I would be grateful for anyone's experiences or opinions here as I am really struggling to make the decision regarding how I will give birth to dc2. I am now 18 weeks and will be seeing the consultant at my 20 week scan (although I know I don't need to make the decision until much later on, I would like to go to the meeting with at least some idea of my preferences!). Here's the background - sorry if it ends up being a bit long.
DS was born two years ago. It was a textbook pregnancy, and I went into labour spontaneously a few hours after my membranes ruptured at 40+3. I had an active labour - used a ball initially, then on all fours, then in the pool. Despite this, he presented with shoulder dystocia, and his actual birth turned into an emergency, with buzzers going off, loads of people in the room, me being put into McRoberts' and having suprapubic pressure applied etc. Luckily these measures worked and he shot out, but in the process I got a 2nd degree tear. This was stitched, but didn't heal well - I had a lot of problems afterwards, and when ds was 8 months old I ended up back in hospital having a Fenton's procedure (re-cut and stitch under GA, together with removal of some scar tissue). This was extremely painful. Luckily it worked and since then, touch wood, I have had no problems with my perineum. I also had a PPH after the birth, was borderline in terms of whether or not I needed a transfusion (tbh I think I should probably have had one as my BP crashed through the floor and I fainted a lot in the days after birth - something I have never experienced before or since).
Since ds, I have had a miscarriage, which whilst I know is (sadly) a very common and normal thing to experience, has made me more anxious about my current pregnancy.
So, now I'm in the position of needing to decide between going for a VB this time, or requesting an ELCS (I have been told I will be given one if I want it, but it's basically up to me whether or not I want one or not). I really can't decide what to do for the best, but here would be a summary of my feelings: 1. All things being equal, I would prefer a VB - I am not particularly scarred by my experiences, and if I could see into my crystal ball that this would be a straightforward labour with no complications, that would be my preference. Obviously though I can't predict this. 2. I'm worried that I might have another SD, and that the next one might be more serious - I had no risk factors for it last time (I'm not obese, I had an active labour...) and yet it still happened. What if it's just the shape of my pelvis and might happen again? 3. I don't want another Fenton's - I don't know if I want to risk my perineum being damaged again. 4. I will be breastfeeding, and want to do everything I can to make that work - I'm worried it might be harder to establish after an ELCS. 5. My anxiety levels are higher this time round, partly due to the last birth and partly to the mc, so I'm worried I won't be able to relax enough for a natural birth and will end up needing intervention anyway (I would probably do a hypnobirthing class to try and overcome this if I opted for VB).
Sorry, this has become an essay! Thanks for reading if you've got this far - if anyone has any thoughts or experiences, please share them as I really don't know how to make this decision. Thank-you.
Thanks - I have done that, and my SIL is an obstetrician so I have plenty of knowledgeable people around - the problem is no-one knows for sure what the risks are. It is known that a risk factor for SD is having had a previous incident, but even then, there are no certainties about anything. It's such a hard decision!
I think in your shoes I'd go for an ELCS if you have enough support for the recovery period/help with your other child. I did natal hypno last time and found it very helpful. I also had a 2nd degree tear, (no issues with healing), but I still think I'd pick an ELCS.
I had a 3rd degree tear with DC1 and opted for ELCS with DC2. This time I'm opting for a vbac. Am also doing natal hypnotherapy and think its great for reducing anxiety (im so much worse with this pregnancy than the other 2 put together).
If you do opt for an ELCS and are worried about BFing try nipple stimulation with your hand or pump for a few days before you go into hospital. I did this with DD and actually had colostrum dripping down my bump whilst they were putting the spinal in