When can I start after a caesarean section. If it was a caesarean, is it possible to give birth naturally? Intestinal gases and urination problems - the norm or pathology

Content

If 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 who is preparing to become a mother should know how the recovery period goes.

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 the 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 caesarean section easier, remember the following recommendations:

1. You will be lying on your back, but you will often need to roll over on your side so that blood clots come out and adhesions do not begin. Put your feet on the bed, lift your hips higher, turn them around and lower them. Do it slowly. Gently expand your chest.
2. When general anesthesia is restored, you will be tormented by coughing, because mucus accumulates in the lungs. When coughing, press down on the seam with a towel or diaper to keep 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 the most even vertical position.
4. Deep breaths will help you get rid of gas in the intestines during the recovery period. You can also swing in your chair.

How to recover quickly after a caesarean section - recommendations

Any woman wants to return to good shape as soon as possible. Fast recovery is possible if you remember certain recommendations. Your whole lifestyle matters: nutrition, daily routine, intimate hygiene. Try to clearly follow all the instructions of the doctor in order to avoid health problems in the future. To understand how to recover from a caesarean section, remember a few basic rules. So you protect yourself from a lot of trouble.

Proper nutrition after caesarean 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 the diet with what you can eat after a caesarean. Diet for recovery days for a young mother:

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

After a caesarean 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;
• sausage products;
• chocolate.

Physical activity

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

Suture care after cesarean

All procedures will be carried out by a nurse for 5 days in a row. She must treat the wound with antiseptics and change the bandage. If the threads do not resolve themselves, then they will be removed after about a week, from this time it is allowed to wet the incision and not wear a bandage. Treatment with antiseptics is supposed to continue independently. Wash the seam with liquid soap, wipe with a disposable towel. After a while, you can use ointments to heal scars.

Wearing a bandage

Many doubt the need for this accessory, 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 contributes to the correct and rapid recovery of the abdomen after a cesarean 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 an intensive recovery of the figure after a cesarean section is possible for you only after six months. In the first couple of months, you need to take care of yourself, do not lift any weights, except for the baby. One of the most dangerous consequences of overload is the divergence of the uterine suture. Check with your doctor before starting exercise. Until six months have passed, walk a lot, do simple exercises for arms and legs, without stress on the abdominal muscles. Don't forget Kegel exercises.

Menstrual cycle

His recovery after a caesarean section proceeds in the same way as after an ordinary birth. One and a half to two months, lochia will come out - 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 be examined and make sure that there are no complications, such as endometriosis. The process of restoring a normal menstrual cycle after dependent caesarean section depends on:

1. age. The younger the woman, the sooner she will begin menstruation and the full resumption of childbearing function.
2. Lifestyle. It affects how a woman eats, whether she performs exercises.
3. lactation. If the mother is breastfeeding, then menstruation will begin in about 6-8 months. In the absence of lactation, they appear after 8-12 weeks.

sexual activity

Doctors recommend that patients after caesarean section begin intimate relationships in 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 the doctor. Do not forget about contraception, because you should not get pregnant before two, and preferably three years after a caesarean section.

Observation at the 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 delivery. Then you need to visit a doctor every 6 months.

How to remove the stomach after cesarean at home

Be sure to wear a bandage and use creams to restore skin elasticity, do body wraps. If you do not know how to restore the stomach after a cesarean section, then try to retract it more often, this helps a lot and can be performed in any conditions. Abdominal exercises, breathing exercises, yoga will help well. Hoop training will be effective. If possible, sleep on your stomach, this will help the correct contraction of the muscles.

Video: effective exercises after cesarean section

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

Pregnant women who are going to have a caesarean section for certain indications are quite reasonably worried about whether the process of restoring the body after the operation will be painful and long. This is what often scares future women in labor who are shown a planned caesarean section.

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

After the operation

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

In it, she should lie for several hours, and if complications appear, then for several days. Medical workers control the level of pressure, the temperature of the puerperal, they inject contracting drugs by the hour. They are necessary, since the own involution of the uterus after a surgical incision is slow, which is fraught with infections.

