If you had an EMCS 1st time and were given the option to VBAC or ELCS, how did you come to your decision? And were you happy about it afterwards? I'm struggling to decide.

(32 Posts)
theborrower Sat 26-Apr-14 11:36:10

I know there are similar threads about VBAC or opting for ELCS, but I'm struggling to make a decision about the birth of my 2nd child, and I'm now 30 weeks.

I had an EMCS following an undiagnosed breech with my first baby. It wasn't a rush scary running down the corridor job, but it was still a shock I guess, and I found the aftermath quite difficult - DD was quite small, terrible trouble breastfeeding etc, and I ended up with PND. If I'm honest, I felt like I'd just been handed a baby, and felt like my body had failed me in more ways than one.

I'm under consultant care with this pregnancy because of the EMCS and because DD was low birthweight, and I've met with the consultant a couple of times and my birth options have been discussed.

At first I thought I wanted a VBAC, and I've been told I've a good chance of this being successful because I went into labour spontaneously last time, although of course, nothing is certain and I could still end up with a EMCS. We've discussed monitoring etc, and I can use telemetry monitoring and a pool etc, so I'm not worried about being tied to a bed or anything (was concerned about this before).

BUT I'm now swithering towards an ELCS because at least I know what will happen and if a CS is on the cards, I'd rather it was planned, but I also don't want a CS because of the longer recovery, the chances it will impact on BFing, and, well, I guess I've got unresolved issues about how I felt about it last time, as well as it being rather frightening to be operated on while you're conscious.

I'm starting to really struggle with how to make this decision, and getting quite anxious and upset when I think about it. I try not to think about it too much, because it feels a little pointless to make any choice, when last time there was no choice in the matter anyway. I'm seeing a psych soon because the consultant thinks I've got unresolved issues, and possibly a little PTSD, so I'm hoping this will help me make a decision that I'm happy with.

If you had an EMCS and were offered the chance to VBAC or ELCS, how did you come to your decision? And were you happy with your decision after the birth, even if things didn't go to plan?

I'm not afraid to hear bad VBAC stories (alhtough positive ones are welcome) but I'm also interested to hear from people that opted for the ELCS and if they were happy they did this.

Thanks for reading this long post.

Jemimapuddleduk Sat 26-Apr-14 12:38:08

No advice but watching with interest as in a similar position!

VeryPunny Sat 26-Apr-14 13:24:53

Same situation - DD was breech (but we knew in advance). Very quick dilation to 10cm, pushed for a good while before she got distressed and then a emcs.

To be honest the CS was fine and recovery easy; it was the mental barrier I found the hardest, and still do. I had planned a home birth, we'd done hypnobirthing and it was the sense of failing that really hit me hard.

I am going to try for a VBAC, but I am worried about the mental fallout if it goes wrong. I dearly, dearly want to experience a "normal" vaginal birth, but I can't face thinking about what I'll feel like if it doesn't go according to plan. A little part of me thinks at least if I go straight to section I won't fail iyswim?

Given how different things were 1st time round from how I thought they would be, I don't have the confidence that things will work out this time.

theborrower Sat 26-Apr-14 17:08:22

jemimapuddleduck are you leaning towards one option over the other, or are you as confused as me?

verypunny I understand what you're saying about feeling a sense of failure, even if I know logically that we didn't fail anything. It's a hard feeling to shake though, and I can't explain it any more than some sort of primal need or connection that doesn't make sense if I pick it apart. I'm also worried about the mental fall out - if I have a good VBAC I imagine that would be quite healing. But while a CS takes away some fear and puts me in a level of control, will I still feel a sense of loss?? I know what you mean about a lack of confidence too. My first pregnancy was totally fine and trouble free, and my labour so far was going fine. For things to change so quickly makes me think.

How far along are you?

