. After this operation, proper recovery is necessary. Every woman preparing to become a mother should know about the recovery period.

Rehabilitation after caesarean section: features of the first days

A new mother immediately has a lot of responsibilities, which complicates recovery after surgery. The woman will have to spend a day in the intensive care unit. Due to anesthesia, a woman in labor cannot get out of bed for 12 hours. To make recovery after a cesarean section easier, remember the following recommendations:

1. You will lie on your back, but you will need to turn over on your side often to release blood clots and prevent adhesions from starting. Place your feet on the bed, lift your hips higher, turn them out and lower them. Take it slow. Smoothly expand your chest.
2. When general anesthesia is restored, you will experience a cough as mucus builds up in your lungs. When coughing, press down the seam with a towel or diaper to prevent it from coming apart.
3. To get out of bed, roll over onto your side and dangle your legs. First, get up and sit for a while. Move your legs, stretch them. When you stand up, try to take as even a vertical position as possible.
4. Taking deep breaths will help you get rid of gases in your intestines during the recovery period. You can also rock in your chair.

How to quickly recover after a caesarean section - recommendations

Any woman wants to get back into good shape as soon as possible. A quick recovery is possible if you remember certain recommendations. Your entire lifestyle matters: nutrition, daily routine, intimate hygiene. Try to strictly follow all the doctor’s instructions to avoid health problems in the future. To understand how to recover from a cesarean section, remember a few basic rules. This way you will protect yourself from a lot of troubles.

Proper nutrition after cesarean section

It is best to eat hospital food prepared taking into account the peculiarities of the recovery of the body of women in labor. Supplement your diet with what you can eat after a cesarean section. Diet according to recovery days for a young mother:

1. After a caesarean section, you are only allowed to drink water for the first 24 hours.
2. On the second day of recovery, lean meat broth with vegetables is suitable. Introduce dairy products into your diet: yogurt, cottage cheese. Eat a small piece of lean meat minced through a meat grinder.
3. On the third day of recovery, you can eat steamed cutlets, meatballs, porridge with water, cheese, cottage cheese, pureed vegetables, chicken, and beef. Food should not be hot. If you have problems with stool, drink kefir.
4. In the subsequent days of recovery, include dairy products, meat, vegetables and fruits, eggs, butter and vegetable oil in your diet.

After a cesarean section, avoid eating the following foods:

• natural honey;
• garlic;
• citrus and exotic fruits;
• strawberries;
• mayonnaise, mustard and other sauces;
• marinades;
• carrots;
• smoked meats;
• canned food;
• seafood;
• sausages;
• chocolate.

Physical activity

The sooner you start moving after a cesarean section, the less likely it is that adhesions will develop. While you are recovering from anesthesia, roll over from one side to the other, try to move your legs and rotate your feet. When you feel better, pull your knees towards your chest. Be sure to start doing Kegel exercises right away, this will help avoid difficulty urinating. After surgery, you will have to get out of bed on the second day.

Suture care after cesarean section

For 5 days in a row, all procedures will be carried out by a nurse. She should treat the wound with antiseptics and change the bandage. If the threads do not dissolve on their own, they will be removed after about a week, from which time it is allowed to wet the incision and not wear a bandage. Treatment with antiseptics should be continued independently. The seam should be washed with liquid soap and wiped with a disposable towel. After some time, you can use ointments to heal scars.

Wearing a bandage

Many doubt the need for this accessory and consider it too inconvenient. Modern experts say that it is necessary to wear a bandage for at least a month during the recovery period. It should not be universal, but special - postoperative. Wearing a bandage promotes proper and rapid recovery of the abdomen after a caesarean section. The accessory will protect your seam from damage, it will be much easier for you to walk and take care of your child.

Physical exercise

Remember that intensive restoration of your figure after a caesarean section is possible for you only after six months. In the first couple of months, you need to take care of yourself and not lift any weights other than the baby. One of the most dangerous consequences of overload is rupture of the uterine suture. Before you start exercising, consult your doctor. Until six months have passed, walk a lot, do simple exercises for your arms and legs, without straining your abdominal muscles. Don't forget about Kegel exercises.

