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11 Cesarean Birth Nursing Care Plans

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By Gil Wayne, BSN, R.N.
Cesarean Birth – Nursing Care Plans Nursing Diagnosis
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Cesarean birth, also termed cesarean section, is the delivery of a neonate by surgical incision through the abdomen and uterus. The term cesarean birth is used in nursing literature rather than cesarean delivery to accentuate that it is a process of birth rather than a surgical procedure. This method may occur under planned, unplanned, or emergency conditions. Indications for cesarean birth may include abnormal labor, cephalopelvic disproportion, gestational hypertension or diabetes mellitus, active maternal herpes virus infection, fetal compromise, placenta previa, or abruptio placentae.

Nursing Care Plans

Cesarean section is currently the most common major surgical procedure in the United States. However, it carries risks to both the mother and the fetus. It also has a lengthy recovery period than vaginal birth. Some women may have difficulty attempting a vaginal birth later. Yet, many women can have a vaginal birth after a cesarean (VBAC). Hence, mothers need to work with health care providers to make the best decision for themselves and the baby.

Here are 11 nursing diagnoses and nursing care plans for cesarean birth: 

  1. Deficient Knowledge UPDATED!
  2. Acute Pain UPDATED!
  3. Risk for Infection UPDATED!
  4. Risk for Deficient Fluid Volume UPDATED!
  5. Risk for Disturbed Maternal-Fetal Dyad UPDATED!
  6. Risk for Injury UPDATED!
  7. Anxiety or Fear UPDATED!
  8. Risk for Situational Low Self-Esteem UPDATED!
  9. Powerlessness UPDATED!
  10. Risk for Ineffective Self Health Management UPDATED!
  11. Risk for Impaired Parenting UPDATED!

10. Risk for Ineffective Self Health Management

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Risk for Ineffective Self Health Management

The postpartum period is a difficult time, where new roles and responsibilities are assumed. During this period, the parents have to learn infant care, establish a safe environment for the infant, learn the new roles, and deal with the problems related to the infant. However, the postpartum period is also when the mother needs the most information, support, and qualitative care. Being discharged from the facility 24 hours after birth may be sufficient to prevent complications; however, it is not sufficient enough to support the mother to adapt to her new situation. Therefore, at such a critical period, the mother’s physical and mental health should be closely monitored after the discharge (Capik et al., 2015).

Nursing Diagnosis

  • Risk for Ineffective Self Health Management

Risk factors may include

  • Ineffective individual coping
  • Complex therapeutic regimen
  • Conflicts with spiritual values or cultural influences
  • Psychological stress
  • Powerlessness

Possibly evidenced by

A risk diagnosis is not evidenced by signs and symptoms, the presence of signs and symptoms establishes an actual/problem diagnosis. Nursing interventions are directed at prevention. 

Desired outcomes and goals

  • The client participates in the development of goals and care plans.
  • The client demonstrates behaviors necessary to incorporate a therapeutic regimen in daily life.
  • The client verbalizes understanding of the therapeutic regimen.
  • The client verbalized acceptance of changing actions to achieve desired outcomes.

Nursing Assessment and Rationales

1. Assess the environment for factors causing sensory overload. 
Cesarean birth can be tedious to the client, and she may not concentrate on the procedures being performed. Determine the factors that can be controlled and cannot be controlled.

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2. Assess the extent of the client’s ability to move in bed and breastfeed.
Explain the importance of getting out of bed and caring for the neonate. Early ambulation helps prevent thrombophlebitis, and early breastfeeding helps establish an adequate milk supply.

3. Assess the client’s and partner’s ability to comprehend information, including literacy, level of education, and primary language.
This provides opportunities to clarify viewpoints or misconceptions. It also verifies that the client and her partner have accurate and factual information to make informed choices. The prenatal and postpartum periods are needed to prepare the woman and family adequately for recovery and parenting (Miovech et al., 2013).

4. Determine cultural, spiritual, and health beliefs and ethical concerns.
Identifying these factors provides insight into thoughts and factors related to individual situations. Beliefs will affect the client’s perception of the situation and participation in the therapeutic regimen. Interventions may be incongruent with the client’s social and cultural lifestyle and perceived role/responsibilities.

