Surgical intervention in obstetric practice allows you to save the health and life of the mother and child in the event of a difficult course of pregnancy, the presence of contraindications for natural childbirth or the development of unforeseen complications already in their process. Many women consider this method of delivery to be more gentle, since it is not associated with the need for a long experience of contractions and possible breaks. All that is required of the mother in such cases is to be an outside observer of the work of doctors busy extracting the child. However, despite the seeming harmlessness of operational childbirth compared to natural, this path is no less dangerous. Caesarean section is an open abdominal operation requiring anesthesia, associated with extensive tissue injury and massive bleeding.

The main difficulties for women arise in the postoperative period. Recovery after caesarean lasts several months, the most unpleasant is the first day. At the same time, during the entire rehabilitation period, no one releases the young mother from the responsibility of caring for the newborn.

Recovery after anesthesia

Like any traumatic procedure, surgery to remove a baby requires the use of anesthesia. With a planned intervention, its type is prescribed taking into account the state of health of the woman. Emergency surgery is often performed under spinal anesthesia. Recovery after cesarean, physical well-being and emotional state in the first days is directly related to the anesthesia used. The body's response to drugs can be the most unpredictable.

Immediately after the operation and for the next 6-8 hours, the woman is forbidden to get out of bed and roll over on her side. Depending on the complications, blood transfusion, infusion therapy containing nutritional and rehydration solutions may be required during the operation. Then movement becomes a necessity. To quickly recover and get rid of the effects of drugs, it is recommended to slowly sit down, lower your legs from the bed. You are allowed to get up the next day. You should not be afraid of the divergence of the seams, since they are fastened until complete healing. Much more trouble is brought by the consequences of anesthesia.

General

The advantage of this method of anesthesia is considered by many to be the complete loss of consciousness and the absence of the need to monitor the progress of the operation. However, for both doctors and patients, this type of anesthesia is associated with great risks.

An endotracheal procedure with the provision of artificial lung ventilation entails a decrease in blood pressure and a slowdown in cardiac activity for 40-60 minutes - while the operation lasts. During this time, doses of drugs are administered intravenously into the body. When all manipulations are over, the supply of drugs is stopped. Their anesthetic effect stops almost immediately. Consciousness gradually returns to the woman in labor after a few minutes. Severe pain sets in almost immediately.

Within 30–60 minutes, residual effects of drugs are observed, hallucinations, hysterical states, stupor, perceptual disturbance, and speech impairment are possible.

To relieve pain after general anesthesia, a woman in labor needs analgesic drugs for several days.

Spinal

One of the easiest anesthesia techniques to use. It involves a single injection of painkillers into the narrow subarachnoid space that separates the spinal cord and arachnoid. The injection is placed in the region of the spine between the 4th and 5th vertebrae. The active substances almost instantly block the nerve endings, anesthesia fully anesthetizes after 15 minutes. The lack of sensation in the lower body allows the operation to be performed while the patient remains conscious.

spinal anesthesia

Body features, nationality or type of appearance also do not affect the time of the return of menstruation.

The physiological processes that occur in a woman's body after the birth of a child ensure a prolonged absence of menstruation. If a young mother is breastfeeding, large doses are regularly released into her blood oxytocin And prolactin. These hormones are natural estrogen antagonists responsible for ovulation. Lactational amenorrhea is a normal state provided by nature. This is a period of a kind of rest of the reproductive system after childbirth. Most women do not have periods until lactation ends on its own or artificially. The recovery period of the cycle in this case is from one to five months from the date of the end of feeding.

Don't expect your next period to be regular. In the first 2-3 cycles, more scanty or abundant than usual discharge with the presence of blood clots is likely. Breaks between them can vary from 21 to 50 days, the duration can be from 2 to 7 days, which is also not a sign of violations. All these phenomena are due to changes in the uterus and the endocrine system. Within a few months, the hormonal level fluctuates, which affects the thickness of the endometrium.

In some cases, pain during menstruation in women who have previously suffered algomenorrhea, after childbirth may weaken or disappear altogether. This is due to changes in the shape and location of the uterus.

In almost 10% of young mothers who traditionally breastfeed their children, menstruation appears before six months after childbirth: in the second or third month. Such a surprise is associated with hormonal disorders, insufficient milk production, long breaks in feeding. Sometimes this is an individual feature of the organism. It is not necessary to curtail lactation in such a situation, but then the mother will have to deal with the increased load: reconsider nutrition and rest a lot. The diet must contain animal proteins, carbohydrates, a sufficient amount of fat, foods rich in calcium, iron, vitamins E, D, A, ascorbic and folic acids. It is necessary to supplement the menu with special complexes and bioadditives.

In cases where circumstances force from the first days to feed the child with artificial mixtures, and there is no need for lactation, the restoration of the monthly cycle can be expected within 1-3 months from the day the postpartum period ends. Usually, for mothers who are not breastfeeding, the first menstruation occurs 6-8 weeks after the end of the lochia.

intimate life

Having sex after surgical delivery should be postponed until the end of the postpartum period and the formation of a dense postoperative scar. The minimum period is about 2 months in the absence of any complications. If nerve endings were damaged during the operation to remove the child, the seam became inflamed, other health disorders appeared, it will be possible to return to intimate life no earlier than in 3-4 months.

Full recovery of tissues after childbirth by caesarean section occurs within a few years. Despite the fact that a woman can start doing household chores, sports, work, and lead an active image much earlier, the next pregnancy is possible only after two years. Otherwise, one cannot hope for its successful outcome: there may be a violation of the integrity of the uterus, its divergence along the seam, improper location of the fetus, detachment placenta or the germination of its tissues through the scar into adjacent organs.

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The danger of an early onset of the next pregnancy makes contraception after a caesarean section more relevant than ever. For safety net, it is desirable to use not one method, but several. It is usually recommended to combine barrier protection and oral contraceptives. The former block the penetration of spermatozoa, but are not reliable enough. Hormonal agents have an almost 100% effect, but do not exclude the so-called "breakthrough" ovulation. The combination of several methods practically guarantees safety.

Hopes for the calendar method or lactational amenorrhea medically insignificant. Their effectiveness is no more than 40-50%, since ovulation tends to come on suddenly. It is impossible for a woman to expose her health to the risk of premature pregnancy after a caesarean section.

Figure restoration

The extra pounds gained during pregnancy and the stretched protruding belly do little to please the young mother. Annoyance after the operation is added by the need to spare one's health, avoiding tension in the first months. Restoration of the figure after a caesarean section, indeed, fades into the background. Compared with the need for proper care of the baby and control of one's own well-being, this aspect can be considered unimportant.

It is not always possible to return an elastic flat stomach and a thin waist after a cesarean section. The reason for this is overstretching of the skin and diastasis - the divergence of the abdominal muscles. This problem is especially characteristic after multiple pregnancies or for women who have never played sports before. With such problems, harmony can only be restored with the help of plastic surgery. In all other cases, you need to be patient.

Diet

In the first days after caesarean section - the use of only light liquid food. During the day, the intestine is unable to function, as it is under the influence of anesthesia. It is allowed to drink plain or mineral water with a small amount of fruit juice. Over the next four days, the menu is gradually expanded, gradually introducing broths, juices, dairy products, liquid cereals and pureed soups into it.

For several weeks after discharge from the hospital, it is recommended to follow a special diet for surgical patients. All dishes must be cooked without frying: steamed or baked, do not contain hard crusts, a lot of salt, spices, animal fats, artificial colors.

• lean meats and fish: turkey, skinless chicken, veal, cod, chum salmon, horse mackerel;
• cottage cheese and kefir with a fat content of not more than 5%;
• chopped vegetables: first stewed and then raw;
• berries, fruits;
• whole wheat bread.

Dishes high in starch and sugar should be limited. These include:

• potato;
• pasta;
• semolina;
• polished rice;
• products made from white flour: cookies, gingerbread, buns, pies;
• sweets: chocolate, sweets.

