HEALTH A Caesarean surgery can set your body back in many ways. KAMALA THIAGARAJAN provides a guide to help you heal

You’re holding your newborn baby in your arms and as you gaze at his/her angelic face, all the aches and pains of the months gone by are rapidly forgotten—all except one! If you’ve delivered via Caesarean section, do keep in mind that while it is a rather common procedure these days, it still is a major surgery.

Unlike mothers who deliver naturally and recover immediately after birth, the circumstances are a little different for you because the pain is just beginning!

According to Dr Rishma Pai, Consultant Gynaecologist: Jaslok & Lilavati Hospital, Mumbai, C-sections are on the rise, especially in urban areas. “The rate of caesarean sections has increased (in our country) especially in urban areas as regular antenatal checkups, close monitoring using sonography and colour Doppler pick up abnormalities such as intrauterine growth retardation (where the baby’s growth isn’t adequate), reduced (amniotic) fluid (oligohydramnious), reduction in blood flow to the baby. All these conditions warrant caesarean delivery to ensure safety of the baby. Also problems which can be risky to the mother and baby both such as placenta previa, abruptio placentae (where the placenta separates from the uterus), pregnancy induced hypertension, gestational diabetes are being increasingly diagnosed. Close monitoring in labour identifies foetal distress when it occurs, requiring urgent caesarean section. With increasing use of fertility treatment there is significant increase in twins; older women are getting pregnant and this too contributes to an increase in caesarean delivery.” If you or someone you know is planning an elective C-section, or is at risk for one, here’s what you need to know for a speedy recovery.

Take those first steps: Today, doctors agree that hard as it may seem, taking those first few steps the day after your C-section can contribute significantly towards healing. “Due to the type of sutures used and almost universally followed procedure of lower segment caesarean section (with the stitches on the lower part of the abdomen in a horizontal line), the risk of the scar on the uterus or the abdomen giving way is very rare. As a result, the patient is out of bed on the day following surgery and is encouraged to be active subsequently,” says Dr Rishma Pai.

Pay attention to your diet: Since food has healing potential, it’s important that you pay close attention to your diet at this stage. Stave off spicy fare and excessive caffeine. Eat calcium rich foods, fresh fruits and vegetables, much like your pregnancy diet, for proper post-natal care as well. “It must be reiterated that the need of calories during breast feeding is more than that during pregnancy. A good diet helps in overall health improvement and also scar healing,” says Dr Basab Mukherjee, a gynecologist based in Kolkata.

Strengthen your back: “Try to breast feed while lying down, if you experience pain while sitting and feeding. As far as possible, try to reduce the strain on the abdomen. Taking basic precautions such as avoiding too much exertion, lifting heavy weights, or exposure to crowded places in order to avoid infection is advised,” says Dr Rishma Pai. “Back strengthening exercise can be started soon after a caesarean section. Continue iron and calcium supplements for a few months after delivery.”

Scar care: Ensuring that your Caesarean scar doesn’t get infected is very important. Most stitches are dissolvable these days, which would mean that most of the healing is internal. This is why you must avoid activities that may strain your abdomen, because this will then delay healing. Don’t carry anything heavier than your baby and avoid or at least restrict your trips up and down the stairs. Report any itchiness, redness or swelling along your scar tissue to your physician immediately. Your doctor may prescribe medicated lotions or Vitamin E oil to speed up healing. Keep your scar area dry and clean and avoid any tight fitting clothes at this time. Be sure to use your hands or a pillow to support your incision when you cough, sneeze, or laugh.

Exercise routine: Understandably, you would like to get back to your pre-pregnant figure as soon as possible. But slipping back into an exercise schedule too soon after a C-section could cause several complications.

“You’ll need to be patient enough to give your body time to heal. I generally advise women to take it easy after a C-section,” says Dr. Mukherjee. Mild walks may be advised a week or two after the procedure. A (full-fledged) exercise program would need to wait till at least six weeks after delivery as that is the time for the sutures inside the body to get completely absorbed. This minimizes the risk of a hernia thereafter.”

Emotional and spiritual relief: Healing from surgery should go beyond just the physical issues. You should ensure that healing on a mental and spiritual plane is effected as well. “I started yoga about a year after my C-section and it helped enormously,” says Mangala Ramprakash, a Bangalore-based housewife and mother of two. “I finally began to feel like I "possessed" my body in its entirety again...that feeling of wholeness and well-being that yoga gave was such a gift.”

Make use of every minute your baby sleeps to pencil in time for yourself. Exercise, meditate, pray, chant, anything that will allow you to feel more like your normal self.

And remember, it took nearly a year for your body to create the miracle that is your baby. It will take just as long for you to regain your original strength and fitness. Give yourself time and care; as you nurture your baby, be sure to embark on your own journey towards health and healing.

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