Nursing Interventions and Rationales

1. Provide the client information about the cesarean birth postpartum care.
Information about postpartum care and how to manage possible complications can help decrease anxiety and put perceived “chaos” in perspective. An unplanned, emergency cesarean delivery can be especially stressful, with its unfamiliar and intrusive procedures occurring in rapid succession, straining the ability of the mother to assimilate the experience (Miovech et al., 2013). Providing information helps prepare the women for a new life, decreases maternal morbidity during this period, and promotes recovery (Salam Ramadan & Farrag, 2018).

2. Explain the physiological process of the woman during the postpartum period.
Explanations about the process of returning to the nonpregnant state should be provided at this time by the nurse. Women need to learn that the discomfort associated with the healing incision may take months to resolve. The ability to move quickly and easily will return gradually. Methods to accomplish teaching can include pamphlets, videos in the postpartum unit, and postpartum follow-up calls (Miovech et al., 2013).

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3. Listen to the client’s and partner’s reports and comments.
Listening actively conveys a message of concern and belief in the individual’s capabilities to resolve the situation positively. Each interaction with the postpartum woman should have specific teaching and learning goals because often the woman will be discharged according to externally applied criteria rather than personal readiness (Miovech et al., 2013).

4. Provide positive reinforcements for efforts.
Positive feedback encourages the continuation of the desired behaviors. Emphasize positive aspects of the situation, maintaining a positive attitude toward the client’s capabilities and potential for improvement. Helping the client to feel accepting about herself and her individual capabilities will promote growth and strengthening of her self-care skills.

5. Promote client and partner’s participation in the planning and evaluating process.
Discharge planning should include helping parents make arrangements for obtaining help from relatives and friends and spacing activities throughout the day to reduce fatigue. The management of one is not effective for the other, therefore, a correct evaluation is necessary so that the woman receives appropriate interventions (Miovech et al., 2013).

6. Develop a plan for self-monitoring with the client.
Share data pertinent to the client’s condition such as laboratory results or blood pressure readings. This provides a sense of control and enables the client to follow their own progress and make informed choices.

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10. Risk for Ineffective Self Health Management

Recommended Resources

Recommended nursing diagnosis and nursing care plan books and resources.

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See also

Other recommended site resources for this nursing care plan:

Other care plans related to the care of the pregnant mother and her infant:

