Don’t worry its going to be OK.
On the day of your surgery you may shower and brush your teeth. Remember not to eat for at least 8 hours before the time of surgery.
If you need to take any of your regular medication you may do so. You can sip some water to help you swallow the medication.
If you are taking insulin for diabetes, the diabetic clinic nurse or doctor will direct you on when to take the insulin and also when you are to eat and drink.
Drive to entrance 97. This is the first entrance to BCWH when you come in from Oak Street. It will have a sign marked Urgent Care Center (UCC) next to entrance 97.
Park the car. You do not need to pay for parking at this time due to Covid restrictions. Please read the parking signs as things may change. Leave the bags in the car. You will get them later. Bring your cell phone (camera), a piece of picture I.D. and your B.C.Healthcare card with you. Only after the surgery when you are in a postpartum ward should you get the bags and take them to the ward in which you will be staying.
Go into the hospital through entrance 97. Before you are allowed to enter you will be asked questions related to your risk of having or being in contact with someone who has Covid 19.It is suggested that both of you wear facemasks at this time.
After the screening check you go through the next set of sliding glass doors, turn left and you will see the admitting clerk. This is where you check in.
The clerk at the admitting desk will admit you and give you your hospital identity bracelets and a map on how to get to the new BC Children’s Hospital where the csection will be done. She will also ask you if you want to donate the babies cord blood to the stem cell donation program. This is a free program and all that is needed from you is to sign a consent from.
From the admitting area you will be given directions on how to get to the surgical unit. This is in the new B.C. Children’s Hospital. It is quite a long walk. If you are unable to walk please ask the clerk or nurse to arrange a wheelchair for you.
Drive to entrance 97. This is the first entrance to BCWH when you come in from Oak Street. It will have a sign marked Urgent Care Center (UCC) next to entrance 97.
Park the car. You do not need to pay for parking at this time due to Covid restrictions. Please read the parking signs as things may change. Leave the bags in the car. You will get them later. Bring your cell phone (camera), a piece of picture I.D. and your B.C.Healthcare card with you. Only after the surgery when you are in a postpartum ward should you get the bags and take them to the ward in which you will be staying.
Go into the hospital through entrance 97. Before you are allowed to enter you will be asked questions related to your risk of having or being in contact with someone who has Covid 19.It is suggested that both of you wear facemasks at this time.
After the screening check you go through the next set of sliding glass doors, turn left and you will see the admitting clerk. This is where you check in.
The clerk at the admitting desk will admit you and give you your hospital identity bracelets and a map on how to get to the new BC Children’s Hospital where the csection will be done. She will also ask you if you want to donate the babies cord blood to the stem cell donation program. This is a free program and all that is needed from you is to sign a consent from.
From the admitting area you will be given directions on how to get to the surgical unit. This is in the new B.C. Children’s Hospital. It is quite a long walk. If you are unable to walk please ask the clerk or nurse to arrange a wheelchair for you.
In the surgical preadmissions unit you will get changed into your OR clothes and you will have an IV started in your hand. Your partner will get changed into OR scrubs too. There are lockers to store your belongings.
The anesthesiologist and the surgical team will come to meet you. I will see you in the preadmission area before you go to the O.R.
Remember to tell them of any allergies or medical concerns you may have.
About 30 minutes before the C-section you will be taken into the O.R. Your partner gets to sit and wait outside the O.R. at this time.
Once in the O.R. you will sit on the O.R table and you will get some local anesthetic into your lower back. The nurses will help you bend forward while this is being given. This is not painful. The needle and solution used are the same as you get when you get dental freezing. Once your lower back is numb you will get the spinal anesthetic. This is given by another small needle that goes into your lower back. You will not feel this, as the area will be anaesthetized and numb.
Soon after receiving the spinal anesthetic you will be helped to lie down on the operating table.
In a few minutes your legs will start to feel numb. You will not be able to move them. This often feels very strange.
Once you are completely numb the nurse will insert a catheter into your bladder. You will not feel this.
After the spinal, you might feel a little shaky, nauseated and dizzy. This usually gets better pretty quickly. Tell the anesthesiologist as they can give you some medication to help reduce these symptoms. It often helps to close your eyes and relax.