It is necessary to completely exclude various delicacies and heavy foods from the menu:

• salo;
• sausages;
• fast food;
• ham;
• margarine.

New mothers who are breastfeeding need to adhere to stricter restrictions. Often, their diet in the first weeks consists only of cereals on the water, pureed meat and vegetable stew.

Usually, within 3-4 months, with proper nutrition, most of the extra pounds accumulated during pregnancy gradually disappear. More radical measures: various express diets and fasting days can be practiced not earlier than the end of the lactation period.

Moms whose children are bottle-fed, in search of how to quickly recover from a cesarean, are also not recommended to torture themselves with a starvation diet. The energy value of the daily menu to preserve all body functions should be at least 1500 kcal. For the full healing of tissues, it is recommended to use meat products, aspic, fruit jelly, chicken eggs.

Fitness

Any physical activity associated with tension in the abdominal muscles after a cesarean section is allowed no earlier than after 4 months. Until the expiration of this period, only walking is allowed.

In the first month, it is necessary to support the press and alleviate pain during the daytime. It is advisable to wear it for several hours a day.

Performing physical exercises aimed at strengthening the press should be regular, and the load should increase gradually. It is better to do it in the gym under the guidance of a coach, it disciplines. If this is not possible, a place should be equipped at home.

Additionally, you can go swimming, skiing, cycling. These exercises gently stimulate the tone of the abdominal muscles, help tighten the abdomen.

Yoga

Of the Eastern practices, strengthening the press after a cesarean section is helped by breathing, static exercises, movements to stretch the muscles. They need to be performed in a calm environment, in the morning or evening, preferably daily. Many yoga exercises are great as a warm-up or the final step in fitness.

Exercise at home

For homework, you can purchase a stepper or treadmill. As auxiliary projectiles, room furniture is suitable: a chair or a sofa. In order for the stomach to tighten after a cesarean section, it is useful to perform twisting exercises, imitation of cycling from a prone position, pulling the legs to the chest, and rocking the press. At home, it is desirable to practice daily, for 30-40 minutes. In the absence of time, instead of a full-fledged complex, you can perform several approaches at different periods if possible.

When to See a Doctor

If the recovery process after surgery is successful, you can come to the next medical examination to the gynecologist six months after the birth.

An earlier visit should be made if warning signs appear:

• change in the nature of lochia before the end of the postpartum period: the appearance of impurities of pus, a heavy odor;
• the occurrence of frequent cramps or sudden cutting pains in the abdomen after the healing of the stitches;
• the appearance of swelling, redness, itching or suppuration in the suture area;
• absence of menstruation for five or more months from the date of cessation of lactation.

An additional medical examination is also necessary in case of a sharp change in the menstrual cycle: the release of blood or pus before or after menstruation, persistent internal pain, attacks of weakness or dizziness.

When a woman is in the hospital, her condition may be relatively stable, and complications after surgery develop later.

What are the possible complications

Approximately 20% of cases of caesarean section in parturient women experience various kinds of complications. Basically, they are associated with existing systemic diseases, circumstances that arose during the operation or during the early recovery period.

Most often, these are various infectious processes, pathologies of the vascular system and hematopoietic functions.

Common complications:

• inflammation or divergence of the postoperative suture, the formation of hernias;
• accession of a secondary infection: the development of an inflammatory process in the uterine cavity, adjacent pelvic tissue or in the appendages;
: during the operation, patients inevitably lose blood, on average, about 500–600 ml.

Depending on the physical condition of each woman, other complications are possible. For these reasons, when figuring out how to recover from a C-section, it's important not to overdo it. In case of strange changes in well-being or a change in the appearance of the seam, the appearance of redness, burning or severe itching in this area, you should consult a doctor.

Doctors' opinion

A caesarean section is a complex surgical operation. She is prescribed to women in labor not out of a whim, but for serious medical reasons, when there is a real threat to the health of the expectant mother or her child. It is no coincidence that doctors of maternity hospitals refuse to perform this procedure for patients at will, without any reason. After all, natural childbirth is a painful, but less dangerous process when it comes to completely healthy women. After a natural delivery, the mother can get up in a few hours and gradually return to normal life. Caesarean section requires a long recovery, sometimes lasting more than six months.

It is important that the first such operation is an almost unconditional reason for subsequent artificial births in the same way. Although over time, the place of the incision of the muscles and the wall of the uterus is reliably overgrown, the structure of the tissues in the area of ​​​​the suture is inelastic. A woman can give birth naturally after a caesarean, but only if she is less than 30 years old and more than three years have passed since the operation.

With a second surgical intervention, the surgeon makes an incision along the previous suture, which significantly slows down subsequent healing and increases the risk of complications. The allowable number of safe caesareans that one woman can endure is no more than four. In practice, successful and relatively fast recovery after caesarean section occurs only after the first two interventions. Of course, each case is individual, there are mothers who were born in this way for 5 or more children, but these are exceptions.

A condition for the successful restoration of health after a cesarean is compliance with all medical prescriptions. The first few days are especially difficult. The young mother suffers from pain, residual effects of anesthesia. Almost everyone develops intestinal atony, so you can not eat solid food.

Staying in bed is not recommended. Already a few hours after the withdrawal of anesthesia, it is desirable to move your arms and legs, start turning. On the second day, the work of the intestines should be activated: rumbling appears in the stomach, gases begin to leave. In the absence of signs of intestinal activity, stimulation with drugs is necessary.

Milk from such women comes with a slight delay - after 3-4 days. During this period, the child has to be supplemented with mixtures.

After discharge, the recovery process continues. You can not load yourself with physical work, walk for a long time, carrying a baby in your arms, lift a stroller up the stairs. To maintain the muscular corset, it is useful to wear a bandage. It is necessary to select not squeezing the sides, but a comfortable elastic model. The design should be worn no more than 6-8 hours a day and only for two months after the operation. The habit of sleeping in a bandage or using it to draw in the abdomen for too long will lead to the opposite effect - the muscles will weaken and become flabby.

To do fitness to return harmony, you need to be careful. In the first few weeks, the daily load should not exceed 20-30 minutes. In this case, you can not use weights or do exercises that strongly strain the press. Before starting classes, you must consult a supervising doctor to exclude possible contraindications.

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Caesarean section - operative delivery. Nowadays, this method of childbirth is quite widespread. The increasing number of pregnancy complications, both on the part of the mother and the child, leads to this state of affairs.

How is a caesarean section performed?

The caesarean section is performed only under anesthesia. Nowadays, there is a gradual transition from general anesthesia to spinal anesthesia during these types of operations. The meaning of such anesthesia is to “turn off” the lower half of the body. The woman is conscious, she can take her baby in her arms immediately after removing him from the uterine cavity. In addition, during general anesthesia, the child receives a certain amount of drugs that are administered to the mother and is born slightly “stunned”, while there are no such features when choosing spinal anesthesia.
After anesthesia, an incision is made in the lower abdomen, opening of the uterine cavity and amniotic sac, followed by removal of the child. As in normal childbirth, the umbilical cord is tied and cut. Then, through the surgical incision, the fetal bladder and placenta are removed. The wound is sutured in layers, a sterile dressing is applied. With caesarean section under spinal anesthesia, the child is immediately applied to the mother's breast, with general anesthesia - after a while, the woman needs to get out of anesthesia.

Early postpartum period

The postoperative period after caesarean section does not differ significantly from that period after other abdominal operations. A common practice is early activation of the patient. After 6-8 hours (depending on the general condition), the woman is allowed to sit down in bed; after 10-12 hours - get up and walk. This tactic minimizes the risk of developing adhesive complications in the abdominal cavity, congestion in the lungs (especially likely after intubation anesthesia).
If the condition of the mother and newborn does not cause concern to the doctor, then on the second day they are transferred to the ward for joint stay (if such wards are available). A woman, most often, is prescribed antibiotic therapy to prevent infectious complications during the postpartum period, as well as painkillers. During this period, it is worthwhile to warn the young mother against taking care of the baby too actively, frequently lifting it in her arms (especially for large children), and sudden movements. To alleviate discomfort in the area of ​​the postoperative scar, it is recommended to wear a special bandage that supports the abdominal muscles.

