How to properly recover after a cesarean section. Recovery after caesarean section: getting back to normal without loss

All over the world there is a clear trend towards gentle childbirth, which helps preserve the health of both mother and child. The tool that helps achieve this is the cesarean section (CS). A significant achievement has been the widespread use of modern pain management techniques.

The main disadvantage of this intervention is considered to be an increase in the frequency of postpartum infectious complications by 5-20 times. However, adequate antibacterial therapy significantly reduces the likelihood of their occurrence. However, there is still debate about in what cases a cesarean section is performed and when physiological delivery is acceptable.

When is surgical delivery indicated?

A caesarean section is a major surgical procedure that increases the risk of complications compared to a normal vaginal birth. It is carried out only according to strict indications. At the request of the patient, a CS can be performed in a private clinic, but not all obstetricians-gynecologists will undertake such an operation unless necessary.

The operation is performed in the following situations:

1. Complete placenta previa is a condition in which the placenta is located in the lower part of the uterus and closes the internal os, preventing the baby from being born. Incomplete presentation is an indication for surgery when bleeding occurs. The placenta is abundantly supplied with blood vessels, and even slight damage to it can cause blood loss, lack of oxygen and fetal death.

2. Occurred prematurely from the uterine wall - a condition that threatens the life of the woman and child. The placenta detached from the uterus is a source of blood loss for the mother. The fetus stops receiving oxygen and may die.

3. Previous surgical interventions on the uterus, namely:

• at least two caesarean sections;
• combination of one CS operation and at least one of the relative indications;
• removal of intermuscular or on a solid basis;
• correction of a defect in the structure of the uterus.

4. Transverse and oblique position of the child in the uterine cavity, breech presentation (“butt down”) in combination with an expected fetal weight of over 3.6 kg or with any relative indication for surgical delivery: a situation where the child is located at the internal os in the non-parietal region , but the forehead (frontal) or face (facial presentation), and other location features that contribute to birth trauma in the child.

Pregnancy can occur even during the first weeks of the postpartum period. The calendar method of contraception is not applicable in conditions of an irregular cycle. The most commonly used condoms, mini-pills (gestagen contraceptives that do not affect the child during feeding) or regular ones (in the absence of lactation). Use must be excluded.

One of the most popular methods is. Installation of an IUD after a cesarean section can be performed in the first two days after it, however, this increases the risk of infection and is also quite painful. Most often, the IUD is installed after about a month and a half, immediately after the start of menstruation or on any day convenient for the woman.

If a woman is over 35 years old and has at least two children, at her request, during the operation, the surgeon can perform surgical sterilization, in other words, tubal ligation. This is an irreversible method, after which conception almost never occurs.

Subsequent pregnancy

Natural childbirth after a cesarean section is allowed if the formed connective tissue on the uterus is strong, that is, strong, smooth, and able to withstand muscle tension during childbirth. This issue should be discussed with your attending physician during your next pregnancy.

The likelihood of a subsequent birth normally increases in the following cases:

• the woman gave birth to at least one child vaginally;
• if the CS was performed due to incorrect fetal position.

On the other hand, if the patient is over 35 years old at the time of subsequent births, she has excess weight, concomitant diseases, and inappropriate fetal and pelvic sizes, it is likely that she will undergo surgery again.

How many times can you have a caesarean section?

The number of such interventions is theoretically unlimited, but to maintain health it is recommended to do them no more than twice.

Typically, the tactics for repeated pregnancy are as follows: the woman is regularly observed by an obstetrician-gynecologist, and at the end of the gestation period a choice is made - surgery or natural childbirth. During a normal birth, doctors are ready to perform emergency surgery at any time.

Pregnancy after cesarean section is best planned at intervals of three years or more. In this case, the risk of suture failure on the uterus is reduced, pregnancy and childbirth proceed without complications.

How long after surgery can I give birth?

It depends on the consistency of the scar, the age of the woman, concomitant diseases. Abortion after CS has a negative impact on reproductive health. Therefore, if a woman does become pregnant almost immediately after a CS, then with a normal course of pregnancy and constant medical supervision, she can carry a child, but delivery will most likely be operative.

