Preparing for the maternity ward. Planned cesarean section What you need in the hospital after cesarean

Mom, how are babies born?, - asks four-year-old Nastya.
The uncle cuts the tummy, takes out the lyalechka and that's it, - the mother answers, deciding not to devote the young daughter to all the subtleties of a real delivery. But there is still some truth in her story, because a huge number of babies on the planet were born that way - through a caesarean section.

Why is a woman having a caesarean section? Firstly, there are cases when this is required by conditions that have developed spontaneously, related to the state of health of the mother or baby, or some kind of emergency. Secondly, there are planned operations, the need for which women know long before the birth. We will talk about them in this article.

How should I prepare for a planned caesarean section?

First of all, morally. A woman should, discarding all emotions and worries, calm down and tune in only for the best. It is necessary to trust your doctor (after all, for him, unlike the patient, this is not the first, but a “nennaya” operation) and be glad that very soon the long-awaited baby will sniff sweetly next to him. If, nevertheless, the unrest is very strong, it is worth talking with your husband, girlfriend, and even a psychologist.

When the date of the operation is already very close, in 1-2 weeks, the expectant mother, having collected everything necessary, goes to the maternity hospital. This is necessary in order to carefully conduct examinations to assess the condition of the fetus (ultrasound and cardiotocography), as well as the mother (blood and urine tests, the degree of purity of the vagina (a smear is taken)). In addition, even if a woman has already done such tests, they will still take blood from her to determine the blood type and Rh factor. If doctors find any abnormalities, the woman will be treated with medication.

The doctor will also set the exact date of the operation. As a rule, this day is chosen as close as possible to the expected date of birth, taking into account the condition of the woman and the fetus, as well as the wishes of the expectant mother.

Sometimes, if nothing interferes and the condition of both the mother and the child is satisfactory, so as not to be in the hospital for a long time, the examination can be done before hospitalization, and the hospital can be admitted the day before the planned caesarean section or even directly on the day of the operation.

What happens on the day of an elective caesarean section?

As a rule, such operations are carried out in the morning. Less frequently during the day. Therefore, in the evening, a woman should take a shower and, if necessary, shave her pubic hair. The food that a woman takes for dinner should be light. You can't eat at all in the morning. In the hospital, the nurse will help you to clean the intestines, as before any abdominal surgery.

After that, the anesthesiologist will talk to the woman, who will talk about what and how will happen to her during the operation in terms of pain relief. Most likely, it will be spinal anesthesia, that is, when the operation is performed with the mind of a woman. But, if there are any contraindications, the patient will be offered general anesthesia. Consent to the operation and a certain type of anesthesia is recorded in writing.

How is a planned caesarean section performed?

Before entering the operating room, a woman is given shoe covers and a cap, and is also asked to wear elastic bandages. The latter are necessary to protect a woman from the development of thrombosis. A woman lies naked on the table. First, the anesthesiologist injects the drug, then the medical staff puts a dropper and connects the device to measure blood pressure. A catheter is also placed to drain urine. When all this is ready, the place where the incision will be made is treated with an antiseptic preparation.

Since a screen is installed between the woman's face and the operation site, next to it, if the woman is conscious, there may be a loved one: husband, mother, girlfriend. True, this practice is not allowed in all maternity hospitals, therefore, it is necessary to clarify in advance about the possibility of attending “support groups” at such childbirth.

The procedure for extracting the child lasts no more than 10 minutes. This time is enough to cut the abdominal wall and uterus, get the baby and cut the umbilical cord. Then the purge begins. The doctor separates the placenta, examines the uterine cavity and sews it up. Then he is on the abdominal wall. This seam is processed and a bandage is applied. Above is an ice pack. This will reduce bleeding and stimulate uterine contractions. This completes the operation, and the newly-made mother is transferred to the intensive care unit.

Postoperative period

In the intensive care unit, the woman is under the close attention of doctors. In order to return to normal as soon as possible, and to avoid various complications, various drugs are administered to her. First of all, these are antibiotics and various painkillers. The latter begin to be administered as soon as the effect of anesthesia stops. To normalize the functioning of the gastrointestinal tract, as well as better contraction of the muscle tissues of the uterus, they also give the necessary medicines. And in order to make up for the loss of fluid, saline is injected into the body of a newly-made mother. At first, a woman may feel pain in the lower abdomen, general weakness, dizziness. Chills and an increased feeling of thirst are possible.

In the first 6-8 hours, the patient should not only get up, but even sit down. After this time, with the help of relatives or medical staff, you can sit on the bed. not very chic. At first, on the first day, you can only drink water. Already on the second, you can treat yourself to low-fat chicken broth (when cooking, the first water is drained) and liquid cereals (oatmeal is especially suitable). The so-called "normal" food can be consumed from the third week, but for now it is necessary to fall in love with diet food.

A day later, the woman is transferred from the intensive care unit to the postpartum unit. There she is with the baby. If there are no complications of any kind, the mother can easily cope with simple tasks: feed the child, wash, change his clothes. But, even if you feel good, you should not overwork.

Approximately 2-3 days after the planned stop anesthesia. But the seam area is carefully treated every day with a disinfectant solution. Sometimes a woman begins to have problems with the intestines. In such cases, the doctor will prescribe laxatives. It can be either a familiar enema or glycerin suppositories. After 4-6 days, a woman needs to take blood and urine tests, conduct an ultrasound scan of the scar, uterus, as well as appendages and adjacent organs. The gynecologist will conduct an external examination to make sure that everything is in order. If the health workers have no complaints about the state of health of the mother and baby, they will be discharged home approximately through them.