My experience was rather different from yours in that I had a very long and awful labour pre my EMCS, I was exhausted and it was all a bit sudden and shocking when we were rushed off to theatre. It is fair to say I wasn't at all keen to experience anything like that again and so I was more worried that they might insist that I go for a VBAC. I did have issues around wanting a natural birth, but my fear of a repeat of 1st time was stronger so I opted for and elective CS. It was totally brilliant, relaxed, planned, easy, enjoyable - I totally loved sitting chatting with the midwives etc and then literally few minutes later the baby was in my arms while I was stitched up. This despite the fact that my Dh wasn't there (he was ill and infectious so they wouldn't let him into theatre, they offered to put off my CS for a few days until he recovered but I just wanted to get on with it). It was great having planned childcare for no. 1 around the known date of arrival. Recovery was super quick and easy. I opted for a CS for no.3 as well which went just as well. Didn't have any trouble BF (I knew all the easiest and most comfortable positions for feeding post CS 2nd and 3rd time around). I can't say whether you would have a sense of loss for never experiencing a 'natural' birth. I thought I might, but I didn't. Looking back now when my children are 9, 7 and 5 the idea seems laughable (although it was a very real concern of mine at the time). Control, order, safety and going with what I knew won the day and both my 2nd and my 3rd births were fabulous experiences. One way or another I'm sure you will work it out.

Vajazzler Sat 26-Apr-14 17:44:10

I had a long labour followed by an emcs which resulted in an 11lb baby. I was 42+1 and he had grown huge. During pregnancy 2 the growth scans suggested I was carrying another whopper and my consultant said that I could wait to go into labour natural but that they wouldn't induce me and I could end up with another emcs. Or I could have a lovely peaceful planned lscs. He recommended the planned lscs and given his expertise I went with his recommendation. However I've now got 5 children all delivered the same way and my abdomen is in tatters. I'll never know if I could have had a natural birth second time round and with hindsight I would have listened to myself rather than the doctor.

Foosyerdoos Sat 26-Apr-14 17:56:31

With my first I was induced at 2 weeks overdue, things did not progress and I eventually had EMCS. My recovery went well and I breasted successfully. When I had my second I was offered a choice.

I definitely did not want to be induced again so was going to go for c section, but after some thought and discussion I decided that I would try VBAC but I would be booked in for section when I was a week overdue.

I eventually went into labour on the afternoon I was booked into hospital for pre c- section tests and got home the following morning.

This was good as the recovery was quicker, but I was happy with either outcome so long as I avoided the induction.

lotsofcheese Sat 26-Apr-14 18:10:01

I had an EMCS with DS - unfortunately I'd developed PE at 29 weeks, so I didn't have labour.

In my 2nd pregnancy, the registrars at hospital were very much pushing me towards vbac - I thought I was a crap candidate given my history. The consultant was much more pragmatic & was pretty sure it would end up in another section.

And she was right. DD was breech & required delivery just short of 36 weeks, so it was another EMCS . No choice for me there, no agonising over decisions etc.

The only thing I'd say is that my stomach is awful - I really have a pronounced "shelf" as they go into the old scar for the next CS - plus a lot of numbness in the area. I do wonder if it had been an ELCS if these would be better. Maybe not.

Good luck with whatever you decide. Or whatever is decided for you!

I had a EMCS after a horrible 3 day labour with DS, it took me while to get over it.

I was given the choice of an ELCS or a VBAC next time and went for a VBAC as I didn't fancy not being able to drive or pick up my toddler.

I ended up having another EMCS and whilst to some extent I regretted my decision and wished I'd had a nice controlled ELCS, I don't regret trying.

Good luck! flowers

MrsGiraffe12 Sat 26-Apr-14 18:30:58

Watching with interest OP as I'm in a similar position. Consultant has offered me a VBAC which for the most part I'm offer to take up, but I'm terrified of an emergency c section. But on the flip side I'm terrified of tearing down below ect too xx

MsTimTam Sat 26-Apr-14 18:35:37

It's such a hard decision to make! I had an emcs with dd1 and opted for a VBAC with dd2 for the sole reason that I gave myself such a hard time about the emcs (which 7 years later seems crazy!) and took such a long time to recover (I think I am a slow healer) that I almost needed to 'try again'

I ended up with a forceps delivery that was almost another emcs and I joked afterwards that if I went for dc3 I would mange with no intervention. I did find that I recovered much more quickly from VBAC (even after an infected episiotomy) and as above for me it was more about trying again rather than how dd2 ended up being born.