The main danger early pregnancy after CS there is a failure of the suture. It is manifested by increasing intense pain in the abdomen, the appearance of bloody discharge from the vagina, then signs of internal bleeding may appear: dizziness, pallor, drop in blood pressure, loss of consciousness. In this case, it is necessary to urgently call an ambulance.

What is important to know when having a second caesarean section?

Elective surgery is usually performed at 37-39 weeks. The incision is made along the old scar, which somewhat lengthens the operation time and requires stronger anesthesia. Recovery after a CS may also be slower as scar tissue and abdominal adhesions prevent the uterus from contracting well. However, with a positive attitude of the woman and her family, and the help of relatives, these temporary difficulties are completely surmountable.

After a caesarean section, as after any operation, you need to move. It is better to wear a postpartum bandage - it is easier to walk with it, it will help quickly return the abdominal muscles to their previous tone, correctly fix the postoperative suture, and relieve the load on the spine. However, wearing it for a long time is undesirable, since the muscles still have to work on their own.

The mother spends the first hours after a cesarean section in the intensive care unit or intensive care unit under the close supervision of doctors. After six hours, with the doctor’s permission, she can already get up, walk and feed the baby on the second day.

To prevent the postoperative suture from becoming inflamed, you can lubricate it 1 – 2 times a day with lavender or tea tree oil, having previously dissolved them vegetable oil in a ratio of 1:10. Pharmacy calendula ointment will also work.

Exercises you can do the day after surgery

Starting position: sitting with support on the back. Perform slowly and repeat up to 10 times.

• Pull the socks toward you, then away from you at an average pace.
• Rotate your feet inward, then outward.
• Press your knees together, then release.
• Tighten your gluteal muscles, then relax.
• Bend one leg and extend it forward, lower it, then the other.

Repeat all exercises up to 10 times, then rest.

Also useful exercise for the muscles of the perineum and pelvic floor.

Kegel exercises: Squeeze your perineal muscles as if you were trying to hold back a stream of urine. Hold in tension for a few seconds, then relax. Do 10–20 repetitions at a fast pace 3–4 times a day. Increase the tension time by 1 second each time, gradually reaching 20 seconds or more.

Regular practice of this exercise helps to avoid problems with urinary incontinence.

After you are allowed to walk, you need to use this to improve your condition. Spend as little time in bed as possible; walking helps you recover after surgery and prevent constipation.

Important! Until the stitches have healed completely, try to get out of bed correctly! You should not raise your head or sit up while lying on your back; this strains the abdominal muscles and can cause the stitches to come apart.

To get out of bed, you need to turn on your side, lower your legs and slowly sit down, pushing off with your hands, without straining your abdominal muscles.

After the stitches are removed With your doctor’s permission, you can begin light exercises for the abdominal muscles:

• Abdominal retraction. Sitting position with a slightly bent back. Inhale, then exhale, and as you exhale, draw in your stomach. Stay in this position for 1 second, then relax your stomach and inhale. Perform 10 – 15 repetitions several times a day.
• Lifting the pelvis. Lying on your back on a hard surface, legs bent at the knees. Raise your pelvis up, without lifting your lower back, and lower it. Perform 15–20 repetitions several times a day.

Intense physical activity and swimming should begin no earlier than after a month and a half. The same is with sexual life, but here doctors’ recommendations differ: from 2 weeks to 2 months, depending on individual characteristics.

This is one of the few advantages of a cesarean section over a natural birth: the vagina does not stretch, there are no tears or stitches in the perineum, so there are no problems with sexual life.

Sometimes after giving birth, some women experience depression. In the case of a caesarean section, this may be exacerbated by the disappointment of a failed birth. It is necessary to understand that all these sensations are normal and characteristic of many women, and in case of severe emotional state seek help from a psychologist.

Recovery after a cesarean section will take a woman quite a long time. But the period during which rehabilitation will take place can be divided into two segments.

Caesarean section: the first days

While the first period lasts, a woman who gave birth by cesarean section will have to lie in bed, because her task is to recover from the operation. And even the simplest actions will be difficult for her, for example, it will not be easy for her to clear her throat, but taking a deep breath will be difficult for her. During this time, the mother is usually forced to stay in the intensive care unit, where she is cared for by nurses who monitor her recovery from surgery.