Behavior of a woman at home after PCS

Being at home, such a woman especially needs help, because it is simply contraindicated for her to do a lot of work. Especially you need to think about an assistant if the family already has a child. If the eldest is 2-3 years old, he will demand his mother's attention and care with extreme perseverance. A woman should try to pay attention to the first child, avoiding taking him in her arms. It is especially contraindicated to be nervous.

Moving on to a more familiar diet, you still need to monitor the diet. In this regard, you should consult not only with your doctor, but also with a pediatrician.

After a planned caesarean section, you can take a shower after 1-2 weeks. But the bath (not hot!) - only after 1.5 months.

It is necessary to explain to the husband that, at least for 2 months, a woman is contraindicated in large physical exertion and sexual intercourse. Last but not least, you need to think about contraception. The next pregnancy can be planned no earlier than in 2 years.

Especially for Olga Rizak

From the guest

Hello everyone, my first caesarean section was an emergency, although I was preparing to give birth, I went through with contractions, then the doctor came, looked at the chair and said urgently on the operating table, the umbilical loops fell out, they held it with my hands, the operation went quickly, anesthesia was good, but the postoperative period was difficult, everything healed hard .... then 2 years later I had a planned caesarean due to the fact that it was short between the first and second ... unlike the first, everything healed quickly and very well ... and now another 4 years have passed, now I'm waiting for the 3rd I think the baby will also be a planned cesarean .... but of course it is better to give birth yourself, especially if you do not have any complications ...))))

If you're having an elective caesarean section, the list of things you'll need for your delivery is slightly different from what you'll use for a vaginal birth.

Specify in the selected one what things you need to have, according to the rules adopted there.

You will likely stay in the hospital for four to six days after your caesarean section. Our list will help you not to forget anything when you are going to the hospital.

According to the rules, bags are not allowed in most Russian maternity hospitals: everything must be put only in plastic bags. A couple of clean, sturdy bags will do just fine.

It is advisable to have an assembled bag for the maternity hospital already about , so that when the birth begins, everything is at hand. Just in case, tell and show your loved ones where your "maternity" bag is, then they will be able to quickly bring you everything you need. Remember: your body doesn't know you're having a caesarean section. Childbirth may begin earlier than the scheduled date.

On our website you will find a list of things in the hospital, which you can print.
Remember that it is not necessary to bring everything bought to the hospital - large packs of diapers, breast pads - you can calculate approximately the amount that will be needed in the first 3-4 days after childbirth, and leave the rest at home.

Documents for the maternity hospital

The most important documents for pregnant women in the later stages are recommended to be carried with them all the time, so that in case of an urgent trip to the maternity hospital there are no problems with registration. Documents required upon admission to the maternity hospital:

The passport
Exchange card. Issued in the antenatal clinic for a period of 30 weeks.
Birth certificate. If you give birth for free.
If you are having a contract.
Money. In some cases, the hospital may need money. For example, if you want to thank someone from the medical staff or buy something at the pharmacy at the maternity hospital.

Childbirth: a celebration of meeting with a newborn

If your hospital has a prenatal shave routine, you may need a disposable razor. The machine can be provided in the hospital, but many prefer to bring their own. It is advisable to clarify the list of things that you can take with you to childbirth at the maternity hospital in advance, since each maternity hospital may have its own requirements and nuances. Usually there are few allowed things, you will need:

Washable slippers. In these slippers, you can take a shower before childbirth, and then go to the delivery room.
Compression stockings. Special stockings in childbirth are used on the recommendation of a doctor for prevention.
Water. You may need it while you are waiting to be transferred to the postpartum ward. Water should be without gas, and it is convenient if it is a bottle with a so-called "sports" neck.
Mobile phone. Allowed in most hospitals. A necessary tool for notifying happy relatives about the addition to the family. Do not forget to take a charger for your phone, but if the phone is not completely discharged, it is not necessary to take a "charge" to the delivery room.
Hair band or hairpin. This item is relevant for owners of long hair. Interestingly, there are different views on pinning hair during childbirth. Some doctors and women in childbirth prefer to let their hair down so that nothing “holds” the woman. And for someone, on the contrary, it is more comfortable to give birth with their hair pulled back.

After childbirth: happy moments

There will be two of you in the postpartum ward! So, first of all, you need to provide everything necessary for the baby. You will need:

Baby clothes. In some maternity hospitals, it is allowed to use only “maternity hospital” clothes and diapers for the child, and they bring their things only for discharge. Others allow the child to wear their own clothes. may include bonnets, knitted overalls or panties with vests, socks, as well as diapers and a blanket. The quantity is calculated approximately on the basis of one set per day, plus a couple of sets in reserve. In case of a shortage of clothes, you can usually use the "maternity hospital" or ask relatives to bring more.
Disposable diapers. Get the smallest size (marked "3-7 kg", "up to 5 kg", "newborn"). At the hospital, your diapers may be placed in a “common pot” for the baby ward, or they may be used only for your baby. The rules can be found in a particular maternity hospital.
Disposable diapers. Useful to lay on the changing table, as well as put in your bed in case of strong postpartum discharge.
Wet baby wipes. It is recommended to wash the baby with every diaper change, but wipes will still come in handy: firstly, you can wipe the baby before taking it to the sink, and secondly, it is convenient to wipe your hands or wipe the changing table with wipes.
Special baby detergent. It is necessary for washing the child, as well as for personal hygiene.
Diaper cream. Baby's original stool (meconium) is very sticky, and even if you don't plan to use diaper cream in the future, it will come in very handy in the early days.

