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How long in bed for post C/S mothers?

Posted

Once they have their legs back, how long do you keep mothers in bed after C/S's? Because of the physical and emotional benefits of getting OOB after surgery, I was used to getting mothers up to the chair maybe 8 or so hours after their births; pre-medicated for pain of course, and stable otherwise. Their second time up was when they'd start ambulating a bit further.

Where I am now, the standard is to wait much longer! I suspect it's actually much longer than necessary. So, I'd like to hear what others do about this. Thanks for your input. :)

When I did L&D we got them up post C/S around the 8-hour mark and they would ambulate to the bathroom where we sat them on the toilet and gave their perineal area a good rinsing off. They would say that's when they began feeling like themselves again. Any mom staying in bed longer before ambulating seemed to have more discomfort/pain.

When I had my c/s I was SOOO ready to walk when I could feel my legs again as I know that walking was good for me to start on the road to recovery. I think it was somewhere around 8 hours later that they let me walk a bit around the room. I think early is better. JMHO

I like the idea of going to the toilet and rinsing the perineal area. Didn't do that, but the sweet nurses did clean me up while I was in bed.

PedsAtHeart, LPN

Specializes in LPN, Peds, Public Health.

I have never worked L&D but I have had 2 C/S's.

With my first (was kinda complicated) I had my daughter at 8 PM and they had me up at 6 AM the next morning walking to the bathroom. Felt very faint and nauseated (but I had lost A LOT of blood during the surgery).

With my son I had a scheduled C/S and I was up walking to the bathroom within just a couple of hours of having him. I had a spinal block that didnt take real well, my legs never did go numb! But I was ambulating very easily within just a couple of hours....

No "nursing" experience here but I had 3 c-sections...with my first I was in bed for pretty much a solid week except to use the bathroom, it was an awful and terrible recovery experience. With my 2nd and third they let me up as soon as they took my IV out...seems like it was only a few hours...4 maybe 5 hours from the surgery itself. (My first was born in 99, 2nd in 07 and third 09, if it makes any difference) The recovery time for my 2nd and 3rd was nothing, I was back in the swing of ordinary activities the day I went home from the hospital (spent 2 nights in the hospital with each).

klone, MSN, RN

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership. Has 15 years experience.

Dangle at bedside by 8 hours post (if she does well and is amenable, she may even ambulate that first time). After the initial dangle, our orders are to ambulate 2x/shift.

Research has found that the sooner the mom gets up after C/S, the faster her recovery will be, with less risk of morbidities like DVTs or pneumonia.

Sooner up the better...most moms have epidural for pain control for the first few days, so...as soon as they were able to feel their legs, they were up-and encouraged to be up and about as tolerated. Sooner they moved, the better off they were gas-wise...

Sooner up the better...most moms have epidural for pain control for the first few days, so...as soon as they were able to feel their legs, they were up-and encouraged to be up and about as tolerated. Sooner they moved, the better off they were gas-wise...

Yep, I think gas pains are worse than the incision pain once the spinal wears off. I had two sections myself and the first one was a mess. Thank goodness by my second time around I had nurses who were proactive in getting me moving.

klone, MSN, RN

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership. Has 15 years experience.

Sooner up the better...most moms have epidural for pain control for the first few days

Really? I've never heard of that. We do epidurals/spinals for the procedure itself, but not for pain management afterwards. Our moms get PCAs for about 24 hours after a C/S, and then PO meds after that.

FLOBRN

Specializes in NICU,MB,Lact.Consultant, L/D. Has 31 years experience.

Out of bed in 6 hours where I am. It is something the charts are audited for as well.

Really? I've never heard of that. We do epidurals/spinals for the procedure itself, but not for pain management afterwards. Our moms get PCAs for about 24 hours after a C/S, and then PO meds after that.
Yes, most mom's, ifthey have hada good epidural for the section, do better than those who have PCA,,they move aboutas if they have not had surgery, some of them. Worst side effect is itching, which they have a standing order for be edryl

klone, MSN, RN

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership. Has 15 years experience.

Yes, most mom's, ifthey have hada good epidural for the section, do better than those who have PCA,,they move aboutas if they have not had surgery, some of them. Worst side effect is itching, which they have a standing order for be edryl

Oh, perhaps I misunderstood. I thought you were saying that they have an epidural in place for a day or two after the C/S. I've never heard of an epidural lasting more than a few hours after the procedure (or after it's turned off post-delivery). I would go so far as to say that if a woman is still feeling the effects of her epidural or spinal more than 3-4 hours after it's done or turned off, the anesthesiologist probably didn't do a good job in dosing, and dosed it WAY too much.

Oh, perhaps I misunderstood. I thought you were saying that they have an epidural in place for a day or two after the C/S. I've never heard of an epidural lasting more than a few hours after the procedure (or after it's turned off post-delivery). I would go so far as to say that if a woman is still feeling the effects of her epidural or spinal more than 3-4 hours after it's done or turned off, the anesthesiologist probably didn't do a good job in dosing, and dosed it WAY too much.

The medication/dosage for post-op are changed in RR...yes, they have pain relief, and are able to walk around. There's a different type of epidural-Duramorph, which lasts for up to 24 hrs, I believe...

shortstuff31117

Specializes in OB.

Our orders say up within 12 hrs of surgery, but I've started getting mine out of bed sooner. Our day shift tends to be terrible about this, we'll come on at night and the AM section will still be in bed, sometimes on a PCA.

I know with my section, I was dying to get out of bed, and they made me wait 12 hours.

Elvish, BSN, DNP, RN, NP

Specializes in Community, OB, Nursery.

We get ours up as soon as they want to, but the very longest we'll let them go is about 18 hours, and even that is pushing it. Most people are at least willing to dangle and/or get up to the chair within about 8-12 hours. The last fresh section I got was in the wheelchair going to see her son in NICU about 6 hours out. Everybody is different but the ones that are up and about sooner do SO MUCH better, on the whole. Pain control is paramount - if she's hurting she's not going to want to get up.

I have had two c-secs. My oldest (2004) I was in bed probably close to 24 hours. I had no medical training then. They asked me if I was ready to get up, I said "No" they didn't press the issue. Terrible recovery! When I had my twins (2008) I was in a wheel chair to the NICU 7 hours later and up to the bathroom (with assist) 2 hours after that. Much better recovery. Of course, I was ambulating alot more after the twins. I was back and forth to the NICU many times each day and I was on the other side of the unit. I actually did my OB rotation at the hospital I had the twins at. It was cool to see it "from the other side"

hoppermom3

Specializes in OB, House Sup, ER, Med Surg. Has 5 years experience.

We get them up and moving as soon as they can stand...usually around 4 hours post op. First time we walk to the bathroom, clean up, and walk back to bed. Second time (usually an hour or two later) we walk in the hall and remove Foley.

jctiabecerra

Specializes in L&D. Has 9 years experience.

we get them up and to bathroom at 8hrs and if they feel like it ambulate in hallway. Foley comes out a 12 hours.