The woman’s condition is monitored by a doctor who makes sure that all indicators (pressure, pulse, temperature) are normal. The doctor also monitors how quickly the recovery progresses, how the uterus contracts after a cesarean section, and how intense the vaginal discharge is. Special attention deserves a woman's stitch. In the postoperative period, it is necessary to regularly change the dressings on it.

What to do after the procedure?

During the caesarean section procedure, anesthesia is required. In this regard, a woman should under no circumstances sit on the bed for a long time after surgery - up to 12 hours. And you can get out of bed in the postoperative period only 3 days after a cesarean section. This will have to be done very carefully. In this case, sudden movements and haste are contraindicated; it is advisable for the mother to be helped up by relatives or medical staff.

But you can rise only after your doctor has given permission to do so. Don't be surprised if you feel dizzy after getting up - this is normal, although recovery is in full swing. And the feeling of weakness and slight malaise is associated with the fact that the woman underwent abdominal surgery under anesthesia. Even though it seems to many to be a fairly simple surgical intervention, this does not negate all the “charms” that accompany the procedure. Do not forget that in the process all layers of the abdominal wall are cut.

Learning to get up

It is important to remember that the doctor’s advice primarily determines how the recovery period after a cesarean section will go. And the doctor will give you the following recommendations regarding the first attempt to stand up:

• before sitting on the edge of the bed, you need to turn over to your side, after which you can hang your legs and sit down slowly
• Now you need to “work” with your legs - for this it is enough to do any light exercises. Avoid sudden movements; after all, you had a caesarean section a few days ago.
• then place your feet on the floor and ask someone to help you stand up. Important nuance– you need to get up with a straight back, it is advisable to stand as well. Only in this case will your postoperative suture be safe, even if you feel a slight tension
• Don’t try to take a step right away - first, wait
• Once you feel ready to take a step, take a small step

These instructions must be followed during the postoperative period. After just a couple of days, you will notice that it is becoming increasingly easier for you to get out of bed. As soon as you stop experiencing discomfort during the climbs, know that you will soon have a full recovery. After this, it is advisable to gradually increase the time of “pacing”, but not sharply, so that the seam does not begin to separate - after this, the second period of rehabilitation of the woman begins after the cesarean section procedure.

Cough correctly

It is important for mothers who have undergone a cesarean section to learn how to cough correctly in order to recover faster. The fact is that the postoperative period in this case differs in that during the use of general anesthesia (if it was used), mucus has accumulated in the lungs, which will gradually drain away, so that a cough will appear in any case. At first it will cause pain - the area where the postoperative suture is located will ache.

To begin with, it is advisable to place your palms on your stomach, as if holding the stitch that appeared after the cesarean section procedure (you can tie it with a towel). Then draw air into your chest - now exhale sharply, trying to keep your stomach pulled in. A proper cough should ideally resemble a dog barking. You will need to exercise several times over an hour if you complain of mucus buildup in your chest during the postpartum period. If not, then the procedure can be done rarely. An important point is that if you know in advance that you will have a cesarean section, it is better to learn the technique before the procedure.

Dealing with sensitive issues

You should be prepared for the fact that after a cesarean section you will have several delicate problems - in particular, intestinal gases will make themselves felt. For abdominal operations, this is a typical consequence, since peristalsis slows down due to surgery and anesthesia. The problem can be dealt with using a number of methods. For example, learn to breathe deeply, try rocking while sitting in a chair, and avoid foods that can cause increased gas formation.

Another problem that you may encounter after a cesarean section is problems with urination. They can be provoked by the catheter used during surgery, as well as by the anesthesia itself. If you are faced with this “trouble”, don’t worry. First of all, drink more to make you want to urinate. If you can't do this, try again in the shower with the sound of running water.

The main thing is to relax and not start to panic. However, remember that in cases where, after a cesarean section, you were unable to go to the toilet “in a small way,” you must definitely warn the doctor about this, because it is vital for you to empty the bladder of urine accumulated in it. Most likely, you will have to use the catheter again, and then undergo an additional examination by a nephrologist. This will somewhat complicate the woman’s recovery in the postoperative period.