The length of the postpartum period

The postpartum period in the case of physiological childbirth lasts 40 days. The postpartum period after caesarean section is up to 60 days. One of the main indicators of the course of the postpartum period is the so-called involution of the uterus: the process of its contraction and epithelialization of the inner surface. During this time, the woman has varying degrees of bleeding from the genital tract (lochia). It should be noted that, as a rule, the intensity of discharge in women delivered by caesarean section is less: after childbirth through the natural birth canal, discharge from the cervix, vagina, injured to one degree or another, is added to the discharge from the uterine cavity.
Since the integrity of the muscle fibers of the uterus, its vessels and nerves was violated during the operation, the rate of uterine involution slows down. If necessary, a woman is prescribed an appropriate drug therapy that stimulates the contractile activity of the muscles of the uterus, reducing bleeding from vessels damaged during incision. Most often, precisely because of the slow decrease in the uterus after childbirth, a mother with a baby after a cesarean section is discharged home a few days later than after a physiological birth.

Nutrition after caesarean section

On the first day after the caesarean section, it is allowed to drink only non-carbonated water, unsweetened tea. From the second day, the diet is gradually approaching the nutrition of the woman who has given birth: starting with the broth, pureed dishes, we gradually move on to a full-fledged diet rich in proteins, vitamins, microelements, which is recommended for a nursing mother.

Hygiene after caesarean section

The hygiene of a woman who has undergone a caesarean section in the first days after the operation must necessarily include a toilet of the external genital organs. Body washing is allowed, excluding the area of ​​the postoperative suture. You can take a shower immediately after discharge from the hospital. The scar area must be washed with clean water, very carefully, excluding friction, exposure to detergents. It is recommended to take a bath, swim no earlier than one and a half to two months after childbirth.

Postoperative scar

The postoperative scar will remind of itself for quite a long time: up to six months, in some women - up to a year. This is due to the fact that during the surgical incision, the integrity of the nerve endings was violated, and their recovery is a long process.
Two months after the operation, a woman who has undergone a caesarean section is advised to start exercises to strengthen the abdominal muscles. I would like to note that the better the muscles of this group were developed, the smaller the subcutaneous fat layer, the faster and better the postoperative wound heals. It is not forbidden to use ointments that promote the resorption of scars, although you should not expect a special effect from their use. The course of the healing process is also influenced by the lifestyle that a woman will lead after surgery. A big role in how the postpartum period after cesarean proceeds is the help of relatives and close people to the woman who has given birth. Ideally, one of them should be constantly at home at this time. Any woman after childbirth needs a proper rest to ensure the recovery of the body and high-quality breastfeeding. The recovery postpartum period after caesarean section requires a serious limitation of the weight of the lifted weights. Overstrain of the abdominal muscles can lead to deformities in the area of ​​the postoperative scar, up to the formation of hernias.

Family planning after caesarean section

The resumption of sexual activity after caesarean section is recommended one and a half to two months after the operation. Be sure to visit a gynecologist by this time, make sure that the recovery period runs smoothly, and discuss acceptable methods of contraception. It is better to postpone planning a subsequent pregnancy for two years - this time is enough to restore the strength of the mother's body, the formation of a strong scar on the uterus (ultrasound is performed to determine its quality).
Medical practice is currently moving away from the establishment that a history of caesarean section is a direct contraindication for natural childbirth in the future. Quite often, women who have undergone a caesarean section give birth to subsequent children through the natural birth canal.

After a caesarean section, as after any abdominal surgery, a long rehabilitation period is required. In order for the body to recover after surgery without complications, you should strictly follow all the recommendations of doctors, carefully care for the suture, visit the necessary specialists in a timely manner, and do gentle physical exercises.

Surgical delivery is performed in cases where natural childbirth poses a danger to the life and health of the mother and child. Despite the fact that caesarean section is one of the safest and most common operations, the percentage of complications after it is quite high, and a young mother will need much more time to recover than in the case of physiological childbirth.

Postoperative period

After the operation, the puerperal is in the operating unit under the supervision of an anesthesiologist, an obstetrician-gynecologist and other specialists. In the absence of contraindications, already 6 hours after the birth of a child, it is recommended to carry out simple gymnastics:

• gently turn from side to side without getting up from the bed;
• stroke the stomach clockwise without affecting the seam area;
• stroke the chest, sides and lower back with movements from the bottom up;
• tense and relax the buttocks and thighs;
• holding the seam area with your palm, cough slightly and take deep breaths with your stomach;
• pull your toes towards you;
• without taking your heels off the bed, rotate your feet;
• slightly bend your knees, alternately sliding your soles along the sheet.

For the prevention of congestion, edema, and thromboembolism, a certain motor regimen is necessary. During rehabilitation, physical exercises should be performed several times a day, gradually increasing the intensity and number of movements.

You should not do gymnastics through strength or if you feel unwell, but physical activity cannot be neglected. It should be remembered that slight dizziness and weakness are normal after surgery.

If a woman feels well after a caesarean section, she is allowed to sit down already on the first day after childbirth. To do this, you need to slowly turn on your side, pushing your pelvis to the edge of the bed, put your feet on the floor and gently raise your head and body, leaning on your hands.

By the end of the first day after a caesarean section, you can get up on your feet with the help of a nurse. You need to rise carefully, without making sudden movements and all the time holding on to the back of the bed. Before you take the first step, it is recommended to stand a little and see for yourself. So that the seam does not begin to diverge, the walking time should be increased gradually, and always get out of bed with a straight back and slightly leaning forward.

On the second day, in the absence of complaints, the woman is transferred to the general ward for postpartum therapy.

During the stay in the hospital, the patient is prescribed the following drugs as medical support:

• painkillers within two to three days after childbirth;
• antibiotics as a prophylaxis of infectious complications (most often used after emergency delivery);
• means to accelerate uterine contraction;
• medicines to normalize the work of the stomach and intestines;
• antiseptics for seam treatment.

Suture materials from the incision on the abdomen are removed approximately 7-8 days after the caesarean section. The exception is subcutaneous sutures, which dissolve on their own within a few weeks after application. It is allowed to take a shower and wet the suture only after the postoperative scar is formed. The seam area should not be rubbed with a washcloth, and after washing, be sure to blot dry with a napkin or soft towel and treat with antiseptic preparations.

Possible complications and consequences

The most common complications of surgical delivery include:

• damage in the suture area (inflammation, suppuration, prolonged pain syndrome);
• infectious and inflammatory lesions of the pelvic organs (adnexitis, parametritis, endometritis);
• anemia as a result of extensive blood loss;
• thromboembolism;
• umbilical hernia, diastasis (divergence) of the rectus abdominis muscles;
• adhesive formations in the abdominal cavity affecting the uterus, ovaries, intestines;
• endometriosis;
• prolonged healing of the dissected walls of the uterus.

A significant part of the possible consequences can be avoided by drug therapy using the latest generation of antibiotics and other drugs in accordance with the doctor's prescription.

Among the mandatory measures before the operation is the consultation of the expectant mother with an anesthesiologist and other specialists, which allows minimizing the risk of complications, taking into account the woman's health status, the presence of chronic diseases and hereditary predisposition.

Among the short-term and, as a rule, not requiring special treatment, the consequences of surgical intervention include weakness, drowsiness, dizziness and nausea.

If general anesthesia was used as anesthesia, many patients in the first hours after cesarean section are worried about coughing, dryness and sore throat. With a strong cough, it is necessary to hold the seam with your hand or press a pillow to your stomach. Another common problem is difficulty urinating, which can be provoked by a catheter placed during the operation.

If the time of urinary retention is more than 12 hours, it is necessary to inform the observing specialist. In the event that it is still impossible to urinate on your own, the doctor will have to resort to the help of a catheter again, and the patient will need to consult a nephrologist.

