Friday, March 13, 2009

Cesarean Recovery: Tips to get your bowels moving

In 1997 when I had my first baby by cesarean section I had no clue as to what my recovery would be like. All I knew was that I felt like I had been run over by a Mack truck and that I could barely move. For the first two days I was confined to a hospital bed and gorked out on drugs. I was not allowed to eat any solid food at all because I was told it would make me sick. On the third day I was told I needed to get up and move around and have a bowel movement, yet I still wasn't allowed to eat solid foods. So on the this day I was given stool softeners, prune juice and eventually a laxative to get things moving. The nurse assured me that as soon as I pooped and they knew my bowels were moving I could have solid food AND that if I could not poop, well they were not going to let me go home from the hospital until I did.

Let me just say, that 12 hours of stool softeners, prune juice (that they heated for me so it would taste better) and a powerful prescription laxatives did the trick. Things got moving alright and I can testify that it was one of the most painful, humiliating experiences of my life. After a few hours of becoming one with the toilet in the neighboring bathroom with excruciating stomach cramps with a eight inch incision in my abdomen I was finally allowed some solid food - lumpy cold mashed potatoes.

When I got pregnant with our second son Jack five years later I did some research to better facilitate my recovery that would not leave me starving or spending valuable time I could be spending with my baby on a commode. Here are just a few of the things I did that you might want to try too after your cesarean section.

  • Drink, drink, drink. As soon as you get into recovery start on the ice chips and then gradually move to sipping water or fruit juice. A study done in Turkey found that cesarean section mothers who had fluids early on in the recovery process had a return to bowel function much sooner than those who waited to have fluids.
  • After surgery, ask to eat as soon as possible. I don't suggest eating a heavy meal from the local fast food joint but there is really no reason you can't have some soft solid foods, fruit, or vegetables a few hours after surgery if you feel up to it. Eating will get your digestive system working again after major surgery.
  • Some doctors will not allow you to have solid food until you are passing gas. This may be harder to do than it sounds. Need to fart, pack some gum in your hospital bag. Chewing gum has been shown to speed bowel function after a cesarean section. Also, don't hold back unless you really want to be in some serious pain. If you have guests come to visit you and your newborn baby, warn them that you are just going to be ripping them as mother nature allows.
  • If you are having a lot of pain from gas, which may present as pain in your chest and shoulders, request a rocking chair in your hospital room if there is not one already there. Rocking has been shown to eleviate pain from gas and help pass it which in turn gets the bowels moving. A study done in 1990 showed that rocking mothers had less gas pain, walked faster and left the hospital one day sooner than cesarean section mothers that did not rock. I can testify from my personal experience that rocking worked with my last three cesarean sections.
  • Get moving as soon as you can. The more you move after having a surgical birth the faster you will heal. Just take things slow. Moving around your room and walking the halls will also get your digestive track moving, and it will also facilitate passing gas. Remember don't hold back! If you are walking the halls and a good fart slips, blame it on your nurse or partner. You will most likely be on drugs and no one will care what you say and will think its funny.
  • Take the stool softeners as soon as possible. Don't wait until they are needed. If you wait until then, its too late. Keep in mind you do not want to put any straining and pushing on your back end after having abdominal surgery.
  • It's likely you will experience some constipation. Until things are flowing like they should you may want to discuss cessation of your prenatal vitamins with your doctor if they are high in iron with your doctor and go to eating iron rich foods. This may not be possible depending on how much blood loss you had during surgery so don't just stop taking your iron because you read this here on the internet.
  • My last tip is try avoiding taking medication that has codeine it. Codeine is one of those pain relievers that stops you up. As my husband would say "it will make things hard as a rock". See what options you have in way of pain management that will not cause you additional discomfort down the road.
Lastly, keep in mind that it is not unusual for you not to have a bowel movement until 3 or 4 days after having a cesarean section. If by day four you are not having a bowle movement then it is likely you will need something to help you go. Discuss using an enema verses a laxative with your doctor if you find yourself in this situation. From personal experience the enema is far kinder to you than the laxative and less painful.

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