What are some pain relief options after you have had a c-section?
First, let’s discuss the pain relief options available during a c-section.
1. Spinal Block
The spinal block is a regional anesthesia that provides pain relief during a surgery. A spinal block is injected one time into the spinal fluid, so it works faster, but is not a continuous dose like the epidural. The spinal tends to be the preferred option for scheduled c-sections, or for someone who had been laboring unmedicated and is now getting a c-section during their birth.
The spinal block has two types of medicine being used: local anesthetic and an opiod. The local lasts about 90 minutes to 2 hours, and the opiod lasts about 4-6 hours. It is not a motor block so you can still move but will still have some pain relief after surgery.
2. Epidural
The epidural is a regional anesthesia that provides pain relief during labor and surgery. An epidural is administered into the space outside the spinal fluid. Because of this it works more slowly than a spinal, but since a catheter is inserted, it can be continuously administered as needed. You may also have an option for a bolus, or additional medication being administered.
Usually, an epidural is used for a c-section if you were laboring and then had a c-section. An epidural can last for about 4-6 hours after the catheter has been removed.
3. General Anesthesia
General anesthesia is administered through an IV, and puts you to sleep. Unlike the spine and epidural, general anesthesia provides no long term pain relief. In cases where general anesthesia is used, a TAPS block may be really helpful to provide supplemental relief. See below for detailed description of TAPS block.
General anesthesia may be used in the event of an emergency, where there is not enough time to place a spinal or epidural, or if a spinal/epidural cannot be placed due to contraindications.
What options do you have for post birth pain relief?
Pharmaceutical
1. TAPS Block
Or transversus abdominis plane block, is a local anesthetic injected into the space between lower abdominal muscles near the incision site. This can be done while you still feel numb at the end of your birth, so you do not feel the needle being inserted! This pain relief option can provide pain relief for up to 30+ hours post birth and can help limit or alleviate the need for opiates postpartum.
2. Opiates
Examples of opiates include hydrocodone, Vicodin, Tylenol 3 among others. While Opiates can be very effective they are also known to be highly addictive after just weeks of use. Side effects can include drowsiness, dizziness, altered level of alertness. Opiates can provide much needed post surgical pain relief but should be viewed as a very short term solution in the first 4-7 days.
3. NSAIDS
NSAIDs are Nonsteroidal anti-inflammatory he drugs such as ibuprofen or Motrin. They can be used as alternating pain medication with opiates or on their own. Side effects may include gastrointestinal discomfort especially if taken without food.
4. Nothing
The body is innately capable of providing some pain relief following surgery or injury. Some women may opt to avoid pharmaceuticals all together. In this case one may opt for mechanical treatments mention bulletin.
What other options do you have to help you manage pain postpartum?
Mechanical
1. Compression with a belly binder
Compression can be helpful to promote initial healing and provide some stabilization to aid in function. Compression should be loose enough that you can still move your abdomen and back, and do not feel extra pressure downward onto the pelvic floor. But tight enough that you can press your core into it for extra stabilization.
Options for compression could include the MamaStrut (that may be covered by your insurance) or Bao Bai Postpartum Compression Garments. There are a lot of other options available too, and your birth location may give you one after surgery. Keep in mind that tolerance to belly compression is highly variable among postpartum women and may even vary from pregnancy to pregnancy.
2. Scar mobilization
As the tissues heal from surgery, collagen remodeling be influenced by scar mobilization. Usually around 3 weeks post c-section, you can begin scar mobilization around the skin near the incision site, and then gradually move towards the incision, as you feel comfortable.
Moving the tissues can help line the connective tissue fibers up, so that they are stronger and function better. Sometimes, you may find that you feel a pulling or tugging sensation near your incision, or even in the lower abdomen or low back, and this could be due to adhesions that are forming near the incision site. You may even develop adhesions internally, between your pelvic organs!
Scar mobilization can help to ensure that those “stuck” points are worked through, and break up any adhesions to support healing and overall function. Working with a pelvic floor PT or joining our upcoming C-Section Recovery Workout are some great options to understand how to better mobilize your scar.
In the US, approximately 30% of women give birth via C-section! Hopefully this blog helps you understand the options you have during your c-section for pain relief during your birth, postpartum to help manage pain as you recover from your birth, and then to support your healing process overall!
Learn more on how to support your c-section experience in our online childbirth education courses! We add new videos weekly to our courses to continue to enhance the education that we provide in our online platforms!