Better C-Section Recovery: A Candid Consult with Dr. Kimberly Bridges-White

The physicians of Axia Women’s Health have pioneered new ways to help women return to health following c-section surgeries. We recently sat down with Dr. Kimberly Bridges-White from Garden State OB/GYN to discuss her team’s use of the ERAS program, which helps new mothers better prepare for surgery, recover more quickly, and manage pain without the use of opioids.

What is the ERAS program?

The ERAS program – Enhanced Recovery After Surgery – is a proven protocol used for women undergoing a cesarean section procedure. The goal of the protocol is to make recovery from the c-section quicker and less painful so new mothers can focus on a more comfortable healing period after giving birth. This is accomplished through making protocol changes prior to surgery, adjusting the use of anesthesia during the procedure, and closely managing pain after the procedure.

What makes the ERAS program beneficial for expecting mothers?

There are two key components of the program:

Eliminate fasting and increase carbohydrate intake before surgery. If you look at studies of marathon runners and tri-athletes, they often increase their carbohydrate intake the evening before a race. Carbohydrates produce endorphins, keep the GI tract moving, and minimize nausea when your body is working hard. Carbohydrates help the body perform at its optimal level. If you equate surgery to an intense physical event like a long-distance run, you can understand why supporting your body with carbohydrates will help. As part of ERAS protocol, a carbohydrate drink is provided to patients before surgery.

Other surgical protocols require strict fasting, which reduces energy and nutrition needed for recovery. As an example, if you are a coffee drinker, the lack of caffeine can give you an uncomfortable headache after surgery. With ERAS, you can still enjoy coffee or tea and enter your procedure without any kind of shock to your system. This process is more supportive of what your body needs and is accustomed to, and allows for a healthier recovery.

Manage pain with a focus on avoiding narcotics. Having gone through a c-section, I know how painful the recovery process can be and the challenges it creates. With the ERAS program, we can manage pain more effectively by treating the underlying inflammation that is causing the pain. Tylenol, Toradol, and Motrin are used in most of our pain management plans. Opioids will only be prescribed if the pain is severe.

In addition to the inherent risks of opioid use, these drugs can hinder your body’s recovery after surgery by disrupting your focus and diminishing your energy level. Opioids can also slow down bowel function, reduce appetite and create feelings of nausea, which makes it very difficult to care for a newborn.

Is the avoidance of narcotics in response to the recent opioid crisis in our country?

The opioid crisis in our country is a driving factor; but additionally, narcotics create disproportionate risks for women over men. From 1999 to 2016, deaths from prescription opioid overdoses increased 596% for women compared to a 312% increase for men. In addition, studies show that women are more likely to develop dependency and addiction from smaller amounts of opioids in a shorter timeframe than men. In general, we’re able to help women recover faster and manage their pain just as well through other means. Because our patients enter surgery in a more natural state, they are able to recover much easier without the need or desire for stronger pain medication.

How does this smoother recovery impact a woman’s hospital stay following delivery?

Because the ERAS program can help speed up recovery, most women are able to be discharged two days after delivery. The option to remain in the hospital for the full 3-day stay is available, but most women appreciate being able to return home sooner and focus on their baby in a more comfortable environment.

Who is a good candidate for the ERAS program?

Garden State OB/GYN does not recommend a c-section unless it is the safest delivery method to ensure the mother’s and baby’s health. Our team’s primary c-section rate is one of the lowest in the State of New Jersey. We always encourage our patients to attempt vaginal delivery before leaning on a surgical outcome.

When we know a c-section is going to be the safest delivery method, most of our mothers-to-be are perfect candidates for the ERAS program. Each patient should speak with their physician to discuss this option in more detail. Diabetic patients should not participate in the ERAS program because they would have a negative reaction to the carbohydrate treatment. A patient with severe pre-eclampsia would not be a good candidate either. However, most healthy mothers would be excellent candidates and would benefit greatly from the ERAS program.

To learn more about the ERAS program with Garden State OB/GYN, call (856) 424-3323.