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Centre intégré de santé et de services sociaux de Laval

    • Cesarean section

    This section provides information on preoperative preparation, postoperative and postpartum care, as well as instructions for the home. 

     

     

        Frédérique Latraverse

         Pier-Charles Laliberté

        Katrie Dupont-Chalaoui

        Maxime Lacerte

        Geneviève Bérubé

        Geneviève Bertrand

        Annie Lamontagne

        Marie-Ève Carette

        France Leduc

        Dominique Thériault

        France Durocher

    This is a surgical procedure used to deliver the baby abdominally when vaginal delivery presents risks for the mother or child. The procedure is performed under spinal, epidural or in certain cases under general anesthesia. 

     

    The Cité-de-la-Santé hospital now offers the ERACS/RAAC trajectory to patients undergoing caesarean section surgery. This rapid recovery program ensures a rapid and safe recovery for both mother and baby. 

    • Approximately 72 hours before your scheduled C-section, a nurse will contact you by phone. During this phone call, the nurse will collect data and give you all the information you need for your C-section. Don't hesitate to ask any questions you may have. 
    • 24-48 hours before your scheduled C-section, the receptionist will contact you to confirm your arrival time. 
    • Depending on the pandemic situation, please refer to the link to the Pregnancy section home page for the current procedure. Please note that precautions will be taken if you or your significant other test positive for Covid, but your C-section will not be cancelled.
    • Bring your hospital card, health insurance card and list of medications. 

     

     

     

    Nail polish, acrylic nails and jewelry (including piercings) must be removed. 
    You dont have to shave.

    The day before

      • From midnight onwards, you must stop taking solid foods: 

        - No gum, no candy; 

        - No food or dairy products; 

        - No tobacco, no alcohol. 

        • You can continue to drink clear liquids. Permitted liquids include water, apple juice, iced tea, black coffee, black tea and sports drinks. 

      The morning of 

      • You must drink 500mL of apple juice, grape juice, commercial iced tea or sports drink (like Gatorade). You can also drink water, black coffee or black tea until 6am. 
      • For diabetic patients, avoid juices. You can drink the same amount of water. You should refer to your endocrinologist's instructions if they differ. 

        • You'll need to wash with Dexidin 4% antimicrobial soap (available in pharmacy or gift shop) to reduce the risk of infection in the surgical wound. Avoid the face with this soap. Afterwards, you must not apply anything to the skin (no cream, no antiperspirant, no perfume, no make-up). 

      Diabetic users

      • Do not take your oral hypoglycemic medication the morning of surgery. 

      Arrival 

        • On the day of your C-section, you must report to the Mother and Baby Module (1st floor, Block D) at the agreed time. 
        • You will be assigned to your room according to availability. 
        • A nurse will take your vital signs, blood test and fetal heart rate. 
        • You will be asked to sign the operative and anesthetic consents for the C section. 
        • A pre-operative check will also be carried out

      What to bring 

      • Hospital card 
      • Health insurance card 
        • Medication you take at home/list 
        • Large sanitary napkins 
        • Disposable diapers for infants 8 to 14 pounds 
        • Personal toiletries (toothbrush, toothpaste, brush, soap, etc.) 
        • Paper tissues (Kleenex) 
        • Nursing pads if necessary 
        • Paper and pencil 
        • Baby clothes according to season (bring some for the trip home too) 
        • Personal clothing 
        • Bring only a minimum of money 
        • No valuables, no jewelry 

      Departure for the operating room

      • A nurse will tell you when and how to go to the operating room with your significant person. 

      Waiting room 

      • You will then be placed in the operating room waiting room for a variable period of 5 to 20 minutes. The person accompanying you will be directed to the checkroom to change and wait to be collected. 

      Operating room

      • You will then be directed to the operating room for the C-section. You will meet the gynecologist, anesthesiologist, nurses and respiratory therapist who will perform the surgery: 
        • Intravenous infusion set-up 
        • Set-up for regional vs general anesthesia 
        • Verification of anesthesia effectiveness 
        • Placement of urinary catheter 
        • Monitoring vital signs 
        • Skin disinfection 
        • Placement of sterile drapes
        • Arrival of significant person (for regional anesthesia) 
        • Birth of baby 
        • Skin-to-skin as soon as baby's condition permits 
        • Transfer to recovery room with baby skin-to-skin. 

      Recovery room

      • After the C-section, you will spend approximately 60 minutes in the recovery room. During this time, the nurse will monitor your general condition, vital signs, bleeding, wound and pain. 
      • If you and your baby's condition allow it, the nurse will place your baby skin-to-skin (see Kangaroo Method). 
      • The significant person must wait outside the recovery room. 

      Back to the room

      • When you arrive at the Mother and Child Unit, the nurse will regularly assess your wound condition, bleeding, vital signs, general condition and pain level. 

      Your baby will stay skin-to-skin with you for a minimum of 2 hours. Click here to learn more about the kangaroo method:

      • Link to the page: kangaroo method.
      • Skin-to-skin contact is encouraged throughout your stay in hospital and when you return home. 
      • During this period, the nurse will provide skin-to-skin care for the newborn. 