Diet

In the first two days after a caesarean section, the woman is given all nutrients intravenously The reason is that food is prohibited due to abdominal surgery - the organs must have time to rest. This way they will be able to recover faster. These days you can only drink still water; if you wish, you can add lemon to it. On the third day, the woman already has the opportunity to eat on her own. To begin with, you are allowed to drink chicken broth - it is usually the first dish that is allowed to be consumed during the period when mommy’s recovery begins.

Gradually, those who have had a caesarean section are introduced to the diet of meat minced in a meat grinder, soufflé, porridge, and liquid curds. You need to eat little by little (100 ml at a time), and it is also advisable to drink a little. During this period, the abdominal organs should work so that they have to strain to a minimum in order to speed up recovery. It is advisable that the food is not too dense and heavy, because the first stool should “happen” on the 5th day after cesarean section. Then the diet should become less strict. Ideally, the diet that characterizes the postoperative period should gradually “degenerate” into a diet for nursing mothers.

Breastfeeding

But what about feeding if a woman had to go through a caesarean section? If recovery is progressing quickly, ask that the baby be brought to you as soon as possible. It is very important for you to establish breastfeeding now, but this will be very problematic if the baby is given to you three days after the caesarean section procedure. The fact is that the baby must constantly stimulate the mammary glands - only in this case the breasts will be filled with milk. If recovery after a cesarean section is delayed or the baby needs additional health care, you will have to learn to express yourself.

Despite the fact that the caesarean section procedure is carried out under local anesthesia, if it is local, ask to put the baby to the breast immediately after his birth. Usually in hospitals for women in labor they use medications that are allowed during breastfeeding, so there is no need to be afraid that you will harm the baby. Even if the baby falls asleep, invite him to do the first test - reflexes can work even in this case. Remember that breast milk will also help the baby recover if he was born on early. But if you still fail to feed the baby, just press him to your chest - he should feel that his mother is still nearby. And he recognizes you by the beating of your heart, which he listened to constantly while in the womb.

However, remember that in the first days after the cesarean section procedure, it is not advisable to pick up the baby very often while you are standing. In this way, you protect your seam, which may partially come apart under heavy load. You will have to limit yourself in this sense for quite a long time - up to six months, although it all depends on how the recovery goes. At home, you will have to ask your family for help more often, especially when you decide to go for a walk for the first time. Also, ideally, it is better not to do household chores for at least the first month - after a caesarean section, it is important for you to recover fully, as well as for your baby. Therefore, you need to devote this time to yourself and the baby.

Seam care

If you had a caesarean section, then the postoperative period is simply unthinkable without taking care of the stitches. It is clear that they require special care - during the first week after a cesarean section they are treated daily, changing the dressings each time. After the stitches are removed, you can safely take a shower, but it’s better not to use a washcloth for now, even though by this time the scar has already formed.

Obviously, the suture will hurt after the operation and during the recovery period - at first, painkillers help the young mother cope with the pain. Gradually, as the discomfort decreases, the woman stops giving them, and from now on she is recommended to wear special bandages. Remember that doctors do not allow new mothers to lift more than 2 kg for at least 60 days.

Immediately after the operation, you will be transferred to a special unit where you will be cared for by experienced nurses. If the operation goes without any complications and you feel well, then after a few hours your child will be brought to you. You can try to breastfeed him: breastfeeding in the first hours after birth is useful if you plan to establish breastfeeding. Many new mothers find that feeding while lying on their side is most comfortable after a cesarean section. Ask the staff to help you with this and don't be shy about asking for advice.

Bleeding from the vagina can be quite strong, so you will need special pads for new mothers. More or less pronounced bleeding can be observed in the first few weeks after childbirth - it does not matter whether it was natural or by caesarean section.

Experts recommend get out of bed already on the first day after surgery. At first, it will be enough to walk slowly to the toilet and back. Walking speeds up the recovery process after surgery, and also prevents the formation of blood clots and stimulates bowel function.