References and Sources

  1. Abdelraheim, A. R., Gomaa, K., Ibrahim, E. M., Mohammed, M. M., Khalifa, E. M., Youssef, A. M., Abdelhakeem, A. K., Hassan, H., Alghany, A. A., & Gelany, S. E. (2019, July 8). Intra-abdominal infection (IAI) following cesarean section: a retrospective study in a tertiary referral hospital in Egypt. BMC Pregnancy and Childbirth, 19(234). https://doi.org/10.1186/s12884-019-2394-4
  2. Ahmadi, Z. (2020, 03 20). Identifying and explaining experiences of fear of childbirth and coping strategies: A qualitative study. Journal of Qualitative Research in Health Sciences, 9(1), 47-58. 10.22062/JQR.2020.90993
  3. Ahmed, W. A. S., & Hamdy, M. A. (2018, August 21). Optimal management of umbilical cord prolapse. International Journal of Women’s Health, 10, 459-465. 10.2147/IJWH.S130879
  4. Akalpler, O., & Okumus, H. (2018, Sept-Oct). Gum chewing and bowel function after Caesarean section under spinal anesthesia. Pakistan Journal of Medical Sciences, 34(5), 1242-1247. 10.12669/pjms.345.15772
  5. Asim, M., Alkadi, M. M., Asim, H., & Ghaffar, A. (2019, January 21). Dehydration and volume depletion: How to handle the misconceptions. World Journal of Nephrology, 8(1), 23-32. 10.5527/wjn.v8.i1.23
  6. Bonnet, M. P., & Benhamou, D. (2016, June 27). Management of postpartum haemorrhage. NCBI. Retrieved January 12, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4926727/
  7. Boushra, M., & Rahman, O. (2021, July 15). Postpartum Infection – StatPearls. NCBI. Retrieved January 9, 2022, from https://www.ncbi.nlm.nih.gov/books/NBK560804/
  8. Bryanton, J., Beck, C. T., & Morrison, S. (2021, April 22). When Fear Surrounding Childbirth Leads Women to Request a Planned Cesarean Birth. Western Journal of Nursing Research. 10.1177/01939459211010192
  9. Burke, C., & Allen, R. (2020, March/April). Complications of Cesarean Birth Clinical Recommendations for Prevention and Management. The American Journal of Maternal/Child Nursing, 45(2), 92-99. 10.1097/NMC.0000000000000598
  10. Carvalho, B., & Habib, A.S. (2019). Personalized analgesic management for cesarean delivery. International Journal of Obstetric Anesthesia, 40, 91-100. https://doi.org/10.1016/j.ijoa.2019.02.124
  11. Caughey, A. B., Wood, S. L., Macones, G. A., Wrench, I. J., Huang, J., Norman, M., Pettersson, K., Fawcett, W. J., Shalabi, M. M., Metcalfe, A., Gramlich, L., Nelson, G., & Wilson, D. (2018, December). Guidelines for intraoperative care in cesarean delivery: Enhanced Recovery After Surgery Society Recommendations (Part 2). American Journal of Obstetrics and Gynecology, 219(6), 533-544. https://doi.org/10.1016/j.ajog.2018.08.006
  12. Chen, H., & Tan, D. (2019, February 21). Cesarean Section or Natural Childbirth? Cesarean Birth May Damage Your Health. frontiers in Psychology, 10(351). https://doi.org/10.3389/fpsyg.2019.00351
  13. Chokshi, A., Sifri, Z., Cennimo, D., & Horng, H. (2019, Jan-Mar). Global Contributors to Antibiotic Resistance. Journal of Global Infectious Diseases, 11(1), 36-42. 10.4103/jgid.jgid_110_18
  14. Chung, F.-F., Wan, G.-H., Kuo, S.-C., Lin, K.-C., & Liu, H.-E. (2018, September 6). Mother-infant interaction quality and sense of parenting competence at six months postpartum for first-time mothers in Taiwan: a multiple time-series design. BMC Pregnancy and Childbirth, 18(365). https://doi.org/10.1186/s12884-018-1979-7
  15. Cripe, E. T. (2017, March 29). “The Scarlet C”: Exploring Caesarean Section Stigma. Health Communication, 33(6), 782-785. 10.1080/10410236.2017.1298953 
  16. Damanabad, Z. H., Valizadeh, L., Hosseini, M., Abdolalipour, M., & Jafarabadi, M. A. (2021, July 23). Comparing the Effects of Face‑to‑Face and Video‑Based Educations on Hand Hygiene Knowledge and Performance among Mothers in Neonatal Intensive Care Unit: A Randomized Controlled Trial. Nursing and Midwifery Studies, 10(3), 158-164. 10.4103/NMS.nms_18_20
  17. Fawole, B., & Hofmeyr, G. (2012, December 12). Maternal oxygen administration for fetal distress. Cochrane Database of Systematic Reviews, (12). 10.1002/14651858.CD000136.pub2