The operation of caesarean section does not pass without a trace for newborns. Small amounts of mucus and amniotic fluid are often deposited in their lungs and airways, which can trigger the growth of pathogenic flora and the development of pneumonia.

If the surgical intervention was carried out under general anesthesia, a small part of the drugs manages to get into the child's bloodstream, causing lethargy, drowsiness and weakness. Sometimes there are cases of asphyxia and breathing problems as a result of side effects of anesthetics.

The adaptation of a newborn to environmental conditions is slower than in naturally born babies. It has been established that the long-term consequences of the operation may be hyperactivity, a slight delay in growth and weight gain.

Diet

On the first day of the rehabilitation period, nutrients enter the mother's body intravenously. To stimulate digestion, it is allowed to drink clean water without gas in small portions with a slice of lemon.

Then liquid food appears in the woman's diet: chicken or meat broth, vegetable broth, diluted kefir or low-fat yogurt without additives. On the third day, you can eat viscous cereals, boiled chopped dietary meat (beef, rabbit, turkey), mashed cottage cheese. From drinks, weak tea, compote, jelly are allowed. By the fourth day, the menu includes rye bread, mashed potatoes, thin soup, steamed fish, and some fruits.

Starting from the fifth day after caesarean section, the patient can switch to a normal diet, excluding alcohol, canned food, sausages, pastries, sweets, fried and fatty foods. Fruits, vegetables and other possible allergens should be introduced into the diet with caution, observing the condition of the newborn. In the event of an intestinal disorder or an allergic reaction in a baby, his mother will need to follow a strict diet and consult a pediatrician.

Often in women who give birth by caesarean section, there is a delay in the production of breast milk and its small volume. This may be due to the late start of putting the newborn to the breast, as well as a gross violation of the natural mechanism for triggering lactation.

If milk does not come 4-5 days after the birth of a child, the pediatrician may advise supplementing the baby with an artificial mixture until prolactin synthesis is normalized in the mother's body.

It is necessary to establish natural feeding as early as possible, often applying the baby to the breast. By fingering the nipple, the newborn not only stimulates the work of the mammary glands, but also causes the uterus to contract intensively, getting rid of everything unnecessary, thereby helping the woman recover faster.

The approved positions for breastfeeding after abdominal surgery are lying on your side or sitting. For comfort, you can place a rolled blanket or pillow under the back of the child. After feeding, it is desirable to lubricate the nipples with special products (Bepanten, Lanolin) to prevent cracks.

Home restoration

In the absence of complications, discharge from the hospital is carried out for 3-5 days. Recovery after the operation has not yet been completed, so a sparing regimen is recommended for a woman, completely excluding physical activity for 2 months and lifting weights weighing more than 3-4 kg. The child should be taken in your arms, hugging you.

To exclude possible divergence of the seam and speed up the process of uterine contraction, it is advisable to periodically use a postpartum bandage. Walking up stairs, frequent bending and standing for a long time during this period must be limited.

The ban on sexual activity after a caesarean section lasts from 1.5 to 2 months, depending on the woman's well-being. In the event of complications, intimate relationships can be resumed only after complete recovery and only with the permission of a doctor.

Daily hygiene procedures during the first weeks after surgery should include suture care. As a rule, bandaging after discharge is no longer required, but it is recommended that the suture be treated with antiseptics or drugs that accelerate wound healing, in accordance with the doctor's prescription.

Sometimes, after a few months, so-called ligature fistulas may appear in the area of ​​the scar, arising from the rejection of the suture material by the tissues. Initially, they are small swellings that eventually increase in size and become inflamed. In this case, it is necessary to contact the surgeon to remove the remnants of the thread and treat the scar. If the scar on the abdomen a few months after childbirth looks rough and sloppy, it can be corrected in a beauty parlor after consulting a doctor.

Particular attention should be paid to the appearance and amount of lochia - discharge that stops within 6-7 weeks after childbirth.

You should immediately consult a gynecologist if you experience the following symptoms:

• abrupt cessation of discharge. This alarming symptom is most often a sign of cervical spasm, which can lead to the development of endometritis and even sepsis;
• abdominal pain, accompanied by fever, chills and a sharp deterioration in well-being;
• profuse blood loss;
• the appearance of itching in the perineum and an unpleasant odor;
• the presence of large clots in the vaginal discharge;
• spotting that persists for more than 6 weeks.

10-14 days after discharge, it is necessary to visit a gynecologist for a postoperative examination and ultrasound examination. The doctor must check the condition of the external seam, uterus and internal organs after childbirth, as well as select contraceptives and, if necessary, prescribe medications. The next appointment at the antenatal clinic includes a scheduled examination after the cessation of lochia.

Further frequency of visits to the gynecologist depends on the rate of restoration of the reproductive system and the presence of complications. 8-10 months after the operation, it is recommended that a woman undergo an ultrasound for a comprehensive examination of the uterus in order to exclude fibroids and other formations, as well as assess the condition of the scar and the possibility of subsequent pregnancies.

Physical exercise and sports

Physical activity and gymnastics will help to recover after childbirth. They should be started a few weeks after the complete healing of the suture, and only with good health, no complaints and contraindications. It should be remembered that any exercises for the press and the abdomen can only be done with the permission of a gynecologist or surgeon.

The load must be increased gradually, avoiding too intense training, which leads to a deterioration in the taste of breast milk due to increased production of lactic acid. Do not do exercises to strengthen the shoulder girdle and upper body too often, as they can significantly reduce lactation or provoke the development of lactostasis.

Walking, yoga, long walks and swimming in the pool are useful for restoring the body.

Exercises to perform at home should be aimed primarily at strengthening and increasing the tone of the back muscles:

1. Body tilt forward and sideways.
2. "Bridge" from a prone position.
3. Retraction of the abdominal muscles in a sitting position.
4. Twisting the body in a prone and standing position.
5. Alternate rotation of the hands in the wrists, elbows and shoulders.
6. Plank with an emphasis on arms bent at the elbows.
7. Walking on bent legs and on tiptoe.
8. Gentle squats.
9. Swing your legs forward and sideways.
10. Foot rotation.
11. Rotation of the pelvis in a circle.

Immediately after childbirth, it is recommended to start performing Kegel exercises that strengthen the muscles of the pelvic floor, accelerate the process of uterine contraction and normalize the process of urination. It is necessary to compress and relax the muscles of the perineum and vagina several times during the day with different duration and intensity.

Repeated births

Caesarean section imposes certain restrictions on the planning of the next pregnancy. Restoration of blood vessels, nerve endings and muscle tissue in the area of ​​uterine dissection in the absence of complications occurs within 1-2 years. Therefore, conception can be planned no earlier than in 2 years to exclude the possibility of scar rupture.

The method of re-delivery will depend on the viability of the suture. However, in most cases, physiological delivery after surgery is not recommended. The incision during the second caesarean section is made at the site of the existing scar or as close as possible to it. The duration of rehabilitation after repeated surgery increases.

In order to restore her health, physical fitness and reproductive function in a short time after the operation, a woman must strictly follow all the doctor's recommendations and take a responsible attitude to her lifestyle.

The operation of a caesarean section today will not surprise anyone. The surgical procedure, which in its essence should be an exception to the rule, in the modern world replaces almost half of the cases of delivery. And all because it gives somewhat greater guarantees of a successful outcome than a natural birth process. However, not everything is so simple - and cesarean has its own risks and disadvantages.

What is a cesarean

Caesarean section (CS) - artificial, surgical delivery, removal of the child through a specially made incision in the anterior abdominal wall and the wall of the uterus. This operation is considered to be the oldest of the existing surgical interventions.

A bit of history

Stories of the "surgical" birth of children have come down to us from the Ancient World. Nevertheless, at that time, such a delivery almost always meant a fatal outcome for the mother (even before the operation or after). Only starting from the XIV century, there are isolated cases of a successful caesarean for both parties. The thing is that at that time there were no stitches on the uterine incision, and women in labor died from blood loss. A small progress in the case was the emergence of the practice of removing the uterus during the operation - about 75% of women began to survive. And only in 1882, for the first time, internal sutures were used, which made a real revolution in obstetrics. Along with the advent of antibiotics and more effective aseptics, this technique eventually led to 100% patient survival, as well as widespread caesarean section.

