• Reference Number: HEY-252/2021
  • Departments: Maternity Services
  • Terminal Updated: 24 May 2021

Introduction

This leaflet has been produced to requite you full general data about your procedure.  Most of your questions should be answered by this leaflet.  It is not intended to supercede the word between yous and your doctor or midwife, but may act as a starting betoken for discussion. If after reading it you accept any concerns or require further explanation, please discuss this with a fellow member of the healthcare  squad caring for you.

What is a caesarean department?

A caesarean section is an operation to deliver a baby. It involves making a cut in the front wall of a woman'due south stomach and womb.

The operation can be:

  • a planned (constituent) procedure, when a need for the functioning becomes apparent during pregnancy.
  • an emergency procedure, when circumstances before or during labour call for commitment of the infant by unplanned caesarean.

A caesarean section is usually carried out under epidural or spinal anaesthetic, where the lower part of your torso is numbed. The operation usually takes a minimum of forty minutes, but can be performed quicker in an emergency. Some caesarean sections are performed under a general anaesthetic.

Why do I need a caesarean section?

A caesarean section is commonly carried out when a normal vaginal birth could put you or your unborn infant at risk. The reason for your caesarean section will accept been discussed with you lot by a senior obstetric doctor.

Tin at that place exist any complications or risks?

Frequent risks when having a caesarean department include:
  • Persistent wound and intestinal discomfort.
  • Haemorrhage.
  • Infection.
  • Injury to baby – small-scale skin cuts are 1 – 2%, difficulty in breathing is 12%.

Serious risks when having a caesarean section include:

Uncommon:
  • Emergency hysterectomy (7 – 8 per 1,000 women).
  • Return to theatre for farther surgery (5 per 1,000 women).
  • Admission to intensive care unit (9 per one,000 women).
  • Time to come pregnancies.
  • Placenta (afterward nativity) covering archway to the womb (4 – 8 per one,000 women).
  • Tear in the womb (2 – 7 per thou women).
  • Stillbirth (1 – 4 per one,000 women).
Rare:
  • Organ injuries: urinary and bowel system (ane – k women).
  • Developing a blood clot (4 – 16 per x,000 women).
Very rare:
  • Death, approximately one adult female in every 12,000.

What is enhanced recovery?

Enhanced recovery following an elective caesarean section reduces the time that you spend in infirmary. If all is well you will be discharged home the following solar day.

Am I eligible for enhanced recovery?

You may be considered for enhanced recovery when you are going to have an elective caesarean section and if y'all do non accept any of the following:

  • A problem with the placenta.
  • A BMI above fifty.
  • Diabetes requiring treatment with insulin.
  • Any clotting / cardiac weather condition.
  • A full general anaesthetic for the procedure.

Or if:

  • Y'all are less than 36 weeks significant.
  • You are unwell.
  • Your babe requires straight admission to the neonatal unit.
  • If you have refused claret products that were recommended clinically.

Tin there be whatsoever complications or risks to enhanced recovery?

If at that place are any concerns well-nigh the well-being of y'all or your babe then yous will remain in infirmary until y'all and your baby have been assessed past the midwives and doctors as set up for discharge dwelling. You do non take to leave infirmary the solar day after your surgery. If you lot exercise not feel set up to be discharged early you can stay in hospital.

How exercise I fix for the caesarean section?

You will be contacted regarding the date for your caesarean department. Withal,  from time to time we may demand to change the date or time of your date fifty-fifty at brusque notice.

You volition be asked to attend the Antenatal Dispensary to obtain the following:

  • A sample of claret to check your blood grouping and to check for anaemia.
  • Swabs taken for MRSA screening (Methicillin Resistant Staphylococcus Aureus). This is to ensure that any required treatment is undertaken before you lot are admitted to hospital.

At this appointment you will be given two packets of tablets:

  • Ane packet containing 2 Omeprazole tablets (this is to reduce the acid in your tum).
  • One package containing ane Metoclopramide tablet (this is to speed up the elimination of your stomach so you are less likely to exist sick during the operation).

You volition not exist admitted to the hospital until the morn of your performance. Information technology is therefore important that you attend this clinic to ensure nosotros have your results from your blood samples and swabs on the date of your operation.

Y'all will be required to have a pubic shave no less than three days before the day of your surgery. This is important equally shaving within three days can cause wound infections.
    • The evening before access y'all may have a lite supper and at 10.00 pm (22.00 hours)  accept only 1 Omeprazole tablet
    • At 06.00am on the mean solar day of your admission y'all may have the following breakfast:

    1 cup of tea or java and one piece of toast (lightly spread with butter/margarine and/or jam/marmalade) if desired.