Menstrual cycle

His recovery after a cesarean section proceeds in the same way as after a normal birth. For one and a half to two months, lochia will appear - a discharge similar to menstruation. The first two periods should be very heavy. The cycle should normalize in 3-5 months. If it does not stabilize, you need to undergo examination and make sure that there are no complications, for example, endometriosis. The process of restoring a normal menstrual cycle after a cesarean section depends on:

1. Age. The younger the woman, the sooner she will begin menstruation and fully resume childbearing function.
2. Lifestyle. It affects how a woman eats and whether she exercises.
3. Lactation. If the mother feeds the baby with breast milk, menstruation will begin in approximately 6-8 months. In the absence of lactation, they appear after 8-12 weeks.

Sexual activity

Doctors recommend that patients after a cesarean section begin intimate relationships after one and a half to two months. If there were or are any complications, then the issue of resuming sexual activity after pregnancy should be discussed with a doctor. Don't forget about contraception, because you shouldn't get pregnant until two, or preferably three, years after your cesarean section.

Observation by a gynecologist

Visit a specialist for the first time 10 days after a caesarean section. He will definitely do an ultrasound of the uterus, register you and observe you for at least two years. Then consult a doctor when the lochia stops coming out, that is, after one and a half to two months of recovery. The next visit is six months after the day of abdominal birth. Then you need to visit your doctor every 6 months.

How to remove belly fat after cesarean section at home

Be sure to wear a bandage and use creams to restore skin elasticity, and do body wraps. If you don’t know how to restore your stomach after a caesarean section, then try to pull it in more often, this helps a lot and can be done in any conditions. Abdominal exercises, breathing exercises, and yoga will help. Training with a hoop will be effective. If possible, sleep on your stomach to help your muscles contract properly.

Video: effective exercises after cesarean section

Attention! The information presented in the article is for informational purposes only. The materials in the article do not encourage self-treatment. Only a qualified doctor can make a diagnosis and make recommendations for treatment based on the individual characteristics of a particular patient.

Pregnant women who are undergoing a caesarean section for certain indications are quite reasonably concerned about whether the body’s recovery process after the operation will be painful and long. This is what often frightens expectant mothers who are indicated for a planned cesarean section.

In this article we will talk about when you can get up and walk after surgical birth and how to do it correctly.

After surgery

A woman who has just had a caesarean section needs special care and monitoring. Therefore, after the end of the surgical intervention, she is immediately transported to the intensive care unit.

She should lie in it for several hours, and if complications arise, then for several days. Medical workers monitor the mother's blood pressure and temperature, and administer contraction medications hourly. They are necessary because the natural involution of the uterus after a surgical incision proceeds slowly, which is fraught with infections.

To ensure that the pain is tolerable after the anesthesia has finally worn off, painkillers are prescribed; if there are signs or fears of infection, antibiotics are immediately administered. Ice packs are applied to the abdomen for better contraction of the uterus. It is clear that in an intensive care ward, no movements are encouraged, except for movements of the arms and head, and even then to a very limited extent.

If there are no complications, after 4-6 hours the woman can be transferred to a regular ward in the department. On the first day, the baby can only be brought in for feeding. He will be left with his mother, if the maternity hospital’s routine involves new mothers and newborns staying together, only when the woman gets up after a caesarean section.

It's time to rise

The sooner a woman begins to engage in physical activity after transfer to a regular ward, the better. Projections for a faster and more successful recovery will be higher. But this does not mean that you can immediately get up and go.

Only 5-6 hours after the operation, a woman can begin to toss and turn from side to side, but not yet get up. It will hurt, but not as much as it seems. The pain itself is dull, because the woman will be given intramuscular painkillers for another 2-3 days. First by the hour, then on demand. In this case, fear is stronger than pain. Postpartum women are afraid that the stitches will come apart and burst. There is no need to be afraid of this. Although it is quite difficult to ignore the pulling sensations that the seams create when trying to turn on your side.