Until the end of the 19th century, a caesarean section was an operation of "despair" - in this case, the woman could no longer be saved.

In 1500, an amazing case of a successful outcome of surgical childbirth was recorded. The Swiss J. Nufer (a veterinarian by profession), after several days of torment of his wife in childbirth, performed a caesarean section on her, as a result of which both the mother and the child managed to survive. The most interesting thing is that after that, Nufer's wife safely gave birth to five more children.

Today, many tend to interpret the name of the operation as "royal" - that is, lightweight, allowing a woman to avoid labor pains. And if modern caesarean delivery does in some way provide such advantages, then, apparently, not so long ago it was associated not only with torment, but also with a risk to life. And this method of delivery was not intended for queens at all. The name of the operation has several versions of its origin:

1. From the word "ceadare" - to cut, cut.
2. From "caesons" - children born by surgery.
3. From "caesarea" - royal, "sectio" - incision.

The most common version is based on the fact that as a result of such “operational” childbirth, Gaius Julius Caesar was born from the womb of a deceased mother.

Operation types

Caesarean section today helps women not only in situations where the risk to their life and / or the life of the child during natural delivery approaches absolute values. Such an operation is resorted to if there is at least minimal suspicion of an unfavorable outcome of childbirth, and even if it is possible to simply aggravate existing health problems.

With all the advantages of caesarean, the priority type of delivery today is natural. Without indications, cesarean is not used.

In the meantime, possible problems with delivery can be suspected both long before childbirth and in their process. That is why the main classification of the varieties of this operation is made according to the criterion - the time of detection of indications. Distinguish between planned and emergency caesarean.

Planned operation

The fact that the delivery of a particular woman should occur surgically may become known even at the very initial stages of pregnancy and even before it occurs. The thing is that there may be absolute indications for a planned operation - those conditions of a woman and a fetus that, without fail (in accordance with medical legislation), require a caesarean section.

Whatever circumstances act as indications for caesarean section, an important condition is the consent to the intervention of the patient herself. Consent, in case it is impossible to make it by a woman personally (for example, she is incapacitated or unconscious), can be signed by her relatives. On his own, a doctor can make such a decision only in an exceptional case - if this is the only way to save a person's life.

Some mothers are preparing for a caesarean from the very beginning of pregnancy - there are absolute indications for this

The absolute (indisputable) reasons for a planned cesarean on the part of a woman are as follows:

1. Narrow pelvis as an anatomical feature of a woman. There are a lot of varieties of such a feature - this is a flat, and transversely narrowed, and oblique pelvis. The value in this case is the degree of narrowing (the absolute indication for the COP is 3–4th degree).
2. Complete placenta previa is such an arrangement of the organ connecting the mother and baby when it completely blocks the entrance to the uterus (pharynx). Under such circumstances, natural childbirth is extremely dangerous, if not impossible.
3. Partial placenta previa (marginal - the placenta only adjoins the pharynx, lateral - partially overlaps it), complicated by open bleeding.
4. An inconsistent scar on the wall of the uterus is a consequence of a previous caesarean or other operations on the body of the uterus. A scar that does not reach the parameters required for normal delivery (narrower than 3 mm, without connective tissue according to ultrasound), threatens to rupture the uterus during childbirth or even earlier than they begin.
5. Several scars on the body of the uterus are a very risky factor in terms of rupture.
6. Late preeclampsia, not amenable to treatment, with the unpreparedness of the birth canal for natural childbirth.
7. Some non-obstetric diseases are those that can either complicate the birth process, or be aggravated by themselves as a result of childbirth. Such diseases include high degrees of myopia, serious nervous and cardiovascular pathologies, diabetes mellitus, severe degrees of hypertension, etc.
8. Anomalies in the structure of the birth canal (tumors, etc.).

There is also an absolute indication from the side of the fetus - its incorrect position. This is called transverse or pelvic presentation, in the second case it is absolute only if the fetus is small, heavy or male.

There are also relative indications for surgery - those that do not oblige to this procedure, the decision is made individually for each specific case after a thorough assessment of the risks and benefits. As a rule, everything depends on the degree of development of a particular condition, the presence of several reasons at once, etc. Among the relative reasons for a planned operation:

1. - excessive divergence of the pelvic bones of a woman.
2. Post-term pregnancy (the totality of circumstances is important here).
3. Complicated gynecological history (preceding abortions, unsuccessful pregnancies, IVF, insemination, etc.).
4. Chronic lack of oxygen in the fetus, associated with this or with other reasons, the delay in its development.
5. Hemolytic disease in the fetus, combined with an unprepared cervix in the mother.
6. Large (more than 4 kg) or giant (more than 5 kg) child.
7. Several fetuses are twins or twins.
8. Varicose veins of the genital organs in a woman.

The timing of a planned caesarean is usually determined in advance (but towards the end of pregnancy). The term is selected in each case individually. As a rule, this is 38-39 weeks, in rare cases (if there are good reasons) - 37. Some experts recommend not setting a clear timeframe - wait for light contractions, and only then artificially give birth to a woman.

emergency operation

The issue of conducting an emergency caesarean is decided immediately before childbirth (a few hours), and more often during childbirth. Absolute indications for such actions can be:

1. Placental abruption of moderate or severe degree, regardless of the location of the "children's" place. This condition is very dangerous due to the risk of massive blood loss, which can lead to instant death.
2. The threat or fait accompli of uterine rupture is a phenomenon that entails a mortal danger for mother and child.
3. Acute lack of oxygen (hypoxia) in the fetus that occurred during childbirth.
4. Prolapse of umbilical cord loops or their presentation. In the process of delivery, such a loop is pinched by the body of the child, which completely blocks oxygen for him. In such cases, you should act very quickly.
5. Death of a woman with a live fetus.

Relative reasons for urgent surgery are as follows:

1. Clinically narrowed pelvis in a woman - with normal measurements of the size of the pelvic bones in childbirth, it is found that the fetal head is incomparable with the "passage".
2. Weakness of tribal forces in the absence of a significant effect from the use of all possible methods of stimulating them.

Emergency surgery is not uncommon today, the number of such surgeries reaches half of all surgical deliveries performed. At the same time, modern medicine makes it possible to carry out an urgent operation in the same mode as a conventional one - without any serious differences in the time of the procedure, and possible consequences.

Sometimes a difficult situation arises right in childbirth - an emergency operation helps

How the operation goes: everything you need to know the expectant mother

A caesarean section, like any operation, requires careful preparation, both on the part of doctors and patients. Before planned operations, the expectant mother is placed in the hospital in advance: at least two days before the planned intervention, more often a week before. In fact, it all depends on the reason for the need for the operation, as well as on the current condition of the patient.

Before the operation, doctors collect as much information as possible about the condition of the pregnant woman. For this, a couple of days before it, general analyzes are given, the necessary studies are carried out:

• general blood and urine tests;
• blood biochemistry;
• pregnant woman's electrocardiogram;
• fetal CTG;

The day before the upcoming operation, the anesthesiologist will definitely talk to the patient. During the conversation, this specialist should find out all the details about the features of the body of the expectant mother, important points in the course of pregnancy. It is important that the woman does not hide (for any reason - out of embarrassment or forgetfulness) from the doctor not a single fact significant for the case - the presence of allergies, chronic diseases, surgical experience, etc. After analyzing the information collected, the anesthesiologist will select the most appropriate option for anesthesia of the operation - and format (general or local anesthesia), and drug.

Be sure to tell your doctor about the severity of your inferior vena cava clamp syndrome (fainting when lying on your back), if any. During the operation, in this case, a roller is placed under the back of the patient on one side, which reduces the load on the vein.

