Recovery After Cesarean – Part II

ACOG has not commented on the new guidelines so pap frequency discretion could be different with your AOA provider.

Getting Moving

After surgery, most patients are encouraged to get up and out of bed within six hours. Simply getting out of bed and taking that first step is the toughest part for many new moms, but it’s crucial to a quicker and healthy recovery. You will feel some pain and discomfort, and many C-Section patients feel anxiety about what’s going on inside of them as they begin to move around, but this is a huge milestone in your recovery process.

Typically you won’t be walking laps around the hospital six hours after surgery, but you are encouraged to simply get up and perhaps stand for a few moments. It’s not only scary and uncomfortable, but there are also some rules to remember when getting moving for the first time. Keep your focus, stare straight ahead, and have someone help you.

Coughing, sneezing and even breathing might be uncomfortable during those first few days after surgery. Your nurse will instruct you on how to do these things so as not to increase pain.

Get Walking

By day two, hopefully you are no longer attached to the catheter and are moving around a bit more. You will begin to eat and drink almost like normal again, and, probably with the help of a nurse and/or partner, you will begin to venture out into the halls.

Your nurses will want you to do more than venture into the halls, and soon will be telling you to take a few laps. While it might be the last thing that you’ll want to do, it’s very important that you get moving to help naturally improve circulation, limit your risk for blood clots and Deep Vein Thrombosis (where a blood clot forms deep within the tissues of the body, which can lead to greater complications in the heart, brain or lungs), and get your bowels moving again.

Take A Look

The second day is also a great time as any to take a look at your incision. It’s actually an important part of the recovery process, because you’ll need to keep note of any changes that might indicate an infection in later days. The incision area will probably notice intense itching and numbness, which is normal.

While your physician will monitor your incision site, it’s your responsibility to care for it and notice any changes over the upcoming days.

Home Recovery

Within 2-4 days, depending on your recovery speed and how many laps you’re taking around the hospital floors, you will be heading home. It’s at this point that you’ll feel that overwhelming fear creeping up once again, because not only will you need to take good care of yourself and your incision, you’ll have a new little one to take care of as well.

You’ll need as much help as you can get, so take advantage if anyone asks to lend a hand. You’ll also be given a prescription for any pain or discomfort. A full recovery could take up to eight weeks, so be sure to plan accordingly. You don’t want to rush back into your old routine. Take it easy, spend time with your new baby, and take care of yourself. You will be recovering both emotionally and physically, so be well aware of that fact and make sure that family members know as well.

Should you notice any redness, swelling, or oozing at the incision site call your OBGYN immediately. If you feel sharp pains or worsening pain, call immediately. If you have a fever, feel pain with urinating, or notice blood in your urine, call your OBGYN immediately.

Recovery After Cesarean – Part I

ACOG has not commented on the new guidelines so pap frequency discretion could be different with your AOA provider.

Everyone’s experience with labor is different, as is everyone’s experiences with a Cesarean. Whether it’s an emergency C-section with high stress, or a planned C-section with low anxiety, recovery is a whole different story. Some women can recover from a Cesarean within a matter of weeks, some a matter of months. And while everyone’s experience with C-section recovery is unique, there are a few things that you’ll need to be aware of when returning home with your new addition to the family.

Cesarean Recovery

You will have a million questions both before and after surgery; how is the post-partum pain, what will I be able to do, what are my restrictions, when can I hold my baby, how long with it take to recover?

Cesarean recovery involves a variety of steps; all monitored closely by your OBGYN and the hospital staff.

Initial Moments after C-Section

 In the initial moments after your Cesarean, you will be closely monitored in a post-op recovery room. Your OBGYN and the hospital staff will closely watch all of your vital signs for the next one to three hours depending on how much anesthesia you were given. The staff will keep an eye on your level of nausea, which could be a result of the anesthesia, your blood flow, any pains you might be feeling in your abdomen, and the firmness of your uterus.

As with a vaginal birth, you could still go through ‘the shakes,’ as they are called, feel extremely fatigued, groggy and nauseous. Much of the way that you will feel immediately after the surgery has to do with the anesthesia that was given.

If you were given morphine through your epidural, an itchy sensation is quite common and can be counter-treated with medicine.

Recovery Room

When you’re OBGYN feels you’ve recovered well, they will move you into the recovery room. You’ll probably notice that this room is a bit more ‘roomy’ and allows for more visitors. You will also notice that things are beginning to hit you first the first time. With C-Sections, once the affects of anesthesia wear off and you’re moved into the recovery room, it is quite common to feel a bit overwhelmed with everything that has just happened. Whether you were completely prepared and it was a planned Cesarean, or it was an emergency situation, when you move into the recovery room is usually when the gravity of the entire situation sets in.

