Pros and cons - ELCS......

(45 Posts)
M0naLisa Tue 28-Aug-12 21:31:36

Posted this in chat too.

I am pregnant with 3rd and I am shitting bricks about going through labour again. We always said number 2 was our last but then decided to have another at Christmas.
It was a huge decision for me as I have to get my kind round giving birth again. I am absolutely petrified of going through it.
I have thought about an ELCS and it's looking like an option but as I am due 1st Dec I don't want to be poorly and sore over christmas.

I want to know what the pros and cons of an ELCS are from you ladies as you say it how it is.

Please.

I had to speak to a midwife today as getting abit of bloody discharge and I mentioned to her my fears and I just cried when I got off the phone as that's what the thought of natural labour does to me sad

Now I know its not an Aibu but I could turn it into one

AIBU to ask for an ELCS as i am a wuss and scared of labour.

mememummy Tue 28-Aug-12 21:46:00

What happened in labour? I have laboured twice and ended up with EMCS both time I asked for elective second time but they refused you have every right to ask for one also you can see a counsellor to help with traumatic labours? I have no idea if it helps so... Bump all the best

JumpingThroughMoreHoops Tue 28-Aug-12 21:47:36

Having had a labour that went tits up followed by an emergency and then 2 x elective CS - I'd take elective every time.

AlexReidsLonelyBraincell Tue 28-Aug-12 21:51:48

I had to have one for medical reasons with dc2, massive third degree tear and subsequent problems from my first delivery.

It's definitely no walk in the park and I think my recovery was reasonable, you need to really consider the pros and cons. Though no doubt you'll have people on to tell you how they were out jogging two days later and didn't need so much as a paracetamol.

Can your midwife refer you for counselling? I know it is offered in many areas. Good luck with whatever you decide.

Scrubber Tue 28-Aug-12 21:52:57

I've never had an ELCS, but have had 2 EMCS. They were fine. The first time I was pretty frightened being wheeled into the op theatre and having all the lights focussed on you knowing they're going to slice you open, but I had been labouring for a couple of days. I quite enjoyed the second one, was mentally prepared for what was going to happen and the staff all seemed to be in a really good mood and they put on The Proclaimers for us which was a bit odd but fun. The recovery for me was fine both times, just try not to do too much too soon and take your painkillers. I've never had a VB so can't compare, but CS are fine ime.

molly29 Tue 28-Aug-12 21:55:51

Ok i had a planned c section, it was a lovely calm birth, we walked through to the room, i had the epidural while my husband got changed into scrubs, then i had a giggle at him as he walked in, it was 7 minutes from cut to here is your baby, i felt alot of tugging and pulling , it was a wierd sensation, i can't really remember what they did after as i had my boy! When i went into recovery it was wierd that i couldn't move and felt panicy about the cut being pulled open, but it didn't of course.
I think if it makes you calmer its probably a good idea.
Obviously there are the con's of infection and recovery and as you probably already know they cut through muscle, it has risks, you already know this i assume!
People give you their opinions on natural births and thats great for them, but you know how you feel.
My experience was wonderful and i fully enjoyed the one to one time with my new little man for my 3 day stay.
You are not a wuss, you know what you felt and experienced, if having a c section gives you happy memories of the birth of your baby then go for it. Worrying will not do ur bubba any good.x

Meglet Tue 28-Aug-12 21:56:59

If you rest properly after the birth you should feel fairly human by Xmas. I didn't do a thing for a month after my ELCS and was so much better for it. I learnt the hard way after my EMCS and was in pain for weeks as I 'got on with things', never again. PJ's and sofa for me second time around.

Can your DH take sufficient leave to cover the month to do school runs so you can rest? A CS isn't a walk in the park but IME it's bearable if you can plan ahead and get lots of help, it's a major operation so plan accordingly.

Olympicnmix Tue 28-Aug-12 22:06:55

I recovered quicker after my ELCS than my 1st VB. You can really plan for it too. So Christmas shopping done all before, online shopping booked and someone else to host Christmas dinner! You could even book a cleaner for a couple of weeks. I was pretty mobile by day 5, changing dc3 on the floor etc but of course it's different for everyone. It also gives you a lovely excuse to go and lie down, air your stitches and cuddle up with your nb.

