Expert: Catherine Beier MS CBE - 1/21/2009

Question
QUESTION: Hi. I have general questions about the cesarean procedure. How wide is the incision usually? I've heard that most cesareans are scheduled in the morning, so how long before that are women not allowed to eat? Also, is it true that women can't have solid food after the surgery, just soup, jello, etc.? How soon after the procedure can women eat? Are women usually in pain after the procedure and once they go home? Thanks

ANSWER: Danielle,


1.  The incision is usually about 6 inches across.

2.  Most cesareans should be performed in emergency situations, not planned.  There are few true reasons to schedule a c-section in advance.  If the c-section is planned, then most women are told to either not eat after midnight or 8 hours before the surgery if it isn't first thing in the morning.


3. & 4.  This will depend on whether the doctor/nurses really know what the research says about eating after a c-section.  Many will forbid food until you are able to pass gas.

However, there is no research to support waiting to let a woman eat after a c-section.  In this study, http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7, it was found that women who were allowed to eat when they felt like eating after c-section did so sooner than doctors thought they would and it also reduced their need for pain medications without raising risk of complications to them after the surgery.

So, the answer should be whenever the woman feels like eating.  In reality, it will depend upon how educated the staff is at that particular hospital.

She should be allowed to eat what she feels like eating, but as above, if doctors/nurses aren't well informed, her diet may be restricted for non-evidence based reasons.


5.  YES.  A c-section is major abdominal surgery.  It's not some little simple in-and-out procedure and shouldn't be though of as "routine".

The mother will be sent home with pain medication and be unable to lift anything heavier than the baby for weeks.  She will have difficulty sitting up, walking, and getting out of bed.

Recovery will last for at least 6 weeks or longer depending on how quickly her body heals and how much help/rest she has.  She will need assistance caring for herself and completing daily tasks such as dressing herself and getting to the bathroom, as well as caring for any other children in the house and daily household chores.


Best,
Catherine

---------- FOLLOW-UP ----------

QUESTION: Can women choose to have staples or stitches to close the incision? Or, does the doctor choose which of those two would be best ? Thanks again

ANSWER: Typically, the doctor uses whichever technique he is most comfortable with and/or the one best suited to the situation.


A mother can always discuss this and any other questions with her doctor, to find out what his preferences are, why he has them, and what her options are.  If she has a preference, she can also state it and her reasons for that preference.



Best,
Catherine

---------- FOLLOW-UP ----------

QUESTION: When a woman doesn't nurse, how long does it take for the milk to dry up? Is that when the breast returns to it's pre-pregnancy shape/size? Thanks

Answer
Danielle,

In reality, a woman's breasts may never return to their pre-pregnancy size and shape due to the hormonal changes of pregnancy.

It typically takes 1-2 months for milk to dry up, but this will also depend upon how much a woman produces.  The more milk she has, the longer it takes.


Best,
Catherine