The day after surgery, doctors usually allow take a shower. You don't have to touch the seams, but it's okay if they get wet. After a shower, the seams can be blotted with a soft towel or even dried with a hair dryer in cold air mode. You will be able to take a bath no earlier than 7-10 days after the operation, when the wound has healed.

Pain after surgery A caesarean section can be quite severe, and in order for the new mother to be able to devote herself to her newborn, she must take painkillers. Be sure to discuss this issue with your doctor, taking into account the fact that not all medications are compatible with breastfeeding.

Seams applied to the skin may need to be removed the day before leaving the hospital. If you have had self-absorbing sutures, there is no need to remove them.

Many mothers are interested in what day after cesarean discharged from hospital. The answer to this question depends on the reasons why the cesarean section was performed, as well as on how the operation went, and how the new mother and newborn feel. After a planned cesarean section, which took place without any peculiarities or complications, the patient is usually discharged on the 6-7th day (in some countries on the 3-4th day).

What happens after discharge from the hospital: answers to frequently asked questions

Is it possible to carry a baby in your arms after a caesarean section?

You can carry your baby in your arms for as long as needed. Fortunately, newborns weigh no more than 3-4 kg, and such a load is safe for a young mother who has undergone surgery. At the same time, for at least 2 weeks after surgery, refrain from carrying anything that weighs more than your baby.

Is it possible to breastfeed after a caesarean section?

Yes, cesarean section is not a contraindication or obstacle to breastfeeding. There is nothing healthier for your baby than breast milk, so don't deny it to him.

Do I need to wear a bandage after a caesarean section?

Although some gynecologists recommend purchasing a bandage and wearing it in the first weeks after a cesarean section, this is not necessary. It is believed that the bandage helps to recover faster after surgery and reduce the size of the abdomen, however, not all women are comfortable wearing a bandage for a long time.

How long will the discharge last after a caesarean section?

Lochia (discharge after childbirth) can last up to 6 weeks. Heavy discharge normally lasts no more than 2 weeks, and then bleeding after cesarean section gradually decreases. Use lochia all the time, but under no circumstances.

How long does the stitch hurt after a caesarean section?

As a rule, a woman experiences the most severe pain in the suture area in the first 2-3 days after surgery, and then the pain gradually subsides. Minor pain when touched in the suture area usually persists for 4-6 weeks. For several months (up to six months), the skin in the area of ​​the postoperative scar may be numb.

How to care for a suture after a caesarean section?

In the first days after discharge, the bandage in the suture area should be changed once a day or more often if the bandage becomes wet or dirty. Your doctor will explain in detail how to apply dressings at home.

Is it possible to take a bath after a caesarean section?

Avoid bathing until the stitch heals. Usually this takes 7-10 days. These days you can take a shower without fear of getting the skin in the area of ​​the seam wet.

When can you exercise after a caesarean section?

You can return to your normal activities no earlier than 6 weeks after surgery. Before moving on to more intense exercise, consult your doctor.

Swimming is one of the best methods quick recovery after a caesarean section. You can sign up for the pool when the lochia runs out and the scar on the skin heals.

When can you have sex after a caesarean section?

Can a woman get pregnant after a caesarean section?

Pregnancy can occur in the first months after a cesarean section, even if the woman is breastfeeding, so be sure to take care of it.

Is it possible to place an intrauterine device after a caesarean section?

The intrauterine device is an excellent method of contraception during the postpartum period, which is not contraindicated during breastfeeding. It can be installed no earlier than 6 weeks after birth, when the uterus shrinks to its original size.

Consequences of caesarean section

In the vast majority of cases, a cesarean section is successful and does not cause serious consequences. However, we should not forget that a caesarean section is a surgical operation, and, like any other operation, may be associated with certain risks: infectious complications, bleeding, blood clots, damage internal organs, the need for an intensive care unit stay and longer hospital stays.

Typically, a birth by Caesarean section has no consequences for the baby. However, there is a small risk of injury when removing the baby from the womb, which in rare cases leads to the development of movement disorders (cerebral palsy).

Pregnancy and childbirth after caesarean section

Many young mothers who have had a caesarean section are wondering how long it will take to try to conceive again. Most gynecologists are of the opinion that the optimal interval between pregnancies is from 18 to 23 months, but it’s best to wait at least 2 years. This time is necessary for a young mother to properly recover from pregnancy and subsequent major surgery, as well as for the scar on the uterus to finally form.