Best of luck! smile

really1234 Sat 26-Apr-14 23:43:44

I had emcs with ds1 after induction (on due date), pushing and failed forceps. It was a proper 'crash' job under general anaesthetic with very long recovery. He was 9lbs 1oz.

Throughout my pregnancy with ds2, I fought for a vbac as I had a really long recovery from the first section. Consultants was ok about vbac, midwife wanted me to have an elective.

As it happened, my body showed no signs of going into labour, I was 14 days overdue and they refused to induce so I ended up with a planned section at 16days overdue. I can't bring myself to call it an elective as I didn't elect it. I was very upset when the consultant said that was the only way forward. Ds2 arrived at 10lbs 2oz and in a way I felt that it was my body's way of saying it wasn't going to happen naturally so it didn't bother trying to go into labour, iyswim?

My second section was actually a far better experience than the first, the major difference being that I was actually conscious and my recovery was better as I was not physically exhausted before the op. It was still many weeks of significant pain then discomfort though.

I would still pick a vbac over another section every time, mainly for the recovery but I also felt that I had given my body every chance to do it 'naturally'.

Good luck with your decision.

MrsHoolie Sun 27-Apr-14 00:07:28

My story....
1st baby,emcs for failure to progress. She was in a crap position and I only got to 4cm after three days
Spontaneous labour.

2nd baby,I changed my mind about Vbac/ELCS on a daily basis!Was all set for Vbac then changed my mind on my due date!So booked in for an ELCS at 41 weeks. Went into labour at 40+3 so decided to go for a Vbac. Ended up with section for....failure to progress,got to 3 cm this time (woo hoo!).

Would you regret not going for a Vbac do you think?
Or would you love to plan it all and go for an ELCS?
Perhaps you could compromise and book in for an elective at 41 weeks or something and see what happens.

It is a really hard decision.

FWIW I found the recovery really easy the 2nd time,no probs with breasfeeding or anything.

Mumoftwoyoungkids Sun 27-Apr-14 06:57:17

I went for the VBAC - the doctor said with my particular history it was safer for both me and the baby - plus I wanted a chance to get it "right".

It worked! Ds was delivered onto my stomach. It was amazing. Best moment of my life. (Sorry dd but I was having a massive haemorrhage when you were born so I wasn't really conscious.)

I also feel very "healed" re the EMCS. I now know it wasn't my fault. Plus if anyone ever says a CS is the easy option I can gleefully (and truthfully) tell them that I found the vaginal birth much easier.

I did have a few "bitter" moments though as I walked around the hospital car park in labour with dh trying to speed things up while muttering about how if I'd had a ELCS I'd have just strolled into the hospital pain free!

Dh's comment "well you never do things the easy way!"

Kantha Sun 27-Apr-14 07:39:08

thanksthanks To all those struggling to make a decision. It completely did my head in waiting for DC2 to arrive constantly wondering what the outcome was going to be. I do sympathise.

DC1 was induced at +14. Hideous experience of being induced but eventually fully dilated and pushed for 2 hours. DC became distressed and they did an EMCS which in itself was a relief after the previous 36 hours. I had no problems breast feeding, but I had a horrible recovery with lingering infections in the wound etc. It was a couple of months before I started to feel like myself again.

With DC2 I was determined to avoid an induction, ideally a VBAC, but an ELCS if I didn't go into labour naturally. In the end I went into labour at 39+3 and DC2 arrived 6 hours later after a straightforward delivery, with no interventions, not even gas and air. My recovery was so different second time around, just to be able to get up off the delivery bed and walk to the shower was quite a revelation. So for me the VBAC was fabulous.