You need to turn on your side correctly - first the woman tries to turn her upper body, the shoulder girdle, and then smoothly, little by little, pulls up her lower body, holding the bandage on her stomach with her hand. The first revolutions will bring a lot of unpleasant moments, but with each subsequent one it will turn out better and better.

After 8-10 hours from the end of the operation, if there are no complications and strict instructions from the doctor regarding the need to lie down and not move, you can get up. But before you can take a more or less vertical position (usually it is conditionally vertical, since the postpartum woman stands in the letter “L”, unable to straighten up), you need to learn how to sit.

From the position lying on your side, which has already been mastered, you need to smoothly lower one leg from the bed, lie there for a while, and then, holding your stomach with your palm and leaning your other hand on the bed, slowly sit down. Don't rush to get up right away. Sit for half an hour, an hour until the dizziness passes, which is completely normal after the operation and anesthesia.

As soon as the sitting position becomes quite comfortable, you can try to rise. If there is someone in the ward who can help do this, take advantage of this opportunity. If not, then rest your hands on the headboard, on the edge of the bed, as comfortably as possible. Do not try to straighten your shoulders and back as soon as you manage to stand on your own two feet. This will be quite painful.

Do not move far from the bed or the person accompanying you, hold on to the wall or headboard, because the first steps may be accompanied by an attack of severe sudden weakness and dizziness. Without insurance in the form of a loved one, a roommate, a nurse, or, in extreme cases, a headboard, a postpartum mother may fall and be injured.

The next day after the operation, women usually move around the ward quite tolerably, and a day later they go to the toilet on their own without any problems, walk along the corridor, and with precautions they can take care of the babies themselves. Wearing a postoperative bandage makes the early postoperative period easier, but be sure to consult your doctor before putting it on.

Could there be complications?

An incorrect mode of physical activity can theoretically cause seams to diverge and disrupt the structure of internal seams. Subsequently, such a scar may become insolvent, which will make it difficult to carry the next pregnancy.

But staying in bed for a long time, if a woman is afraid to get up and walk, can have very negative consequences - the uterus begins to contract worse, the release of postpartum blood discharge and clots is difficult, which increases the likelihood of developing an infection and endometritis.

The algorithm for correct lifting after surgery is presented in the following video.

” №12/2014 22.07.16

Talk about how natural childbirth is better in all respects becomes meaningless in a situation where a woman objectively cannot give birth herself. In this case, the only option is a caesarean section.

There are, of course, clinics in which anyone who wants to be treated will be given a “caesarean” only because she wants it - she is afraid to give birth, for example. However, any self-respecting doctor will try to dissuade the expectant mother from having a caesarean section without medical indications.

Who needs a caesarean section?

Caesarean section – abdominal surgery; serious reasons are needed to carry it out:

1. Unsuccessful presentation

The fetus is located in the uterus in such a way that it either will not pass through the birth canal at all, or both mother and child will receive serious injury during natural childbirth. For example - transverse or oblique position, some types (full or foot), frontal or facial presentation, stable posterior occipital presentation.

2. Craniopelvic disproportion

Either the fetus has a large head, or the mother has a narrow pelvis, or both. Disproportion is rarely detected before labor begins. Usually the diagnosis is made if a lot of time has passed after the 1st contraction, the contractions themselves are quite strong, and the transition to the 2nd stage of labor does not occur.

3. Prolonged labor

For example, a woman began giving birth a long time ago, it’s time for the baby to be born, but the contractions are weak, stimulation does not help. Or the cervix does not want to open, and the fetus does not descend, despite all the efforts of doctors.

4. Cord prolapse

Normally, the head descends into the cervix first; if the umbilical cord is ahead of it, there is a serious risk that during childbirth the baby’s body will squeeze it, the supply of oxygen will decrease significantly, and the baby’s brain will suffer from hypoxia.

5. Placenta previa: the baby's place completely or partially covers the cervix

A pregnant woman needs bed rest and medical supervision. If the situation cannot be corrected by the time of birth, the pregnancy will end with a cesarean section.

6. Placental abruption – its premature separation from the wall of the uterus

If the bleeding during detachment is slight, contractions are going as expected, and the fetal heartbeat is normal, you can give birth yourself; if not, surgery is needed.