    • No alternative is adequate.
    • Y'all must not eat or drink anything else after this.
    • Afterward xxx minutes (approximately 06.30am) take the Metoclopramide tablet. After xxx minutes (approximately 06.30am) take the second Omeprazole

Do not article of clothing nail varnish (on finger or toe nails). Remove any acrylic / false nails. Delight leave all jewellery at dwelling other than a hymeneals ring. Please remove all body piercings.

What will happen?

Please arrive on the ward no afterward than 07.00am accompanied by your birth partner.

A bed has been booked for you on:

Labour and Commitment (second flooring) Tick Box
Enhanced Recovery Maple Ward (first flooring) Tick Box

A midwife will be allocated to you lot on your admission who will coordinate, support and keep you informed of all procedures.

You will be seen by the anaesthetist and all options for anaethesia volition be discussed. If you are having an epidural or spinal anaesthetic, your nativity partner will exist able to attend and support you at the caesarean section.

Yous volition be asked to have a shower in the infirmary when you go far (towels volition be provided). Yous will be asked to alter into a hospital gown prior to going to theatre and will exist given a hospital dressing gown and skid socks to habiliment. Your birth partner will be shown where to modify their apparel when arriving in the theatre department.

Y'all will likewise be seen past an obstetric dr. who will explain the procedure and obtain your written consent. Y'all will have an opportunity to discuss any concerns yous may take.

To ensure the safe of both you and your baby it is not possible to give a specific time for your surgery. In some circumstances, your caesarean section may have to exist rescheduled for some other date. If this occurs, a doc will provide a full explanation.

Please pack essential toiletries and a change of nightwear, a set of baby clothes and some nappies. Your belongings will remain on the ward where you lot are admitted. Ensure that you have any valuables with you lot at all times, or they are placed in the lockable locker at your bed side while y'all are in theatre. But a mobile phone or camera tin can be taken into theatre. Please do not bring with you whatsoever unnecessary items.

What happens later?

Following your caesarean section, you and your baby (or babies) will exist transferred to a recovery area on the Labour ward. You volition be cared for and observed by the midwifery, obstetric and anaesthetic teams. You will be supported with caring for your baby (or babies).

One time you take recovered from the anaesthetic and all your observations are stable, you and your babe (or babies) will be transferred to the postnatal ward. If you are eligible for enhanced recovery you lot will stay on the Labour Ward for 30 minutes following your caesarean section.

If you are well you lot will be transferred to the enhanced recovery bay where you volition be monitored for 4 hours. You will be encouraged to get out of bed prior to transfer to the postnatal ward.

Visiting

There is no visiting in the Enhanced / Labour Ward recovery area; yet your nominated nascency partner tin accompany y'all throughout your caesarean section and in the recovery surface area for iv hours following the operation.

In one case you have recovered you will be transferred to the postnatal ward where visiting hours are:

Birthing partners      08:00am – 23:00pm
All other visitors        13:00pm – xx:00pm

2 visitors per bed are permitted during visiting times. But the patient'southward ain children are allowed on to the postnatal ward. You lot may cull one birth partner to stay with you overnight, please ask a midwife for the patient information leaflet 'Visiting and Birth Companions on Rowan Ward'.

Caring for your wound

Your wound (area cut for the caesarean section) will be covered with a waterproof dressing which allows the midwife to see your wound so an assessment can exist made. The midwife will give you lot advice about removing the dressing on 24-hour interval vii after your caesarean section. If there are whatever signs of infection, the wound dressing may remain in place until 24-hour interval 10.

Whilst your wound dressing is in place, y'all may have a shower. Gently pat dry the wound surface area. Once the dressing has been removed, a midwife will proceed to suggest you lot on how to expect after your wound to prevent infection. This volition include communication on how to gently clean and dry the cut area daily using a make clean towel. Information technology is advised that you lot wear comfy underwear which does non printing on the wound.

To reduce the risk of infection, wash your hands:

  • before and after visiting the toilet.
  • prior to feeding your baby.

Preventing blood clots

During your hospital stay, you volition be assessed for your chance of thrombosis (blood jell). You will be asked to wear compression stockings and will exist given some to take abode with you. Following your caesarean section you lot volition be prescribed an anti-clotting daily injection. This is commonly for 7 days or it may be longer if yous are assessed as a loftier risk for thrombosis.