This is the time when family and friends, and the sight of your newborn baby, are extremely important. It is also a very important time for your partner to step up and be by your side, reassuring you that all is well.

You will continue to be closely monitored by the nurses, and will most likely have your catheter, blood pressure monitors, and IVs with you in the recovery room for another day or two. You can expect to feel some pain and discomfort. It is important that you remain honest in discussing the amount of pain you’re in with your nurses so that they can prescribe the proper pain medication.

Jump to Part II

Emotional Stress, Physical Stress, and Pregnancy Risks

Stress is a part of life. Whether it’s work related, family related, or financially related; we all live with stress in our lives. As physicians, we all know how detrimental extreme stress and chronic stress can be on heart health. From increasing your risk for heart disease, studies have shown that chronic stress can also limit your life expectancy. But when it comes to pregnancy, how much ‘normal’ stress is too much? What constitutes extreme, chronic stress?

Physical Stress and Pregnancy

Your body goes through an entire array of stressful conditions while pregnant, from morning sickness to lower back pain, vomiting and nausea, constipation and headaches, and much more. The natural stress and is associated with pregnancy can sometimes be far worse than any physical or emotional stress that comes from outside sources. So, it’s important to keep in mind how stressed your body already is, how taxing pregnancy can be on your body, and how your stress threshold is a bit lower now that you’re dealing with these additional physical stresses.stress and pregnancy

Physical stresses on the body include lifting, bicycling, amusement park rides, snowboarding and surfing and waterskiing, and tennis or contact sports. Most of these items seem pretty self-explanatory. The main idea is that you do not want to stress the abdomen. Trauma to your abdomen, according to the MayoClinic, is the leading cause of ‘pregnancy-associated maternal deaths in the United States.’ So, when considering physical activity and actions that might affect your abdomen, consider not only your baby’s health but your own as well.

Emotional Stress and Pregnancy

According to the March of Dimes, women who experience high levels of stress also may be at increased risk of premature delivery.

 

Babies born before 37 completed weeks of pregnancy are considered premature. Babies born too small and too soon are at increased risk for health problems during the newborn period, lasting disabilities (such as mental retardation and cerebral palsy), and even death.

 

Don’t fret if you’re facing everyday stresses such as being late for work, getting the kids off to school, making dinner, etc. However, those stresses that involve a death in the family, divorce, loss of a job, or any other catastrophic life event, can constitute an extreme stress and one in which you’ll want to consult your physician.

Extreme stress causes a hormonal reaction within the body, and a hormone called corticotrophin-releasing hormone, or CRH, which is produced by the placenta, can trigger the release of prostaglandins and uterine contractions.

Stress is a factor of our lives, yet if that stress becomes chronic; where it lasts for many weeks, if it is physical such as a car accident, or emotional such as a death in the family, speak to your physician immediately.

Contraceptives: The Controversy and The Facts

Contraceptives, also known as birth control, are a very hot topic right now not only in Arizona but around the nation. From politicians talking about pending bills to moms sitting at play dates, contraceptives and their uses are being discussed at length right now. But let’s take a look at the facts. Why are women using contraceptives? Are contraceptives just for birth control? What are the medical reasons for using contraceptives?

Why are Women Using Contraceptives?

Women use ‘the pill’ for many reasons; to lower cancer risk, help clear up blemishes in the skin, ease painful periods, ease PMS, ease endometriosis, and control unwanted pregnancies. OB GYN’s prescribe contraceptives to women of all ages, for all of the mentioned reasons.contraception

Are Contraceptives Just for Birth Control?

While the debate rages on regarding pregnancy, birth control and ‘the pill,’ the reality of the situation is that contraceptives are prescribed every day for many other medical reasons. Nearly 11.5 million women use The Pill, and according to NPR over 1.5 million women use birth control for anything but birth control and 762,000 of those women have never had sex.

In a study conducted by the nonprofit Guttmacher Institute, using information from a federal survey the ‘National Survey of Family Growth,’ the Institute found that less than half of all women using birth control, approximately 42 percent, ‘used it exclusively for contraception.’ (See the NPR Article here).

What are the Medical Reasons for Using Contraceptives?