If you do decide to go ahead with a ELCS there are loads of hints and tips MNers can share with you to make it successful. Mine is to lie absolutely flat as much as possible after the op to get a straight, smooth scar and help avoid CS overhang.

BigRedIndiaRubberBall Tue 28-Aug-12 22:11:29

Watching with interest as I am due with DC2 on December 2, and had a birth options appointment today to discuss whether to ELCS or not. DC1 was an 11lb via EMCS, so not keen to repeat that experience ... But I keep swinging between the two.

My main reason to try for VBAC is the recovery time. I had a very straightforward, completely pain-free recovery last time, but there's no way I could have been running round after a toddler with a baby in tow for weeks afterwards. But then you never know what kind of recovery you'll get with a VBAC either ...

M0naLisa Tue 28-Aug-12 22:12:16

Dh isn't working at moment and if he's not working at the time then he will help big style.

It's all from my first birth. I was wheeled down to theatre as baby was distress his HB was dropping. I was 4cm and hadn't dilated anymore for 6hours despite the painful and excruciating contractions. He was born in theatre via ventouse, I was cut and had tears.

My second would be a normal birth, felt like he got stuck sad but midwife said he didn't they kept saying push and I was pushing and they'd say one more then I'd push again and baby wasn't coming. He was born a normal delivery with no interventions but the pain was worse than the first and it terrified me. I passed out from the pain 6 times. Midwife said I didn't but I know I did. I know the feeling of passing out I've done it loads of times.
My episiotomy cut ripped and had 2nd degree tears as well as labia lacerations. It was horrific and I never wanted to go through it again. When we decided to ttc I thought about labour and the birth and thought I can do it again. But now it geting closer my fears are coming back thick and strong and I cry at the thought if it.
I know if I talk to a midwife bout I'll be in tears. I'm seeing her on 10th sept when I have GTT and 28 week bloods.

My mum had sections with both me and my sister.
Emcs with me and ELCS with sister. She said she wouldn't wish a section on anyone. She was in hospital 14 days after both times. But this was in the 80s. Surely times have changed now.

WelshMaenad Tue 28-Aug-12 22:17:52

I loveloveloved my elective. Dc1 was an emergency section, my recovery was average. My recovery from my elective was really quick and I felt great. I was driving after 13 days. I recommend a theraline caesarean belt and lots of Manuka honey, eaten and also gathered on the wound. I also bought hibiscrub and washed with it for a few days before my elective date and afterwards until the wound healed.

I guess only you can decide what's right. Vbsc wasn't an option for me for medical reasons but even if it had I would have opted for the elective for the sake of my mental health. I would recommend asking for a debrief of your previous births with a midwife, and time to chat. This really helped me. Best of luck, whatever you choose. X

youngermother1 Tue 28-Aug-12 22:19:14

NICE guidelines seem to suggest that ELCS is fine - detailed information about problems reduced by CS and potentially more likely under CS (compared to vaginal delivery)

Wigglewoo Tue 28-Aug-12 22:21:55

I opted for an elcs with ds now 10 weeks. I had a very long 3 day labour ening in ventouse with dd now aged 9 and I didn't want to go through that again. I argued with my consultant after referral through the midwives and gp and I was booked in for my elcs at my 35 week consultant appointment. I wish I had been granted it earlier as I spent the entire pregnancy in fear of being forced to have a natural birth so if you know you want an elcs start fighting early!!!

For me the elcs was 1000000x better than the vaginal birth. No trauma (well for me there was as they discovered I had undiagnosed placenta previa - I don't "do pregnancy well!!!) But still... Even with this is was reasonably calm. Everyone was lovely to me, there was little pain - the spinal hurt a bit but I felt nothing after (nothing compared to labour and I had had an epidural before too)!!!

The moment I saw my son being held up was amazing and I have to be honest and say I felt a surge of love for him immediately that I took time to develop with dd because her labour had been so long and drawn out.

I enjoyed my 3 day stay in hospital with ds. We really enjoyed that time just us two to bond and the midwives were great and very helpful unlike when I'd had a natural labour and they just fucked off and were horrid (but maybe I was lucky!)