  18. Fernández, V. R., y Cajal, C. N. L. R., Ortiz, E. M., & Naveira, E. C. (2018). Intrapartum and perinatal results associated with different degrees of staining of meconium-stained amniotic fluid. European Journal of Obstetrics & Gynecology and Reproductive Biology, 228, 65-70.
  19. Fowler, J. R., & Simon, L. V. (2021, September 8). Chorioamnionitis – StatPearls. NCBI. Retrieved January 9, 2022, from https://www.ncbi.nlm.nih.gov/books/NBK532251/
  20. Galante, D. (2010, March 10). Considerations on labor analgesia and drug complications. British Journal of Anaesthesia, 105(eLetters Supplement). https://doi.org/10.1093/bja/el_5617
  21. Ghi, T., Pasquo, E. D., Dall’Asta, A., Commare, A., Melandri, E., Casciaro, A., Fieni, S., & Frusca, T. (2020, October 13). Intrapartum fetal heart rate between 150 and 160 bpm at or after 40 weeks and labor outcome. Acta Obstetricia et Gynecologica Scandinavica, 100(3), 548=554. https://doi.org/10.1111/aogs.14024
  22. Gibbs, B. G., Forste, R., & Lybbert, E. (2018, January 31). Breastfeeding, Parenting, and Infant Attachment Behaviors. Maternal and Child Health Journal, 22, 579-588. https://doi.org/10.1007/s10995-018-2427-z
  23. Grant, E. K., Gattamorta, K. A., & Foronda, C. L. (2020, March 21). Reducing the risk of unintended retained surgical sponges: A quality improvement project. Perioperative Care and Operating Room Management, 21. https://doi.org/10.1016/j.pcorm.2020.100099
  24. Hasan, F., Ahmed, N., Jamil, R., Ali, L., & Khan, F. A. (2021, 06 30). Frequency and Indications of Primary Cesarean Section. Journal of Surgery Pakistan, 26(1). 10.21699/jsp.26.1.2.
  25. Ilska, M., Banas, E., Gregor, K., Salmeri, A. B., Ilski, A., & Cnota, W. (2020, August). Vaginal delivery or cesarean section – Severity of early symptoms of postpartum depression and assessment of pain in Polish women in the early puerperium. Midwifery, 87. https://doi.org/10.1016/j.midw.2020.102731
  26. Kim, D. R., & Wang, E. (2015, August 15). Prevention of supine hypotensive syndrome in pregnant women treated with transcranial magnetic stimulation. Psychiatry Research, 218, 1-2. 10.1016/j.psychres.2014.04.001
  27. Kjerulff, K. H., & Brubaker, L. H. (2017, October 20). New mothers’ feelings of disappointment and failure after cesarean delivery. Birth, 45(1), 19-27. https://doi.org/10.1111/birt.12315
  28. Kruse, A. R., Lauszus, F. F., Forman, A., Kesmodel, U. S., Rugaard, M. B., Knudsen, R. K., Persson, E.-K., Uldbjerg, N., & Sundtoft, I. B. (2020, November 11). Effect of early discharge after planned cesarean section on recovery and parental sense of security. A randomized clinical trial. Acta Obstetricia et Gynecologica Scandinavica, 100(5), 955-963. https://doi.org/10.1111/aogs.14041
  29. Labor, S., & Maguire, S. (2008, December). The Pain of Labour. Reviews in Pain, 2(2), 15-19. 10.1177/204946370800200205
  30. Leifer, G. (2018). Introduction to Maternity and Pediatric Nursing (8th ed.). Elsevier.
  31. Li, L., Wen, J., Li, Y., & Li, Y. (2010, December 23). Is routine indwelling catheterization of the bladder for cesarean section necessary? A systematic review. BJOG: An /International Journal of Obstetrics and Gynecology, 118(4), 400-409. https://doi.org/10.1111/j.1471-0528.2010.02802.x
  32. Macones, G. A., Caughey, A. B., Wood, S. L., Wrench, I. J., Huang, J., Norman, M., Pettersson, K., Fawcett, W. J., Shalabi, M. M., Metcalfe, A., Gramlich, L., Nelson, G., & Wilson, D. (2019, September). Guidelines for postoperative care in cesarean delivery: Enhanced Recovery After Surgery (ERAS) Society recommendations (part 3). American Journal of Obstetrics and Gynecology, 221(3), 247. https://doi.org/10.1016/j.ajog.2019.04.012
  33. Miovech, S. M., Knapp, H., Borucki, L., Roncoli, M., Arnold, L., & Dorothy Brooten. (n.d.). Major Concerns of Women After Cesarean Delivery. NCBI. Retrieved January 14, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3694506/