  • Acne: Contraceptives are often prescribed to teenage girls for extreme acne situations. According to WebMD, estrogen helps to clear your skin ‘by decreasing levels of testosterone.’
  • Manage Painful Periods: Many women spend one week out of every single month in a great deal of pain due to painful periods. OB GYN’s will often prescribe The Pill to help these women manage these painful periods. The Pill also facilitates a smoother transition into the second half of a women’s cycle when hormonal shifts can cause dramatic PMS symptoms.
  • Endometriosis: The Pill is often prescribed to reduce the hormones that cause uterine-lining tissue to grow in other areas of the pelvis, which can lead to endometriosis.
  • Migraines: As the hormones change within a woman’s body and estrogen levels drop, those hormonal changes can trigger painful migraines. The Pill can decrease these hormone migraines.
  • Polycycstic Ovary Syndrome (PCOS): According to EveryDayHealth.com, Around five million women have polycystic ovary syndrome (PCOS), a serious condition that can lead to infertility, irregular periods, multiple ovarian cysts, and pelvic pain. For many, treatment will include the pill, which helps correct the hormonal imbalance and relieve some of the symptoms like an irregular period.
  • Cancer: Taking oral contraceptives (OCs) can slash your risk for both endometrial and ovarian cancer by more than 70 percent after 12 years; even just one to five years may lower your risk by 40 percent, according to WebMD. In fact, the American Cancer Society estimates that “30,000 cases of ovarian cancer worldwide could be prevented each year” through contraception use.

As contraception remains in the spotlight, we want your opinion of the controversy. Let us know on our Facebook Page. And, as always, if you have questions regarding birth control contact us today.

Music for Prenatal Development

Do you play music for your baby? Do you listen to music while pregnant, or perhaps place headphones on your belly? You’re not alone, and new studies are showing how important this is for your child’s development and their ability to share an even greater emotional attachment with mom and dad.

Music Research

Psychobiologist Carolyn Granier-Deferre of Paris Descartes University conducted a study in 2011 with 50 ‘heavily pregnant women’ and the affects that music had on their child. The results ‘suggest that newborns pay more attention to what may be their mother’s melodic sounds than they will of those of other women.’prenatal music for development

What does this really mean? A baby’s hearing develops during the last three months of pregnancy, and according to researches on this study the evidence suggests that babies who have been played music will better perceive the ‘sounds of speech’ after birth, and perhaps share a greater emotional attachment to those familiar sounds from mom and dad.

According to BabyZone.com, studies conducted by Thomas R. Verny and Rene Van de Carr provided proof that babies who were stimulated while in the womb ‘exhibit advanced visual, auditory, language, and motor development skills.’

How To Play Music For Your Child

Sure, you could watch American Idol and turn the volume up loud for baby to hear, or you could purchase some of the prenatal products on the market that are designed specifically for baby to hear music. You could go the ‘old school’ route and place headphones on your belly, or you could simply listen to the music yourself.

What Music to Play

While there are many conflicting studies on the type of music you should be playing for your child, the key seems to be in the pace and rhythm of the music, more than the type of music itself. A babies heart rate will mimic that of the music, so choose music with uniform, balanced beat rather than music with random, sudden shifts in rhythm.

The Mozart Effect

The Mozart Effect was an incredibly popular study conducted by the University of California at Irvine back in 1995. The results of this study showed that college students who listened to Mozart showed a temporary increase in spatial relationship skills and IQ points.

Unlike Beethoven or Bach, Mozart’s music is incredibly repetitive, with a melody that is very balanced. At the beginning of 2010, research was conducted at the Tel Aviv Medical Center in Israel to test the affects of The Mozart Effect on preterm babies. Once a day for two consecutive days the doctors played Mozart  for these babies, and found that after listening to Mozart the babies were calmer and ‘expended less energy,’ which allowed them to gain weight faster and ‘thrive more quickly’ then their counterparts who were not played music.

Music is wonderful stimulation for both babies in the womb, newborn babies, and children of every age. Musical instruction at a young age has been shown to improve literacy, verbal memory, mathematics and IQ. Music can make us happy, angry, or feel relaxed. Do you play music for your little one? If so, what do you play? How does your child respond?

The Benefits of Exercise During Pregnancy

Exercise during pregnancy will decrease weight gain, may ease the pain of delivery, lower your risk for gestational diabetes, reduce pressure on your lower back (as mentioned in a previous article), and can increase your overall energy levels during those 9 months. We’ve spoken about yoga during pregnancy, and stretching, but how important is exercise, really? Can exercise make pregnancy and labor easier? The answer; yes it can.

Mommy and Baby Benefits to Exercise

Feeling your best during pregnancy can be tough. Besides the aches and pains, there can be mood swings, cravings, and plain feeling down.