When you are discharged from hospital

A community midwife volition visit you the following 24-hour interval. At this visit, the midwife volition carry out a total review of yous and your baby (or babies) needs and discuss a management programme for your care and visits. Part of this review will exist to assess how your wound is healing. If she is concerned how your wound is healing, she will refer you to your doc.

If you have concerns at whatever fourth dimension you tin call the hospital on the 24 hour contact telephone numbers included in this leaflet.

Symptoms to watch out for

After having a caesarean section, contact your midwife or GP direct away if you have any of the following symptoms:

  • severe hurting
  • leaking urine
  • excessive vaginal bleeding
  • your wound becomes more crimson, painful and swollen
  • a coughing or shortness of jiff
  • swelling or pain in your calf

These symptoms may be the sign of an infection or blood clot, which should exist treated every bit soon equally possible.

Information technology takes longer to recover from a caesarean section than it does after a vaginal delivery. In the first few weeks after giving nascence, try to get as much residue every bit possible. Avoid walking up and down stairs likewise often, equally your stomach may exist sore. However, you should take gentle daily walks to reduce your risk of claret clots.

You will be given regular pain relief medication to have at home, for equally long as y'all need them. In full general, information technology volition take about vi weeks for all your tissues to heal completely. Earlier this time, bones activities, such as caring for your new baby and looking after yourself, should be possible. It is brash not to bulldoze for 6 weeks following your caesarean section. Ring your insurance company for advice if you experience able to drive before this time. It is advised not to lift annihilation heavier than your infant for half-dozen weeks. It is advised non to practice any procedure that involves pushing or pulling for 4 weeks every bit this may place a strain on your abdominal muscles and the wound.

Future pregnancies

If you have had a delivery by caesarean section, it does not necessarily mean you volition accept to take a caesarean once again in the future. Yous tin can discuss future pregnancy options with your obstetric doctor or midwife in the infirmary or community who should take account of:

  • the reason for your first caesarean.
  • your preferences and priorities.
  • the overall risks and benefits of a caesarean section.
  • the risk of tearing the wall of your womb (uterine rupture) along the scar from your previous caesarean department.
  • the run a risk to your ain and your baby'south life and health at the fourth dimension of birth.
Should y'all require further communication on the issues independent in this leaflet, please do not hesitate to contact: Antenatal Dispensary on (01482) 382623 or the Community Office on (01482) 382658/382742.

Full general Advice and Consent

Most of your questions should have been answered past this leaflet, merely remember that this is only a starting bespeak for discussion with the healthcare team.

Consent to treatment

Earlier any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In guild to make a decision, yous need to have information from health professionals about the treatment or investigation which is being offered to you. You should e'er ask them more questions if you lot exercise not sympathise or if you lot want more data.

The information you receive should be about your status, the alternatives available to you lot, and whether it carries risks likewise equally the benefits. What is important is that your consent is 18-carat or valid. That means:

  • y'all must be able to requite your consent
  • you must be given enough information to enable you to brand a conclusion
  • you must be acting under your own gratuitous volition and not under the stiff influence of another person

Information about yous

We collect and employ your data to provide yous with care and treatment. As function of your care, information about you will exist shared between members of a healthcare team, some of whom you may not meet. Your data may also be used to help train staff, to check the quality of our intendance, to manage and plan the wellness service, and to assistance with research. Wherever possible we use anonymous information.

We may pass on relevant information to other health organisations that provide yous with care. All data is treated as strictly confidential and is non given to anyone who does not need information technology. If you lot take whatever concerns please ask your physician, or the person caring for you.

Under the General Data Protection Regulation and the Data Protection Human action 2018 we are responsible for maintaining the confidentiality of any data we hold most you. For further data visit the following folio: Confidential Information about Yous.

If you or your carer needs information well-nigh your health and wellbeing and about your care and treatment in a different format, such as large impress, braille or audio, due to inability, damage or sensory loss, please suggest a member of staff and this can be arranged.

Your newborn babe'south NHS number

An NHS number is allocated to everyone whose nativity is registered with a Registrar of Births and Deaths in England and Wales. Y'all already have an NHS number and your babe will be assigned an NHS number presently after nascence. Your NHS number is unique to you and provides a reliable ways of linking you to the medical and administrative information we concur about y'all. NHS numbers are allocated on a random basis and, in themselves, provide no information about the people to whom they relate.

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