For a new mother, suddenly learning she has to have a c-section can be a frightening experience. With fear and trepidation, she may ask, “What is a c-section?” (For anyone wanting information in this respect, the website Medline Plus answers basic questions about c-sections.)
The new mother who is having, or has just had a c-section needs to know how to care for her incision. She may not have had previous experience with incision care and taking care of a c-section incision may appear frightening.
Be aware that experiencing a sudden, unexpected c-section may have been a traumatic surgical event to her. Ideally, she will have her initial dressings taken care of by a medical professional, who will be able to help her to deal with her reaction to the c-section, as well as any fears and concerns about the care of her c-section incision.
The new mother may find that looking at her c-section incision is frightening at first, because of the length of the incision, sutures, staples, etc. There may be dried or fresh blood on her dressings. If there is a lot of fresh bleeding, the caregiver or patient should notify the doctor immediately. Immediately applying a pressure bandage will help to control the bleeding.
Note that the patient may become alarmed if she sees betadine antiseptic solution or another ‘surgical scrub’ that has not been washed off following her c-section. She may also be worried about stretch marks, or abdominal skin that appears to be loose. Reassure the new mother that what she sees is normal for post-pregnancy and a c-section surgical wound.
Surgical wound care for a c-section involves a closed wound, but at times, the incision may have a drain, or the incision may open up later, so it is important for the c-section patient to learn how to care for open wounds, as well as closed wounds. It may be a good idea to teach the patient’s husband, or another family member how to do c-section dressing changes, as well.
Medline Plus lists five basic guidelines for surgical wound care, including proper hand washing techniques, removing old dressings, caring for the wound, putting on new dressings and basic instructions about when to call the doctor.
Preparing a clean site first, for all necessary dressing supplies is important.
Hand washing techniques for the c-section patient or her caregiver, include washing of her hands prior to dressing removal and again, immediately following the removal of the dressing. The patient or caregiver should not be wearing jewelry on her hands or wrists, when changing the dressing. She should wash her hands and arms up to her elbows, with running water and soap, for a minimum of thirty to sixty seconds. (Rubbing alcohol also acts as an effective skin disinfectant.) A clean towel should be available to dry her hands.
Removing a c-section dressing involves loosening the ends of the tape and carefully removing the outer dressing. (Wearing disposable gloves for this is a good idea.) If the inner dressing sticks to the incision, then it should be soaked with normal saline or water, before trying to remove it. When removed, the dressing should be immediately disposed of in a plastic bag.
Cleaning the incision involves the use of sterile gauze and normal saline, or water.
She should remove any drainage or build up of dried blood or fluid around the incision, sutures or staples, being careful not to dislodge them. If the wound needs to be irrigated this should be done with a sterile syringe and normal saline or water. She should hold the syringe at least an inch away from the incision and wet it gently. Then, she can pat the incision area dry using a piece of gauze.
If there is a slight gaping of the incision, steri-strips will usually bring about effective closure of the wound.
A new dressing entails applying sterile gauze and abdominal pads gently over the incision. Skin tape is preferable to adhesive tape to hold the outer dressing in place, if the patient is allergic to adhesive tape. Montgomery straps will hold the outer abdominal dressings in place and allow a change of only the inner dressing.
Note that applying large abdominal pads help the patient feel more comfortable. Splinting the abdomen with a pillow, may make it easier for a c-section patient to move around and hold her baby.
The patient or her caregiver should call the doctor if there is redness, bleeding or swelling noted. Unusual drainage with a foul smell, abnormal pain and fever are indications that there may be problems with the c-section incision. Report any bleeding or gaping of the incision to the doctor.
Proper disposal of all dressing material is important to prevent the spread of infection.
Most new mothers are encouraged to be out of bed and walking about following a c-section. Note that a c-section is abdominal surgery. Like any other kind of surgery it may cause discomfort, so loving care and compassion for the new mother is always important.