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New C-section approach can shorten recovery times, reduce the need for pain medication
The M Health Fairview Birthplaces, our pregnancy and birth centers across the metro, have adopted a new approach for cesarean (C-section) deliveries that can shorten recovery times by a third and reduce post-surgery opioid pain medication use by half.
- September 09, 2021
- By Staff Writer
Caitlin Perszyk needed an emergency cesarean (C-section) delivery for her first pregnancy due to difficult labor. Her recovery was challenging, and she needed medications to help manage her pain. So when Perszyk found out she’d need to deliver her second child by a planned C-section, she was understandably nervous.
Thankfully, the second delivery and recovery went much smoother – thanks to a new C-section approach used by Perszyk’s care team at The Birthplace at M Health Fairview Woodwinds Hospital. Perszyk delivered her daughter Laney at Woodwinds Hospital last September. In just two days, she and her husband were able to bring Laney safely home to meet her older sibling.
“I felt significantly better than I did after my first cesarean, and I didn’t have to take painkillers after returning home,” said Perszyk. “Since the delivery also happened during the COVID-19 pandemic, I was grateful to be able to go home with Laney after only two days at the hospital.”
Perszyk’s quicker return home with Laney, and her reduced need for pain medication after birth, are the result of a new effort to standardize care and improve planned C-section recovery across our M Health Fairview Birthplaces . The new approach is based in large part off Enhanced Recovery After Surgery (ERAS), a program developed by experts that can be tailored to many different surgeries. M Health Fairview’s Birthplace leadership adapted the ERAS program, creating our own Optimal Recovery After Surgery (ORAS) program for patients with planned C-sections.
Development of the ORAS program was an effort to shorten hospital stays and combat the nationwide opioid epidemic. Recent data show a link between opioid use after delivery and the potential for continued abuse or overdose, with Vanderbilt University reporting that more than 90 percent of people fill an opioid prescription after a C-section delivery.
As part of the new ORAS protocol, patients are given educational materials before delivery detailing what to expect and how to best prepare for a planned C-section. Everything from what a patient eats and drinks before surgery to what soap they shower with can impact their recovery and potential for infection. After surgery, an improved pain management program emphasizes identifying and treating issues as they arise – instead of prescribing opioids if they’re not necessary.
The ORAS approach sets benchmarks that patients should meet throughout recovery. Our care teams can then monitor each patient closely to meet those goals and offer healing support when needed. Prescribing opioid medications is only done if the patient needs more intensive support.
“This a group of people who are generally healthy, but then undergo a surgical procedure,” said M Health Fairview Maternal-Fetal Medicine Physician Phillip Rauk, MD. “Our new protocol allows these patients to recover as healthy people, and not be treated as a patient who is having surgery because they are ill.”
M Health Fairview has been tracking data for this new approach since implementing it in February 2020. We have found that recovery time has been reduced by 29 percent and opioid pain medication use has been cut by more than half after a planned C-section.
“Long recovery times and opioid use after cesareans are nationwide issues,” said Obstetrician/Gynecologist Laura France, MD, medical director for M Health Fairview’s Birthplaces. “Within our own system, we wanted to get everyone on the same page about when to prescribe opioids and how to optimize patients’ recoveries – starting with proper preparation and support before surgery.”