Woman’s Hospital Implements New Recovery Process for C-Section Patients

February 03, 2019

To reduce the risk of post-surgery opioid abuse, side effects

In an effort to reduce the risk of long-term opioid abuse and side effects after a cesarean section, Woman’s Hospital has implemented a new process called “Enhanced Recovery After Surgery,” or ERAS.

A C-section is a major surgery that involves a longer recovery than typically experienced with a vaginal delivery. This extended recovery often requires use of narcotic pain medication. According to a study published by The American College of Obstetricians and Gynecologists, most women, especially those with normal in-hospital opioid use, are prescribed opioids in excess of the amount needed.

As part of ERAS, non-opioid medication is used to not only reduce the risk of long-term opioid abuse, but also reduce post-surgery side effects. This approach reduces the risk of breathing difficulties, helps a patient maintain normal gastrointestinal function, and requires a shorter time period before ambulation. Earlier mobilization after surgery enhances circulation, reducing the risk of clotting and promoting proper wound healing.

“Woman’s is committed to following evidence-based practices that improve quality and safety for our patients,” said Cheri Johnson, Vice President of Perinatal Services. “Early results of implementing the ERAS process show decreased narcotic use after C-section, which will reduce side effects as well as the risk of chronic dependence.”

The enhanced recovery process begins in the obstetrician’s office with education about proper fluid intake and discussions on pain management. The mother’s nurse initiates the ERAS process when she arrives at the hospital. Patients receive long-acting pain medication during surgery, which lasts for up to 24 hours. Ibuprofen and Tylenol are given in the recovery room along with fluids and a small amount of food. The routine non-opioid medications continue in conjunction with ERAS guidelines, which also include earlier removal of the urinary catheter, ambulation as early as 12 hours after surgery, and a bowel medication regimen. The ERAS process is also used with vaginal deliveries to ensure the same quality of care and safety.