Mothers who have undergone cesarean section should know the following things. It is recommended that you save them in advance!

Author: Wang Shaowei, chief physician of Beijing Hospital

Member of the Nutrition and Metabolic Disease Committee of the Perinatal Medicine Branch of the Chinese Medical Association

Reviewer: Duan Hua, Chief Physician, Beijing Obstetrics and Gynecology Hospital, Capital Medical University

Standing Committee Member of the Obstetrics and Gynecology Branch of the Chinese Medical Association

Many pregnant mothers cannot give birth naturally due to their own reasons or the reasons of the fetus, and have to choose cesarean section. At this time, many pregnant mothers will be a little anxious, because cesarean section requires anesthesia, will it affect the baby? Cesarean section requires cutting the abdomen, will it be very painful after the operation?

Facts have proved that cesarean section anesthesia will not affect the baby. Cesarean section usually uses spinal anesthesia, which is an injection behind the spine. After the cesarean section, you can choose an analgesic pump for pain relief, or inject pethidine, morphine and other short-acting analgesics for pain relief, so that mothers will not have to endure this kind of pain after giving birth.

After eliminating these anxieties, there are actually many things that need attention after cesarean section, such as how to care after the operation, how long to have sex, and a series of other issues.

1. How to care after cesarean section?

From a medical point of view, those who have undergone cesarean section will recover more slowly than those who have given birth vaginally, and may need more careful care and protection in the first few days.

The first thing to do after cesarean section is to recover from anesthesia. During the recovery process of spinal anesthesia, lower limb movement may be impaired. In order to prevent thrombosis, especially for older mothers, after returning to the ward and unable to move, the caregiver should help the mother massage her legs to move her legs.

Figure 1 Original copyright image, no permission to reprint

Second, there are risks of bleeding and infection after cesarean section, so you need to pay attention to observation. If the incision is not infected, it will generally start to repair after 24 hours and will be completely healed in 7 days. If the incision is infected, the most important manifestation is redness, swelling, heat and pain. If there is no redness, swelling, heat and pain, and no tendency to infection, no special treatment is required, and normal dressing changes are sufficient.

Third, after cesarean section, encourage people to get up and move around as soon as possible to prevent thrombosis and support breastfeeding.

There is actually no big difference in other precautions after a normal birth, whether it is diet or care, they are the same as normal confinement period.

2. What are the methods to reduce scars after cesarean section?

Scars are a matter of physique. Some people have a very good physique, so their scars are not very obvious. Some people have a scar-prone physique, and after the subcutaneous connective tissue proliferates and becomes fibrotic, the scars become unsightly.

To reduce scars, using a better suturing method during surgical suturing will reduce the formation of scars. Try to sew as well as possible and avoid subcutaneous bleeding and infection.

Within 24 hours after surgery, if the patient has a scar-prone constitution, low-dose radiotherapy can be used, which may help reduce connective tissue hyperplasia and subcutaneous fibrosis.

There are currently patches, films, and gels for preventing scars. Current medical technology is not yet able to make scars disappear completely.

3. How long will it take before you can have sex after a cesarean section?

Cesarean section is the same as natural birth. You can have sex after the lochia is discharged, which is usually 21-42 days after delivery. Regardless of whether it is a cesarean section or a natural birth, you must pay attention to contraception.

Some mothers say that they will not get pregnant because they do not ovulate during breastfeeding. There are many examples of women getting pregnant without taking contraceptive measures during breastfeeding. For safety reasons, you must take good contraceptive measures, because there must be a certain time interval after a cesarean section before getting pregnant again, otherwise there will be risks.

4. How long is the best interval before getting pregnant again after a cesarean section?

Generally speaking, whether it is a natural birth or a cesarean section, the physiological recovery time after delivery is generally 6-8 weeks, and after recovery, the conditions for pregnancy are met.

However, if the fertilized egg is implanted on the uterine wall and the endometrium has not been fully repaired, the fertilized egg will not grow well and miscarriage may occur. If the placenta's gestational sac is not implanted in the right place, there is a risk of placenta previa.

For cesarean section, there is an additional risk. If the incision in the lower uterine segment does not heal well, there is a risk of uterine rupture in the late pregnancy, which is more troublesome.

When is the right time to get pregnant again after a cesarean section?

If there are no complications, the best interval is 2-5 years. Why is it 2-5 years? In 2 years, the lower uterine segment incision will heal better and the scar repair will be in the best state.

Is it okay to get pregnant after 5 years? After 5 years, the elasticity of the scar will be poor and it will not be in the best condition.

Therefore, it is best to wait 2-5 years before getting pregnant again after a cesarean section.

Women who have had a cesarean section can have normal prenatal checkups when they become pregnant again. What needs to be noted is that in the early stages of pregnancy, when doing ultrasound examinations, attention should be paid to scar healing, whether the fertilized egg is implanted on the scar, and the continuity of the lower uterine muscle layer. This is related to whether there will be a risk of uterine rupture during pregnancy. The location of the implantation of the fertilized egg is also related to the future location of the placenta and the future development of the child.

5. If the first child was delivered by caesarean section, can the second child be delivered naturally?

Whether a natural birth is possible depends on the condition of the pregnant woman and the fetus.

If the factors that led to the last cesarean section no longer exist this time, such as fetal distress, problems with the birth canal, and there are no contraindications to vaginal delivery, then if the conditions are met, a natural birth can be achieved. About 60% of women can give birth smoothly vaginally.

If the indications for the previous cesarean section still exist, such as severe pelvic deformity, a natural birth is absolutely not possible. Even if the indications for the previous cesarean section no longer exist, if the lower uterine incision is not well healed and the continuity of the lower uterine muscle layer is not good, a natural birth is not possible.

Therefore, whether or not a natural birth is possible is not absolute and depends on the specific circumstances.