In order for the pain to be bearable after the anesthesia has finally passed, the administration of painkillers is provided, if there are signs or fears of infection, antibiotics are immediately started to be administered. Ice packs are applied to the stomach for better contraction of the uterus. It is clear that in the conditions of the intensive care unit, no movements are welcome, except for the movements of the hands and head, and even then it is very limited.

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 child can only be brought in for feeding. Leaving him with his mother, if the routine of the maternity hospital involves the joint stay of newly-made mothers and newborns, will only be when the woman gets up after a caesarean section.

It's time to rise

The sooner a woman begins to engage in motor activity after transfer to a regular ward, the better. Forecasts 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 rise. It will hurt, but not as much as it seems. The pain itself is dull, because the woman will be given painkillers intramuscularly for another 2-3 days. First by the clock, then by demand. In this case, the fear is stronger than the pain. Women in childbirth are afraid that the seams will open, burst. There is no need to be afraid of this. Although it is difficult to ignore the pulling sensations that the seams create when you try to turn on your side, it is quite difficult to ignore.

You need to roll over on your side correctly - first, the woman tries to turn the upper body, the shoulder girdle, and then smoothly, gradually pulls up the lower body, holding the bandage on her stomach with her hand. The first coups will bring a lot of unpleasant moments, but with each subsequent one it will get 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 puerperal stands with the letter “G”, unable to unbend), 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 down for a while, and then, holding your stomach with your palm and leaning your other hand on the bed, slowly sit down. Don't be in a hurry to get up. Sit for half an hour, an hour until the dizziness passes, which after the operation and anesthesia is completely normal.

As soon as the sitting position becomes quite comfortable, you can try to get up. If there is someone in the room who can help you do this, take advantage of this opportunity. If not, then lean your hands on the back of the bed, on the edge of the bed, as convenient. Do not try to straighten your shoulders and back as soon as you manage to be on your own two feet. It will be quite painful.

Do not go far from the bed or the accompanying person, stick to the wall or back of the bed, because the first steps may be accompanied by an attack of severe sudden weakness, dizziness. Without insurance in the form of a loved one, a roommate, a nurse, or, in extreme cases, a headboard, a woman in labor can fall and be injured.

The next day after the operation, women usually already move quite tolerably around the ward, and a day later, without any problems, they go to the toilet themselves, walk along the corridor, and with the observance of precautionary measures, they can take care of the babies themselves. Wearing a post-op bandage makes the early post-op period easier, but be sure to check with your doctor before wearing it.

Can there be complications?

An incorrect mode of physical activity can theoretically cause a divergence of the seams, a violation of the structure of the internal seams. Subsequently, such a scar may be insolvent, which will make it difficult to bear the next pregnancy.

But a long stay in bed, if a woman is afraid to get up and walk, can have very negative consequences - the uterus begins to contract worse, the exit of postpartum blood secretions and clots is difficult, which increases the likelihood of infection, endometritis.

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

” №12/2014 22.07.16

Talking about the fact that natural childbirth is better in every way becomes meaningless in a situation where a woman cannot objectively give birth herself. In this case, the only way out is a caesarean section.

There are, of course, clinics in which anyone who wants to be "procesary" just 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 a caesarean section without medical indications.

Who needs a caesarean section?

Cesarean section - abdominal operation; There are serious reasons to do so:

1. Unsuccessful presentation

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

2. Craniopelvic disproportion

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

3. Prolonged labor

For example, a woman began to give birth a long time ago, it would be time for the child to be born, and the contractions are weak, stimulation does not help. Or the cervix does not want to open in any way, 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 her, there is a serious risk that during childbirth the child's body will squeeze it, the oxygen supply will decrease significantly, 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 by the time of delivery the situation could not be corrected, the pregnancy will end with a caesarean section.

6. Placental abruption - its premature separation from the uterine wall

If the bleeding during detachment is small, the contractions go 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 more than five diopters

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

8. Multiple pregnancy

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

Preparing for a caesarean section

You will sign an agreement - "I understand the possible risks and agree to the operation." Then - shaving pubic hair, enema; they will put a dropper and insert a catheter into the ureter (it makes sense to ask for the latter to be done after anesthesia).