7. Mom has kidney problems, diabetes, hypertension, preeclampsia, myopia of more than five diopters

The doctor weighs the pros and cons and makes the right decision.

8. Multiple pregnancy

With it, there are more often complications such as umbilical cord prolapse and.

Preparing for a caesarean section

You will sign an agreement - “I understand the possible risks and agree to the operation.” Then – shaving of pubic hair, enema; They will put in an IV and insert a catheter into the ureter (it makes sense to ask that the latter be done after pain relief).

Anesthesia is more often used (also known as spinal or spinal): the patient is conscious, but does not feel anything below the chest. However, if there is a threat to the life of the child or mother and a caesarean section needs to be performed urgently, anesthesia is used - it acts faster.

You will be placed on your back (there is a pillow under your hips to move the uterus away from large vessels), your abdomen will be washed with an antiseptic, covered with a sterile sheet and a screen will be placed between your head and abdomen. If you are conscious, the screen can be raised so that you can see the baby.

How to do a caesarean section

The cesarean section operation itself is simple and takes about an hour; The baby will be born in the first 10–15 minutes. The rest of the time is stitching.

The doctor makes 2 incisions - the abdominal wall and the uterus; the muscles are not cut, but moved apart - this facilitates healing. The doctor then ties or cauterizes the vessels, sucks out the amniotic fluid from the uterus, removes the baby, hands it to the nurse, and manually separates the placenta.

The sister cleans mucus from the newborn's mouth and nose. The baby is examined and assessed using the Apgar score.

The uterus and abdominal wall are sutured with a special surgical thread, which will then dissolve on its own. And the incision on the skin can be connected either with a soluble thread, or with an insoluble thread, or with staples, which will be removed before discharge. A bandage will be placed over the suture and a drug will be injected to contract the uterus. Nausea and trembling may occur as a side effect; but they will pass in an hour.

Suture after caesarean section

Stitches after cesarean section heal quickly. They leave scars, but if the cut was transverse, the marks will be hidden under the panties. The abdomen will shrink, the scar will fade and become less noticeable. In rare cases, an overhang occurs - the skin above the scar protrudes slightly. Walking and swimming will help here - they perfectly strengthen the abdominal muscles.

When can you get up after a caesarean section?

For the first 2 hours you will lie with an ice pack on your stomach - so that the uterus contracts faster and less blood is lost. You will spend a day in the postoperative department. Specialists are monitoring you - what is your blood pressure, is your bladder working well... They will prescribe pain medication for 2-3 days. They will give you medications to contract the uterus and normalize the gastrointestinal tract; saline will be administered intravenously to replenish fluid loss. Antibiotics - only for infection.

6 hours after the caesarean section, they will help you sit up, and after that you will be allowed to stand for a while. Enough for the first time, you can go back to bed. More intense physical activity is possible when you are transferred to a general ward. If you have a post-operative bandage in advance, it will make life easier - it will be easier to move around.

On the 1st day you can only drink mineral water without gas. Then the menu will include lean boiled meat and broth, porridge, and tea. Starting from the 3rd day, your diet is normal for a nursing mother.

On the 5th day they will do an ultrasound of the uterus, and on the 6th day the sutures (or staples) will be removed. As a rule, on the 6th–7th day - discharge home with the baby.

Types of incisions and subsequent births

It is very important to know which uterine incision the doctor used; This determines whether you will be able to give birth naturally in the future.

• In recent years, a transverse skin incision has been most often used; it is performed horizontally, just above the pubis. It is also called a bikini cut. After this, a lower transverse incision of the uterus is usually made - it heals well and minimizes the risk of bleeding. This is the case when repeated pregnancies may well end in natural birth.
• However, if the baby needs to be removed from the uterus as quickly as possible, the incision is made vertically - simply because it takes less time. The skin of the abdomen is cut between the navel and the pubic bone, the uterus is cut in its upper part. After such an incision, subsequent pregnancies end with a repeat cesarean section.