After giving birth, you have to restore your strength and establish breastfeeding. In order for these processes to take place comfortably, let the maternity hospital bag contain:

Clothing, underwear in the postpartum ward

Bathrobe and nightgown. You can use the ones that will be given in the hospital, or you can take your own. A nightgown in the postnatal unit is preferable to trousers with a T-shirt. The elastic band from the bru can put pressure on the seam. In addition, you will often change pads, go to procedures and be seen by a gynecologist. You can purchase a special shirt with slits for feeding. The advantage of the maternity hospital clothes is that they are changed every day for clean ones.
. Fortunately, today almost all maternity hospitals allow the use of postpartum pads. You can buy special ones, or you can use night ones. Please note that the surface of the pads is breathable, not mesh.
Gasket holders. They look like underpants made of elastic mesh. Very comfortable thing for the first days after childbirth. They are usually sold together with postpartum pads.
Comfortable shorts. If you do not take holders for pads, you need to take care of suitable panties. Firstly, they must be made of cotton, and secondly, they must be comfortable: thongs are excluded. Calculate the quantity with a margin: washing in maternity hospitals is not welcome. The elastic band of the pants should not injure the postoperative suture.
Breast pads. They absorb milk, which often leaks in the first days and even months of feeding. Pads are disposable and reusable. Disposable ones are easier to use, but reusable ones are more economical.
Nursing bras. An indispensable thing for a nursing mother. At first, it is recommended to use special underwear for feeding both day and night.
Socks, slippers.
Postpartum bandage. Ask your doctor which bandage is preferable to use after a caesarean section.

Hygiene, cosmetics in the postpartum department

Each woman will have her own list, but, probably, everyone will need:

Towel. In the maternity hospital, state-issued ones are issued, but your own is more pleasant.
Toilet paper. Unfortunately, not all maternity hospitals still have this necessary item.
Toothpaste and brush.
Shampoo, shower gel, washcloth.
Deodorant.
Comb, hair dryer.
Cosmetics, mirror.
Cream for the skin of the abdomen after childbirth.
Cream for nipples. Unfortunately, or irritation are frequent companions of the first days of feeding. It is advisable to choose a cream that does not need to be washed off before. Some nipple creams and ointments are also suitable for lubricating a baby's irritated skin. These may be products containing panthenol or lanolin. Check with your doctor before using any creams or ointments.
Cotton swabs, napkins.
Glasses, contact lenses and accessories.
Nail scissors. By the way, some babies are born with long nails. Scissors might come in handy for them too.

Other useful little things that you can take to the hospital

Charger for mobile phone.
Notebook and pen. At the maternity hospital, you can get useful advice on caring for your baby, as well as meet new people and exchange contacts. A notepad and pen will come in handy for this.
Camera. A newborn baby changes literally every hour! And every moment can be captured for history. Also take care of the charger or batteries for the camera.
Water and food. Of course, in the hospital you will be fed and watered. In addition, relatives can bring you useful products. But just in case, you can take water without gas in advance and have a snack, for example, dried fruits or green apples. This will be especially true if you give birth in the evening or at night.
Books, player, laptop. These items are more likely to apply to those women who will give birth in a maternity hospital with a separate stay of mother and child. In this case, they will have enough free time to read or listen to music. In the case of a joint stay, there will be less free time, but it will still be, since newborns sleep almost constantly. Some new mothers take a book on infant care and breastfeeding to the maternity hospital, as well as notes from courses for expectant mothers.

If you arrive at the maternity hospital during labor, you will have to leave your bags at the front desk, taking only the essentials during the birth. The nurse will then bring you bags with the rest of your things to the postpartum ward. Therefore, it is necessary to provide for the possibility of inscribing packages, and it is better to attach labels to them with your last name in advance.

And don't worry if you forgot something. Firstly, people work in the maternity hospital, and they will help if something is needed. And secondly, transfers are allowed in any maternity hospital, and relatives will be able to purchase or bring everything you need from home.

What to take to the hospital in case of a planned caesarean section - tips for moms BabyCenter

“Ask relatives to bring you something to eat. For example, muesli, prunes or anything high in fiber, because after the operation you will get hungry. It's even better to start eating lean, high-fiber foods three to four days before your caesarean section. Going to the toilet after the operation will be very painful at first, and such food will facilitate the process.”
“Bring a walkie-talkie, books, or something to help you relax. Recovery after a caesarean can be painful, you want to somehow distract yourself.
Ira

“Take cheap disposable flip-flops to go to the shower or toilet. Hospital floors don't inspire confidence."
Kate

"Sanitary napkin! No one will tell you about it, but in the maternity hospital they give out giant rags from a hundred years ago. So take one pack of long, thick pads with you.”
Pauline

“I used hospital underwear, pads and socks. In order not to stain my shirt or gown, I simply put on a hospital gown under them. Like most women, I had a strong discharge, and I did not want to ruin my things - I took care of them until I returned home.
Albina

“I took a pair of nursing pajamas with me, but I never wore them. The robe was much more comfortable. Also, after the caesarean, I didn’t feel like walking back and forth too much.”
Marina

