Nursing Component Task
Nursing procedures & clinical learning

Midwifery (RM)

Pre and Post Operative Management of the Mother (Caesaerean Section): Immediate Care

Immediate post-operative care after caesarean section provides close observation during recovery from anaesthesia and surgery. It focuses on airway, breathing, circulation, bleeding, uterine tone, wound, urine output, pain, temperature, newborn contact, and early complication recognition.

Purpose

  • Maintain physiological stability after surgery and anaesthesia
  • Detect haemorrhage, infection, anaesthetic complications, and thromboembolism early
  • Support bonding, feeding, comfort, and safe transfer

Indications

  • Recovery immediately after caesarean birth
  • Transfer from theatre or recovery area
  • Any post-operative deterioration

Equipment

  • Maternal monitoring equipment
  • Oxygen and emergency equipment
  • IV fluids, prescribed medicines, and infusion devices
  • Urinary catheter and output measurement
  • Wound and drain supplies
  • Post-operative record and newborn support equipment

Preparation

  • Check emergency equipment, infusion and catheter function, and post-operative orders.
  • Maintain privacy and include the mother in decisions.

Procedure steps

  • Receive structured theatre handover including operation, anaesthesia, blood loss, medicines, fluids, complications, and newborn status.
  • Assess airway, breathing, circulation, consciousness, pain, temperature, oxygen saturation, and vital signs at required intervals.
  • Assess uterine tone, fundus, vaginal loss, abdominal wound, dressing, drains, IV site, and urine output.
  • Maintain prescribed IV fluids, analgesia, antibiotics, thromboprophylaxis, and oxygen; check effects and adverse reactions.
  • Position safely, prevent aspiration and pressure injury, and maintain warmth.
  • Support skin-to-skin and breastfeeding when mother and newborn are stable and anaesthesia permits.
  • Monitor motor and sensory recovery after regional anaesthesia and assist movement safely.
  • Recognize haemorrhage, hypotension, respiratory depression, high block, allergic reaction, infection, or reduced consciousness.
  • Escalate abnormal findings and arrange review before transfer to the postnatal ward.
  • Document observations, interventions, medication, response, newborn contact, education, escalation, and handover.

Precautions

  • Do not leave a recovering mother unobserved.
  • Use prescribed doses and monitor sedation, respiratory depression, and hypotension.
  • Check wound and uterine bleeding together; a normal vaginal loss does not exclude internal bleeding.
  • Use safe moving and falls precautions until sensation and strength return.

Aftercare

  • Continue observations and structured transfer handover.
  • Begin post-operative education about pain, breathing, mobilization, wound, feeding, and warning signs.

Nursing considerations

  • Trend observations and respond to changes early.
  • Use multidisciplinary handover and medication checks.

Patient education

  • Explain monitoring, pain relief, breathing and leg exercises, safe movement, wound care, and feeding.
  • Report breathlessness, chest pain, heavy bleeding, severe pain, fever, or feeling faint.

Documentation

  • Record handover, vital signs, pain, consciousness, wound, uterus, lochia, drains, urine, medicines, fluids, response, and newborn contact.
  • Document escalation and transfer readiness.

References and further reading

Educational resource only. Follow current Nursing and Midwifery Council guidance, local institutional protocols, scope of practice, and clinical supervision.

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