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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Powerlessness

Women who underwent cesarean birth reported a sense of loss, powerlessness, and lack of control during the birth, and many used the word “traumatic” to describe their experience. Many women view childbirth as a “landmark event,” and cesarean birth may be perceived as a loss of this experience. Loss of control is significant, as women with the lowest perceived control have the least satisfaction and the greatest risk for postpartum depression (Burcher et al., 2016).

Nursing Diagnosis

  • Powerlessness
  • Interpersonal interaction
  • Illness-related regimen
  • Lifestyle of helplessness

May be evidenced by

  • Verbal expressions of loss of control over the situation
  • Lack of participation in the care and decision-making
  • Passivity or anger

Desired outcomes and goals

  • The client verbalizes fears and feelings of vulnerability.
  • The client expresses individual needs and desires.
  • The client participates in the decision-making process whenever possible.

Nursing Assessment and Rationales

1. Appraise circumstances contributing to a sense of powerlessness. 
Powerlessness becomes a major stress factor for clients experiencing their first hospitalization, including fear of the unknown. Unplanned (and sometimes planned) cesarean birth may be characterized by the client’s or couple’s sense of loss of control over the birth experience (Burcher et al., 2016). 

2. Identify the client’s strengths and past successful coping strategies.
Helps the client to recognize their ability to deal with a difficult situation. One of the most important strategies for coping with the fear of childbirth is the feeling of confidence. Maternal confidence can be derived from four important factors, according to a qualitative study by Ahmadi (2020): faith in God, receiving support, raising awareness, and positive thinking.

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Nursing Interventions and Rationales

1. Encourage the client to consider options in care when possible (e.g., IV placement, choice of anesthesia, and use of the mirror). 
Provide client opportunities to control as many events (e.g., choice of food, placement of IV cannula, choice of anesthesia type, etc.) as care restrictions may permit the client to have some sense of control over the situation. 

2. Recognize client or couple’s expectations and desires concerning the delivery experience.
Provides an opportunity to accommodate needs and encourage a positive experience. Increasing awareness and preparation for childbirth is an important strategy for coping with the fear of childbirth. Well-prepared women have higher confidence which translates to reduced fear of losing control of the situation (Ahmadi, 2020). 

3. Allot personal time and space for the couple before the surgery, if possible. Stay with the client if the partner is absent.
Provide an opportunity to let the couple talk about the situation through their means. Leaving the client alone may result in feelings of abandonment and adds anxiety. Providing ongoing emotional and psychological support to the mother creates comfort and reassurance and reduces fear and pain (Ahmadi, 2020).

4. Provide information, and talk about the client or couple’s perceptions.
Providing information diminishes stress brought by misconceptions and unfounded fear. By receiving correct information, well-prepared women for pregnancy and childbirth have greater expectations of actual pain levels and are less likely to experience inability and loss of control (Ahmadi, 2020).

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5. Develop a care plan with the client specifying goals agreed on.
Enhances commitment to the plan and optimizing outcomes. Shared decision-making before and during labor and delivery is critical for developing and preserving a client-provider relationship characterized by trust, mutual respect, multidirectional communication, and shared power/control (Ahmadi, 2020).

6. Facilitate return to a productive role in whatever capacity possible for the client.
The extent of recovery following a cesarean birth varies among clients. For some women, emotional recovery is much more difficult than physical recovery. Difficulties with infant care, particularly breastfeeding, also influence the client’s productive role. The presence of support and social interaction can positively impact the client’s emotional and physical recovery. Education about infant care and breastfeeding also increases the client’s control of the situation and her new role as a mother (Puia, 2018).

7. Encourage the client to think productively and positively and take responsibility for their thoughts.
Having positive attitudes such as paying attention to positive aspects like becoming a mother and others’ positive experiences and using positive visualization such as imagining the pleasing results of childbirth and having beautiful perceptions about the moment of mother and child visit creates positive thinking. It ultimately reduces the fear of childbirth (Ahmadi, 2020).

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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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