After the preparations are done, your partner will come and join you. They will be seated next to you on your left.
Don’t worry about feeling the surgery. Before I start I will test to ensure that you are comfortable. You may feel pressure but no pain. There will also be a small screen at the level of your chest, which prevents you or your partner from seeing the surgery.
The cut is made low down through a bikini incision. I make the cut as small as possible.
If you have a previous scar this will be removed. You will only have one scar.
When the baby is born you will feel me pushing on the top of your tummy for a few moments. I will give you warning before the baby is born so your partner can get the camera ready. The surgery cannot be filmed or photographed but as the baby is being born, your partner can stand up and take photos of the birth. Video is not allowed.
Once the baby is born I will hold it up for you to see.
I wait 30 to 60 seconds before cutting the baby’s cord and the screen is lowered so you can see the baby as soon as it is delivered. The baby gets handed to a nurse who will bring the baby directly to you. After you have held your baby for a few moments the nurse takes the baby over to the pediatrician who will be standing close to the bed. Your partner goes with your baby if they wish to.
The baby is examined and weighed and brought back to you as soon as possible. While the exam is taking place you can see the baby on a TV monitor at your head.
You can get to cuddle your baby at this point. We encourage skin-to-skin contact. If you do not feel you are able to hold your baby at this point, the baby will be given to your partner to hold. The baby can have skin-to-skin contact with your partner at this time.
You will not be able to breastfeed in the O.R. but you can start as soon as you are in the recovery room.
It takes me a few more minutes to complete the surgery.
The skin is closed with a dissolving stitch that lies beneath the skin. There are no stitches to remove after the surgery.
After the surgery is complete all three of you will be moved to the recovery room where you will stay for an hour or so. The baby will have skin-to-skin contact with you and you can start to breastfeed.
While you are in the recovery room the nurses will take your blood pressure and check you incision. The nurses will help you with the breastfeeding.
You will be thirsty after the surgery. You can have sips of water and ice chips to chew on.
Once this is completed all three of you will go to a private post partum ward where you will stay until discharge.
Once you get to your room you can eat and drink if you wish. Start slowly. You can drink coffee. The nurses on the ward may not give you anything to eat or drink for a while, so your partner may go to the fridge on the ward to get you some water or juice to drink. There will also be some crackers on the ward for you to snack on.
The IV usually comes out before bedtime. The catheter comes out the next morning.
I encourage you to get up and out of bed as soon as possible. The anesthetic takes a few hours to wear off. You can probably start to get up and out of bed 6 hours after the surgery. It is suggested that you and your partner wear a facemask when walking in the hospital common areas.
When I do the surgery I do not cut your muscles so when you get moving you cannot injure yourself or damage your incision. You may shower the next morning. Just pat the wound dry after you wet it. The wound dressing will be removed after your first shower.
The incision will hurt at the edges and may feel numb in the center.
It will hurt when you sit up, laugh, sneeze or cough. You cannot break your wound open even though it may feel as if you can.
Pain medication will be given to you on a regular basis for the first 24 hours after the surgery. This will consist of a combination of Tylenol and an anti-inflammatory. If you are still in pain you can ask for some extra pain medication called hydromorphone (Dilaudid). Try to stay ahead of the pain. Don’t let the pain get too severe before you ask for more pain medication. All the medications you get in hospital are breastfeeding friendly.
On the second day after the surgery you will be given Tylenol and Advil to take on your own every 4 to 6 hours. This helps somewhat but if you continue to have pain ask the nurse for extra hydromorphone (Dilaudid). This is only given if you ask for it. It is very effective at reducing pain but it can have some side effects such as nausea and making you feel dizzy. You will also get a stool softener.
You will probably not have a bowel movement for a few days. Ask your nurse for a laxative if needed.
Your partner can stay in the room with you and this is often very helpful as you will not be able to get out of bed to pick up your baby. They sleep on the floor and the hospital will provide a foam mattress. They are welcome to bring their own inflatable mattress and sleeping bag if they want to. As no visitors are allowed, if your partner cannot stay overnight in hospital to help you, the nurses on the ward will help you.
After the surgery you may feel very bloated and have a lot of gas pains.
Eating, drinking and chewing gum helps you pass the gas and also helps to get your bowel moving again.
