What post-operative care should be provided to a patient following an emergency caesarean section?

Following an emergency caesarean section, post-operative care should include continuous one-to-one observation until the woman is haemodynamically stable, able to communicate, and has regained airway control if general anaesthesia was used. Observations such as oxygen saturations, respiratory rate, heart rate, blood pressure, temperature, pain, and sedation should be monitored every 30 minutes for 2 hours, then according to local protocols if stable. If spinal or epidural anaesthesia was used, continuous observation should continue until haemodynamic stability is achieved. For women who received intrathecal or epidural diamorphine and have risk factors for respiratory depression, hourly monitoring of oxygen saturations, respiratory rate, and sedation for at least 12 hours is recommended ¹.

Wound care involves removing standard dressings 6 to 24 hours postoperatively, monitoring for fever, assessing the wound for signs of infection (such as increasing pain, redness, discharge), separation or dehiscence, encouraging loose, comfortable clothing and cotton underwear, and gentle daily cleaning and drying of the wound. Negative pressure wound therapy may be considered for women with a BMI of 35 kg/m2 or more to reduce infection risk ¹.

Women should be supported to initiate breastfeeding as soon as possible and offered early skin-to-skin contact with their baby ¹.

Monitor for urinary symptoms postoperatively, considering urinary tract infection, stress incontinence, urinary tract injury, or retention ¹.

Be vigilant for signs of thromboembolic disease, such as respiratory symptoms or leg pain and swelling, as women post-caesarean are at increased risk ¹.

Inform women that hospital stay is likely longer than after vaginal birth, but discharge after 24 hours is possible if recovery is uncomplicated, with appropriate follow-up at home ¹.

Provide opportunities for women to discuss the reasons for the emergency caesarean and offer verbal and printed information about future birth options, either during hospital stay or later as preferred ¹.

Inform the woman’s GP if follow-up investigations are needed after discharge, including plans for abnormal results ¹.

Advise on resumption of activities such as driving, carrying heavy items, exercise, and sexual intercourse only when fully recovered from the caesarean birth ¹.