“My half-sister gave me silk pajamas with a drawstring under the bust. At the bottom, she made a U-shaped cut so that the fabric does not rub the seam. I felt divine in these cozy pajamas and wore them at home for a long time. To quickly feel attractive again, you can take cosmetics, shower gel with you. After all, after giving birth, you don’t feel like a beauty. ”
Lily

“One thing I did not foresee is a nipple cream. It was hard for me to breastfeed my baby, because my nipples were cracked! I had to look for someone who would buy me a cream.
Pauline

“Bring your kid's nail scissors and nail file. In the maternity hospital where I gave birth, they did not give scissors - they did not want to take responsibility. As a result, my son scratched his face when he was not even 12 hours old.”
Zhenya

“I had both a vaginal delivery and a caesarean section. I regretted only one thing: that I did not take a long dress for discharge after cesarean. I put on loose trousers, but despite their elasticity, it hurt a little when they came into contact with the seam.
Julia

“I took maternity clothes for discharge from the hospital, I thought that after giving birth, these things would sit on me quite freely. How wrong I was! When checking out, wear a loose dress or dressing gown. No pants!
Anna

“I felt great on discharge in overalls. And I had three planned caesarean sections.”
Maria

The birth of a child is one of the most exciting and responsible periods in the life of any family. In order for it to go smoothly and without unnecessary worries, the expectant mother should have everything ready in advance for a trip to the hospital. In the case of planning an operative delivery, it is much easier to prepare, since the date of the operation is known exactly. I advise you to make a list in advance to the hospital for a caesarean section, and then mark in it what you have already collected and what else you need to purchase.

When to pack a bag for the hospital?

The date of the caesarean section is negotiated with the obstetrician-gynecologist who leads the pregnancy, so most often a woman clearly knows what number she needs to be ready for. However, it is necessary to provide for an option in which labor activity will begin earlier than the appointed date (and the likelihood that this can happen is quite high), and then the caesarean operation will be performed on an emergency basis. Therefore, I recommend having a fully assembled bag by the end of the 35th week, so that at any time everything you need is at hand.

Did your doctor give you a list for the maternity hospital?

YesNo

Each maternity hospital may have its own characteristics of surgical intervention and hygienic care for the baby, so you should definitely take a list of things to the maternity hospital for a caesarean section in the hospital where you plan to give birth. Most of the items in it, of course, are standard, but the list of necessary items will insure you and your family from unforeseen worries and troubles at the most crucial moment.

You should not take too many things, as later this can make it difficult to store them and find something you need. Make it a rule to put in your bag only what you will use 100%. If there is any doubt whether this thing will be needed or not, it is better not to clutter up the place and leave it at home.

What bag to put things in

When choosing it, the main thing you should pay attention to is spaciousness, since the list in the hospital for a planned caesarean section is quite large. Preference should be given to compact and lightweight models that can easily fit under the bed or in a locker. It will be convenient if the bag has many departments and small pockets, as this will allow you to arrange things so that they are accessible and organized. It is best to choose a bag for the maternity hospital from durable and non-staining materials, since with the advent of the baby there will definitely not be time for washing or cleaning it.

What to take with you from documents

It is very important to have all the necessary documents upon admission to the maternity ward, since in their absence there will be problems with registration in the hospital and further registration of the child.

List of required documentation:

Passport of a citizen of the country (if it is damaged or lost, you must obtain a document that temporarily replaces it).
An exchange card is a document that is maintained and drawn up by a gynecologist who oversees the course of pregnancy from the beginning of registration in the antenatal clinic.
Documentation of health insurance (mandatory and, if available, voluntary).
A birth certificate that a pregnant woman receives when applying for maternity leave for a period of thirty weeks.
Individual insurance account number.
A medical record with test results and discharge epicrises (if any) - if the woman has concomitant somatic pathology.

If partner births are planned (when the father is present during caesarean section), it is required to have the entire list of medical examinations of the partner (the list of laboratory and instrumental studies is negotiated with the attending physician when planning joint births).

What you will need in the hospital before the operation

To stay in the maternity hospital while waiting for the operation, a pregnant girl will need the following things:

personal hygiene products (toothpaste and brush, soap, deodorant, toilet paper, wipes (dry and wet), towel);
several sets of underwear;
nightgown or pajamas made from natural fabrics (cotton, linen);
house dressing gown;
indoor shoes (comfortable slippers are best);
set of dishes (cup or glass, fork, spoon, plate or saucer).

In the cold season, it is best to have a warm jacket and a small blanket with you.

Necessary items after surgery

During the stay in the hospital after the operation, you will need things not only for the mother, but also for the newborn. I advise you to divide the list of things in the hospital for cesarean section into categories and sort by sets for different cases.

Clothes and underwear

After the surgery, the mother is given a set of hospital linen, but clothes for the baby during the stay in the hospital should be prepared independently and in advance.

Hygiene products

It is necessary to take several sets of sterile bandage, gauze and cotton wool. You will need special, small clean towels and diapers. It is also recommended to purchase a hypoallergenic cream to lubricate the skin around the nipples and breast liners.

Other little things

You can take with you (it is recommended to discuss its use after the operation with your doctor in advance) and a breast pump.

