11 Cesarean Birth Nursing Care Plans

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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!
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Risk for Impaired Parenting

The early postpartum period is critical and sensitive for the close relationship between the mother and her infant, which may be affected by their separation at birth and type of delivery. In a cesarean birth, long-term separation of mothers and infants occurs due to such complications as pain, bleeding, and infection. Cesarean birth may affect mother-infant attachment due to issues such as the side effects of anesthesia and delivery location in the operating room. Additionally, women with induced cesarean birth experience higher postpartum fatigue than those with vaginal delivery, resulting in problems with infant care (Rookesh et al., 2021).

Nursing Diagnosis

  • Risk for Impaired Parenting

Risk factors may include

  • Unplanned cesarean birth
  • Discomfort from surgery
  • Prolonged separation at birth

May be 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 voluntarily holds and feeds the infant.
  • The client voices out positive comments about the infant.
  • The client participates in the decision-making process about the infant.
  • The client demonstrates techniques to enhance the care of the infant.
  • The client displays a desire to strengthen her parenting skills.

Nursing Assessment and Rationales

1. Assess the client’s or couple’s perception of the situation and note individual concerns.
Identifying individual factors will aid in focusing interventions and establishing a realistic care plan. When a cesarean birth is unscheduled, the client does not have much preoperative time to think about how she will feel after surgery. Most clients are surprised to realize how quickly they become fatigued and how painful a simple surgical incision can be. Identifying essential factors that can affect their parenting role should be done early to put forth interventions before discharge.

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2. Determine cultural and religious influences on parenting expectations of self and infant.
This information is crucial to helping the family identify and develop a treatment plan that meets its specific needs. For example, Chinese parents rarely praise their children verbally, because their culture encourages modesty and humility. Chinese typically express their emotions in more subtle forms than Western people (Chung et al., 2018). 

3. Assess the client’s or couple’s level of stress and discomfort.
A study demonstrated that an atmosphere full of stress and discomfort in high-risk pregnancies might reduce maternal attachment behaviors. Adaptations to changes in pregnancy in normal conditions were already considered a crisis, as well. In case of a health risk for the mother or the infant, conditions would be more difficult, requiring more flexibility and patience (Rookesh et al., 2021).

4. Assess parenting skill level, considering intellectual, emotional, and physical strengths and limitations.
This identifies areas of need for further education, skill training, and factors that might interfere with assimilating new information. If the parent’s behavior shows strong intent for interaction, it attracts the attention of infants and initiates the mutual exchange, response, and participation (Chung et al., 2018).

5. Note the presence and effectiveness of extended family support systems.
Having a support system provides role models for parents to help them develop their parenting style. However, some role models may be negative and/or controlling. The history of parental evolution and the way parents have interacted with their own parents can also influence how they behave with their children in the future (Vafaeenejad et al., 2019).

Nursing Interventions and Rationales

1. Encourage the mother to breastfeed the infant.
Unless the infant was transferred to another unit, the nurse should provide the mother ample time to hold and breastfeed her infant. The average woman can breastfeed satisfactorily after a cesarean birth. However, caution the client that this may cause temporary uterine pain as the uterus contracts with breastfeeding, which could be beneficial in preventing postpartum hemorrhage. Intensive breastfeeding may facilitate increased maternal emotional care resulting in greater security attachment (Gibbs et al., 2018).

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2. Involve the client in activities with the infant that they can accomplish successfully.
Participating in infant care enhances the client’s self-concept. Studies showed that mothers in a vaginal birth group are more motivated to take care of newborns and felt less tired than mothers in a cesarean birth group, who were more likely to fail in their efforts to care for their infants (Chen & Tan, 2019).

3. Encourage early skin-to-skin contact between mother and infant.
Research showed that mother-infant attachment status directly affected infants’ emotional, sentimental, and neonatal dimensions and behavioral problems. Results of a study indicated that the ratio of infants transferred to the Neonatal Intensive Care Unit (NICU) for examination after skin-to-skin contact immediately after cesarean birth was significantly different from the group with no mother-infant contact. These results support immediate, uninterrupted skin-to-skin contact for all mothers regardless of birth mode (Rookesh et al., 2021).

4. Recognize and provide positive feedback for nurturant and protective parenting behaviors.
Emphasize positive aspects of the situation, maintaining a positive attitude toward the parent’s capabilities and potential for improvement. This reinforces the continuation of desired behaviors. Helping the parents to feel accepting about themselves and individual capabilities will promote growth and strengthening of their skills.

5. Refer the client/couple to resources such as books, classes, and support groups. 
The client should be able to develop support systems appropriate to their situation. Providing information and role models can help people learn to negotiate and develop skills for parenting and living together.

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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

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With contributions by Marianne Belleza RN.

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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