Things during pregnancy that helped me though were:
1) Natal hypnotherapy VBAC CD. I found the first disk that asks you to examine your feelings about your CS surprisingly cathartic. The second one was great as a script for staying calm in labour.
2) Getting a full debrief of my labour notes with a consultant and MW. I sobbed throughout sad. It helped me understand why labour didn't start naturally (awful position); why DC1 wouldn't come out naturally (awful position!); and that there was nothing in my anatomy to have caused this, so no reason for it to happen again. Finally that, having fully dilated that I was a great VBAC candidate.
3) I had some acupuncture sessions towards the end of the pregnancy. No idea if it helped or not, but it gave me a sense that I was giving myself the best chance of spontaneous labour.
4) Read the Ina May Gaskin Guide to Childbirth book. Completely unlike any other childbirth book, totally wacky and hippy, not at all 'me' but I loved it and it did change my attitude to some of my feelings about childbirth. I would recommend it.

Good luck with whatever route you take.

HairyPorter Sun 27-Apr-14 07:51:09

Easy decision for me. DS was only 2.8kg and it was an obstructed labour (I'm only 5' so not that surprising). I concluded my pelvis isn't made for normal deliveries and had an elective c/s for my 3.4kg dd. No regrets but I do wonder what a normal delivery would have felt like and what the recovery would have been like. Had a tough time with recovery for 1st c/s but an easy time with the second one.

Cannotbelieveit Sun 27-Apr-14 08:07:01

Dc1 was an EMCS last march due to RFM (so I never laboured). Dc2 was due yesterday! I chose to try VBAC mainly for recovery reasons as dc1 doesn't walk yet and still needs me for lots of lifting etc!

I still might need to be induced if I get to +10. Have got a consultant appt and scan tomorrow and they will attempt another sweep as they'd prefer spontaneous labour rather than inducing as that can lead to higher risk of uterine rupture/complications/possible cd again!

How old is your dc1? Would you be able to manage recovery of an ELCS if you chose it?

Flickstar Sun 27-Apr-14 19:42:38

I'm 33 weeks and have just been through the same discussion with my consultant. I have pregnancy induced hypertension which resulted in me being induced at 38+5 in my last pregnancy. 2 days later DS was born by EMCS. I found it to be a really good experience- quick recovery and no problems breast feeding. I have decided that if I go into spontaneous labour I will go for a VBAC but if the baby needs to be delivered early due to BP then I will go straight to ELCS. I am keen to avoid induction so am not bothered whether I have a VBAC or ELCS really, just no induction! What has swayed me towards the VBAC is the quicker recovery with a 23 month old to think of too and also the risk of complications in future pregnancies with the more CS you have. If I knew I was done with two children I would probably have gone for an ELCS.

Fivemoreminutesmummy Sun 27-Apr-14 19:59:46

I had EMCS 1st time around- not a very nice experience after a long labour.
I agonised too re: VBAC but felt I couldn't bear for it to go wrong again and wanted some control.
My ELCS was wonderful. Calm, peaceful and joyous. I wasn't exhausted, had arranged childcare and breastfed and bonded easily. For me it was definitely the right decision.
Good luck with whatever you choose.

theborrower Sun 27-Apr-14 20:43:02

Thank you for all the responses everyone, I appreciate it. Apologies in advance for typos/mistakes - I'm on my phone, and much prefer the laptop for long messages!

nellytheelephant Control, order, safety and going with what I knew won the day
This is what appeals to me about a CS. I'm one of those 'organised' / 'control freak' people sometimes (or so DH tells me), which is maybe why the loss of control and choice bothered me. The consultant obviously reminded me that loss of control is common in childbirth. I know that. But knowing what will happen, and being fully rested in advance, has it's appeal.

theborrower Sun 27-Apr-14 20:49:28

mrshoolie ^Would you regret not going for a Vbac do you think? Or would you love to plan it all and go for an ELCS?
Perhaps you could compromise and book in for an elective at 41 weeks or something and see what happens.^

Yeah, I may regret not trying. Or not knowing if it would have been a smooth vb.

I have agreed with the consultant so far, if I aim for VBAC, that I will not be induced (they don't recommend it anyway) and if I've not gone into labour by 41, it'll be a planned CS. I don't want any messing about.

theborrower Sun 27-Apr-14 20:59:19

cannotbelieveit How old is your dc1? Would you be able to manage recovery of an ELCS if you chose it?