I found recovery better than I thought... I was almost back to normal in around 5/6 days but I left it about 2 weeks before venturing out mainly from tiredness. I found the pain not bad at all - and at least you can sit on your bum without pain from your fanjo! smile

I always thought ds would be my last baby but because having the elcs was so easy and relaxed I remember thinking in the hospital "I'd like to do this again" ....

Now 10 weeks on and the pain of sleepless nights make the pain of an elective c section pale in comparison!!! smile

Olympicnmix Tue 28-Aug-12 22:22:04

Jmo, but sounds like your undercarriage would not bear up well under a vb and a ELCS would be the cautious way to go. If you have friable tissue prone to tearing you also need to think about your future sex life and also continence post-menopause.

your mother has only her CS sections to compare with of 30 years ago. You've had only VB to compare with. It is stepping into the unknown but if the previous two times have not gone well I'd not choose the same option again.

BigRedIndiaRubberBall Tue 28-Aug-12 22:24:12

Well if I knew DH could be around for a few weeks, that would swing it for me. As I said, my CS was pain-free and recovery straightforward, and I quite enjoyed sitting on the sofa for ages afterwards smile.

A friend who had two CSs said the hardest thing was not being able to pick up DC1 for six weeks afterwards. I don't think she missed doing the housework though wink.

1944girl Tue 28-Aug-12 22:29:25

I can sympathise with your mother OP.Both of my children were born by EMCS in 1969 and 1972.I was in hospital a fortnight both times.
Best of luck in trying to get an elective ceasarian this time.I was denied one the second time, not allowed to ask then, doctors knew best.It was only when my second labour went terribly wrong when it was realised that I could only give birth by section.

M0naLisa Tue 28-Aug-12 22:32:52

I do worry about the continuance issue. I nearly pissed myself in shoezone this morning when out in town and I'm only 26 weeks pregnant and it was only a little cough. blush

The worry about the tearing too scares me due to the trauma of last time. I had loads of stitches and it took the midwife 2 hours to stitch me up afterward ds2.

I for PND bad after ds2 and I dunno if it was something to do with the birth as its making me just want the baby out now sad I don't want to go through PND again. But then I don't want a midwife to tell me that I'm stupid requesting one iykwim?

M0naLisa Tue 28-Aug-12 22:34:07

Incontinence*

Wigglewoo Tue 28-Aug-12 22:37:36

My mum kept scaring me too - she waffled on about how long I'd be in pain for and made me think I'd feel like I'd been hit by a truck.. I'm sure some people do but the pain relief nowadays and the way they cut and sew you up is vEry different. Even she was completely shocked how well I was and said I was so much better than when I'd had dd.

M0naLisa Tue 28-Aug-12 22:39:21

Yes my mums like that
"you don't ever want a section I was so poorly afterwards etc etc"

I just think hmm you've never had a VB though.....my mum never got contractions!

BigRedIndiaRubberBall Tue 28-Aug-12 22:40:26

I was slightly dreading today's appointment for just that reason Mona - but the midwife was lovely. I said I was leaning towards an ELCS, and she just nodded and wrote that down. I think it varies from trust to trust how willing they are to let you have one, but I really don't think they'll laugh at you or anything like that.

It was really useful going through my notes too - she took one look at them and came up with a really straightforward explanation for how things turned out which nobody had even suggested at the time. Helped allay any guilt/regret/other emotional bollocks which inevitably gets attached to it.

HazzleMcDazzle Tue 28-Aug-12 22:41:35

I don't think YABU at all.

I had an ELCS having had a horrendous VB with forceps four years previously. Physically, there was no medical need for me to have one but, like you, the thought of having another 'natural' birth completely freaked me out to the point that I couldn't enjoy being pregnant. I talked about this with my Midwife, who recommended a CS for the good of my mental health and stress levels.

I can only tell you what my personal experience was, but I can honestly say that having a section second time around was wonderful. I felt calm, in control and enjoyed the whole thing (in stark comparison to the VB which left me so battered about and traumatised that I ended up with PND). Recovery was also a lot easier - I was discharged after 24 hours and although the first five days or so were quite painful, it was manageable if I kept on top of my pain relief (dicloflenac for the first few days, paracetamol/nurofen thereafter).

I'm aware that mine is only one side of the story, and I'm sure that a lot of other people will have had a much rougher ride, but I wanted to give you a positive account. All the best for the rest of your pregnancy and hope everything goes the way you want it to when you see your Midwife.

