The American Congress of Obstetricians and Gynecologists defines a cesarean birth as "the delivery of a baby through incisions made in the mother’s abdomen and uterus." During the procedure, the mother is anesthetized so she doesn’t feel anything, but afterward ... hello, pain!
It’s no wonder that hospital stays for cesarean births usually last two to four days and moms are sent home with prescriptions for opioids like oxycodone and hydrocodone to deal with the pain.
The problem is that patients are usually given a prescription for way more pills than they actually need and those suckers are addictive. What’s more, these unused prescribed opioids are often not stored securely and make it into the hands of others. In case you haven’t heard, this country is in the midst of an opioid and heroin crisis. It's so bad that the National Institute on Drug Abuse reports that more than 90 Americans die every day from overdosing on opioids.
All this makes any rational person wonder if there's a better way for moms recovering from C-sections to deal with the pain so that they aren't being sent home with potentially addictive substances.
As far as OB-GYN Dr. Richard Chudacoff of Texas is concerned, there is, in fact, a better way and he wants to bring it into the mainstream.
Dr. Chudacoff is on the cutting edge of using a non-opioid anesthetic called EXPAREL, which is injected around the patient’s C-section incision immediately after suturing and can reduce or altogether eliminate the need for opioids.
His patients get an opioid-free spinal tap to block pain during surgery. Then once the patient is sutured, he injects EXPAREL, which is an anesthetic that takes 72 to 96 hours to dissipate, around the incision. What this means is that the patient is receiving pain relief even before she is aware of any pain and the pain relief continues for days.
As a result, moms are able to get up and walk around more quickly after surgery and avoid the dreaded opioid-induced constipation.
Three hours after surgery, they are out of bed. They’re walking. By six hours, they have walked, peed and eaten.
Whereas most cesarean births necessitate a mother staying in the hospital for two to four days, Dr. Chudacoff’s patients go home in about a day.
“I’ve always been interested in getting patients out of the hospital quickly because studies show that patients do much better at home than in the hospital," says Chudacoff. “Our average elective C-section patient stays in the hospital 1.2 days. Three hours after surgery, they are out of bed. They’re walking. By six hours, they have walked, peed and eaten."
Unlike other doctors, he doesn’t send patients home with opioid prescriptions. Instead, his patients follow a regimen of alternating acetaminophen and ibuprofen for about three days after they are home. Yup, the same stuff that you would take for cramps or a headache is all his patients are using post-op.
According to one of Dr. Chudacoff’s patients, Keely Rorick of Colorado, “It was such an easy experience. I just went in there and I was calm. Then right after, as soon as I could feel my legs, I was up and walking around. It was amazing. I was only on Tylenol and ibuprofen for about four days after. I actually moved from Texas to Colorado four days after surgery.”
You read that right: This new mom moved FOUR DAYS after having major surgery.
Aside from getting patients home quickly, Chudacoff’s drive to get the word out about using EXPAREL for C-section pain management is motivated by how his own life has been touched by the opioid crisis in this country.
“I’m very sensitive to opioids because of a family member who is a heroin addict,” he says. “My secondary goal is not only to take care of my patients, but to limit the amount of opioids left in somebody’s medicine chest. Now what we’ve done is we’ve stopped the excess amount of opioids going home because you know that most opioid and heroin addicts start with somebody else’s prescription pills.”
And, in case you were wondering, EXPAREL is still compatible with opioids, so if you find that you're still in a great deal of pain and need them, you can still use them. But how great is it to have choices? Just knowing that there's an opioid-free option that gets you moving faster can be a total game-changer for moms with newborns to tend to.