A basic list of what a future baby will need

The doctor or nurse of the maternity ward will tell you in detail about what a newborn will need in the first days of his life. The list of things for the baby most often includes:

Indications for caesarean section can be identified both during pregnancy and directly during childbirth (even if the pregnancy was uneventful). Thus, for one reason or another, any pregnancy can end with an operation, and every expectant mother should be prepared for the fact that the baby will be born as a result of a caesarean section. Having information about the indications for surgery, types of pain relief, about the surgical intervention itself and recovery after it will help a woman overcome her natural fear of a caesarean section and interact with doctors in a coordinated manner. In this case, the recovery period is also easier.

When is an operation needed?

A caesarean section is a surgical operation in which the baby is removed through an incision in the uterus and anterior abdominal wall. To date, in various maternity hospitals, the frequency of cesarean section ranges from 10 to 25?% of the total number of births.

This operation can be planned and emergency (if complications arise directly in the process of natural childbirth, an emergency caesarean section is performed). If indications for caesarean section are detected during or before pregnancy (this may be a pathology not directly related to pregnancy, such as eye disease), the operation is performed as planned.

An obstetrician-gynecologist who leads her pregnancy, or doctors of other specialties (therapist, ophthalmologist, neuropathologist) directs the patient to a planned caesarean section. The final decision on the need for a planned caesarean section and the timing of its implementation is made by the obstetrician-gynecologist in the maternity hospital.

Some expectant mothers ask the doctor to perform a caesarean section at their request (for example, a woman is afraid of complications of natural childbirth or pain). In fact, during this operation, the woman in labor is exposed to the same risk of possible complications as in any other abdominal operation, and strict indications are required for a caesarean section. Therefore, at present, at the request of a woman, in the absence of any medical indications, this operation is not performed.

Indications for caesarean section are divided into absolute And relative.

Absolute readings- these are situations when a child cannot be born through the birth canal or this will threaten the life of the mother:

transverse or stable oblique position of the fetus;
placenta previa (the placenta completely or partially blocks the exit from the uterus) and its premature detachment;
discrepancy between the size of the pelvis of the woman and the head of the fetus, when the head of the baby is larger;
significant narrowing of the pelvis of the woman in labor;
severe degree of preeclampsia (a complication of the second half of pregnancy, manifested by an increase in blood pressure, the appearance of protein in the urine, edema), if drug therapy is ineffective;
failure of the scar on the uterus - thinning of the uterine wall at the site of a previous operation (previous caesarean section, myomectomy - removal of myomatous nodes);
tumors of the pelvic organs that make childbirth difficult (eg, large fibroids, large ovarian tumors);
severe varicose veins of the vulva (external genitalia) and vagina;
diseases of various organs (for example, pathology of the fundus, in which the ophthalmologist gives a conclusion about the exclusion of the straining period).

Relative readings occur when the birth of a child through the birth canal is possible, but can lead to serious complications for the mother and fetus. In this situation, several factors are taken into account:

incorrect insertion of the fetus - the head is inserted into the pelvic cavity in such a way that it can get stuck when passing through the pelvic bones;
prolonged infertility;
in vitro fertilization (IVF);
the age of the primipara is over 35 years;
breech presentation of the fetus (the pelvic end of the fetus is adjacent to the exit from the uterus - the buttocks, knees, feet of the baby);
aggravated obstetric history (presence of miscarriages, abortions, malformations of the uterus in the past);
multiple pregnancy with transverse or pelvic presentation of the first or both fetuses;
preeclampsia of mild or moderate degree;
large fruit (more than 4 kg);
severe chronic diseases (for example, diabetes mellitus, diseases of the cardiovascular system, kidneys, hypertension);
chronic hypoxia (lack of oxygen) of the fetus, intrauterine growth retardation.

During childbirth, the following complications may occur:

premature detachment of a normally located placenta;
threatening or beginning uterine rupture;
anomalies of labor activity (discoordination, weakness) with ineffective conservative therapy;
acutely developed intrauterine hypoxia (oxygen deficiency) of the fetus;
prolapse of umbilical cord loops with unprepared birth canal (unopened cervix).

In these cases, even with a normal pregnancy, doctors will perform an emergency operation.

Preparing for the operation

Approximately at a period of 34–36 weeks, the issue of indications for a planned caesarean section is finally resolved. The gynecologist of the antenatal clinic sends the pregnant woman to the maternity hospital 1–2 weeks before the expected date of the operation, if it is necessary to carry out drug treatment of the identified changes in the health of the mother and fetus (for example, correction of fetoplacental insufficiency), and a preoperative examination is also prescribed.

Additional examinations carried out in the hospital include ultrasound, fetal cardiotocography (monitoring of the heartbeat), dopplerometry (study of the fetal-placental-uterine blood flow). The expected date of delivery is specified and the day as close as possible to the date of delivery is selected. If there is no need to stay in the maternity hospital in advance (for example, with a transverse position of the fetus), then a preoperative examination can be done at the antenatal clinic. After that, the woman should visit the doctor of the maternity hospital, discuss the date of the operation with him and go to the hospital on the eve of the expected date.

Before a planned caesarean section, a pregnant woman is sent for the following tests:

Complete blood count and coagulogram(study of the blood coagulation system). Determination of the blood group and Rh factor is necessary for a possible blood transfusion during surgery with large blood loss.

ultrasound, dopplerometry(study of fetal-uterine-placental blood flow) and cardiotocography (CTG - study of fetal cardiac activity) to assess the condition of the baby.

