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Learning Objective 1: identify how pre-operative preparation, will effect postpartum recovery in women who have experienced an elective cesarean birth.
Learning Objective 2: identify specific needs of women who have experienced an emergency cesarean birth in order to improve postpartum recovery.
Since 2001 there has been an increase of 30% in the number of women who delivered by cesarean birth, with a current cesarean birth rate of 24.4% (2,405 women) at Sheba Medical Center. Fifty two percent of those women experienced an elective cesarean birth. Over 60% of all women who experienced a cesarean birth visited the Preoperative Clinic managed by a midwife and physician, receiving preoperative instruction. Women who experienced an emergency or semi emergency cesarean birth lack this preparation and may experience a more difficult recovery period.
Methods:, Prospective research study, was conducted including women over 18 who experienced elective, semi-elective and emergency cesarean birth. A self report questionnaire was distributed 40 hours postoperatively, a second telephone questionnaire 6 weeks postpartum. A total of 131 questionnaires were distributed, with 82 women completing participation, a (68%) response rate.
Results:, Substantially more women (84%) who experienced an emergency cesarean birth participated in the study as opposed to 53% who experienced an elective cesarean birth. Significantly more women who experienced an elective cesarean birth received pre-operative instruction and preparation, compared to women who experienced an emergency¸ (6.37) P>.001.
Conclusion:, Women who experienced an elective cesarean birth, experienced less anxiety, more satisfaction with a cesarean birth, initiated earlier infant contact and breast feeding, experienced an easier recovery period, than women who experienced an emergency or semi elective cesarean birth. Women who experienced an emergency cesarean birth expressed a need to "debrief" with the nursing staff post partum, therefore new nursing intervention is needed. Women from all the groups needed further teaching in timely and adequate post operative pain relief.
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