Anesthesia is more often used (it is also spinal, 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 must be performed urgently, anesthesia is used - it acts faster.

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

How is a caesarean section done?

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 uterus; the muscles are not cut, but moved apart - this facilitates healing. Then the doctor bandages or cauterizes the vessels, sucks out the amniotic fluid from the uterus, removes the baby, hands it over to the nurse, and manually separates the placenta.

The sister cleans the mouth and nose of the newborn from mucus. The baby is examined and evaluated on the Apgar scale.

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 an insoluble thread, or with staples, which will be removed before discharge. A bandage will be applied over the seam, a drug will be injected to reduce the uterus. As a side effect, nausea and trembling may occur; but they'll be gone in an hour.

Suture after caesarean section

Stitches after caesarean section heal quickly. They leave scars, but if the incision was transverse, the traces will hide under the panties. The abdomen will shrink, the scar will fade and become less visible. In rare cases, an overhang is formed - the skin over the scar slightly protrudes. Walking and swimming will help here - they perfectly strengthen the abdominal muscles.

When can I get up after a caesarean section?

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 the day in the post-operative department. Specialists are watching you - what is your blood pressure, is your bladder working well ... They will prescribe painkillers for 2-3 days. They will give drugs to reduce the uterus and normalize the work of the digestive tract; intravenous saline will be administered to replace fluid loss. Antibiotics - only when infected.

6 hours after the caesarean section, they will help to sit down, and after that they 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 the general ward. If a postoperative bandage is stored in advance, it will make life easier - it is easier to move around.

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

On the 5th day, an ultrasound of the uterus will be done, on the 6th, the stitches (or brackets) will be removed. As a rule, on the 6-7th day - discharge home with the baby.

Types of incisions and subsequent births

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

• In recent years, a transverse skin incision has been most commonly used; it is made horizontally, just above the pubis. It is also called a bikini cut. After it, 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 childbirth.
• 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 - in its upper part. After such an incision, subsequent pregnancies are completed by a repeated caesarean section.

Home after caesarean section

• Take care of yourself - get as much rest as possible. Don't take on all the homework right away.
• For the time being, it is better to limit water procedures to a shower; it will be possible to plunge into the bath, as well as into the pool, one and a half months after the operation.
• Around the same time, you can slowly resume. Just do not forget to take care of contraception - doctors recommend re-pregnancy no earlier than two years later.

Lyudmila Potapchuk

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

Caesarean section: first days

While the first period lasts, a woman who has given birth by caesarean 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, she will not just clear her throat, but a deep breath will be hard for her. At this time, the mother is usually forced to be in the intensive care unit, where nurses look after her, watching how the rehabilitation after the operation goes.

The woman's condition is monitored by a doctor who pays attention to the fact 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, how intense the vaginal discharge is. The seam of a woman deserves special attention. In the postoperative period, it is necessary to change the dressings on it regularly.

What to do after the procedure?

During the caesarean section procedure, anesthesia is mandatory. In this regard, a woman should never sit on the bed for a long time after the operation - up to 12 hours. And you can get out of bed in the postoperative period only 3 days after the caesarean section. This will have to be done very carefully. In this case, sudden movements and haste are contraindicated, it is desirable that relatives or medical staff help mommy to get up.

But you can climb only after the attending physician has allowed it 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 connected with the fact that the woman underwent an abdominal operation under anesthesia. Although it seems to many to be a fairly simple surgical intervention, this does not negate all the “charms” accompanying 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 goes. And the doctor will give you the following recommendations regarding the first attempt to stand up:

• before you sit on the edge of the bed, you need to roll over to one side, after that you can hang your legs and slowly sit down
• 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 put your feet on the floor and ask someone to help you get up. An important nuance - you need to get up with a straight back, it is also desirable to stand. Only in this case, your postoperative suture will be safe, even if you feel a slight pull.
• do not immediately try to take a step - first, wait
• after you feel ready to take a step, take a small step

This instruction must be followed during the postoperative period. After a couple of days, you will notice that it is becoming easier for you to get out of bed. As soon as you stop experiencing discomfort during the rises, know that you will soon have to fully recover. After that, it is desirable to gradually increase the “pacing” time, but not sharply, so that the seam does not begin to diverge - after this, the second period of the woman’s rehabilitation begins after the cesarean section procedure.

