17 different women, 36 crazy children, 0 babies in utero
Adventures, Advice and Questions from a group of Mormon women who met in Queens, NY and have now scattered all over the place.

Saturday, February 11, 2006

C-Sections 101

Face it, no one really WANTS to have a c-section. Heck, the whole birthing process is a little frightening. Add the prospect of having your belly cut open WHILE you're awake and things get a little scarier. But sometimes c-sections are a necessity. I know that there are some diehards out there who claim no woman should have to have a c-section, but I beg to differ. As my OB told me right before child #1 was born, I would have been one of those women ages ago who would have died in childbirth. So thank goodness for c-sections. Sometimes, circumstances drift from your birthplan and your idea of the perfect birth. It's OK. At the end of the day, the only goal is to deliver a healthy baby and leave mom as safe and healthy as possible too.

I had two c-sections nineteen months apart and have a few tidbits to share. The bulk of what I'm going to write I gleaned from my own experiences; unfortunately no one told me this stuff before I hit the operating table.

On the table:

Draping: Once you have been spinaled/IV'd and strapped to the table (yes, you're strapped and yes, it is a little alarming but you've got bigger fish to fry) you will be draped with a dividing curtain from the chest down. Trust me, you will NOT be able to see your belly being cut open. This is a common fear - its not going to happen. You are numb from the breastbone down so even if you wanted to sit up and take a peak, its not going to happen. Moving on...

Tugging: Another common misconception (mine included) is that you will feel absolutely nothing when the baby is removed from your belly. You are numb and you will not feel cutting or any sharp pains, but you will feel that baby coming out of your body. I was shocked at the tugging and pulling I felt before ds made his entrance into the world. With #2 child, my husband told me later that he was surprised by how "rough" the doctors and nurses were with getting the baby out. It won't necessarily hurt, but you will feel tugging and pulling. No one said birth was painless, right?

The shakes: Almost everyone experiences shaking immediately post-birth. They are much stronger when you have a c-section. This is due to the spinal/epidural that numbed you for surgery and the trauma of having your belly cut open. With child #1 I shook violently for 1 1/2 hours. One nurse laid her body over my chest in an attempt to keep my body still. With child #2, I knew better. I told the anestegiologist that immediately after the baby was out he needed to give me SOMETHING to curb the shakes. I don't know what he gave me but I didn't have one shake. It was wonderful. So speak up and tell them to give you something for the shakes. It's your body and the only shake you should want is one with ice cream.

The incision: Mine is 3 1/2 inches long. That's it. I have heels that are that high. It's very low and very small. So don't be freaked out about having a huge scar on your stomach. Most sections today are lateral and between 3-5 inches, depending on the position of the baby. You'll probably be able to wear your favorite yellow polka dot bikini should you so desire (but that's another post altogether).

You will most likely have staples to close your incision. The staples are usually removed four to seven days after delivery, sometimes while you are still initially in the hospital. With child #1 I was nauseous with fear the morning my staples were removed. Such a huge build up for no reason - it was NO big deal. Barely felt it.

Off the table and into your room:

Drugs: You will be groggy, but not really in pain yet. The drug of choice following a c-section is morphine. This is fine for the first few hours but get yourself off of that as SOON as possible. With child #1 I was in a terrible fog, throwing up and itching like crazy. When I mentioned this to the nurse she said "Oh, its the morphine. Would you like something else?" Ummmmm....yes. So with child #2, I told them in the OR no morphine, find something else for 12 hours and then get me on a different painkiller. It made all the difference in the world. I wasn't foggy, was able to nurse without throwing up and still managed the pain. Get off the morphine if and when you can.

Pain: You're gonna hurt. A lot. But you just had a baby for crying out loud! Your incision will hurt, your entire stomach will be sore. Don't be a martyr - take your pain medicine. This pain medicine is prescribed for a reason. You won't be able to move or nurse or heal unless you can manage the pain and rest properly. So take it and take it ON TIME. If its administered every 4 hours call your nurse at 3 1/2 hours and make sure it is brought to you within 30 minutes. If you are slightly off with your timing in those first few days you will pay dearly with pain.

