ARRANGING AND ASSISTING THE

WOMEN FOR C-SECTION AND CARE

OF WOMAN AND BABY DURING
C-SECTION

PREPARED BY:
AANCHAL RAUTELA
SUPARNA ALU
BSC. NURSING 4TH YEAR
INTRODUCTION

A cesarean delivery, also called a cesarean

section or c-section, is surgery to deliver a
baby. The baby is taken out through the
abdomen (belly). In the United States,
almost one in three babies are born this
way. Some cesarean deliveries are planned.
Others are emergency cesarean deliveries,
which are done when unexpected problems
happen during delivery.
 When is a Cesarean Delivery needed:
Mother may need cesarean deliveries because:
• she had health problems, including infection
• In case she is carrying more than one baby
• The baby is too big
• baby is in the wrong position
• Labor is not moving along as it should
• There are problems with the placenta (the
organ
that brings oxygen and nutrients to your baby)
Indication for Caesarean section
1. Absolute:
• Vaginal Atresia
• Advanced carcinoma of cervix
• Cervical or broad of contracted pelvis.
• Severe degree of contracted pelvis.

2. Relatives:
• Cephalopelvic disproporton
• Previous uterine scar
• Fetal distress.
• Malpresentations
• Antepartum hemorrhage
• Elderly primigravidae
• Chronic hypertension
• Diabetes
3.Fetal indicaton:
• Fetal distress
• Umbilical cord prolapse
• Macrosomia
• Placental insufficiency
• Multiple pregnancy
Contraindication:

• Dead fetus
• Baby is too much premature
• Presence of blood coagulation disorder
Nursing Management
A. Pre-operative management:
 Patient should be physically prepared i.e.
abdomen, back ,private parts and upper part of
thigh are shaved and cleaned.
 Prepare mother psychologically by providing
assurance and explaining the indication,
procedure and need of caesarean section.
 Administration of IV infusion of 50% dextrose to
avoid hypotension following spinal anesthesia,
the infusion line is maintained patent by an intra
venous cannula.
 Blood grouped and cross matched for
emergency requirement.
Bladder should be empty by inserting
foleys catheter. This may be done before
and after induction of anesthesia.
Mother should be in NPO for about 8
hours.
Patient should be in clean gown, valuable
ornament should be taken off and all
make up should be removed.
If elective caesarean section then
Ranitidine 150mg should be given orally
in the night before and repeated one hour
before surgery to prevent gastric PH
Supplies/ Equipment
1. Extra drape sheet
2. Towels
3. Receiving pack for baby
4. C-section tray
5. Delivery forceps
6. Cord clamp
7. Basin set
8. Blades
9. Neonatal receiving unit
10. Self-contained oxygen
11. I.D bands
12. Suction
13. Bulb syringe
14. Solutions
B. Post operative care :
Immediate care (4-6 hours):
• In the immediate recovery period, vitals
should be recorded in every 2 hourly.
• The wound must be inspected half hourly
to detect any blood loss(500-1000ml is
normal bleeding after c-section delivery).
• The lochia is inspected, Following general
anesthesia, the women is nursed in left
lateral or recovery position until she is fully
conscious.
• Analgesic is given as prescribed.
 2. First 24 hours:
• IV fluids are continued, blood transfusion is helpful in
anemia mothers.
• Prophylatic antibiotics(cephalosporins, metronidazole )is
usually given for 1st 48 hours.
• Ambulation is encouraged following day of surgery and
baby is given to mother.

3. After 24 hours:
• Orally feeding is started with clear liquid and then
advanced to normal diet and IV fluid are continued for
about 48 hours.
• Catheter may be removed on following day when the
women is able to get up to the toilet. She should be
helped to get out of bed.
• The mother must be encouraged to take rest and
provide care to the baby and should breast feed the
 Complication:
• Mother:
partum hemorrhage related to uterine atony
and rarely blood coagulation disorders.
Shocks related to blood loss.
Anesthesia hazards
Sepsis, secondary PPH.
Thrombosis
Lung infection post.
• Late complication:
Menstrual irregularity
Chronic pelvic pain
Backache
 Checklist for essential newborn care
S.No. STEPS OBSERVATION
1 2 3 4 5
1. Call out the time of birth
2. Deliver the baby on a warm clean towel on the
mother’s abdomen or chest
3. Immediately dry the baby with a warm clean
towel(ensure warmth)maintain room temperature
of 25-28°c.
4. Establish and maintain patient airway (during this
secretions of month and nose are suction to clear
the earring of mucus and amniotic fluid)

5. Wipe both the eyes separately with sterile gauze

From medial to lateral side

6. Clamp and cut the umbilical cord in one to three

minutes(the umbilical cord is clamped with two
clamps and then cut between the clamps leaving
about 5 cm from baby’s abdomen)
S.No. STEPS OBSERVATION

7. Leave the baby in between the mother’s

breast to initiate skin to skin care

8. Assessment and documentation of infant

condition should be done at 1 to 5 minutes
of birth , apgar scoring is done and while
drying the baby head to toe assessment is
done to find out any abnormality in the
newborn

9. Before the baby is transfer from labour

room an identification band is placed to
baby wrist specifying the name of the
mother ,registration number, time of birth
and sex

10. Encourage initiation of breastfeeding

(With in half an hour of birth)
THANK YOU