I just finished a very uneventful OB rotation in a hospital.
What I saw, surprised me and I am wondering if what I thought was the correct procedure, is.
When I had my c-section, the hospital had a very, very clear policy of putting me on clear liquids until I had my first bowel movement post-op.
Then they put me on a regular diet, so I was on the liquid diet for about 2 days. When I asked why they said, "If you start eating food immediately after post-op, it can cause your bowel to back up and you could be off to another surgery."
Made perfect sense to me (this was before I started nursing school).
When I did my OB rotation, these women came straight back from the OR to a regular diet on their very next meal.
Needless to say, we were giving out stool softeners AND enemas to the same patient, and these women complained of alot of deep, internal pain that seemed to be c-section unrelated.
Which procedure is correct? I just thought it was unnecessary that these women had to go through that b/c making that transition was easy for me and these women were miserable! I took no enemas, no stool softeners, and I had two friends that gave birth at the same hospital within a couple of months of me, and their experience was like mine.
Because most C-section moms are healthy patients and general anesthesia is rarely used, it seems that some providers have gotten lax in adhering to clear liquid diets. (Heaven forbid, we don't want to say "No" to a patient's request for "real food". It's all about customer service.)
In my experience, most docs order clear liquids until bowel sounds are active and mom is passing gas. But there are some who cave in when a whiny patient starts to complain. Or some patients will simply ignore medical and nursing advice and have family members bring in food. McDonald's seems to be a favorite. Those are invariable the same moms who have horrendous gas pain a day or so later, to the point of tears and being unable to care for baby.
See, that is what I thought.
They were just handing these women a full plate of regular food, and then started with the enemas, etc.
I remember getting enemas as a child, and I also remember the cramping, etc that came with it...yeah, that sure sounds like fun on a fresh c-section!!!!
When I started nursing, it was not uncommon to keep a patient on tea and tap water for 3 days. (Ice, straws, and sodas are said to increase gas). Now the order is to advance diet as tolerated. I don't see a big difference in problems with gas. I think the difference is that today we have much better post op pain control with spinal/epidural morphine or PCA pumps. With less pain, the patient is more able and willing to move around; they ambulate sooner and more than they used to in the old days. This gets the intestine moving and back to normal much sooner. I haven't seen a C/S patient with a post op ileus in years, and I used to see a couple a month. I really hope I haven't jinxed myself.
justme1972
2,441 Posts
See, that is what I thought.
They were just handing these women a full plate of regular food, and then started with the enemas, etc.
I remember getting enemas as a child, and I also remember the cramping, etc that came with it...yeah, that sure sounds like fun on a fresh c-section!!!!