What to do if pregnancy occurs earlier than 2 years after cesarean section?

Early pregnancy after cesarean does carry an increased risk of complications such as uterine rupture, preterm labor, and low birth weight. However, there are many known cases of successful outcome early pregnancy after cesarean section. Obviously, for good results, you should work closely with your doctor and listen carefully to his advice.

A caesarean section is an operation that delivers a fetus by removing it through an incision in the abdominal wall and uterus. The postpartum uterus returns to its original state within 6-8 weeks. Trauma to the uterus during surgery, swelling,

the presence of hemorrhages in the suture area, a large amount of suture material slow down the involution of the uterus and predispose to the occurrence of postoperative purulent-septic complications in the pelvic area involving the uterus and appendages in the process. These complications after cesarean section occur 8-10 times more often than after vaginal birth. Complications such as endometritis (inflammation of the inner layer of the uterus), adnexitis (inflammation of the appendages), parametritis (inflammation of the periuterine tissue) further affect the reproductive function of the woman, because may lead to violation menstrual cycle, pelvic pain syndrome, miscarriage, infertility.

The initial health status of women, the choice of a rational method and technique for performing the operation, the quality of the suture material and antibacterial therapy, as well as the rational management of the postoperative period, prevention and treatment of complications associated with surgical delivery, determine the favorable outcome of the operation.

A transverse incision in the lower segment of the uterus is made parallel to the circular muscle fibers, in a place where there is almost no blood vessels. Therefore, it least traumatizes the anatomical structures of the uterus, which means it disrupts the healing processes in the operating area to a lesser extent. The use of modern synthetic absorbable threads promotes long-term retention of the wound edges on the uterus, which leads to an optimal healing process and the formation of a healthy scar on the uterus, which is extremely important for subsequent pregnancies and childbirth.

Prevention of complications after cesarean section

Currently, in order to prevent maternal morbidity after cesarean section, modern highly effective broad-spectrum antibiotics are used, since microbial associations, viruses, mycoplasmas, chlamydia, etc. play a great role in the development of infection. During a cesarean section, prophylactic antibiotics are administered after cutting the umbilical cord to reduce their negative impact on the child. In the postoperative period, preference is given to short courses of antibiotic therapy to reduce the flow of drugs to the baby through mother's milk; If the course of a cesarean section is favorable, antibiotics are not administered at all after the operation.

On the first day after a cesarean section, the postpartum woman is in the intensive care ward under the close supervision of medical personnel, while the activities of her entire body are monitored. Algorithms have been developed for the management of postpartum women after cesarean section: adequate replacement of blood loss, pain relief, maintenance of cardiovascular, respiratory and other body systems. It is very important to monitor discharge from the genital tract in the first hours after surgery, because there is a high risk of uterine bleeding due to impaired contractility of the uterus caused by surgical trauma and the effects of narcotic drugs. In the first 2 hours after the operation, a constant intravenous drip of drugs that contract the uterus is carried out: OXYTOCIN, METHYLERGOMETRINE, an ice pack is placed on the lower abdomen.

After general anesthesia, there may be pain and sore throat, nausea and vomiting.

Great importance is given to pain relief after surgery. Within 2-3 hours, non-narcotic analgesics are prescribed; 2-3 days after surgery, pain relief is carried out according to indications.

Surgical trauma, entry into the abdominal cavity during surgery of the contents of the uterus (amniotic fluid, blood) cause a decrease in intestinal motility, paresis develops - bloating, gas retention, which can lead to infection of the peritoneum, sutures on the uterus, and adhesions. An increase in blood viscosity during and after surgery contributes to the formation of blood clots and possible blockage of various vessels by them.

In order to prevent intestinal paresis, thromboembolic complications, improve peripheral circulation, and eliminate congestion in the lungs after artificial ventilation, early activation of the postpartum woman in bed is important.

After the operation, it is advisable to turn in bed from side to side; by the end of the first day, getting up early is recommended: first you need to sit in bed, lower your legs, and then start getting up and walking a little. You need to get up only with the help or under the supervision of medical staff: after lying for a long enough time, you may feel dizzy and fall.

