Caesarean Section
Visuals Are A Great Way To Teach!
Teaching Tools
Arouse Interest:
Select a question statement, real-life experience or new item that induces interest. – adapt your introduction to the subject of class.
Identify the main point of your teaching: make sure that your introduction makes the subject and purpose of your presentation clear to your listeners
Make it clear why the subject is important /adapt what you say to the practical needs of your listeners. That should be able to clearly understand how the subject can help them personally.
•When preparing your class – make yourself familiar with your clients needs
•Observe activities and surroundings, body language
Planned C-Sections
Previous Caesarean Sections
Breech
Placenta Previa
Previous surgeries
Fibroid Block
Indication - Maternal Choice
Multiple pregnancy
Caesarean Section During Labour
Conditions that may develop during labour that might put either mother or baby at risk eg: severe infection of the uterus
Baby is Struggling With Labour
ie: drop in heart-rate
Labour Stops progressing
Either the cervix does not fully open
despite contractions or the baby stops moving down the pelvis
Cord Prolapse
Where a portion of the umbilical cord slips through the cervix and is at the front of the baby's head, which can limit blood supply to the baby
Preparing for a Caesarean Section
At Home
No eating solids or drinking non-clear fluids 8 hours before (eg. milk, orange juice, coffee with milk)
No drinking clear fluids 3 hours before (eg. water, clear juice)
Shower
The day before surgery, mum may be asked to shower using a special antibacterial soap to reduce the risk of developing a skin infection after surgery.
Jewellery - removal of all jewellery prior to your C-section, including piercings (It is best to leave all valuables at home)
Hair removal - Is not needed. If mum wishes she can trim, wax or shave several days before. *Do not shave your skin immediately before the procedure.
Nail polish is permitted
At Hospital
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Arrive when you are asked to usually 2 HOURS before your surgery time
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Clothing - mum will be asked to change into a hospital gown
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Nursing care - mum will have a blood test and and an intravenous (IV) line will be put in the hand to give fluids and medications during surgery.
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Support person - mum can bring one person into surgery. This person will be asked to wait outside the operating room until you are comfortable and positioned for surgery.
Spinal/Epidural
Most C-sections are done with freezing using a spinal/epidural anaesthetic
This is performed by placing a needle in the back, which is removed before surgery starts.
The Doctors will make sure there is no feelings, starting the surgery.
General anaesthetic
Its uncommon, but mum may need to be put to sleep for this surgery, for example in very urgent situations.
The Team
The medical team involved in the surgery, are:
The anaesthetist
Who will be providing freezing during the surgery.
The obstetrician
Who will be performing your C-section.
The surgical assistant
Who is a fellow, resident, or another doctor.
The nursing team
Who will assist with the surgery.
The respiratory therapist
Who will monitor the baby immediately after delivery.
Preparation
Once the spinal or epidural is working the abdomen will be cleaned with a special cleaning solution.
A small tube (Foley catheter) will be placed inside your bladder to keep it empty for the procedure. This is usually left in until after the surgery.
Mums body will be covered by a sterile sheet to protect you during the surgery.
The team will test mums skin to make sure it's numb.
At this point mum's support person will join you in the operating room.
Delivery
A bikini skin incision is made on the lower abdomen.
The muscles are separated (not cut) to access the uterus.
An incision is made in the lower uterus.
At this point, mum will feel pressure while the doctors press on your abdomen to deliver your baby.
At this point, if the baby is crying, the team may proceed with delayed cord clamping.
Generally, baby will be in the room with mum the whole time.
The baby can be on the warmer, held by your support person, or held on your chest by your support person during the remainder of the surgery.
After the Delivery
After the baby is delivered the placenta is removed.
Then the uterus and the layers of the abdomen are closed.
Usually the skin is closed with a stitch that will slowly dissolve so that you do not have to have the stitches removed. Other options may include a dissolvable glue or staples which require removal.
Sometimes tapes called steri-stips will be placed over the incision and these should be removed 7 days after surgery.
The incision is then covered with a bandage.
After a C-Section
Mum will be transferred to the recovery room and monitored closely until the anesthesias wears off.
The catheter will be removed once you are able to walk without support.
Mum will be encouraged to eat, drink and walk as soon as you feel ready.
Midwives will provide you with oral (by mouth) pain medications to keep you comfortable.
Everyone’s recovery is different, and some women will need stronger pain medications (narcotics).
The narcotics that are used are safe for breastfeeding.
Constipation is common after your delivery, especially when using narcotics, so a stool softener may be recommended.
Getting ready to go home
There will be lots of support in hospital to care for yourself as well as your baby.
The Midwives are always available to answer questions and provide help and support, including breastfeeding assistance.
A Dr will see you prior to discharge home.
Most women spend 1-2 nights at the hospital after a C-section - but can vary taking into consideration the health of mum and baby
The criteria for going home include:
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Good pain control
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Ability to walk around, pee and pass gas
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Ability to eat and drink
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Tests that baby needs before going home:
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Physical exam, including baby’s weight, Bilirubin, Hearing test
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Newborn screen (Done no earlier than 24 hours. If you leave prior to this, you may need to come back for it.)
Going home
Coming home with a new baby after a C-section can be an overwhelming time.
It is normal to feel tired and to experience some pain as you heal.
Mum will be encouraged to rest, take pain medication, and walk around to promote healing.
You can shower and perform activities as needed.
The incision should be kept dry, mum should avoid applying creams/ointments unless prescribed. leave the scar uncovered (i.e. avoid bandages and tight clothing).
Numbness along the scar is normal for many women and usually resolves several months after the surgery.
The Mother will experience vaginal bleeding following your delivery. Bleeding may last until 6-8 weeks and is normal.
Avoid
There are very few limitations following a C-section.
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Heavy lifting
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Avoid lifting anything more than 10 pounds (other than the baby) until 6 weeks after surgery.
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Driving - Avoid driving until you are no longer taking narcotic pain medications and can make quick movements (i.e. slam on brakes). This time frame is different for everyone.
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Sex - Avoid intercourse for 6 weeks postpartum, until the bleeding stops, to prevent infection.
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Swimming - Avoid swimming for 6 weeks postpartum, until the bleeding stops, to prevent infection
By 6 weeks most women are completely healed. Mum will see a care provider at 6 weeks for a routine postpartum visit. Usually after this visit, mum may resume full activities without any restrictions.
Assignment - Caesarean Section
"We are not expected to know everything - but knowing where to go
for accurate information is essential"
Teaching Techniques
This game can be used in either a face to face class or via zoom
in the Zoom class - use a pregnant mannequin to show where the pad go