Using a bellyband or an abdominal binder to support your abdomen may help you to get moving faster. It may also help reduce some of the pain you may feel when walking or getting into and out of bed. It can also help support the abdominal muscles from separating especially if they have been repaired at the time of the csection. See if your friends can lend you one or you can buy one online or from a maternity store or pharmacy. There are some especially made for support after a csection.
If this is your first c section you will probably stay for 2 to 3 days in the hospital. If this is not your first c section you may go home earlier if you wish as long as you and the baby are doing well.
When you go home there are no restrictions as to what you can do.
You may climb stairs; lift the car seat and push the stroller. You can lift any weight as long as it is not painful. If you have other children at home you will not be able to lift them up but you can have them sit on your lap. They can press up against the incision without injuring you.
You should not drive for 10 to 14 days after your surgery. Only resume driving when you feel completely comfortable and safe to do so.
There will be a steri-strip over the incision. Leave it on for a week after going home. To remove it you just pull it off as you would a Band-Aid.
After the dressing is removed, apply polysporin over the incision once or twice daily for a week. This helps the healing process and helps prevent infection.
It is common to have a small amount of bleeding coming from the incision for up to six weeks after the surgery. The bleeding is usually from the stitch coming to the surface or from an ingrown hair on or near the incision.
For pain I suggest using Extra strength Advil and Extra strength Tylenol. Take one or two of each pill together every 4 to 6 hours on a regular basis for moderate to severe pain. I do not suggest you use Naproxen or Aleve for pain control when you get home as this medication often causes a lot of stomach irritation. If you still have pain after taking the Advil and Tylenol combination you may need a stronger pain medication called Dilaudid. This you take in addition to the Advil and Tylenol and only as needed for breakthrough pain. You will need a special prescription for the Dilaudid, as it is a narcotic. All these meds are safe to take while breastfeeding.
Stool softeners. These will be given to you. Your first bowel movement will not be as difficult as you expect and it may take a few days for your bowel to work. When you go home you can buy more of these over the counter.
Constipation is a common problem after having a baby. I suggest you hold off on your vitamins, increase your fibre intake and take a gentle laxative such at Restoralax every day or every other day until you become regular again.
This may happen, but the chance of it happening is small. If you do start to get contractions, wait to see if they progress into active labor. I suggest you wait until the contractions become regular – say 5 to 7 minutes apart and they are intense enough that you cannot ignore them. Also, if your water breaks with or without you having contractions come to the hospital as soon as possible. Do not eat or drink anything. It may help to notify the staff before you arrive so that things are ready when you arrive. Please call 604-875-3070 and let the staff know that you are en route.
The same rules apply during pregnancy, delivery and postpartum. Socially distance, wash hands and wear a mask.
In the hospital, moms, partners and babies stay together.
Partners can leave and come back to the hospital but they cannot swap out with another person.
Patients do not need to wear a facemask in labor or in the OR.
Mom and partners should wear facemasks when walking in the hospital common areas.
Moms are encouraged to breastfeed. If a mom has Covid she can still breastfeed but she should wear a facemask while doing so.
The hospital is fully operational and there are enough nurses, doctors, support staff and PPE’s to go around.
You will be asked a series of questions on admission to determine your risk status for having Covid. If deemed necessary you may be swabbed for Covid.
NO VISITORS are allowed in the hospital. That includes siblings and grandparents.
We encourage as short a hospital stay as possible.
Doctors are not allowed to visit their patients if they are not working on call. If I am not allowed to see you, a member of the call group will see you during your postpartum stay and discharge you when you and baby are ready to go.
At home try and limit visitors. All visitors should wear a facemask and wash hands on entering the home. It is acceptable to ask visitors who have a cold etc. or who may have been in contact with a person suspected or confirmed of have Covid not to visit your home.
Fever (greater than 38.5c)
Redness, swelling or worsening pain over the wound.
Puss or blood oozing from the incision
Very heavy vaginal bleeding (soaking a pad every 10 minutes for an hour)
Bruising around the wound that is getting worse.
Call my office at 604 874 6848.
After hours call 604 875 2161 and ask for the OB group doctor on call.
If you feel that your problem may be urgent or serious go back to B.C. Women’s Hospital immediately.
