Enhanced Recovery After an Elective C-Section

Enhanced recovery, what on earth is that? That was exactly my thought's when my consultant uttered these words when discussing my planned c-section last year with Henry. I was due to have a planned c-section after having a very traumatic failed induction with Darcie that resulted in an emergency c-section. So whilst I felt quite prepared for my actual section, I had no clue what an enhanced recovery was.

My consultant informed me that because this was my second c-section, I would be enrolled on to the enhanced recovery program. Which basically meant that all being well, I would be going home the next day after the section. At the time I really didn't know what to think.

At the hospital, where I had both Darcie and Henry (Norfolk and Norwich University Hospital NNUH), their objective of the enhanced recovery programme is as follows;

"This enhanced recovery programme aims to improve patient care and decrease the length inpatient stay following an elective caesarean delivery. We are trying to naturalise the process and improve the patient experience and satisfaction."

To be able to go home the next day the following must apply;

Be reviewed by the obstetric team and be deemed fit for discharge that day.
Baby checks completed (patients on enhanced recovery programme are priority)
No concerns with infant feeding
No concerns about the patient's clinical condition and they must be willing to be discharged.

When I had Darcie I was in hospital for five days. I was in a lot of pain after my section and we were really struggling with breastfeeding. In fact, even when we left she was only feeding with the aid of a nipple shield. I felt I needed that time in hospital, I was very emotional, crying to the midwives because I was so confused as to what happened during my labour, plus very upset and worried about feeding my daughter. When I did eventually go home, I didn't feel ready. At all. Despite having care from the midwives once I was home, I still didn't feel like it was enough when I look back now.

With Henry, his birth was entirely different. In fact, it was the most incredible and beautiful experience I could of ever wished for. I was up fairly quickly after he was born and by the evening I was getting out of my bed and into my chair. The next morning I had a shower, dressed myself (last time with Darcie I actually had to have someone help me shower... how humiliating!), did those all important toilet trips and most of all we had nailed breastfeeding. I was actually feeling on top of the world and by 3pm I was begging the midwives to get me discharged so we could go home. By 6pm I was at home, in the comfort of my own surroundings, enjoying our precious new bundle. I felt incredibly lucky that I felt so well. It was the polar opposite to the feeling that I had with Darcie.

From that experience, I am pro enhance recovery. However, if I had the same experience as I had last time, I would have been terrified to have gone home. Though I am almost certain that they wouldn't of let me. I guess the key message here is that we are all different and have different experiences and hopefully hospitals listen to their patients and not wrongfully discharge them before they're ready to go home. From the above hospital guidlines, it would seem that they should listen to their patient's wishes and concerns and if you're not ready to be sent home you will remain in hospital.