No later than the first day after surgery, it is necessary to begin drug stimulation of the stomach and intestines. For this, PROZERIN, CERUKAL or UBRETID are used, in addition, an enema is performed. In an uncomplicated course of the postoperative period, intestinal motility is activated on the second day after surgery, gases pass on their own, and on the third day, as a rule, independent stool occurs.

On the 1st day the postpartum woman is given something to drink mineral water without gases, tea without sugar with lemon in small portions. On the 2nd day, a low-calorie diet is prescribed: liquid porridge, meat broth, soft-boiled eggs. From 3-4 days after independent bowel movement, the postpartum woman is transferred to a general diet. It is not recommended to eat too hot or too cold food; solid foods should be introduced into your diet gradually.

On the 5-6th day, ultrasound examinations of the uterus are performed to clarify its timely contraction.

In the postoperative period, the dressing is changed daily, the postoperative sutures are examined and treated with one of the antiseptics (70% ethyl alcohol, 2% tincture of iodine, 5% potassium permanganate solution). Sutures from the anterior abdominal wall are removed on the 5-7th day, after which the issue of discharge home is decided. It happens that a wound on the anterior abdominal wall is sutured with an intradermal “cosmetic” suture using absorbable suture material; in such cases there are no external removable sutures. Discharge is usually carried out on the 7-8th day.

Establishing breastfeeding after cesarean section

After a cesarean section, difficulties with breastfeeding often occur. They are caused by a number of reasons, including pain and weakness after surgery, the child’s drowsiness due to the use of painkillers or disturbances in the newborn’s adaptation during surgical delivery, and the use of formulas to give the mother a “rest.” These factors make breastfeeding difficult. Due to the need for a low-calorie diet for 4 days, the formation of lactation occurs against the background of a deficiency of macro- and microelements in the diet of a nursing woman, which affects not only the quantity, but also the quality of milk. Thus, daily milk secretion after cesarean section is almost 2 times lower compared to spontaneous birth; Milk has a low content of main ingredients.

It is important to ensure that the baby is latched to the breast in the first 2 hours after surgery. Currently, most maternity institutions operate on the principle of mother and child being together.

Therefore, if everything went well without complications, you can express a wish to keep the baby next to you and begin breastfeeding under the supervision of staff as soon as the anesthesia wears off and you have the strength to take your baby in your arms (about 6 hours after the operation). Postpartum women whose feeding is postponed for various reasons to a later date (the birth of children requiring special treatment, the occurrence of complications in the mother), you should resort to expressing milk during feeding hours to stimulate lactation.

One of the main conditions for successful breastfeeding after a cesarean section is to find a position in which the woman is comfortable feeding the baby. On the first day after surgery, it is easier to feed while lying on your side. Some women find this position uncomfortable because... in this case, the seams are stretched, so you can feed while sitting and holding the baby under the arm (“soccer ball under the arm” and “lying across the bed”). In these poses, pillows are placed on the knees, the child lies on them in the correct position, and at the same time the load is removed from the suture area. As the mother recovers, she can feed the baby while lying down, sitting, and standing.

In order to stimulate lactation, physiotherapeutic methods of stimulating lactation are used (ultraviolet irradiation of the mammary glands, UHF, vibration massage, ultrasound, sound “bioacoustic” stimulation), herbal medicine: decoction of cumin, dill, oregano, anise, etc. To improve the quality composition of breast milk, it is necessary to introduce food additives (specialized protein-vitamin products) into the diet of a nursing mother: “Femilak-2”, “ Milky Way", "Mama Plus", "Enfimama". All these activities have a beneficial effect on performance physical development children during their stay in the maternity hospital, and the mother is discharged with well-established lactation.