At home after caesarean section

• Take care of yourself - get as much rest as possible. Don't take on all the homework at once.
• For now, it is better to limit water treatments to a shower; You will be able to immerse yourself in a bathtub, just like in a swimming pool, one and a half months after the operation.
• Around the same time, you can slowly resume. Just don’t forget to take care of contraception - doctors recommend getting pregnant again no earlier than after two years.

Lyudmila Potapchuk

Recovery after a cesarean section will take a woman quite a long time. But the period during which rehabilitation will take place can be divided into two segments.

Caesarean section: the first days

While the first period lasts, a woman who gave birth by cesarean section will have to lie in bed, because her task is to recover from the operation. And even the simplest actions will be difficult for her, for example, it will not be easy for her to clear her throat, but taking a deep breath will be difficult for her. During this time, the mother is usually forced to stay in the intensive care unit, where she is cared for by nurses who monitor her recovery from surgery.

The woman’s condition is monitored by a doctor who makes sure that all indicators (pressure, pulse, temperature) are normal. The doctor also monitors how quickly the recovery progresses, how the uterus contracts after a cesarean section, and how intense the vaginal discharge is. The woman's seam deserves special attention. In the postoperative period, it is necessary to regularly change the dressings on it.

What to do after the procedure?

During the caesarean section procedure, anesthesia is required. In this regard, a woman should under no circumstances sit on the bed for a long time after surgery - up to 12 hours. And you can get out of bed in the postoperative period only 3 days after a cesarean section. This will have to be done very carefully. In this case, sudden movements and haste are contraindicated; it is advisable for the mother to be helped up by relatives or medical staff.

But you can rise only after your doctor has given permission to do so. Don't be surprised if you feel dizzy after getting up - this is normal, although recovery is in full swing. And the feeling of weakness and slight malaise is associated with the fact that the woman underwent abdominal surgery under anesthesia. Even though it seems to many to be a fairly simple surgical intervention, this does not negate all the “charms” that accompany the procedure. Do not forget that in the process all layers of the abdominal wall are cut.

Learning to get up

It is important to remember that the doctor’s advice primarily determines how the recovery period after a cesarean section will go. And the doctor will give you the following recommendations regarding the first attempt to stand up:

• before sitting on the edge of the bed, you need to turn over to your side, after which you can hang your legs and sit down slowly
• Now you need to “work” with your legs - for this it is enough to do any light exercises. Avoid sudden movements; after all, you had a caesarean section a few days ago.
• then place your feet on the floor and ask someone to help you stand up. An important nuance is that you need to stand up with a straight back, and it is advisable to stand as well. Only in this case will your postoperative suture be safe, even if you feel a slight tension
• Don’t try to take a step right away - first, wait
• Once you feel ready to take a step, take a small step

These instructions must be followed during the postoperative period. After just a couple of days, you will notice that it is becoming increasingly easier for you to get out of bed. As soon as you stop experiencing discomfort during the climbs, know that you will soon have a full recovery. After this, it is advisable to gradually increase the time of “pacing”, but not sharply, so that the seam does not begin to separate - after this, the second period of rehabilitation of the woman begins after the cesarean section procedure.

Cough correctly

It is important for mothers who have undergone a cesarean section to learn how to cough correctly in order to recover faster. The fact is that the postoperative period in this case is different in that during the use of general anesthesia (if it was used), mucus has accumulated in the lungs, which will gradually drain away, so that a cough will appear in any case. At first, it will cause pain - the area where the postoperative suture is located will ache.

To begin with, it is advisable to place your palms on your stomach, as if holding the stitch that appeared after the cesarean section procedure (you can tie it with a towel). Then draw air into your chest - now exhale sharply, trying to keep your stomach pulled in. A proper cough should ideally resemble a dog barking. You will need to exercise several times over an hour if you complain of mucus buildup in your chest during the postpartum period. If not, then the procedure can be done rarely. An important point is that if you know in advance that you will have a cesarean section, it is better to learn the technique before the procedure.