Clamping syndrome of the inferior vena cava became one of the main problems of the last weeks of my pregnancy. Perhaps this happened because of the pronounced polyhydramnios. As soon as I lay down on my back or even took a sitting position with my back slightly tilted back, I literally fainted - there was a sudden lack of air, wild nausea and weakness appeared, up to darkness in my eyes. I could bring myself to my senses only by lying on my side. By the way, I even did an ECG the day before the planned cesarean only after going through this condition and very frightening the doctors. I very persistently warned the anesthesiologist about this peculiarity of mine, to which he replied: “Don't worry - everything will be fine! Let's put a roller - you won't feel bad at an angle. However, doubt and fear on this very occasion did not leave me at that moment - I really doubted that the roller would help me, given the fact that I felt bad even sitting. My fears were completely justified. After anesthesia was injected into my spinal cord, the nurses, not tolerating any objections, ordered me to lie down on my back. Roller, I note for the sake of justice, still planted. But its size (at least 15 cm in diameter) did not help me. Exactly half a minute later, I screamed in a panic: “Turn me on my side - I feel bad!”. No one did this, but seeing that the indicators of my condition began to fall rapidly, they got scared and urgently began to call surgeons (they were not yet in the operating room). The anesthesiologist, however, found some kind of medication, and my condition was stabilized. Nevertheless, the surgeons hurried to urgently remove the baby so that the pressure on the vein would stop.

Rules of behavior of the patient before the operation

The introduction of anesthesia, as well as any surgical intervention, requires the patient to comply with certain rules of conduct a day before the procedure:

1. Power limit mode. On the day before the operation, you should eat very limitedly - the last meal should happen at lunchtime, however, it can also be represented only by a light meal (soup, for example). After dinner, you can only drink, and only water. On the day of the operation, neither drink nor eat.
2. On the eve it is necessary to make a complete depilation of the genital organs and take a shower.
3. On the day of surgery, you will be given a cleansing enema.

Of course, it is very important that on the eve of the operation, the expectant mother has a good rest - sleep. Not everyone succeeds in this - nevertheless, the excitement takes its toll. With the permission of the attending physician, you can drink valerian at night.

Often, women, especially those who have problems with blood vessels, are recommended to wear compression stockings for surgery.

As for the "emergency" patients, of course, not all of them can be measured and thoroughly prepared for the operation. Those who are preparing for childbirth directly in the hospital, and then urgently caesarean, can be prepared before childbirth, taking into account a possible operation. If the expectant mother enters the operation "from the street", there are quick preparation methods for this case:

• a woman will definitely take all the required tests and prepare the results almost instantly;
• the woman will be given an enema, the stomach will be cleaned with a probe if she has been eating;
• even in the emergency room of the maternity hospital, they will depilate all the necessary zones.

On the day of the operation

The caesarean section lasts about one hour.

Immediately before the operation, a woman is given a CTG, monitoring the condition of the fetus. The steps of the procedure itself are:

1. Promedication (20-40 minutes) before the start of the operation. This is the introduction of a special drug that relaxes the body and mind, which is used before any operation.
2. The introduction of a catheter into the bladder, the removal of the urine in it (the catheter will stand for another day).
3. The introduction of local anesthesia (the woman is sitting on the operating table, rounding her back, the nurse injects the drug through a puncture between the vertebrae).
4. After the injection of the drug, the woman is laid on the table, as the lower part of the body after a few seconds will begin to become insensitive.
5. Connecting a woman to devices (to measure pressure, pulse and other indicators), installing a dropper.
6. Installing a curtain that will hide what is happening in the operating field from the gaze of the woman in labor. Treatment of the surgical field (stomach) with antiseptics.
7. The introduction of general anesthesia (if such a - more rare - anesthesia format is chosen).
8. Operation directly. It begins with an incision (as a rule, the incision is low and horizontal; rarely, in special cases - vertical). The incision of the abdominal wall is followed by an incision of the uterus, the fetal bladder is incised. The child is removed approximately 10-15 minutes after the start of the operation. It itself lasts about 1 hour - most of the time it takes the release of the uterus from the placenta, suturing.
9. After the child was accepted, processed and weighed, he was examined by a neonatologist (if everything is fine), he is shown to his mother (they give him to touch), in some maternity hospitals they are applied to the breast (which, according to modern specialists in breastfeeding, is the key to a successful start of breastfeeding). feeding).

During the operation, I did not feel the lower part of the body, however, some not quite familiar and not quite pleasant sensations were present - tremors from the actions of the surgeons, the feeling that "they are digging into you." At some point, a muffled pain began to appear in the left upper abdomen, when the doctors did something there. I asked the anesthetist if this was normal. He responded by injecting an additional drug of anesthesia, and everything went away. At the end of the operation, I felt cold (some kind of side effect of anesthesia) - my hands began to pound, my jaw began to shake. But I had to endure. I learned about the end of the operation when I saw someone's legs in front of me (mine - I recognized them by the pattern of moles). You can’t feel your legs, so it seems that they lie flat and straight. But in fact, the midwife, "cleaning" after the operation, raised them. We remembered this moment for a long time, laughing, with the same caesarean girls in the ward - everyone had the same thing.

After the operation, the newly-born mother is transferred to the intensive care unit (reanimation), where she will spend the next day under round-the-clock supervision of specialists - doctors and nurses. Children are taken to the neonatal ward.

After operation

On the day of the operation, the caesarean mother will not be allowed to get up and eat. It is only allowed to drink water (and then - after a few hours, starting with single sips). You can turn on your side, bend your knees, move them (after the anesthesia has worn off).

In an hour or two, the doctor who operated on her will examine her mother - he will feel the bottom of the uterus, ask about discharge and well-being. All postoperative days, resuscitation staff continuously monitors the condition of the postoperative patient - measures the amount of urine excreted, takes the necessary tests.

Recovery

A day after the operation (if everything is fine), the puerperal is transferred to a regular ward and, after giving some time to recuperate and settle down, reunite with the baby. At first, postoperative puerperas are not given the child permanently, realizing that due to recent surgical intervention, they need some time to recover. First, the child is brought for several hours, then for a day, and only on the third day - with an overnight stay (in fact, much depends on the rules of a particular maternity hospital).

Postoperative therapy may include:

• antibiotics compatible with HB;
• anesthesia;
• replacement of lost fluid (droppers with saline);
• hormone therapy (droppers or injections of oxytocin) - to reduce the uterus.

The woman in childbirth is advised to move as much as possible, not to lie down - this helps to minimize the adhesive process, normal discharge of lochia, and in no case prevents the suture from healing. Of course, you don’t need to lift weights and run cross-country, you should try your best - as far as possible - to strive to return to your normal lifestyle. Fortunately, this is greatly facilitated by new chores - chores about a newborn.

After I was brought to a regular ward from intensive care, I did not lie for a minute. After the "settlement" and the adoption of natural hygiene procedures, the first thing I could do - a little hunched over and limping - I went to the neonatal department - to get acquainted with my baby. Fortunately, the nurses were sympathetic, and against the rules they let me into the “sanctum sanctuary”. No supernatural pains tormented me, the seam was felt, but it didn’t hurt so much that it interfered with my usual activities. I only needed pain relief for the first two nights.

In general, after a cesarean, a mother must comply with all the same restrictions (wishes) as after a natural birth:

1. Eat with great care. Perhaps this restriction is the only one more severe in the case under consideration. Due to recent surgery, a new mother should introduce products gradually, avoiding those that increase gas formation.
2. Observe personal hygiene - wash daily, change hygiene products in a timely manner, wear the right underwear.
3. Observe the period of sexual rest recommended by the doctor (until the end of lochia -1.5–2 months).
4. Monitor your condition, and in doubtful cases, consult a doctor.

They are discharged after caesarean on average two days later than after natural childbirth. In the absence of a mother and a child, they can be discharged for 7-8 days.