Gymnastics after cesarean

6 hours after the operation, you can begin simple therapeutic exercises and massage of the chest and abdomen. You can do them without an instructor, lying in bed with your knees slightly bent:

• circular stroking with the palm over the entire surface of the abdomen clockwise from right to left, up and down along the rectus abdominis muscles, from bottom up and top down obliquely - along the oblique abdominal muscles - for 2-3 minutes;
• stroking the front and side surfaces of the chest from the bottom up to the axillary region, the left side is massaged right hand, right - left;
• hands are placed behind the back and the lumbar region is stroked with the dorsal and palmar surfaces of the hands in the direction from top to bottom and to the sides;
• deep chest breathing, to control the palms are placed on top of the chest: on the count of 1-2, take a deep breath in through the chest (the chest rises), on the count of 3-4, exhale deeply, while lightly pressing on the chest with the palms;
• deep breathing with your stomach, palms, holding the suture area, inhale for a count of 1-2, inflating your stomach, exhale for a count of 3-4, drawing your stomach in as much as possible;
• rotation of the feet, without lifting the heels from the bed, alternately in one direction and the other, describing the largest possible circle, bending the feet towards oneself and away from oneself;
• alternate flexion and extension of the left and right legs, the heel slides along the bed;
• Coughing while supporting the suture area with your palms.

Repeat exercises 2-3 times a day.

Restoring physical fitness after cesarean

Warm dousing of the body in parts from the shower is possible already from the 2nd day after the operation, but you can take a full shower after discharge from the maternity hospital. When washing the seam, it is better to use fragrance-free soap so as not to injure the crust. You can immerse yourself in the bath no earlier than 6-8 weeks after surgery, because By this time, the inner surface of the uterus has completely healed and the uterus returns to its normal state. Going to the bathhouse is possible only 2 months after examination by a doctor.

To postoperative scar dissolved faster, it can be lubricated with prednisolone ointment or CONTRACTUBEX gel. The scar area may feel numb for up to 3 months until the nerves that were cut during surgery are restored.

Restoring physical fitness after a cesarean section is of no small importance. From the first day it is recommended to wear a postpartum bandage. The bandage relieves lower back pain, helps maintain correct posture, accelerates the restoration of muscle and skin elasticity, protects the stitches from coming apart, helping to heal the postoperative wound. However, wearing it for a long time is undesirable, because muscles must work and contract. As a rule, the bandage is worn for several weeks after childbirth, focusing on the condition of the abdominal muscles and general well-being. Therapeutic exercises should begin 6 hours after surgery, gradually increasing its intensity. After removing the sutures and consulting a doctor, you can begin to perform exercises to strengthen the muscles of the pelvic floor and the muscles of the anterior abdominal wall (Kegel exercise - compression and relaxation of the pelvic floor with a gradual increase in duration up to 20 seconds, retraction of the abdomen, elevation of the pelvis and other exercises), which causes a rush of blood to the pelvic organs and speeds up recovery. When performing exercises, not only physical fitness is restored, but also endorphins are released - biologically active substances, improving a woman’s psychological state, reducing tension, feelings of depression, and low self-esteem.

After surgery, lifting weights of more than 3-4 kg is not recommended for 1.5-2 months. You can start more active activities 6 weeks after giving birth, taking into account your level of physical fitness before pregnancy. The load is increased gradually, avoiding strength exercises top part torso, because this may reduce lactation. Active types of aerobics and running are not recommended. In the future, if possible, it is advisable to engage in an individual program with a trainer. After high-intensity training, the level of lactic acid may increase, and, as a result, the taste of the milk deteriorates: it becomes sour, and the baby refuses the breast. Therefore, engaging in any kind of sport for a nursing woman is possible only after breastfeeding has ended, and not for breastfeeding women - after the restoration of the menstrual cycle.

Sexual relations can be resumed 6-8 weeks after surgery by visiting a gynecologist and asking for advice about a contraceptive method.

Second and third births after cesarean

Gradual restoration of muscle tissue in the area of ​​the uterine scar occurs within 1-2 years after surgery. About 30% of women after a cesarean section plan to have more children in the future. It is believed that the period 2-3 years after a cesarean section is more favorable for pregnancy and childbirth. The thesis “after a caesarean section, childbirth through the birth canal is impossible” is currently becoming irrelevant. For a variety of reasons, many women attempt a vaginal birth after a cesarean section. In some institutions, the percentage of natural births with a uterine scar after cesarean section is 40-60%.