After consulting an obstetrician-gynecologist and an anesthesiologist, the patient gives written consent to the operation and anesthesia. On the eve of the operation, it is necessary to take a shower, you can drink a sedative (only on the recommendation of a doctor). In the evening, a light supper is needed; On the morning of the operation, you can no longer eat or drink.

2 hours before the operation, a cleansing enema and shaving of the perineum and, if necessary, the lower abdomen, where the incision will be made, is performed. Immediately before the start of the caesarean section, a catheter is inserted into the bladder, which is removed a few hours after the end of the operation. This measure helps to prevent injury to the filled bladder during surgery.

Anesthesia

To date, the safest method of anesthesia for both mother and fetus is regional (epidural, spinal) anesthesia. In modern maternity hospitals, more than 95?% of operations are performed using these types of anesthesia. With epidural anesthesia, pain medications are injected into the epidural space (the space between the hard shell of the spinal cord and the vertebrae) through a catheter, and with spinal anesthesia, the medication is injected directly into the spinal canal. The puncture is made in the lumbar region. Thus, the anesthetic anesthetizes the spinal nerves that innervate the pelvic organs and the lower body.

During the operation, the woman is conscious and can communicate with the medical staff, and also hears the first cry of her baby and sees him immediately after birth. With this type of anesthesia, the drugs do not enter the mother's circulatory system, and the fetus is not exposed to the drug.

Much less often, general anesthesia is used when the woman is under anesthesia throughout the operation: this occurs in cases where there are contraindications for epidural or spinal anesthesia, or when an emergency caesarean section is necessary and there is no time for regional anesthesia.

Epidural anesthesia begins to act 10-20 minutes after the administration of drugs, and spinal anesthesia - after 5-7 minutes, while a woman is immersed in general anesthesia immediately after intravenous administration of drugs. This is important, for example, when urgent surgery is needed in case of severe bleeding (placental abruption) or acute hypoxia (lack of oxygen) of the fetus - this condition threatens the life of the baby. In addition, a woman may have contraindications to epidural or spinal anesthesia: low blood pressure (this type of anesthesia further reduces pressure, which can lead to impaired blood supply to the fetus and poor health of the mother); severe deformities of the lumbar spine (hernias, injuries), in which it is impossible to accurately puncture and trace the spread of the drug. The disadvantage of general anesthesia is that anesthetics penetrate the mother's blood and can have a negative effect on the fetus.

Operation progress

After anesthesia, the woman is lubricated with an antiseptic and covered with sterile sheets. The operating field itself, as well as the doctors who will perform the operation, the woman does not see, since a barrier is installed at the chest level.

The skin incision is made along the upper edge of the pubic hairline or in a straight line slightly higher. After moving the abdominal muscles away, a transverse incision is made on the uterus (such an incision heals better), then the fetal bladder is opened. The doctor inserts his hand into the uterine cavity, removes the child by the head or pelvic end, then crosses the umbilical cord between two clamps placed on it.

The baby is handed over to the midwife, who measures and weighs him, after which the child is examined by a pediatrician. Then the doctor removes the placenta by hand, and the incision on the uterus is sewn up with a thread, which dissolves after 3-4 months. Next, the abdominal wall is restored in layers. Stitches are applied to the skin, and a sterile bandage is placed on top.

Currently, the so-called cosmetic suture is increasingly being used, when a self-absorbable thread passes intradermally and is not visible from the outside. Such a seam does not need to be removed, and the scar after a cesarean section is almost invisible: it is a “thin thread”.

The duration of the operation is on average 20–40 minutes (depending on its technique and complexity), while the child is removed already at 5–10 minutes.

Upon completion of the surgical intervention, an ice pack is placed on the lower abdomen for 2 hours: this helps to contract the muscles of the uterus and quickly stop bleeding.

An emergency caesarean section follows the same pattern as a planned one. Sometimes during an emergency operation, not a transverse, but a longitudinal incision is made on the skin - from the navel down to the pubis: this speeds up the process of entering the abdominal cavity. In addition, in this case, better access to the pelvic organs is provided, which is necessary for some complications in childbirth. But a transverse incision on the skin is preferable, since the scar forms better and heals faster.

If the operation is performed under regional anesthesia, when the woman is conscious, then after the birth of the baby, the midwife shows her the baby and, if it is in a satisfactory condition, leans the newborn against the mother's cheek. This is the first contact between mother and baby.

Recovery period

in the maternity hospital

control of the woman's condition. After a caesarean section, the patient is transferred to the intensive care unit (intensive care unit), where her condition is monitored around the clock during the day: blood pressure is measured, breathing and heart rate are monitored, the general well-being of the woman in labor, the effectiveness of uterine contraction, the amount of discharge from the genital tract, the condition postoperative suture, the amount of urine.

A few hours after the operation, it is allowed to move a little in bed, bend your knees, and turn slightly on your side. After 6 hours, you can slowly get out of bed: with the help of the medical staff, the woman first sits down, then gets up and can stand for a while. And after the transfer of the puerperal to the postpartum department after 12-24 hours, she can move slowly.

Baby care. On the first day, the newborn is in the children's department. In the absence of complications, after a day the baby is transferred to the ward of joint stay with the mother. Early activation of a woman after a caesarean section is very important for better contraction of the uterus and restoration of intestinal motility (contractions). In addition, in the joint room, a woman can feed and care for a child.