Breastfeeding after CS

Due to the absence of some very important parts of the birth process, with a surgical method of delivery, milk may come to the new mother a little later. Nevertheless, it will come without fail, normally - from the 5th to the 9th day of the baby's life. There is an opinion among breastfeeding experts that early attachment of the baby to the breast will help speed up and facilitate the process of milk supply - immediately after delivery (in many maternity hospitals this is practiced at the request of the woman).

With certain knowledge, desire and perseverance, breastfeeding after cesarean is just as easy as after natural childbirth

The rules for establishing HB after cesarean are the same as after natural childbirth:

1. Frequent breastfeeding.
2. Lack of supplementary feeding (if colostrum has already appeared, you don’t have to worry that the baby will be hungry - he will have enough).
3. Correct application.

There is an opinion among doctors that milk after caesarean comes earlier from those who were "let" into childbirth, and only then they were caesarean.

Despite the fact that my planned cesarean took place ahead of schedule - at 38 weeks, the milk came on the 4th day. Before that it was colostrum. I didn’t have any problems with the establishment of breastfeeding - I didn’t feel any differences from women who gave birth naturally in this regard. By the way, I breastfed the baby for a long time - up to 1.7 years, never feeding the mixture.

Possible complications and consequences for mother and baby in comparison with natural delivery

Many mothers who have gone through a surgical delivery note a great number of difficulties in comparison with natural childbirth at the recovery stage. So, there are quite physiological features:

• the seams hurt for some time, cause discomfort (pull), itch;
• seams need to be processed;
• the incision site, which will leave a memory of itself for life, does not make the stomach attractive (sometimes the tissues of the seam grow ugly, forming the so-called keloid scar);
• in some cases, the sutures have to be removed (if a non-cosmetic suture was applied);
• subsequently, the state of the scar on the uterus will have to be monitored by ultrasound (it is of decisive importance for the next pregnancy).

We only note that there are sutures during natural childbirth (ruptures, episiotomy) - all the consequences of their imposition are absolutely the same (except for the need to monitor the uterine scar).

The fact that the seam after cesarean hurts, pulls, itches is absolutely normal for the first weeks after surgical delivery

Another unpleasant, but common consequence of a caesarean is swelling of the legs, which will go away on their own within a maximum of two weeks after the operation.

Possible pathological consequences of cesarean:

1. Suppuration and divergence of sutures, fistulas are a direct consequence of poor-quality or unsuitable suture material for a woman, unprofessional work of a surgeon or nurses, and insufficiently good suture processing. The problem is solved by using more intensive antiseptic methods, ointments designed to relieve inflammation and promote speedy healing (Vishnevsky Ointment, Bepanten, etc.). In the most difficult cases, the stitches are applied again.

   Small areas of open suture usually do not need to be resutured.

2. Adhesive disease is a natural consequence of any surgical intervention. Adhesions - strands of connective tissue, formed as a result of a protective reaction of the body to tissue damage. Adhesions connect and pinch the internal organs, which can lead not only to discomfort, but also to a violation of their functionality. A mild degree of adhesive disease can be cured by conservative methods - mud therapy, injections of absorbable drugs. Severe degrees are treated only surgically.

   Adhesions after caesarean appear almost always, the only question is - to what extent

3. The effects of anesthesia. General anesthesia (rare for caesarean section) has both short-term (hard exit) and long-term (mild memory impairment in rare cases) effects. Local anesthesia is sometimes fraught with inflammation at the injection site, pain that will pass with time.

   The injection site of an unsuccessfully administered anesthesia may make itself felt for some time.

4. Endometriosis is a gynecological disease, which is the appearance of areas of the endometrium, which is normal only for the uterus, on other organs or in uncharacteristic places. The disease has a lot of symptoms (the most obvious are intermenstrual bleeding and pain) and unpleasant consequences, including infertility.

   Endometriosis may result from caesarean section

5. Hernia. As a result of improper joining of the edges of the incision, their discrepancies may result in hernias - protrusions of tissues and organs. Such a defect has very unpleasant symptoms and consequences, it is treated exclusively by surgery.

   Hernia is an extremely unpleasant disease

6. Preeclampsia - in the strict sense of the word, it is not a consequence of caesarean. Late preeclampsia occurs in the last stages of pregnancy, and it is its consequence that surgical delivery often becomes (often ahead of schedule). After childbirth, preeclampsia (if it was very serious) may continue, but it is on the wane (completely disappears after 14 days). Symptoms of preeclampsia - high blood pressure, persistent edema, high protein values ​​in the urine. Within 48 hours of a child's life, a woman may be at risk of preeclampsia (convulsive seizures). Treatment of preeclampsia after childbirth is a drug therapy compatible with HB aimed at reducing edema (diuretic), lowering blood pressure, supporting the liver, and stabilizing the state of the nervous system.

   Preeclampsia is characterized by extensive edema and high blood pressure.

A caesarean section is not considered very useful for a baby either. Of course, the advantage of such a delivery for the fetus is considered to be a much lower risk of injury than in childbirth. However, a disturbed natural sequence of events, each of which is important as nature intended, can be fraught with:

• weak immunity - without passing through the birth canal, the child loses the opportunity granted by nature itself to get acquainted with the microorganisms and bacteria he needs;
• diseases of the respiratory system directly in the postpartum period - this is due to the fact that during the surgical birth, the mechanism for clearing the lungs of mucus does not work;
• stress caused by sudden extraction from the womb.

Perhaps I was once again lucky, but the artificial birth did not affect the health of my daughter. Now she is already 4 years old - she does not get sick more often, and maybe even less often, easier than other children. Maybe the whole point is not at all in the way of being born, but, for example, in long breastfeeding, feasible hardening, or something else.

Video: why cesarean is not an easy way of delivery

When can you get pregnant again

One of the most burning questions that women ask after a caesarean section is when a new pregnancy is possible. Doctors in this case are absolutely unanimous in their categoricalness - not earlier than in two years. This is the time the body needs to fully recover. In addition, it is by this time that a full-fledged, trustworthy, but at the same time still quite elastic, extensible scar on the uterus is formed. By the way, a new pregnancy later than the indicated period already threatens with other problems - an inelastic scar, which is also not very good, but not critical.

If pregnancy does occur before the due date, there is no unambiguously correct solution to the problem. Abortion in this case is no less dangerous than pregnancy itself, because injuring a fresh seam from the inside is a big risk of inflammation and even infertility. The development of pregnancy threatens to rupture the uterus in the later stages.

In order not to face a difficult choice later, a woman needs to resolve the issue of protection immediately after the operation. Most often, gynecologists recommend hormonal contraception compatible with breastfeeding (Lactinet, Charosetta).

Video: features of pregnancy after cesarean

The opinion of Dr. Komarovsky

• when, without this operation, the mother simply will not give birth (both the mother and the fetus will die);
• when childbirth is possible, but will bring many unnecessary and dangerous consequences.

Evgeny Olegovich emphasizes that a cesarean, like any operation, of course, has unpleasant consequences. However, modern medicine has successfully learned how to resolve every possible related problem. It's just that the mother needs to approach the operation thoroughly prepared - knowing how to behave and what to ask the doctors about.

According to the doctor, children after cesarean are born exactly the same - no better and no worse than after natural delivery. The only moment - after extraction from the mother's womb, it is desirable that the contact of the skin of the mother and the skin of the child takes place in order to populate it with "native" bacteria.

According to statistics, today every 3-4 pregnancy ends with an operation. The newly-made mother will have to face not only the postpartum period, but also the condition after the operation.

And this is doubly difficult. No one canceled the duties of caring for a baby. No one but you can put the baby to the breast. It is not for nothing that women are interested in how to quickly return themselves to their previous shape.

How to recover after a caesarean section?

The change in your body begins immediately after the removal of the child, still on the operating table. The uterus reacts to a decrease in volume and shrinks sharply. Thus helping to stop bleeding.

From now on, it will decrease in volume every day. It will be completely reduced somewhere by 2 months. After the operation, an ice pack is placed on your stomach - this is also a means for improved contraction of the uterus and stop bleeding. Be sure to prescribe uterine contraction injections.