Dealing with sensitive issues

You should be prepared for the fact that after a cesarean section you will have several delicate problems - in particular, intestinal gases will make themselves felt. For abdominal operations, this is a typical consequence, since peristalsis slows down due to surgery and anesthesia. The problem can be dealt with using a number of methods. For example, learn to breathe deeply, try rocking while sitting in a chair, and avoid foods that can cause increased gas formation.

Another problem that you may encounter after a cesarean section is problems with urination. They can be provoked by the catheter used during surgery, as well as by the anesthesia itself. If you are faced with this “trouble”, don’t worry. First of all, drink more to make you want to urinate. If you can't do this, try again in the shower with the sound of running water.

The main thing is to relax and not start to panic. However, remember that in cases where, after a cesarean section, you were unable to go to the toilet “in a small way,” you must definitely warn the doctor about this, because it is vital for you to empty the bladder of urine accumulated in it. Most likely, you will have to use the catheter again, and then undergo additional examination by a nephrologist. This will somewhat complicate the woman’s recovery in the postoperative period.

Diet

In the first two days after a caesarean section, the woman is given all the nutrients intravenously. The reason is that food is prohibited due to abdominal surgery - the organs must have time to rest. This way they will be able to recover faster. These days you can only drink still water; if you wish, you can add lemon to it. On the third day, the woman already has the opportunity to eat on her own. To begin with, you are allowed to drink chicken broth - it is usually the first dish that is allowed to be consumed during the period when mommy’s recovery begins.

Gradually, those who have had a caesarean section are introduced to the diet of meat minced in a meat grinder, soufflé, porridge, and liquid curds. You need to eat little by little (100 ml at a time), and it is also advisable to drink a little. During this period, the abdominal organs should work so that they have to strain to a minimum in order to speed up recovery. It is advisable that the food is not too dense and heavy, because the first stool should “happen” on the 5th day after cesarean section. Then the diet should become less strict. Ideally, the diet that characterizes the postoperative period should gradually “degenerate” into a diet for nursing mothers.

Breastfeeding

But what about feeding if a woman had to go through a caesarean section? If recovery is progressing quickly, ask that the baby be brought to you as soon as possible. It is very important for you to establish breastfeeding now, but this will be very problematic if the baby is given to you three days after the caesarean section procedure. The fact is that the baby must constantly stimulate the mammary glands - only in this case the breasts will be filled with milk. If recovery after a cesarean section is delayed or the baby needs additional medical care, you will have to learn to express yourself.

Despite the fact that the caesarean section procedure is carried out under local anesthesia, if it is local, ask to put the baby to the breast immediately after his birth. Usually in hospitals for women in labor they use medications that are allowed during breastfeeding, so there is no need to be afraid that you will harm the baby. Even if the baby falls asleep, invite him to do the first test - reflexes can work even in this case. Remember that breast milk will also help the baby recover if he was born early. But if you still fail to feed the baby, just press him to your chest - he should feel that his mother is still nearby. And he recognizes you by the beating of your heart, which he listened to constantly while in the womb.

However, remember that in the first days after the cesarean section procedure, it is not advisable to pick up the baby very often while you are standing. In this way, you protect your seam, which may partially come apart under heavy load. You will have to limit yourself in this sense for quite a long time - up to six months, although it all depends on how the recovery goes. At home, you will have to ask your family for help more often, especially when you decide to go for a walk for the first time. Also, ideally, it is better not to do household chores for at least the first month - after a caesarean section, it is important for you to recover fully, as well as for your baby. Therefore, you need to devote this time to yourself and the baby.

Seam care

If you had a caesarean section, then the postoperative period is simply unthinkable without taking care of the stitches. It is clear that they require special care - during the first week after a cesarean section they are treated daily, changing the dressings each time. After the stitches are removed, you can safely take a shower, but it’s better not to use a washcloth for now, even though by this time the scar has already formed.

Obviously, the suture will hurt after the operation and during the recovery period - at first, painkillers help the young mother cope with the pain. Gradually, as the discomfort decreases, the woman stops giving them, and from now on she is recommended to wear special bandages. Remember that doctors do not allow new mothers to lift more than 2 kg for at least 60 days.