  34. Mostafayi, M., Imani, B., Zandi, S., & Jongi, F. (2021, June). The effect of familiarization with preoperative care on anxiety and vital signs in the patient’s cesarean section: A randomized controlled trial. European Journal of Midwifery, 5, 1-7. https://doi.org/10.18332/ejm/137366
  35. Nanthiphatthanachai, A., & Insin, P. (2020). Effect of chewing gum on gastrointestinal function recovery after surgery of gynecological cancer patients at Rajavithi Hospital: a randomized controlled trial. Asian Pacific journal of cancer prevention: APJCP, 21(3), 761.
  36. Pillitteri, A., & Silbert-Flagg, J. (2018). Maternal & Child Health Nursing: Care of the Childbearing & Childrearing Family (8th ed.). Wolters Kluwer.
  37. Puia, D. (2018, Winter). First-Time Mothers’ Experiences of a Planned Cesarean Birth. The Journal of Perinatal Education, 27(1), 50-60. 10.1891/1058-1243.27.1.50 
  38. Rookesh, Z., Kaviani, M., Zarshenas, M., & Akbarzadeh, M. (2021, October 22). Comparison of Maternal-Infant Attachment in Cesarean Delivery Based on Robson Classification: A Cross-Sectional Study. Iranian Journal of Nursing and Midwifery Research, 26(6), 500-507. 10.4103/ijnmr.IJNMR_230_19
  39. Salam Ramadan, S. A. E., & Farrag, R. E. (2018, October). UTILIZATION OF SELF CARE GUIDELINE TO PROMOTE QUALITY OF LIFE AMONG WOMEN UNDERGOING CESAREAN SECTION. The Malaysian Journal of Nursing, 10(2). :10.31674/mjn.2018.v10i02.007
  40. Sentilhes, L., Senat, M. V., Le Lous, M., Winer, N., Rozenberg, P., Kayem, G., Verspyck, E., Fuchs, F., Azria, E., Gallot, D., Korb, D., & Desbriere, R. (2021, April 29). Tranexamic Acid for the Prevention of Blood Loss after Cesarean Delivery. The New England Journal of Medicine, 384(17). 10.1056/NEJMoa2028788
  41. Shen, D., Moriyama, M. H., Ishida, K., Fuseya, S., Tanaka, S., & Kawamata, M. (2020, May 12). Acute postoperative pain is correlated with the early onset of postpartum depression after cesarean section: a retrospective cohort study. Journal of Anesthesia, 34, 607-612. https://doi.org/10.1007/s00540-020-02789-5
  42. Solehati, T., & Rustina, Y. (2015, June 22). Benson Relaxation Technique in Reducing Pain Intensity in Women After Cesarean Section. Anesthesiology and Pain Medicine, 5(3). 10.5812/aapm.22236v2
  43. Tennant, K., & Rivers, C. L. (2021, September 21). Sterile Technique – StatPearls. NCBI. Retrieved January 9, 2022, from https://www.ncbi.nlm.nih.gov/books/NBK459175/
  44. Vafaeenejad, Z., Elyasi, F., Moosazadeh, M., & Shahhosseini, Z. (2019, April 9). Psychological factors contributing to parenting styles: A systematic review. F1000Research, 7(906). https://doi.org/10.12688/f1000research.14978.2
  45. Wilson, R. D., Caughey, A. B., Wood, S. L., Macones, G. A., Wrench, I. J., Huang, J., Norman, M., Pettersson, K., Fawcett, W. J., Shalabi, M. M., Metcalfe, A., Gramlich, L., & Nelson, G. (2018, December). Guidelines for Antenatal and Preoperative care in Cesarean Delivery: Enhanced Recovery After Surgery (ERAS) Society Recommendations (Part 1). American Journal of Obstetrics and Gynecology, 219(6), 523.e1-523.e15. https://doi.org/10.1016/j.ajog.2018.09.015

With contributions by Marianne Belleza RN.

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Gil Wayne, BSN, R.N.
Gil Wayne graduated in 2008 with a bachelor of science in nursing. He earned his license to practice as a registered nurse during the same year. His drive for educating people stemmed from working as a community health nurse. He conducted first aid training and health seminars and workshops for teachers, community members, and local groups. Wanting to reach a bigger audience in teaching, he is now a writer and contributor for Nurseslabs since 2012 while working part-time as a nurse instructor. His goal is to expand his horizon in nursing-related topics. He wants to guide the next generation of nurses to achieve their goals and empower the nursing profession.

  • This one is valuable for nurse-midwifery trainees. It’s good for to us make an advanced care plan and easy to work in the OB ward.

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