Caesarean birth: preparing the woman, the newborn in theatre and postoperative care
- Safe practice
Before a caesarean the nurse prepares the woman and theatre; after it she checks vital signs, uterus, bleeding and wound, and helps her move and breastfeed.
What it is
A caesarean is major surgery and a birth at the same time. Colombia's Ley 2244 de 2022 calls for a «humanised caesarean»: done only when the health of the woman or baby needs it, or at the woman's free and informed request, protecting skin-to-skin contact, breastfeeding in the first hour and her right to a companion. The nurse prepares the woman and the theatre, receives or helps receive the newborn, and in recovery watches for haemorrhage, airway problems and pain. On the ward she supports early walking, bladder and bowel recovery, wound care and breastfeeding. Res. 3280 sets a minimum stay of 48 hours after a caesarean.
What it requires
- Before surgery: explanation, informed consent, allergy check, blood sample for haemoglobin and blood group with cross-match as ordered, and the team informed of the urgency (WHO).
- Ready in theatre: equipment and drugs for adult and newborn resuscitation, checked and in date (WHO).
- The surgical safety checklist is applied as in any surgery.
- Bladder catheter: removed about 8 hours after surgery or after the first night if the urine is clear; it stays longer after uterine rupture, prolonged or obstructed labour or a bladder injury (WHO).
Components
- Before: preparation of the woman, the companion and the theatre.
- In theatre: newborn reception and early skin-to-skin contact if both are stable.
- Recovery: airway, vital signs, bleeding, uterus, pain and consciousness.
- Ward: walking, breathing exercises, bladder, diet, wound, breastfeeding, VTE prevention and discharge teaching.
How it is applied (and why)
- Explain the procedure, confirm consent and indication, and check allergies — the woman and her family should understand what will happen.
- Send the ordered samples and confirm the antibiotic is given before the incision — this lowers wound and uterine infection.
- Place the bladder catheter if ordered and record vital signs and fetal heart before surgery — they are the baseline.
- Check that newborn resuscitation equipment works and the newborn team knows — the baby may need help.
- If mother and baby are stable, start skin-to-skin and the first feed — Ley 2244 protects this bond in a caesarean too.
- In recovery, place her on her side if drowsy; vital signs and saturation every 15 minutes the first hour — airway and bleeding fail early.
- Palpate the uterus and look at the pad at each check — a soft uterus bleeds after surgery too.
- Leave the first dressing for a day; if stained, reinforce it and mark the edge — if it grows or covers half, inspect the wound and report.
- Get her up once or twice on the first day, teach breathing exercises and use compression stockings if ordered — this prevents clots.
- Show breastfeeding positions that keep the baby off the wound — the incision hurts with pressure.
In nursing practice
- Unstable vital signs or a falling haematocrit after surgery suggest internal bleeding: tell the surgeon at once (WHO).
- Endometritis is more common after a caesarean or a long labour; watch the temperature and the lochia (see infection after birth).
- Reassess the risk of venous thromboembolism after birth and start the preventive measures ordered (Res. 3280).
- Avoid oversedation: good pain control helps her walk, and walking helps her recover (WHO).
Common mistakes
- Changing a stained dressing on the first day instead of reinforcing and marking it.
- Looking only at the wound and not at the uterus and vaginal bleeding.
- Keeping the baby away from the mother after the caesarean without a clinical reason.
- Leaving the catheter in longer than needed: it raises the risk of urinary infection.
Test yourself
Think of the answer, then tap the question to see it.
How often are vital signs checked in the first hour after a caesarean?
Every 15 minutes in the first hour, then every 30 minutes in the second hour.
When should the prophylactic antibiotic for a caesarean be given?
Before the skin incision, not after the cord is clamped.
What should the nurse do if blood leaks through the first dressing?
Reinforce it and outline the stain; if it grows or covers half the dressing, inspect the wound and report.
What is the minimum hospital stay after a caesarean in Res. 3280?
48 hours.
Connections
Educational content for students; it does not replace your institution's protocols, supervised clinical training or a prescriber's order. Dose-calculation examples use made-up numbers: they are educational, not a clinical order.
Sources: Managing complications in pregnancy and childbirth: a guide for midwives and doctors, 2nd ed. (World Health Organization, 2017); After a C-section - in the hospital (MedlinePlus, U.S. National Library of Medicine, 2025); Ley 2244 de 2022 (Ley de parto digno, respetado y humanizado) (Secretaría General del Senado de la República de Colombia, 2022); Resolución 3280 de 2018: lineamientos técnicos y operativos de la Ruta de Promoción y Mantenimiento de la Salud y de la Ruta Materno Perinatal (Ministerio de Salud y Protección Social de Colombia, 2018).
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Representative model, for educational purposes only.