  • Endorphins: Exercise has been proven in scientific research to release endorphins; those little protein molecules that can control pain, cravings, reduce stress and make you feel good. Endorphins can be released during meditation, deep breathing, laughter, and exercise.
  • Improved Posture: According to SutterHealth.com, one of the most important contributions to a healthy pregnancy is good posture. Maintaining good posture can reduce pressure on your lower back, reduce pain and decrease fatigue. Mindful exercises that focus on the lower back and abdominal muscles will help train your back to maintain good posture throughout the pregnancy.
  • Gestational Diabetes: According to FitPregnancy.com, exercise can reduce your risk for gestational diabetes by as much as 27 percent. While genetics and age play key roles in whether you are at risk for developing gestational diabetes, you can fight batck with exercise.
  • Stress Relief: Stress can play a major role in your pain tolerance, levels of fatigue, mood, even preterm labor. A high degree of anxiety and stress can affect your baby’s health, as well as your own, contributing to a boost in risk for preterm labor and/or delivering a low-birthweight baby.  Regular exercise reduces stress, plain and simple.
  • Less Weight Gain: With regular exercise, research has shown you are more likely to gain less weight. Studies have shown that women who exercise during pregnancy put on 7 pounds less than those who didn’t exercise during pregnancy.
  • Increased Odds for Vaginal Birth: According to FitPregnancy.com, regular exercisers are 75 percent less likely to need a forceps delivery, 55 percent less likely to have an episiotomy and up to four times less likely to have a Cesarean section.

On top of those wonderful benefits to exercising during pregnancy, your labor might be shorter and less painful; you’ll likely experience less leg swelling, less likely to experience morning sickness, and will reap the benefits of impressed onlookers at the gym. It’s always nice to get some positive feedback when it comes to your appearance during pregnancy, and this added little benefit will help to decrease some of the self-consciousness that we all struggle with.

Pregnancy and Streching

While there are many aspects of your pregnancy that you do not have control over, there are still just as many that you can manage with determination; mood, soreness, and the pain associated with childbirth can be managed with exercise, stretching and breathing techniques. For the purpose of today’s article, let’s dive into the important of some good stretching to get your body through the day-to-day, and to prepare you for childbirth.

Stretching While Pregnant

Stretching is an amazing activity that everyone should be doing every day, especially while pregnant. Stretching not only increases overall flexibility, it teaches slow breathing, controlled breathing, and releases tension throughout the body that could be causing pain from muscle tightening.

Stretching and controlled breathing go hand-in-hand, and by teaching your body to relax with controlled breathing you will be preparing yourself for labor pains. When stretching, be sure to breathe deeply and slowly, feeling your abdomen and lungs expanding fully, allowing for better gas exchange and more oxygen to your baby. In the end, you and your baby will fee refreshed and better than ever.

Useful Pregnancy Stretches

The most common pregnancy stretch, according to Mayo Clinic, is the lower back stretch. This can be incredibly beneficial, helping you feel your best and increasing oxygen flow to your baby. Because pregnancy places a great deal of pressure on your lower back, and in fact changes your posture for a better part of 9 months, lower back pain is quite common, which can lead to other pregnancy aches and pains.

The lower back stretch, also known as the Cat Stretch in yoga, involves arching your back while on hands and knees on a soft surface. Inhale as you round your back, holding the position for 5 to 10 seconds, an exhaling deeply as you release the position. This will take pressure off of your lower back and help to relax those overused muscles of the spine.  (cat stretch photo)

Another area of the body pregnancy greatly affects are the hips. With the baby resting on your pelvis and lower abdomen, the hips deal with a lot more pressure than they normally would. Hip stretches are wonderful for releasing some of that pressure, decreasing pain, and preparing those hips for childbirth.

While it is often overlooked, the neck holds a great deal of tension during pregnancy, and releasing that pressure could decrease any headaches you’ve been having. The most basic way to stretch your neck is with neck rolls, tilting your head from side to side while maintaining focus on your breathing.

Remember, as you began to breathe deeper and more controlled while stretching your muscles, you are also helping to increase circulation, all of which are wonderful things for both yourself and your baby.

What stretches work for you? What have you found to be most effective at releasing lower back pressure and tension? Let us know here in the comments below, or on our Facebook page. Join the conversation!

AOA Patient Testimonial

I am personally recommending to any woman who doesn’t want to get pregnant and doesn’t want their period anymore to serious consider and have the Nova Sure uterus ablation with Dr. Valerie Sorkin-Wells, MD, FACOG. My gyno – Dr. Sorkin-Wells was very thorough and particular with proper procedures which made me feel very confident with getting the procedure done to me because I knew she was focused on all the details and as an intelligent woman I know that is what really matters.