Moving: The secret to healing quickly from a c-section is moving. I was out of my bed and walking 12 hours after child #2. Oh, it hurt and I needed 2 people to help me from the bed to the bathroom but I did it. And once you get over that initial hurdle of getting out of your bed the rest is easy (barring any complications of course). You need to move. Walking will reduce the risk of blood clots, get your bowels moving and help water weight dissipate. Go slowly but GO. On day 2 or 3 start walking around the floor with your baby in a wheeled bassinet and dh or other family for support. It clears your head and reintroduces you to your body post baby.

Shower: I was pretty freaked out about taking a shower after my c-section. I was so afraid to get the incision wet (all psychological, I know) and even more afraid to SEE my incision. I thought that it might come apart when the water touched it. Make sure you have taken your pain medication recently before taking your first shower - it will take more effort than you realize. But once that warm water hits your skin....oh....so much better. And you won't come apart.

Hospital Stay: Depending on the hospital and your insurance you will stay for 3-5 days (longer if there are complications with you or the baby). If you have the opportunity to stay 5 days (as I did) and have other small children at home, STAY. Yes, you may be going out of your mind and wishing you were at home in your own bed, but at least in the hospital the only obligation you have is 1) to nurse your baby, 2) to heal and 3) to poop (that first poop is a bit frightful, but I think that's common with vaginal deliveries as well). Once you go home there is no nurse to remind you about your pills and eating and drinking enough. At home, those little children will desparately want you to pick them up. Once you're back, you're back. So if you can, take those few days in the hospital for yourself and your baby.

Home with baby:

Lifting: The doctors will tell you that you shouldn't life anything heavier than your baby. As soon as you get home you will realize that most things in your house/life weigh more than your 7 or 8 pound (or more) baby. But do the best you can. I came home to a 19 month old ball of energy who wanted SO much for me to pick him up and hold him. I did it a few times and instantly regretted it. My stomach wasn't ready yet. Give it some time. Find alternatives to medium/heavy lifting. For me, I stopped using the changing table with ds and changed him on the floor - I didn't need to lift him as much. And ask dh/family/friends for help. Heavy lifting will only add to your pain and recovery time.

Nursing: It's not comfortable to hold your baby across your stomach for nursing immediately after a c-section. I used the football hold when sitting up and nursed on my side while laying down. After a few weeks I was fine holding them across my stomach because I'd had time to heal. If you can, have dh/family member bring the baby to you to nurse.

S.E.X: Believe it or not, there will come to a time when you'll want to do the deed again and you'll wonder how's its going to go. Your doctor will tell you to refrain from intercourse for the first 6 weeks and then giddy-up when you're ready. With child #1 I figured that since I had not PUSHED him out of my body that all systems "down there" were fine and ready to go. So when I pounced on my husband 4 weeks after giving birth I was SO shocked to find that everything was not good to go. Just because you had a c-section does not necessarily mean that things in "that area" will feel OK. It's different for everybody, but consider waiting the 6 weeks and take it slow. Man, I learned my lesson on that one. Wince...

And finally, those silly comments:

I was so grateful when child #1 finally came out that I gave no thought to HOW he arrived. He was healthy and I was safe - that was all that mattered to me. But more than one person had the nerve to say to me "Are you disappointed that you had a c-section?" Ummmm....NO. I delivered a healthy baby. One of us could have died if he had come out the other way. Like I said before, the GOAL is to get the baby out. Your birthing experience will be different than those who deliver vaginally, yes. But again, the goal is to get the baby out. Don't allow anyone to discredit how you delivered. It's not their body and it wasn't their birth. Be proud that you got through it and survived and that now you can focus on being a mom. Congratulations, you did it!