My daughter will be almost 4, and my husband is going to take 3 weeks off work this time, so yes, recovery should be ok, if there are no complications. In truth, apparently I had a 'good' recovery last time in that I had no scar infection and I generally felt loads better a fortnight later (but hated hobbling around for the first week), but I do remember having pain again a few weeks after and had to remind myself to take it easy. It's the thought of DD bouncing around and still having to take her to nursery and keep her entertained while looking after a baby and having an achy tummy that I'm not keen on. And the 4 day hospital stay was tough. But that was mainly because she wasn't feeding.

Nowitscleanugobshite Sun 27-Apr-14 21:17:33

Haven't read the whole thread-sorry! But I had induction, looong labour and then a very very EMCS under GA with DD nearly 19 years ago. Her apgar scores were 2 and 4-and the obgyn told me those were on the generous side! We have no pics of her on the day she was born as we were both so poorly. I couldn't believe I'd given birth when I woke up. Thankfully she looked just like the baby I'd picked from the Boots catalogue-so I knew she was mine!!! (I'd pointed out this particular -very pretty dark haired & obv "foreign"- baby to my dad late on in my pregnancy and when he saw her the first thing he said was "you got the one you ordered then"!
With DS I talked it through with my obgyn-same one as before. He was prepared to let me try to deliver if I'd wanted to but I knew it wasn't to be. I'm tiny. He wasn't. My pelvis hadn't grown in between deliveries so the outcome was likely to be the same. I had ELCS and it was like a party! Everyone was so relaxed-inc me! I kept asking "does it have hair? Until the Indian registrar said "have hair??? This could be my own child!!" yes. It has hair"!! We didn't want to know the gender before delivery, and the baby cried on the way out do my first view was of an upside down backside with VERY obvious boy bits!!! I got to hold him first-with DD I hadn't. And it was amazing! I have no regrets about not having a "natural" delivery.

sdaisy26 Sun 27-Apr-14 21:34:36

My first labour ended in emcs due to a combination of foetal distress & failure to progress. I hadn't even considered the possibility of a cs & found the whole experience hugely upsetting / traumatic and quite frankly felt they might as well have taken dd out of the broom cupboard for all the connection I felt to birthing her. I felt a huge sense of failure and cried every day about her birth for probably the first 9 months of her life.

I really felt I had to try for a vbac this time around, and very much hoped it would work. I spent a lot of time preparing - hypnobirthing, lots of reading, discussed my birth preferences with consultant mw & negotiated things that were v important to me. Went quite overdue (9 days in the end) & got to the point of having a cs booked at term + 12, which I felt v upset about. Anyway, I did labour naturally (a very long labour - 68 hrs of regular contractions!) but ds got himself completely stuck & I ended up with another emcs. I had been quite concerned about this happening & worried beforehand how this would affect my mental health, but what a difference from first time! It was a really wonderful experience and I actually do feel like I gave birth to ds - it proved a very healing experience in terms of my feelings around dd's birth too.

I'm so glad I tried (and boy did I try!) - I really feel I gave it my all but it just wasn't meant to be. Had I gone for elcs I always would have felt 'what if', I think. It also really helped that I'd discussed all sorts of eventualities beforehand (both with h & with medical professionals) so everyone knew exactly what was important to me & why and that made a huge difference to the whole experience, including the section.

I'm now 3 weeks post section & recovery has been great - though the first week was hard as I wasn't physically able to do much at all with dd - but luckily I had lots of support. Funnily enough, I was pretty sure we'd stop at 2 chn (and definitely was while I was in labour!) but as soon as they told me I'd really have to have a section if we have any more I found myself thinking 'I could do that'!

MrsHoolie Sun 27-Apr-14 22:55:33

Your plan sounds good OP.
Aim for Vbac but book in for ELCS at agreed date.
Best of luck and let us know how you get on.

If only we all had a crystal ball for these decisions!

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