In the first 2-3 days after the operation, the young mother feeds the baby with colostrum, a very valuable and useful product for the child, which fully provides his body with all the necessary substances. A few days later (usually on the 4-5th day after the operation), the woman has milk. With cesarean section, milk usually comes a little later than in the case of natural childbirth, when it appears on the 3rd day. This is due to the fact that the hormone that triggers lactation is released into the blood a little later due to the lack of early attachment to the breast (during natural childbirth, the baby is applied to the breast a few minutes after birth - in the absence of contraindications). But this does not affect the health of the child in any way - colostrum fully provides for his energy needs.

The most comfortable position for breastfeeding for mother and baby during this period is the side lying position: this reduces the pressure on the postoperative suture. Almost all modern maternity hospitals are focused on the joint stay of a woman with a child, which is extremely necessary to establish full lactation and psychological connection between mother and baby. If there is no such opportunity in the maternity hospital, the child is regularly brought to the mother, and she has the opportunity to feed him.

Medical therapy. After the operation, painkillers are prescribed, their dosage and frequency of administration depend on the intensity of the woman's pain, usually they are required in the first 2-3 days after the operation. Drugs are also introduced that promote intensive contraction of the uterus. Antibiotics are prescribed as indicated. Physiological saline (0.9?% NaCl solution) is also administered intravenously, since a woman loses more blood during a cesarean section than during natural childbirth. All drugs administered are compatible with breastfeeding. On the 2nd day, a cleansing enema is prescribed to improve intestinal motility and better contraction of the uterus: after the operation, the intestines function poorly, overflow, which interferes with the normal contraction of the uterus and the discharge of blood clots.

Seam processing. Every day, the nurse treats the postoperative suture with an antiseptic solution (iodine, potassium permanganate) and applies a sterile bandage. In addition, the woman is sent for physiotherapeutic procedures for the speedy healing of the suture. The skin scar is formed 5-7 days after the operation, so if non-absorbable sutures are applied to the skin, they can already be removed at this time. If a cosmetic suture has been applied, it is not removed. On 3-4, less often - 4-5 days after cesarean section, ultrasound is performed; it helps to clarify whether the uterus contracts normally and what is the condition of the postoperative suture.

Wearing a bandage. It is necessary to purchase a bandage in advance: it will greatly facilitate movement around the ward and reduce pain in the area of the postoperative suture, and will also help restore stretched abdominal muscles. The bandage is recommended to be worn for at least 1 month after the operation for several hours a day.

Nutrition. On the first day after a cesarean section, doctors are allowed to drink only mineral water without gas. In the following days, the use of fermented milk products (kefir, ryazhenka) is recommended, as they restore intestinal function well, as well as boiled meat, vegetable broths, cereals. You should not eat raw vegetables and fruits, as well as foods that are a source of allergies in a child (honey, nuts, chocolate) and lead to increased gas formation in the intestines of mother and baby (cabbage, grapes, radishes, radishes, flour products and sweets).

After discharge

If the mother and baby have no complications, they are discharged 6-8 days after the operation. During the first month, a woman may be disturbed by pulling pains in the area of the postoperative wound and in the lower abdomen. This is due to uterine contractions and healing of the uterine and skin scar.

If discharge, swelling, redness and swelling appear in the area of the scar, a woman should definitely contact the doctor of the antenatal clinic or the maternity hospital where the operation was performed. These changes in the suture indicate the possible development of an inflammatory reaction as a result of the addition of an infection, which requires mandatory treatment. In addition, a specialist consultation is necessary if there is a heavy or cloudy discharge with an unpleasant odor from the genital tract, fever, sharp pains in the lower abdomen: all this may indicate the development of postpartum endometritis (inflammation of the inner layer of the uterus). After caesarean section, endometritis is more common than in the case of natural childbirth. This is due to the fact that the uterus contracts worse after the operation than after natural childbirth, since it has a seam. It can cause retention of blood clots in the uterine cavity, which are a favorable breeding ground for the reproduction of microorganisms that cause inflammation of the inner layer of the uterus.

In a antenatal clinic or a medical center, a woman is regularly monitored by a gynecologist for 1–2 years after a cesarean section.

At home, if possible, you need to limit intense physical activity - lifting weights (more than 2 kg), sharp slopes. The seam until complete healing can be washed under a warm shower with soap, but in no case rub with a washcloth. In the first few months, it is also not recommended to take a bath. This is due to the fact that in the postoperative period, the uterine cavity is a wound surface, and taking a bath can provoke infection and the development of endometritis. After 6-8 weeks, new cells of the uterine lining will form, and the woman will be allowed to take a bath.

You can apply sterile dressings to the seam area - then the clothes will irritate the seam less. At home, it is recommended not to use a bandage so that the seam "breathes".

Sexual intercourse after surgery can be resumed after 6-8 weeks, after consulting with a gynecologist.

On the uterus, a full-fledged scar is formed 2-3 years after the operation, by this time the general recovery of the body after childbirth occurs. Therefore, planning the next pregnancy is recommended precisely through this time period. The possibility of spontaneous childbirth after caesarean section is decided individually, but recently women are increasingly giving birth through the natural birth canal (in the case of a well-formed scar on the uterus) under the strict supervision of specialists.

Things collected in advance for the maternity hospital make the expectant mother more calm and balanced. The bag, which contains everything you need, gives confidence. Therefore, doctors and psychologists recommend paying special attention to the fees for the obstetric institution, especially if a planned caesarean section is due. In this article, we will tell you what nuances you need to consider, what to take with you if the birth is planned to be performed surgically.