  • Chloe, I'm glad you're sharing your wisdom with the world. I will never forget making DH call you guys that Sunday morning just a few hours after my emergency c-section - first of all, to spread the word that he wouldn't be teaching Elder's Quorum that day, but secondly to pump you for information on post c-section healing. Thank goodness you blazed that trail before me!

    I think you've got it 100% correct on this one. I had the shakes, the itching and vomiting from morphine, all of it. I had a nurse come in and I was itching like crazy and she asked if I wanted some benadryl. I told her I thought it was just because I was just dirty and sweaty from not taking a shower and she said "no, it's an allergic reaction to the morphine". GEEZ. If I had known that, I would have said something a lot earlier!

    I had never been in a hospital before, never even had an IV before, so being hooked up to so many tubes and wires (I think I counted 12 at one point in my labor) was a bit overwhelming for me. I was scared to death when they came to take my catheter out, but that was no big deal. Same thing with the staples - I made a big deal that they wait until after I took my latest dose of painkiller, but just like you, it didn't hurt a bit.

    I had a lot of luck nursing with the boppy placed high up - around my ribcage more than anything else. I know you were never a boppy girl, but for me it gave me good positioning but also provided a good layer of padding between the baby/my flailing arms and the c-section area.

    I always really liked my doctors, but I give them so much credit for keeping things calm and upbeat, even when rushing me down the hall to the OR with DH running behind throwing on scrubs. Sure, c-section wasn't exactly my birth plan, but I got a healthy little boy out of it, so no complaints here.
    posted by Blogger marian at 2/11/2006 04:58:00 PM  

  • Great post.

    My first was c-section because he was breach. I was so frustrated that my husband was watching everything and wouldn't tell me exactly what was going on. He thought it'd freak me out, but it didn't. I wanted to know what was going on!

    Also, I could smell the cauterization. Don't know if you did. Sounds horrible and gross but it wasn't. I was too anxious to know what exactly the doctor was doing. My husband thought I'd freak out if he told me "now the doctor's cauterizing your veins..." (Or whatever it is he was doing.)

    You didn't mention the worst part. Which is the huge needle going into your spine. I don't remember it hurting, but I do remember being VERY nervous about it. They gave me something to stop contractions, I believe--whatever it was for, it made me shake. And then they came at me with a giant needle saying "hold still!"
    posted by Blogger Susan M at 2/11/2006 05:31:00 PM  

  • "Face it, no one really WANTS to have a c-section."

    I did:


    BTW, neither time was I strapped down. No shakes, either. No staples (self-whatevering stitches). No morphine, no pain after. They asked me to walk much sooner (like 4-6 hours), and,er, no desire to pounce on husband anything like 4 weeks later :).

    I think a lot of these things might just depend on your dr. and hospital ('cept the last, of course).

    But this was a great post to show the variety of experiences that women have with c/s.
    posted by Blogger Julie M. Smith at 2/11/2006 05:52:00 PM  

  • susan m, the thing I remember most about my epidural is that they made my husband leave the room for it. I was so dang nervous, because my contractions were coming fast and hard and I was scared to death that I would move and be paralyzed. I kept chanting to myself "they wouldn't do this during my contraction if they were worried about that" but I was still totally freaked out! I would have liked to have had him there holding my hands instead of the nurse, but I was so desperate for them to get it done that I wasn't about to start complaining!
    posted by Blogger marian at 2/11/2006 05:54:00 PM  

  • Ok I read the whole thing and the worst thing seemed to be the draping paragraph. I would not want to be awake during all that I don't think.
    posted by Blogger Kage at 2/11/2006 07:02:00 PM  

  • Ah yes, the epidural. Honestly, I was in so much pain from my contractions that the pain from a needle paled in comparison. I also, like Marian, had no husband in the room when they put the needle in - apparently its policy (happend both times in NY and CA births) and I hated that I NEEDED him there so much for that one small thing. I cried both times and squeezd the nurses hands.