We cough correctly

For mothers who have gone through a caesarean section, it is important 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 application of general anesthesia (if it was used), mucus has accumulated in the lungs, which will gradually leave, 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 put your palms on your stomach, as if holding the seam that you had after the caesarean section (you can tie yourself with a towel). Then draw air into your chest - now exhale sharply, trying to keep your stomach drawn in. A proper cough should ideally resemble the barking of a dog. You will need to exercise several times within an hour if you complain of a buildup of mucus in your chest during the postpartum period. If not, then the procedure can be done rarely. An important point - if you know in advance that you are going to have a caesarean section, it is better to learn the technique before the procedure.

Dealing with delicate issues

You should be prepared for the fact that after a caesarean section you will have several delicate problems - in particular, intestinal gases will make themselves felt. For abdominal surgery, this is a typical consequence, because due to surgery and anesthesia, peristalsis slows down. 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 give up food that can cause increased gas formation.

Another nuisance that can be encountered after a caesarean is problems with urination. They can be provoked by the catheter that is used during the operation, as well as the anesthesia itself. If you encounter this "disaster", do not worry. First of all, drink more to make you want to urinate. If you are unable to 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 an additional examination by a nephrologist. This will somewhat complicate the recovery of a woman in the postoperative period.

Diet

In the first two days after a caesarean section, a 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. Thus, they will be able to recover faster. These days you can drink only water without gas, 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, it is allowed to drink chicken broth - it is he who usually becomes the first dish that is allowed to be consumed during the period when mommy's recovery begins.

Gradually, meat, soufflé, cereals, liquid curds are introduced into the diet of those who have had a caesarean section. You need to eat little by little (100 ml at a time), it is also advisable to drink a little bit. 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 desirable that the food is not too dense and heavy, because the first stool should "happen" on the 5th day after the caesarean section. Then the diet should become less strict. Ideally, a diet that distinguishes the postoperative period should gradually “reborn” 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 for the baby to be brought to you as soon as possible. It is very important for you to establish breastfeeding now, but it will be very problematic to do this if the baby is given to you three days after the caesarean section. The fact is that the baby must constantly stimulate the mammary glands - only in this case the breast will be filled with milk. If recovery after a caesarean section is delayed or the baby needs additional medical care, you will have to learn how to express yourself.

Despite the fact that the caesarean section is performed under anesthesia, if it is local, ask to attach the baby to the breast immediately after he is born. Usually maternity hospitals use medicines that are allowed while breastfeeding, so there is no need to be afraid that you will harm the baby. Even if the baby falls asleep, offer him to make the first test - reflexes can work even in this case. Remember that breast milk will help the baby recover if he was born at an early stage. But if you still fail to feed the baby, just press him to your chest - he should feel that his mother is still there. And he recognizes you by the beating of the heart, which he constantly listened to while in the uterus.

However, remember that in the first days after the cesarean section, it is undesirable to take the baby in your arms very often at the moment when you are standing. Thus, you save your seam, which can partially disperse from a strong load. You will have to limit yourself in this sense for a long time - up to six months, although it all depends on how the recovery is going. 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 cesarean section, it is important for you to recover completely, like your baby. Therefore, this time should be given to yourself and the crumbs.

seam care

If you had a caesarean section, then the postoperative period is simply unthinkable without taking care of the sutures. It is clear that they require special care - during the first week after the caesarean section, they are treated daily, changing the bandages each time. After the stitches are removed, you can safely take a shower, only it is better not to use a washcloth yet, although by this time the scar has already formed.

It is obvious that the seam after the operation and during the recovery period will hurt - at first, painkillers help the young mother to cope with the pain. Gradually, with a decrease in discomfort, they stop giving them to a woman; from that moment 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.