Big J

You have been pregnant for nine months, hopefully (actually 10 for you OB nurses), and you are impatiently waiting for the big day. This time it won't be Braxton Hicks contractions; fingers crossed, it will be the real thing—labor! Hooray! You have survived your pregnancy and the baby is coming. But then, suddenly, you need a cesarean section (c-section) surgery to get the baby out. This was not part of the plan. But, as a nurse yourself, you are more than prepared for what is about to happen, or so you hope. This is a very scary time for any mom, whether you are a nurse yourself or whether it is your first baby or the fourth. Although c-sections are very common surgeries, so common in fact that they happen every day in the United States, you must remember that it truly is a major surgery. And with that information, you have to assume a certain amount of responsibility to follow the post-op and discharge orders from your doctor in order to avoid many of the common complications after c-section surgery. Post-op Orders Please listen to your nurses and doctors and obey your post-op orders while you are still in the hospital. You might think you know the do's and don'ts after a c-section because you are a nurse. But remember, that makes you a terrible patient! Discharge Orders It helps if you actually read the discharge orders. You just gave birth. It's not like you're hormonal or anything (duh). Being a nurse, you know how busy nurses can be. So please don't just depend on the quick run-through of the discharge orders by the nurse. Read them yourself to make sure you understand all the small and important details. Common Complications Hopefully, by following your post-op and discharge orders, you will avoid most of these issues. But here is a list of the most common complications for your reference: Excessive bleeding This is the most common complication during the actual surgery. So if your post-op or discharge instructions include a high iron diet or an iron pill of some sort, make sure you understand what that entails, and remember to watch for possible constipation. You have a newborn to take care of now, so you must get your strength back ASAP. Infection Possible infection issues are another major complication. This could be an incision site infection or endometritis, which can lead to Pelvic Inflammatory Disease (PID). And what does infection equal? Antibiotics in some form or another. So if you are asked to have an iodine sponge stick run through your lady parts or some type of antibiotic douche, your answer will be yes (hopefully), as this technique has been proven to reduce the percentage of post-op endometritis cases. It might be horrifying and uncomfortable for you, but it's not as bad as having PID and the complications that come with that, including possible sterilization. Injury to the baby There are the standard possible injuries that can happen to the baby during the course of the c-section. These include skin laceration, fracture of the clavicle (collar bone) or skull, facial or brachial plexus nerve damage, and cephalohematoma, which is a medical term for some minor bleeding or a blood clot between the skull and the membrane that covers the skull. Mostly this just looks bad on your baby's head because it looks like an unusual bump. It happens most commonly with the use of forceps and/or the vacuum, and it usually resolves itself. All of these injuries can happen during a c-section, but they actually happen more frequently with lady partsl deliveries. So, rest easy. Long-term issues for Mom If you needed a vertical c-section cut on your uterus, this requires that you have all future births via c-section. This is not a disaster, but it does take away your choice in the future of having any of your babies lady partslly. Adhesions for Mom Any abdominal surgery can lead to adhesions down the road for both women and men. But they can particularly lead to problems when having another baby. They can increase operating time, time to delivery, and risk of bladder injury. So long story short, even though we are nurses and we can be terrible patients, it's really important to follow your doctor's post-op and discharge orders after a c-section birth to help prevent any further complications. References/Resources National Vital Statistics Reports: Centers for Disease Control and Prevention C-section: Mayo Clinic Cesarean Section: National Library of Medicine Battling adhesions: from understanding to prevention: BioMed Central Pelvic inflammatory disease (PID): Mayo Clinic