    Kage, I hear you about the draping part. With child #1 there was no time to think about what was happening because it was so fast. But with #2, I KNEW what was going to happen and I really had to control my thoughts to NOT think about being cut open while awake.

    So freaky...
    posted by Blogger chloe at 2/11/2006 07:23:00 PM  

  • Great info! The only thing I would add is that pooping is NOT a pleasant experience for the next few weeks. I would cry every time I had to go and it was awful! Metamucil was my very very best friend.

    Emily--2 c/s mom
    posted by Blogger emlouisa at 2/11/2006 07:40:00 PM  

  • Being awake during the proceedure isn't that big a deal, honestly - you're a little distracted by the whole having the baby thing. I just remember thinking it was strange that the doctor kept making conversation with us - I wanted to tell her to just concentrate on what she was doing!

    Like Susan M, my hubby watched over the screen the entire time. Kind of weirded me out, I didn't like to think about what he was seeing, but he did get this awesome picture of Max right as he was born. He took some other ones too, but nobody's lookin' at those. My insides are for me only, thank you very much. And I don't even want to look at them.
    posted by Blogger marian at 2/11/2006 07:49:00 PM  

  • I had three sections. They wouldn't allow my husband to witness, all I know is the music that was playing at the time of birth for each.

    My advice on the getting up and walking thing. The hardest part was sitting up. I figured out about the third day that if I rolld onto my tummy, and sort of got on my knees, I could get out of bed easier. I was great after that.

    Staples first one. Steri-strips the other two. They were kind of like tiny strips of paper stuck to me. I don't have a scar to speak of.

    Awake during delivery. One yes, two no. They used a medication on me that I turned out to be allergic to on the waking delivery, I then began 'throwing PVCs' and was assigned a cardiologist. This was baby #2. I went back to a twilight sleep for the third. I was only out for a short duration during the birth and was awake within 15 minutes of the birth, the shakes were there but I was alseep for them.

    The hardest part was choosing when to be in public again. Stuff like going to the store. Don't try to get out too soon. If you do, you will likely have, a case of cold sweats and the feeling of losing it in a public place. It's not fun.

    And, yes, I had three babies. Just because they didn't expel from my body naturally doesn't change the fact that I had them. Some people can be incredibly inane.
    posted by Blogger chronicler at 2/11/2006 09:36:00 PM  

  • marian: awesome photo...I want to see your insides too...
    posted by Blogger Kage at 2/12/2006 05:52:00 AM  

  • Chloe,

    Thanks for an interesting read while we wait out the Blizzard of '06 here in NY.

    Dumb question: If you have a c-section, do you still have to deal with post-birth vaginal bleeding for the next month? That was one of the worst parts for me...it seemed like it would never stop!
    posted by Blogger Jen at 2/12/2006 08:44:00 AM  

  • I love that you've posted this very clear-headed step-by-step explanation of what sounds absolutely horrible. It still SOUNDS absolutely horrible, and makes me really, really grateful I adopted, but I love the matter-of-fact take on the mysteries of "woman problems." Implied in your post is that the not-knowing is far worse, and this really resonates. Many thanks.
    posted by Blogger newmom at 2/12/2006 09:11:00 AM  

  • Jen, No, at least not for me.
    posted by Blogger chronicler at 2/12/2006 10:06:00 AM  

  • Jen, I had bleeding for about 2 1/2 weeks with both kids. SO not as bad as a natural delivery but still not as "clean" as I would have thought.

    As for poop issues, I strongly recommend Colace. I didn't listen to my doctor about taking it with the child #1 and paid for it. I took some on day two after child #2 and it made such a huge difference. Take Colace!

    Marian, I"m up for seeing pics of your insides! Sam thought it was so facinating to look at my uterus laying on my stomach, but alas, I have no pictures of it.

