C-section, part 2: routines after birth in sweden

In part one I covered what kind of different c-sections that exist and what different routines can be a part of having a c-section birth in Sweden. When I edited that video I realized what was missing was information on what happens post surgery, so I wanted to share this in general terms. 

Like I mentioned in the first video and blog post what happens directly after birth depends on the situation and the hospital routines. But after surgery in most places the person who has given birth via c-section will be brought to a postnatal ward to be monitored after surgery. This monitoring is regular monitoring of vital signs for an example heart rate, blood pressure, oxygen level in the blood, and pain. If you were not awake during surgery the time in the post surgery ward is usually a bit longer. But in my experience if you have been awake with spinal anesthesia you will be in the post surgery ward for two to three hours depending on how you feel. 

Once you feel good enough to not need constant monitoring you will go back to the delivery ward or the postnatal ward where the birth companion or partner is waiting with the baby. Here you may meet new staff and will get some information of what is to be expected over the coming hours and days. 

You will receive regular pain medication. Usually you will have a base medication of some sorts and extra medication when needed. I always tell people post surgery that it's very important to let the staff know when the pain is increasing as it's easier to remove the pain when it's not at it's most painful. The pain you feel won't be removed completely, but it should be manageable. Once it's more than manageable then you should ask for extra pain relief.  

You may have a urinary catheter that will be removed, when this happens varies from hospital from hospital. In general it is very good to try to move, maybe sit on the bed and then stand next to the bed a few hours after surgery. When this happens it's important you are sufficiently medicated for your pain beforehand. 

The benefit of starting to move a few hours after surgery is less pain in the long run. The first time standing up is usually the hardest, but it gets easier and easier. And the staff is there to support and help you. 

Movement is important for your overall healing, it minimizes risks for blood clots, it helps the bowels to start moving and I have seen many times how it reduces pain. The important thing here is to not rush, but also not to be scared to move. 

The surgery wound can be closed by stitched or staples. I have been asked many times over the years if these stitches can open through movement, and in my 5 years plus of working in post natal care I have never experienced it, so I would not worry about that. 

C-section scar

If you are coughing or laughing a tip is to hold a pillow over the surgery wound for counter pressure. 

Once you are reunited with your baby I recommend to place your baby skin to skin as soon as possible, even if you're in pain, even if the baby is sleeping. The benefits of skin to skin for both you and baby are so great that I wouldn't delay it. If they put clothes on your baby ask to remove them and have your baby in a diaper only and place them on your chest. If you are planning th breastfeed this may stimulate baby to start searching for the breast. If no I suggest to hand express some milk on a teaspoon and giving that to baby every couple of hours until they wake up and start searching for the breast actively. 

A couple of hours after surgery you should eat and drink as well as rest as much as you need. The first 24 hours are the toughest when it comes to pain and immovability. But I always say to people coming post surgery "When I return to my next shift tomorrow you'll be feeling a lot better and moving around in the room." Many times they look at me with doubt, but when I return to my next shift they say "You were right! I feel so much better!"

One thing that a lot of people struggle with post surgery is bowel movement, this is part of post birth but mostly from the medications given and immovability. There are medications that can help to get your bowels moving, but the best things is to eat fibers, drink lots of water and move around. Usually this gets better after a couple of days. 

How long you stay in the hospital varies. In general I'd say most people stay at least two days in hospital postpartum after a c-section birth. After two days the pain is usually more manageable. But for others they need more time, especially if they have other health issues that need treatment as well. 

During the healing period it's not recommended to carry anything heavier than your baby. You should also listen to your body and not overdue it too soon. 

The surgery wound is in several layers and needs time to heal. If you had stitches, these generally don't need to be removed. If you have staples these will have to be removed, and you should find out how before you are discharged from the hospital. You should also have solid information about how to care for your wound and what to be observant about when at home. 

Some people need to continue to take some pain medication for a while after leaving the hospital, others don't. Just listen to your body.