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 Situational Low Self-Esteem

Society currently perceives childbirth as a natural process. Therefore, women who give birth through cesarean section are stigmatized because they are seen as having avoided something difficult- the rite of motherhood- going through hours of agonizing labor- for not having their babies the “natural way” (Cripe, 2017). Following a cesarean birth, women were more likely to experience loss of self-esteem and report struggling with body image (Burcher et al., 2016).

Nursing Diagnosis

  • Risk for Situational Low Self-Esteem

Risk factors may include

  • Perceived “failure” at a life event
  • Behavior inconsistent with a belief system
  • Fear of stigma

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 identifies and discusses negative feelings.
  • The client verbalizes confidence in herself and her abilities.
  • The client identifies coping strategies for the present situation.

Nursing Assessment and Rationales

1. Assess the client’s unusual feelings about self and pregnancy. Note cultural influences.
Diagnosis of a shift in the self-concept is based on past perceptions and experiences. Cesarean birth can change how the client feels about herself, even if planned or not. The client sees that the birth plan has been changed and that surgical intervention is needed to deliver the infant, while most women can deliver without any such intervention.

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2. Assess for grief, depression, and ineffective coping.
Grief can result from not being able to follow a birthing plan or going against a cultural belief can lead the woman to question the decisions made and may increase the risk for depression in the postpartum period. Women who undergo cesarean birth have higher risks of postpartum depression (Shen et a., 2020). The nurse should provide comprehensive education about the fear of childbirth. 

Nursing Interventions and Rationales

1. Allow the client to verbalize feelings and thoughts.
Determines areas to be discussed. Clients’ feedback varies and may be hard to diagnose in the preoperative stage. Feelings of negative self-image related to disappointment in the birth experience may interfere with postpartum activities related to successful breastfeeding and infant care.

2. Encourage questions and give facts. Reinforce previous learning.
Improves understanding and clarifies misconceptions. Women who do not have a spontaneous vaginal delivery at first childbirth may have mixed feelings after the delivery: happy about their new baby but sad or disappointed about the labor and delivery process. Family and friends may have difficulty understanding a new mother’s feelings after a cesarean or instrumental vaginal childbirth (Kjerulff & Brubaker, 2017).

3. Associate cesarean birth as an alternative method of childbirth.
Terms like “C-section” and “normal delivery” may bolster the client’s thought that the cesarean birth is unusual and abnormal, and the client may look at herself as inadequate, flawed, or weak. Women who had unplanned cesarean were considerably more likely to feel like a failure (Kjerulff & Brubaker, 2017). Therefore, the nurse needs to reinforce cesarean birth as another delivery method instead of surgical intervention or a treatment method.

4. Provide verbal communication of assessment and interventions. Written information can be given at a later time.
When a self-esteem problem arises for the client, it may become more critical postpartum. During the preoperative period, the client focuses on the here and now and may not be ready to read or deal with additional information.

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5. Recognize other couples or resources to refer the situation to after delivery.
At this significant time, the view of the situation usually does not provide a chance to communicate with others who have shared the same experience. However, these activities may help with the resolution of feelings and perceptions.

6. Allow a partner’s presence at the delivery as desired.
Provides support for the client, encourages parental bonding, and gives additional input to the client’s recall of the birth experience because memory lapses are more common during periods of crisis. Some cultures may prevent the father’s presence during delivery, necessitating a female family member instead.

7. Encourage the client or couple to participate in room bonding activities (e.g., breastfeeding and holding the infant) as able.
Reinforces the birth experience and deemphasizes the surgical nature of the delivery. Women who underwent cesarean birth may feel disappointed or fail because of their birthing process. However, maternal bonding and breastfeeding may reinforce the feeling of purposefulness.

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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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