Expert advice: C-section pain relief, safe sex, mom-in-law woes

Q:

I’m having a c-section, and I’m worried about pain relief afterwards. I’m going to be cut open after all, and surely that wound is going to hurt a lot once the spinal wears off? What will I be given in hospital, and what can I take once I’m home? Also, I plan on breastfeeding, so I don’t want to take anything that will interfere with that. How long does the pain last afterward?

Some friends say a week, some say six weeks. I want to know what I’m in for and how to cope.

A:

Dr Shimange-Matsose answers: Pain after a caesarian is always a concern and fear of most mothers. Having had three caesars myself, I can advise from both personal and professional experience. Pain is inevitable, but it can be managed. A part of it does also depend on your pain threshold.

What are your options?

Immediately after your caesar, while you’re in theatre, you can be given an intramuscular opioid or a nonsteroidal anti-inflammatory suppository. This basically ensures that when the spinal wears off, you are covered. In the ward, you get multimodal analgesia. What this means is that all pain pathways are covered by being given paracetamol, a non-steroidal anti-inflammatory such as Voltaren and an opioid such as pethidine.

A little hack is, as soon as you start getting sensation in your feet, ask for your medication. Obviously, this depends on whether something was given in theatre or not and what was given.

Another option in the ward is a patient-controlled analgesia or PCA pump. This pump is basically connected the same way an IV line is; you control it by pressing the pump, and it administers the medication. I’m personally not a fan of this method post-caesar, because it gets in the way of you nursing your baby and makes you less mobile.

Lastly, in hospital, get moving, get moving, get moving – as early as six hours post-caesar. It’s very easy to say you’re in too much pain to move. That only makes matters worse.

Upon discharge you will also be given some of the meds you got in hospital (obviously not the PCA pump or those given intravenously).

These won’t affect breastfeeding, but be aware of constipation from those painkillers containing opioids. How long will the pain last? That differs from person to person.

From my personal and professional experience: moving and taking analgesia as early as possible after the delivery decrease your need for long-term analgesia. I’ve found that by the time my patients are discharged, their need for analgesia has decreased and they’re fully mobile without much discomfort. By the two-week visit almost no analgesia is being used. Remember there is no c-section that’s pain-free. And more importantly, pain can be managed.

Connect with Dr Lusanda on Twitter @myfirstgynae She is based at Sandton Mediclinic