Each maternity hospital or perinatal center has its own requirements for the contents of a woman's bag. Therefore, it is worth asking the staff of the maternity hospital of your choice in advance to give a sample list, according to which it would be possible to collect everything that is needed without any problems and misunderstandings.

If for some reason such a list was not provided, be guided by the average norms, but keep in mind that everything that will be packed in the bag should be conditionally divided into three groups:

what you need before and during the operation;
what is needed for a woman for the entire period of stay in the hospital;
what is required for child care.

Do not try to embrace the immensity and put everything down to the smallest detail. If you forget something, then you can ask relatives to pass it on to you. Also keep in mind that the list for a caesarean section is longer than for a woman in labor who goes to give birth on her own. However, there are points that cannot be ignored. Choose a bag that is comfortable, roomy, not too easily soiled, so that it can be easily washed and dried later.

There are special bags for the maternity hospital with a lot of pockets, which are not so difficult to find a practical use.

Before surgery and for surgery

With a caesarean section, if it is planned, a woman is hospitalized in the direction of the antenatal clinic 3-5 days before the expected date of the operation. They try to carry out surgical childbirth after a full 39 weeks of pregnancy. Thus, between 38 and 39 weeks you will need to go to the hospital. Documents are needed, according to which the pregnant woman will be registered in the chosen maternity hospital or perinatal center for hospitalization. In order to easily register in the hospital of the obstetric institution, a woman will need:

passport or certificate from the passport office, if the passport is being changed, it is lost or damaged;
an exchange card of a pregnant woman, who was brought in a antenatal clinic when she was registered, where all the data of analyzes, planned visits to the doctor, screening studies were entered;
compulsory medical insurance policy;
additional voluntary medical insurance policy (if any);
birth certificate (issued in consultation when applying for maternity leave at 30 weeks of pregnancy);
SNILS;
a woman's medical record (if she has chronic diseases, which doctors in the maternity hospital must know about);
a package of ready-made analyzes of the partner, if they are planning a joint birth.

Some perinatal centers today are ready to provide additional services and issue a birth certificate to the child upon discharge. If the chosen health facility does this, be sure to take:

photocopy of husband's passport;
Marriage certificate.

In the process of preoperative preparation, a woman will need the following things:

comfortable dressing gown according to the season (warm in winter);
nightgown (made of natural fabrics);
several shorts and 1 bra;
toothbrush and paste;
soap in a soap dish;

toilet paper;
wet wipes;
slippers with a hard sole, not fabric, which are easy to wash if necessary;
bowl, spoon, plate;
body towel and face towel;
bottle of drinking water without gas.

During the preparation period, you should also not forget about a mobile phone and a charger for it, as well as an interesting book that will allow you to pass the time while waiting for the readiness of all tests and examinations before the operation. For all preoperative procedures, a woman will need:

disposable new razor (for shaving the pubic area before surgery);
disposable diaper (lay on the couch during the cleansing enema);
elastic bandage or compression underwear (stockings) - put on before surgery to prevent thromboembolism.

After operation

The postoperative period will require the presence of other things. The dressing gown and nightgown will be replaced with a hospital shirt, and every day the medical staff will bring a fresh sterile gown. It is impossible to be at home in the first days after the operation. For this period, a woman may need the following things:

postoperative bandage (optional);
sterile postoperative dressings (size from 15 centimeters) and a bactericidal sterile plaster - for treating the suture;
special postpartum pads (it will be possible to use for the intended purpose from 4 days of stay in the maternity hospital, before that only sterile hospital pads are recommended, which will be issued daily with a margin);
"Bepanten" - for lubricating the nipples if cracks form when the baby is attached to the breast;
a separate small towel for wiping the mammary glands after washing before feeding, after them and after pumping;
breast pump;
baby cream for moisturizing hands.

Ready-made first-aid kits for mother and child do not stand up to criticism. There is little useful and much unnecessary in the hospital. Therefore, it makes no sense to overpay for them.

For child care

The baby in the very first days of his life does not need so much. But even here a lot depends on the requirements of the hospital and the wishes of the mother herself. If she plans to swaddle a baby, she doesn’t need to take anything special - diapers are provided by the children's department (they are also sterile). But if you want to dress the baby in full-fledged clothes from the first days, and the administration of the obstetric institution has no objections, then you should take comfortable things from natural fabrics:

undershirts (5 pieces);
sliders (5 pieces);
hats (3-4 pieces).

You will also need:

waterproof diaper (for covering the changing table, on which the child will be changed and laid out during the examination by a doctor);
a thin diaper (lay over a waterproof one);
diapers for newborns (small package);
baby cream;
powder;
optional - dummy;
wet wipes;
cotton buds (for treating the umbilical wound);
brilliant green;
cotton pads.

If the obstetric institution does not imply the joint stay of the mother and the newborn, then nothing but hats and socks for the newborn should not be taken. Children are swaddled and brought to feed at the set hours, after feeding they are immediately taken back to the children's department. Most modern maternity hospitals have switched to a cohabitation system.

Also, don't forget to bring a notepad and pen. They will facilitate the task of remembering the appointments of the doctor, the new mother will be able to write down questions that appear during the day to ask the doctor during her rounds.

For information on what to take with you to the hospital for a caesarean section, see the following video.