      Caesarean sections can delay the onset of lactation. To encourage breastfeeding, breastfeed as soon as possible, keep your baby skin-to-skin as much as possible and breastfeed frequently (8-12 times a day). 

      For further information, please refer to:

      Plan a stay of around 36-48 hours. 

      Visiting hours

      • Visits are permitted from 7 pm to 8:30 pm, for 2 visitors (over 12 years of age) at a time. Please note that your significant person can be present at all times.
      • Grandparents can also be present at all times, and the newborn's siblings are allowed during the day. 

      Food

      • You can resume drinking clear liquids 1 hour after you return to your room. If the liquids are well tolerated, a meal rich in fiber and protein will follow. 
      • It is normal to feel abdominal cramps the first days after your Caesarean section. This is due to the presence of gas and the restart of intestinal movements. To reduce discomfort, take regular walks. 

      Verticalization + mobilization 

      • When your legs are completely thawed and your condition permits, you will get up for the 1st time under the supervision of the nursing staff. This usually takes place 4 hours after your Caesarean section. You will then be able to move around freely and independently. 

      IV

      • The IV will be removed as soon as possible (depending on your state of health) to allow you to circulate freely. Although, a saline cap will be left in place for 24h or more. 

      Urinary catheter

      • The urinary catheter will be removed 4 hours after your arrival in the room. 

      Wound care/dressing

      • Unless otherwise indicated, the wound will be closed with melting stitches and steri-strips. Staples are less commonly used at CISSS de Laval. Your wound will be covered with a honeycomb dressing, which must be kept on for 7 days. You may shower while the dressing is on. Afterwards, you can remove the dressing, clean your wound with a mild, unscented soap and dry your skin. The steri-strips will eventually roll off on their own after 4-5 days following the dressing removal. If they still haven't come off within of the dressing removal, you can remove them. 
      • If a PICO dressing has been applied, follow-up with your local CLSC will be arranged. 
      • Burning and/or numbness around the wound is normal for the first few days. In addition, your wound may be numb because nerves have been cut. Theses sensations will gradually fade, but may last up to 3 to 4 months. Your scar will fade as it heals. 
      • You should start massaging your scar 3 weeks after surgery or when it has completely healed. You can massage the scar 1 to 2 times a day for 5 to 10 minutes. 

      Hygiene

      • The honeycomb dressing is a waterproof dressing. This means you'll have no trouble showering after your C-section. Just don't spray directly onto your wound. Once the dressing has been removed, you can take a bath without adding any product to the water. Avoid using a vaginal douche or tampon. 

      Pain management 

      • It's normal to feel pain after a C-section. The level of pain varies from person to person. However, with a combination of pain medication (acetaminophen, anti-inflammatories, narcotics, etc.), mobilization and alternative methods, pain can be well controlled. Pain should not prevent you from moving. Reducing your activities and giving yourself periods of rest should reduce your pain. After the second day, you should consider reducing your medication, and after a week, you should no longer need it. All the medications you are taking are compatible with breast-feeding. 

      Signs and symptoms to watch out for 

      • Acute pain and persistent at the surgical site 
      • Redness, warmth, swelling and abnormal discharge at the surgical site 
      • Fever lasting more than 24 hours (38.5°C or 101°F and higher) 
      • Sudden heavy vaginal bleeding (1 well-soaked sanitary towel/hour) 
      • Malodorous, greenish-yellow vaginal discharge 
      • Burning while urinating, frequent need to urinate or feeling of not emptying the bladder completely
      • If you experience one or more of these symptoms, please contact a nurse at your CLSC or call 811. 

      Recovery

      • Please allow about 6 weeks before resuming a normal routine. Give yourself time to rest and eat a balanced diet. Accept the help offered and lower your expectations. 
      • Do not lift or carry weights over 5 kg (with the exception of your newborn baby). 

      Sexual relations (after 6 weeks)

      • After 6 weeks, your wound will be completely healed. You can then resume sexual relations if you feel ready. 
      • Pregnancy and Caesarean section bring about changes in your self-image that can be embarrassing, so be sure to discuss them with your partner. In addition, a decrease in sexual desire is common after childbirth.
      • Vaginal dryness may require the use of lubricant during intercourse. 

      Have another child

      • If this is your first C-section, you may be planning to expand your family without knowing how this operation may influence your decision. Unless you have a health problem, there's nothing to prevent you from having more children later on. The possibility of having a vaginal birth after your C-section will be discussed with your doctor. If this is not possible, you can easily have several C-sections if your uterine incision is transversely low. 

      Driving 

      • In general, you need to wait at least 2 weeks and stop taking narcotics (e.g. morphine) for at least 24 hours before you can resume driving. 

      Others

      • You can resume your daily activities gradually and according to your tolerance. 
      • Pools and lakes: No swimming in lakes or pools for at least 6 weeks. This is to avoid infections. 

      Additional information