I am going to write my personal details for you to use as an example and guide since everything I read on the internet did not give these kind of details so it might help you even though your experience might be totally different because everyone’s body heals and takes this procedure differently. So as my own caveat, please note my experience is not going to denote your own personal experience, just know that I’m writing this for you to see how a girl who has never had kids & was afraid of pain in my cervix about this procedure.

I am an organic food eater and the kind of person who doesn’t want to take hormones for either birth control or for painful period control. I really just didn’t want to have an invasive procedure and I wanted to end my days of painful periods and live my future period free!

[Day 1] I got my procedure done on a Friday afternoon which only took a few minutes under anesthesia. Got a ride home from my significant other and felt a little sore, groggy & little lower back soreness. I took 2 painkillers then ate dinner watched a movie at home with him and then took only 1 painkiller before bed at the appropriate time stated on the prescription label. I had a little discharge when I went to the bathroom that night and no spotting on my pad.

[Day 2] Saturday morning I woke up without any cramps and just a little lower back soreness. By noon I took 800mg of ibuprofen and the soreness went away all night. There was no discharge that day.

[Day 3] Sunday morning I woke up wondering if I even had the procedure done. I didn’t feel a thing. I was totally fine! My periods were way worse than anything I felt with this procedure. I could not believe I got a real ablation without any severe cramps, even my significant other was shocked and we both didn’t believe the procedure took. There was no discharge that day. & we had a very active day hiking for hours.

[2 weeks later] I’ve been wearing panty shields al this time daily, thinking discharge was going to happen at any unknown time. The day I was supposed to have my period I had mild cramping as if my period was coming on. Mind you it was nothing like the severe cramping I used to get when I got my period before this procedure. I put on a real pad not knowing what to expect since this procedure is not guaranteed, and since I felt so good afterwards I was afraid I would have to get the procedure done again. Well, after awhile nothing was showing up on the pad, then in the afternoon when I went to the bathroom, there were 3 very small clumps of discharge, no blood, no yuck. I still wore pads for 3 days but nothing else happened. I was done, no period, no more discharge and I am so happy.

So my biggest fear was pain and side effects and I can really say the pain was so minimal it was less than my period because I took it easy the 1st day and night. And there weren’t any side effects for me whatsoever! For me to have the freedom of not using hormones for birth control and never getting my periods anymore is amazing for my lifestyle of traveling, good love making and not having cramps anymore and to wear whatever I want whenever I want to is truly a wonderful way to live daily!

Thank you Dr. Sorkin- Wells for making this an easy experience for me to live period free!

Sincerely your patient,
Dalia

Yoga for Pregnancy

When you are pregnant, often the last thing you feel like doing is moving…at all. However, the more you move and the more stretching you do, in particular, the more beneficial it is for you in every day. You will feel better and when it’s time to put in the work of delivering your baby, you will be so much more prepared physically. In fact, this is the main benefit of prenatal yoga, which is becoming a more popular pastime among moms-to-be. Yoga for moms can be done at just about any time during the pregnancy, unless yours is a high-risk pregnancy.

In fact, before starting any workout regimen, pregnant or not, it’s always prudent to check with your doctor first. During pregnancy, this point is even more poignant as you need to be aware of your general physical condition at all times. If your doctor gives you the go-ahead, then you might consider prenatal yoga for any number of reasons.

Yoga for moms will improve your balance (which you’ll find declines towards the end of your pregnancy), helps you to become more limber and provides great muscle tone. More than that, you learn the art of deep breathing and how to use it to work through just about any situation, including labor pains. The process of breathing in yoga involves taking breaths through your nose and completely filling your lungs. You then exhale all of the air you just took in. This type of deep breathing will help you to maintain a sense of calm throughout the childbirth process, which can be frightening for first-time moms in particular. Yoga for moms can help to mitigate that fear through deep breathing.

In fact, according to a study published in Complementary Therapies in Clinical Practice, researchers found that pregnant women that took prenatal yoga for at least 10 weeks were generally more comfortable during the labor process.  A similar study done in Thailand by researchers at the Prince of Songkla University found similar benefits, citing that yoga for moms helps pregnant women to maintain a better sense of peace and calm during the labor process, which in turn helps to control pain.

Yoga for moms is just another tool in the arsenal for women preparing to give birth. It provides invaluable mental and physical benefits to prepare you for the miraculous but laborious process of delivering a baby.