Caesarian Section

Patient Information Leaflet on Having an Elective Caesarian Section.

You are due to be admitted to Hospital for an Elective Lower Uterine Segment Caesarian Section, to be done on _____________. On the afternoon before this you will be asked to go into delivery suite to have some bloods done and to talk to the anaesthetist about the method of analgesia. Most Caesarian Sections are done these days with you awake, via a "spinal" anaesthetic (a single one shot injection into your back). The anaesthetist will discuss all the options open to you.

I would also like you to know if you have any worries or questions about your operation, please feel free to telephone me on the above numbers.

THE OPERATION

A Caesarian Section is an operation to deliver you baby. I make an incision in your bikini line in your lower abdomen.I then go down layer by layer until baby is delivered. This is the fast part of the operation. Everything has to be stitched together again and this usually takes a little longer. The operation usually last between 20 to 45 minutes. A paediatrician or paediatric nurse is on hand at all Caesarians to examine baby at delivery. Baby will be handed to you once baby has been checked over. As this is an operation and not a normal delivery, you will be permitted just one support person in theatre if you are having a spinal anaesthetic, however this will not be permitted if you are being put to sleep.

AFTER THE OPERATION

When the anaesthetic has worn off you may be in pain. The pain can be like a strong wind pain which may be felt in your abdomen, neck and shoulders. I like to act early to reduce your pain. You can help me to do this by telling us how strong the pain is.
We use a pain score numbers 0 – l0

( 0 = NO PAIN ) ( l0= VERY STRONG PAIN )

I will have ordered pain relief for you and you should ask for this as soon as you require it.
You may have a catheter left in the bladder. This happens if the bladder is manipulated a fair bit during the operation and it is usually left in for 24 to 48 hours.
You will be in hospital for about 4-5 days.

You should try to have 6 weeks of rest with no heavy lifting or strenuous exercise. Youshould be aware that you may need up to 12 weeks off from work after a Caesarian Section.
In general, the vaginal bleeding is not much different from that following a normal delivery. You should use sanitary towels but not tampons. If you have heavy bleeding, bad pains, a smelly vaginal discharge or a temperature you should contact me, your doctor, or your midwife.

It is important to prevent any infection after your operation. Good personal hygiene is important. The day after your operation you may take a bath or shower. The dressings on your wound will have to be changed if they become wet. Check that the cut is clean and dry. This will help them heal. Where possible continue with a daily bath or shower.
I also advise that you do not have sexual intercourse for at least 3 weeks, or at least until the bleeding has stopped. After a Caesarian Section there is a possibility of getting a urine infection. Watch out for cystitis and if it does occur drink plenty of fluid. If symptoms persist contact me or see your G.P/Midwife.

The risks of this procedure are minimal, but very occasionally heavy bleeding may occur. Injury may also occur to the ureter which is the tube leading from your Kidneys to your bladder. If there is any risk of this a scan or xray of your abdomen will be arranged while you are in hospital. Very, very rarely a repeat operation may be needed to unblock this tube.
You may have a tube sticking out of your tummy for drainage. This is left in if there is more than average bleeding at the operation merely as a precautionary measure.
Occasionally there may be a fair amount of Bruising (blue-black) around the skin incisions. These usually disappear completely in 3 to 4 weeks.

DISCHARGE FROM HOSPITAL

It is aimed that you are discharged on Day 5 to Day 6 after the procedure.
If you have problems such as bad pain, increased bleeding, temperature, or generally feeling unwell please contact me or your GP. Remember to keep this leaflet to show to your GP.
You should not drive until you can sit comfortably in the seat with the seat belt across you. You should be able to turn your body as though to reverse and you must be able to do an emergency stop.
Similarly if you try to do too much to soon you will know all about it. Rest and avoid any lifting.
I will review you at my rooms 4 to 6 weeks after the operation.

PLEASE BRING THIS LEAFLET WITH YOU WHEN YOU ARE ADMITTED

PERMISSSION TO REPRODUCE THIS LEAFLET IS GIVEN AS LONG AS ACKNOWLEDGEMENT IS GIVEN TO NAYLIN APPANNA.