Postoperative scars on the uterus, anterior abdominal wall and skin will make themselves felt almost immediately. Especially severe pain in the first 3 days. Pain contributes to the release of stress hormones: adrenaline and norepinephrine, which negatively affects the state of the body, as well as the healing of scars and pelvic organs.

In addition, the tone of the muscles of the anterior abdominal wall decreases in order to save the cut stomach. This can lead to the formation of hernias in the future. You must be prescribed painkillers.

The suture after cesarean will be processed daily. Will be removed for 7-8 days.

Doctors will tell and show, and only you can help yourself.

14 ways to recover faster after a caesarean

1.​After the operation, do not lie down! After the operation, 10-12 hours, and if you had spinal anesthesia, then a day, you will have to keep bed rest. The first time you need to climb in the presence of doctors. The earlier you get up, the better for you.

2.Physical activity. Almost immediately after the operation, it is necessary to move, turn in bed. The seam is tightly sutured with threads, it will not disperse. 3-4 hours after cesarean, you need to perform the first exercises. Bend and unbend the legs at the ankle and knee joints, hands.

3. Do breathing exercises.

• Lying on your back, take your hand to the side - inhale, return to ip. - exhale.
• Lying on your back, with outstretched legs and arms along the body. Raise your straight arms up - inhale through your nose, lower your hands down - exhale through your mouth.
• Lying on the left side, the left hand is under the head, the right hand is along the body, the legs are straight. Raise your right hand up, touch the pillow - inhale, lower - exhale. Repeat 1-2 times. Repeat on the right side too.
• Lying on your back, legs extended, right hand on the stomach, left hand on the chest. Inhale through the nose - inflate the stomach, exhale through the mouth - blow it off.

After you can rise, on the 2nd day, start doing the exercises sitting on the edge of the bed, legs lowered.

• Flexion, extension of the legs in the knee joints.
• Inhale - pull your knees to your chest, helping with your hands, exhale - return to SP.
• Inhale - spread your arms to the sides, exhale - draw in your stomach and return to SP.

From 3-4 days:

• Lying on your back, bend your knees, arms along the body. We raise the pelvis and turn it to the right - to the left, lower it.
• Lie on your back, knees bent, arms outstretched. We lower our knees to the right, outstretched arms to the left, we lower our knees to the left, outstretched arms to the right.
• We lie on our back, legs and arms are extended, raise one leg and begin to draw numbers from 1 to 6. Then do the same with the other leg. Every day we add 1 digit and we reach 20.
• To restore the tone of the muscles of the perineum, there is a set of Kegel exercises.

If you do gymnastics, then recovery after a cesarean will go much faster. There will be no adhesions, with time the former elasticity of the tummy will return, the uterus will shrink in a short time. But first, you should consult with your doctor.

Against the background of temperature, if during the operation there was a large blood loss, if you have thrombophlebitis, exercises are contraindicated. Do not perform gymnastics through force. Stop exercising if pain occurs.

Caesarean section is not compatible with intense physical activity. You can not lift weights, pump the press, exercise on simulators, run, squat for the first 2-3 months.

Important! It should also be remembered that excessive physical activity will not contribute to the production of milk. Therefore, it is contraindicated for nursing mothers.

3.​ Lactation. Breastfeed your baby. What will it give? During nipple sucking, the body produces oxytocin. It stimulates the production of milk in the mammary glands and the contraction of smooth muscles, i.e. uterus.

In addition, it is a hormone of love that helps the formation of maternal instincts. And a lot is said about the beneficial properties of breast milk for a child, and everyone knows that there is nothing better.

4.​Anemia. The need for iron during pregnancy and lactation is always increased. With a caesarean section, blood loss is several times higher than after a natural birth.

You may become anemic after surgery. This disrupts the healing of tissues, contraction of the uterus and does not affect well-being in the best way. If the doctor says that you have low hemoglobin, then you need to take iron supplements.

5.​ Lie on your stomach. Already on the second day after cesarean, you can lie on your stomach. This will speed up the contraction of the uterus.

The first day after the operation, you will have to endure a urinary catheter. This is not pleasant and makes it difficult to move. It is placed before surgery to control the amount and color of urine, as well as to prevent injury to the bladder during surgery.

After the operation, they also consider how much urine was released per day. This is important to assess if there has been damage to the bladder or ureters. An empty bladder is an important condition for proper uterine contraction, and you will not be able to get on the ship on your own for the first 12-24 hours.

After the operation, you may experience constipation. This is due to reduced intestinal tone, hormonal stress and, of course, an inactive lifestyle. If there is no stool by the third or fourth day, you will be given an enema.

Drink more water, move more. At home, it is worth eating more vegetables and fruits, dairy products, soups and cereals with buckwheat and pearl barley, vegetable oils.

7.​ Nutrition. The body needs strength to return to normal after surgery, as well as to feed the child. Therefore, eat more meat, protein is a building material, and you have scars that need to heal.

More fiber: vegetables and fruits, but avoid overseas fruits. Remember that you will be breastfeeding your baby. Therefore, your menu should not harm the baby. You can not eat food with preservatives, spices, hot sauces, smoked meats, grilled chicken, hot dogs, pizza, fatty and fried foods. Food should be stewed, boiled and steamed.

8.​ Massage and self-massage will help to restore. It improves skin tone, improves blood circulation and metabolism. Muscle tone also increases.

Interesting! In addition, massage has a positive effect on the nervous system. Normalizes sleep, reduces pain sensitivity. You can perform self-massage.

In technique, there are 4 techniques: stroking, rubbing, kneading and vibration.

Already from the first hours, you can stroke your stomach with your palm in a circle, from top to bottom and from bottom to top.

You can use a tennis ball. Write them out in a circular motion clockwise starting from the navel.

Perform a massage with a contrast shower.

9.​ Wear a bandage. It will relieve pain, support weakened abdominal muscles. The bandage is especially indispensable in the first days and weeks. In the prone position, the bandage is not needed, only when moving. Do not wear the bandage for more than 3 hours. From 4-6 weeks, the bandage is not needed, and its prolonged wearing can lead to the opposite effect, i.e. weakening the press.

10.​ Hygiene. Unfortunately, if you had a caesarean section, then you will be allowed to take a shower only after the suture is removed and then on condition that it has healed well. This will happen in about a week.

Before this, it is necessary to wash in parts so as not to wet the seam. Be sure to observe intimate hygiene: it is necessary to wash yourself with soap after each visit to the toilet.

11.​ Watch for secretions.

• In the first 3 days they are bright red and very plentiful.
• From 4 to 10 days pink-brown e or brown. Every day their number decreases, and the color becomes lighter.
• By day 10 yellowish or white spotting.
• By 3 weeks they contain streaks of mucus.
• The discharge will completely stop by 6-8 weeks.

If they are very plentiful, dirty in color and with an unpleasant odor, while you are worried about pain in the lower abdomen or a fever, you should consult a doctor. Perhaps complications have arisen that will slow down the recovery of the body after childbirth and the healing of the scar on the uterus.

12.​Dream. The body must be well rested. Sleep during the day with your baby.

13.​ Properly care for the scar on the skin. The stitches will be removed on the 6-7th day. If there are no complications, take a shower every day at home, but do not rub the incision area with a washcloth. After a shower, treat it with brilliant green, unless the doctor prescribes anything else upon discharge.

In order to avoid a rough scar, after a month you can use special ointments (kontroktubeks, solcoseryl, klirvin), if you wish, you can contact a beauty salon.

Important! If there is pain, swelling and pus in the area of ​​​​the suture, you should consult a doctor.

14.​ Walks in the fresh air. Rapid wound healing and tissue nutrition is impossible without oxygen. In addition, it will be useful for your baby.

After 6-12 months, scars will heal, muscle and skin tone will return.

Putting your body in order after childbirth and caesarean is not so easy, but the joy of the birth of your crumbs will overshadow all the difficulties.