Midwifery (RM)
Pre and Post Operative Management of the Mother (Caesaerean Section): Subsequent Care
Subsequent post-operative care supports recovery after the immediate anaesthetic period. It includes ongoing observation, pain and wound management, mobility, nutrition, bladder and bowel care, thromboprophylaxis, breastfeeding, discharge planning, and education.
Purpose
- Promote uncomplicated recovery after caesarean birth
- Prevent infection, haemorrhage, thromboembolism, ileus, and wound complications
- Prepare the mother and family for safe discharge and self-care
Indications
- Post-operative ward care after caesarean birth
- Review of wound, pain, mobility, bladder, bowel, feeding, or emotional wellbeing
- Discharge planning after surgical birth
Equipment
- Post-operative observation and wound-care supplies
- Vital-sign and pain-assessment tools
- Mobility and thromboprophylaxis aids
- Medication, feeding, and newborn-care resources
- Discharge records and referral information
Preparation
- Review post-operative orders and ensure the woman can access medicines, wound review, transport, and support.
- Use an interpreter and individualized teaching.
Procedure steps
- Review operation, anaesthesia, blood loss, complications, orders, allergies, and current observations.
- Monitor vital signs, pain, uterine involution, lochia, wound, dressing, drains, urine, bowel function, mobility, and nutrition.
- Administer prescribed analgesia, antibiotics, thromboprophylaxis, iron, and other medicines; monitor effects.
- Encourage breathing exercises, ankle movements, mobilization, hydration, nutrition, and safe positioning.
- Assess wound for redness, swelling, discharge, separation, increasing pain, or fever and use clean or aseptic dressing care.
- Support breastfeeding, comfortable positions, skin-to-skin, and newborn care while protecting the incision.
- Assess emotional wellbeing, birth experience, sleep, support, safeguarding, and ability to care for self and baby.
- Teach hygiene, medicines, wound and perineal care, activity limits, sexual health, contraception, and warning signs.
- Complete discharge criteria, follow-up, referrals, transport, and handover.
- Document observations, interventions, education, discharge plan, and response.
Precautions
- Escalate fever, severe pain, wound separation, heavy bleeding, breathlessness, chest pain, calf symptoms, or reduced urine output.
- Use safe mobilisation and falls prevention.
- Check medication compatibility with breastfeeding and local prescribing policy.
- Do not discharge without a safe support and follow-up plan.
Aftercare
- Arrange wound and postnatal review and provide contact information.
- Continue monitoring until discharge criteria are met.
Nursing considerations
- Make discharge teaching practical and confirm teach-back.
- Support recovery while respecting the mother’s autonomy and cultural context.
Patient education
- Take medicines as prescribed, keep the wound clean and dry, mobilize safely, and attend follow-up.
- Seek urgent care for heavy bleeding, fever, wound discharge, severe pain, breathlessness, chest pain, or calf swelling.
Documentation
- Record trends, wound, pain, uterus, lochia, urine and bowel function, mobility, feeding, medicines, education, referrals, and discharge criteria.
- Document complications and escalation.
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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