    Susan M., YES, I forgot about smelling the cauterization! Don't remember it with child #1 but definately remember it with child #2. I actually asked if anyone could smell something burning, thinking I was having a smell reaction and dh told me they were cauterizing me. Yuck...
    posted by Blogger chloe at 2/12/2006 11:09:00 AM  

  • Wow, what an awesome photo!

    We brought a videocamera to the hospital. My husband was hoping to tape the whole thing, but they only allowed us to set it on a counter and let it run. So of course, there's nurses walking in front of it at strategic moments. I haven't watched it in years, but maybe we'll pull it out today. I do remember being able to see Nathaniel's little butt kind of sticking out of the incision before they pulled him out.
    posted by Blogger Susan M at 2/12/2006 11:23:00 AM  

  • I'm sorry that you were offended by people who asked if you were disappointed by having a c/section. For some women it is terribly disappointing and may even be traumatic to not have the birth they planned even though they are at the same time completely thrilled to have their precious baby. I appreciated those who understood that I had both those kinds of feelings after my c/section. I'm glad that you weren't upset because you had a c/section but perhaps somebody who asked about you maybe being disappointed is coming from an experience similar to mine.
    posted by Blogger Vicki at 2/12/2006 11:40:00 AM  

  • Great post Chloe! As a nurse who also worked in an OR setting for about 5 years, I couldn't have done it better myself. There is a difference between a spinal block and an epidural. A spinal block basically leaves you "paralyzed" (no movement or feeling) from the waste down whereas an epidural is administed into the nerve only-leaving your motor skills a bit more intact so you are able to move your legs and use your stomach muscles without feeling the pain of birth or C-section.

    The "shakes" come not necessarily from the epidural but also from a cocktail of drugs you are given during surgery. It it usually inevitable, but some nurses or anesthesiologists catch it early enough to not even be detected whereas other times your body simply won't respond to the "anti-shake" drug. Never assume anything uncomfortable is "normal". I promise there's a drug for it and you'll be so much more comfortable if you would just ask. Good suggestion to ask for your pain meds and take them ON TIME. Some people have a fear of addiciton. It won't happen unless you've had a serious addiction to some type of opiate drug in the past. If what they're giving you isn't working or is making you sick, demand something else. Don't be a pain martyr. Your body heals much better when it's relaxed enough to focus on healing rather than telling you how much pain it's in.

    12 hours is quite a long time to wait before becoming mobile. The quicker you start, the better you'll feel later, the quicker you'll have a BM and the earlier you'll go home.

    Isn't the tugging the strangest thing? You just assume that because you've had an epidural and A LOT of local anesthetic (once you're draped they also inject you with local anesthetic to further the numbnes) that you aren't going to feel anything. But you do, it just isn't pain.

    I had an ACL replacement knee surgery at the hospital I worked at in SLC. Because I knew the Dr.s and nurses so well, they allowed me to stay awake and watch. I was used to the smells of cauterization and bone saws, but it was strange when it was my own. I too was surprised to be able to feel everything they did- minus the pain and I was AMAZED at what the anesthiologist could do with drugs. I would tell him I felt too sleepy and he'd wake me up with something. Nauseous? Something else. Generally uncomfortable? A whole new love in my blood.

    Bottom line- these people walking around in scrubs who seem like they're untouchable aliens are just people too. Don't be afraid to speak up and don't worry that they'll feel annoyed. It's their job to keep you comfortable and happy and no matter what your discomfort or request during the procedure (and usually after too)- there's bound to be a way to fix it.
    posted by Blogger Krista at 2/13/2006 11:36:00 AM  

  • Krista, you are a nice person, I would guess that some of those scrubs people are not. So..if you were my nurse, I know you would listen and understand. Thanks for the follow up to chloe...reading both was the perfect combination.
    posted by Blogger Kage at 2/13/2006 11:58:00 AM  

  • Excellent comments Krista - I'm so glad that we have your perspective as a nurse. And thanks for clarifying the difference between a spinal and epidural - I couldn't remember what it was. Thanks also for explaining the shakes - oh, they're awful.

