The benefits of early alimentation post-caesarean section : impact on maternal satisfaction and bowel activity

Abstract

Purpose and Objectives This study aimed to provide strong evidence to advocate a change in post-caesarean nutritional practices. It was conducted so as to determine whether early rather than delayed post-caesarean alimentation has an impact upon gastrointestinal recovery and maternal satisfaction. The objectives of this research project aimed to explore and understand an evidence base approach to healthcare by conducting a critical review of the research-base evidence in relation to the research question, thus learning by inquiry. The PICO question set for this study asked: following a caesarean section, how does early compared to delayed introduction of fluids and/or food effect post-operative gastrointestinal recovery and maternal satisfaction? Methods This review was accomplished primarily by posing the above clinical question based on a framework composed of the population of interest, the intervention and comparable actions and measured outcomes [PICO]. A methodological search process was conducted through several reliable databases to select and identify the available, relevant and rigorous research evidence to answer the proposed inquiry. Adhering to an inclusion and exclusion criteria six randomized controlled trails and one systematic review were considered relevant for appraisal. Subsequently the strength of these studies was established following a systematic critiquing process. An in-depth discussion followed to analyse whether the findings could be applied to the local obstetric clinical settings. Results and Conclusion The results of the high-quality studies indicated that early post-operative oral intake in women who had undergone an uncomplicated caesarean delivery is safe and well tolerated hence resulting in higher maternal satisfaction. When comparing the local target population and clinical setting to those in the studies examined, it was suggested that findings could be applicable to the local obstetric clinical context. Recommendations and Implications for practice Results of this research project should be made available to local obstetric practitioners. Through active dissemination of knowledge, awareness will be generated which will in turn promote a change in practice. The formation of a focus group to discuss and diffuse an evidence-base approach to practice through new and effective learning techniques, is also recommended as it will enhance the body of knowledge in local obstetric care. Consequently, by collaborative and proper counselling on details of both regimes, flexible early alimentation programmes can be accommodated according to the women's wishes.