The memory of my first caesarean experience 17 years ago is still fresh in my mind — only because it was borderline traumatic. No one can ever prepare you for an emergency caesarean due to premature labour, but that was exactly what happened. I went into labour at 35 weeks gestation and was kept in labour limbo — without epidural — for a good 14 hours of nerve-wrecking pain and panic before the doctor said the baby was in distress and they had to do an emergency c-section. The entire experience, from hobbling into the hospital keeled over in cramps, to waking up post-op in excruciating pain are moments that I will never forget, and an experience that I would never wish on any mummy-to-be.
My subsequent caesarean births with the second and third child were pretty unspectacular and in fact, I bounced back in no time at all. I can’t say the same for the most recent caesarean procedure though. You see, my third and fourth c-sections were only 13 months apart and this made all the difference in my post-op recuperation period. Even after two weeks following the birth of my newborn daughter, my wound still hurts and I have to watch how I move about, careful not to stress the stomach muscles while learning how to get by with other muscle groups. The unusually slow healing process and the recurring pain was something I did not expect.
That’s the thing with childbirth: every experience is different. Even for a caesarean veteran like me, with all the mental and physical preparation I went through for the last nine months, I was still caught off-guard by the eventual result.
On hindsight, it would have helped though, if someone had told me then 17 years ago what I know now, my childbirth choices could have been wider, and the entire birthing experience could have been less stressful and traumatic. Which is why I decided to share some tips with you (should you find yourself in similar shoes) and here are some caesarean heads-up I wish I’d known back when I was a new mummy-to-be:
- Have an in-depth, heart-to-heart consultation on birth planning with your doctor:
It is common for most healthy pregnant women to assume that “it wont happen to me”. I made the same mistake many years ago as a new mummy-to-be. I took for granted that I would have a smooth, uneventful pregnancy and when the time comes, have a natural vaginal delivery. Hence, I did not speak to my gynae about birth scenarios and choices. In hindsight I could (and should) have asked questions like:
“What is the full operation procedure like in the event of an emergency caesarean?”
“I would like to have a vaginal birth for subsequent pregnancies. Is that possible after a caesarean?”
“Can I choose spinal epidural over general anaesthetic for an emergency caesarean?”
It is important that the medical team is clear about your decisions on that day, even if things don’t go as planned.
- If yours is an elective caesarean, pick morning procedures.
Before every major operation, you are instructed to fast for at least eight hours. Trust me, you will be starving after your procedure and after the anaesthetic wears off. So if you do not have to follow a lunar timing and are free to pick the period, a morning procedure is much ‘friendlier’ to the stomach, not to mention, your peace of mind. It is much easier to fast overnight than it is in the day.
Having had both morning and late afternoon procedures, I also realise that you will feel more energetic in the day to bond with the baby and attempt breastfeeding immediately. Somehow, late afternoon and evening timings tend to mess up your biological clock somewhat. And with the the darkening skies outside, your body will want to sleep off the day’s experience, leaving less time with the baby for immediate bonding.
- In an elective caesarean,you can request for the intravenous cannula (also known as The Plug) to be placed only when you are in the operating theatre.
Some hospitals put in the plug while you are in the hospital room preparing for the procedure. I find that really uncomfortable and it interferes with my movements — and it certainly hurts when you knock it against something. Having said that some hospitals can be quite strict about procedures and they might not oblige. Still, there is no harm asking. The mother’s well-being should be top priority on that special day.
- You CAN and SHOULD request for the catheter to be inserted only after they have knocked you out with the general anaesthetic or after they have administered the spinal epidural. Oh, and they only take out the catheter (painless, compared to the insertion procedure) one day after the c-section.
I must say that I have quite a high threshold of pain. But when the nurse inserted the catheter in me in preparation for the emergency c-section, all wide awake and alert, I screamed like a banshee. It was more painful than labour pangs (I kid you not!) and probably the most traumatising aspect of my birthing experience. After that for all subsequent births, I would insist that they do it only in the operating theatre and only after some form of anaesthetic has been administered. It has been 17 years but the thought of that agonising moment still gives me the hibbie jibbies.
- You can ask for painkillers to be administered immediately after the operation into your IV.
Don’t be a heroine and think you can fight off post-op pains with sheer guts and grit — it’s simply not worth it. There is nothing to prove by wanting to be as au natural as possible and skipping painkillers altogether. You’ve just had your stomach sliced through to pop out another human being so you will feel pain and for most mothers, quite tortuous pain. Oral painkillers do not work as well as having the painkiller pumped straight into your system via the IV. To me, a relaxed, pain-free mother is in a better state to bond with the newborn than a stressed-out, traumatised mummy.
- If you are having a spinal epidural operation with laser instead of a scalpel, you will be able to hear and smell your skin being ‘lasered’ open. And yes, you will be able to feel tugging, pulling and pushing movements although you will not feel pain and will be numb through from the anaesthetic.
I had a spinal epidural for my second child and was wide awake throughout the operation, so I could hear everything that went on in the room. What I didn’t count on was being able to smell my skin burning! It was unnerving, to say the least. Plus, even though I was numb and pain-free from the waist down, I could feel my body shake, move and rock during the process. So in short, no, I didn’t like that at all. Hence, for my subsequent births, I chose GA instead. I didn’t enjoy the feeling of being awake and feeling utter helplessness.
- You can request for immediate skin to skin with the baby, if you are having a spinal epidural.
The last thing on my mind when I was going through the procedure, wide awake but trapped in paralysis state from waist down, was the baby. I just wanted the entire process to be over and done with. So when they pushed the baby out to the father after cleaning her up, I did not think of asking to hold her in my arms. I was too preoccupied with deep breathing, trying not to panic and asking the doctor incessantly, “Are we done yet? Are we done yet?”
- After a GA procedure, you will have a bad sore throat and will not be able to speak normally.
Almost after every GA caesarean, I will wake up with hardly any voice and a painful sore throat. During the procedure, the medical team will put an endotracheal tube (breathing tube) tube down your throat and this will invariably cause some abrasion to the walls of your throat, hence the soreness and raspy voice. The raspiness usually corrects itself after an hour or two. Just drink water and take the lozenges your doctor prescribe you for the soreness.
- Do get ready a post-surgical tummy binder or corset.
The post-op compression binders are a godsend. By keeping your stitches and muscles tightly in place, it eases the pressure and pain from the stomach muscles when you are moving about. Most hospitals will provide one if you ask for it. But what they’ll give you is basic hospital fare and at almost twice the cost of what you can get in the pharmacy or medical stores. I have sensitive skin so the normal abdominal binder makes me break out in angry, itchy rashes. I usually get a non-latex, compression binder that won’t cause me to break out in angry welts. Do a quick Google search, there are many online to choose from.
- Post caesarean flatulence is not a myth and will hurt bad – very bad, in some cases. But then, the eventual expulsion is also highly satisfying.
You’ve just had a major surgery and in the process of having your insides rearranged, some air would be trapped. That, plus the post-op recovery process entails your intestinal system auto-correcting itself to pre-op working order. So expect gas – lots of it. For most, the air is stuck inside for a couple of days and the tidal wave of unbearable spasm that grips you usually surprise even the most hardened c-section veterans among us. Some nurses would advise you to move around to release the trapped gas, while some doctors would prescribe medication to relieve the gas. However, if you are breastfeeding, you will tend to refrain from unnecessary medication. The most logical thing to do is to stick to a low-fat, low oil and easily digestible diet one or two days before the operation and let nature takes its course. When you do eventually expel the gas buildup in the system, hopefully it will be satisfying enough to balance off the few days of discomfort and pain.
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