    Great comments!
    posted by Blogger chloe at 2/13/2006 12:23:00 PM  

  • Where to start? Marian, I will show you my insides if you show me yours. As for being disappointed. I still am disappointed to this day. I have seen every episode of Baby Story, and my delivery's were supposed to be like those. C section or not. My first was a C after 21 hours of labor and not progressing. Turns out I have big babies, and I am sure that she was not in the mood to squeeze through... I can't explain in words how awful that experience was. As for bleeding, yes folks, you still bleed after. I bled for 12 weeks with number one and 8 with number 2. I thought we would at least get that break! My second was elected cuz I didn't like the odds I was given about having him naturally. The process started out better, not as traumatic, then all of the sudden I felt excruciating pain as they were pulling the insides out of me. Yep, I had a horrible epidural. I felt too much. So, they said it's a boy and knocked me out. Fun... The recovery for me wasn't too bad, just the first day was awful. Then I was doing laundry and vaccumming on day 3. Just my way of healing. My scar is horrible. My first one was okay. But the second one my doc cut me all up and stapled me back together all jacked up. Then took the staples out too early leaving a huge open wound to heal with the help of a visiting nurse every day for 2 weeks. Good thing my swimsuit picture taking days are over. But at least the scar is there for when I have my tummy tuck someday. I will be a pro by C number 3. I think I will just be out for the whole thing. It was that bad for me. I know that my situation is not the norm, but C sections SUCK!!
    posted by Blogger Zinone at 2/13/2006 02:10:00 PM  

  • Oh, Zinone, I'm in agony just reading your post. Awful. Births whether naturally or c-secs are all so different that its really impossible to find a common thread through the whole thing EXCEPT that the baby gets born! I'm so sorry that you have not had good experiences with them. If I could take it away I WOULD!
    posted by Blogger chloe at 2/13/2006 02:50:00 PM  

  • I'm with Zionne--my emergency C was bitterly disappointing and I wish I could just shake it off and say "hey, we are all healthy" but the disappointment does not leave. I also fear it will mean more disappointment with ech successive child, now that I am high risk.

    I am glad that others, like you and Julie, feel positively about Cs and I appreciate your discussion of them. Maybe some day I will get there. Right now, though, I cry whenever I think about it.
    posted by Blogger a spectator at 2/14/2006 10:12:00 AM  

  • One thing that my emergency C made me think about was the futility of a birth plan. Don't get me wrong - knowing what you prefer, what you want and what you don't want are very important, when you have choices. But sometimes you don't. I spent a lot of time pre-birth thinking about what I wanted and what I didn't want, but in a way I think I knew I had only so much control over the situation. Yes, it's my body, but our bodies don't always do what we want them to do! In the movie Kicking and Screaming (the Noah Baumbach one, not Will Ferrell) there's a line, "How do you make God laugh? Make a plan." I certainly don't consider that my guiding principle in life, but it comes to my mind whenever I think about giving birth.
    posted by Blogger marian at 2/14/2006 11:19:00 AM  

  • My mother had to have all four of us by C-section back in the 80s. If it hadn't been for modern medicine, my mother too would have been one of those women who die in childbirth. In fact, my maternal grandma had her two children by C-section as well. (In the 50s!) I've had my two children vaginally, with no medication. I wanted to deliver without intervention and then my kids came really, really fast, so I wouldn't have had time anyway. Reading your post makes me grateful that I was able to have a vaginal delivery. The contractions and pushing are harder than the C-section, but it absolutely sounds as if the recovery is more difficult. (I was honestly back to normal within a day, albeit with a big flabby tummy.) I'm impressed with your ability to deal with it! I would be majorly squeamish about the whole thing.
    posted by Anonymous Erin at 11/17/2006 09:27:00 AM  

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