M0naLisa Tue 28-Aug-12 22:42:10

Would they be able to go through my last labour notes? I'm going for the same hospital as ds2 birth but not ds1s birth. It will cost me around £50 to get my notes from my labour with ds1 sad

M0naLisa Tue 28-Aug-12 22:43:32

Also what about breastfeeding after an elcs? Would that be an issue?

I've had an elcs and an emcs after a failed vbac. I would chose an elective again. I was back on my feet very quickly, driving after four weeks, did sod all housework grin. Joking aside it was calm, relaxed, my boy was born healthy and there was no trauma. Compared to
A failed vbac and emcs it was a wall on the park, although I maintain the best part of my vbac was the spinal for my section.

Good luck in your decision op.

DameEnidSpink Tue 28-Aug-12 22:47:28

A couple of things that took me by surprise with C/S that HCPs didn't mention to me were:

Wind - terrible, painful trapped wind in my abdomen afterwards for a good few days

CS Stoop - hobbling around slightly bent for the first few days as the stitches kind of tug at your tummy

DDs breathing - not being squeezed through the birth canal can result in the fluid from their lungs not being expelled properly. DD had to be suctioned several times while we were still in hospital as she wasn't breathing properly. She has daily inhalers now for asthma and I do sometimes wonder what if I'd had a VB?

Oh just seen q. About bf. I bf ds1 for over 2 years after an elcs and ds2 is 20 months and still going strong.

HazzleMcDazzle Tue 28-Aug-12 22:54:16

Not sure about notes as no-one ever asked for mine - DD and DS were born in different hospitals too. Neither the Midwife nor the consultant seemed to think they were relevant (?) Also not sure about breastfeeding as I couldn't due to medication, but none of my friends who've had sections have had a problem. Probably something to discuss with your MW, though...

chandellina Tue 28-Aug-12 22:56:30

My elcs was wonderful and so much better emotionally and physically than my first vb with forceps and lots of drama. It was k

chandellina Tue 28-Aug-12 22:58:20

My elcs was wonderful and so much better emotionally and physically than my first vb with forceps and lots of drama. It was just a couple of weeks before Christmas and I was totally fine. I never really took bedrest once home and was doing long walks within a month and jogging after two.

M0naLisa Tue 28-Aug-12 23:16:47

I really don't know what to do sad

bumperella Tue 28-Aug-12 23:17:36

I had an ELCS under general anaestheitc. It wasn't my choice as such - medical condition meant it was the only sensible option. I found it horrific. Not at the time (obviously I was oblivious) but I can't remember anything of the following 24 hrs (when I had a morphine PAP), then had no pain relief until my DH wemt to supermarket for paracetamol the following evening.

a) statistcally women who want to BF but have CS are less likely to successfully BF than those with same desire to BF but who VB. I had no milk until 8 days after, and obv difficulty in finding a good position. If you've already BF earlier DC then you're likely to be less ham-fisted than first-timer (and know what you're doing) so maybe not an issue?
b) Will they give you a date? Or will they wait until early onset labour? Mine was teensy when she was born - she simply wasn't ready, but because of the GA they needed to give me a date. Having a "not-yet-cooked" baby (even though she wasn't at risk medically speaking) is v guilt-inducing. In your shoes I'd want to wait for waiting for labour to start if I could.
c) Babies don't get "squeezed" out so they're likely to be sicky-er for a while, and it never really felt to me that it was "right" for my DD. I felt like she'd had second-best birth-wise, which made me feel terrible.
d) Recovery - I can't compare as haven't had both, but it is hard with CS. Maybe becuase am older (38) but I definitely didn't bounce back. Even now (16 mnths on) am completely numb around scar with occasional odd, random twinges. I had a "good" CS, and am not suggesting that this is a dreadful thing, but I do feel that there's a generally feeling of "I'd rather have stitches in my belly than anywhere else" without realising that its a slice through big important core muscles.
e) People look down on you for having a CS, especially an elective. It's fairly trivial if the alternative is risking brain hemorrhage etc, but it still isn't nice.
f) Poo-ing. I didn't for 6 days.
g) Knowing the date is wierd. Most know/assume that their baby will be born before they go to about 42 wks, but to have an appt to turn up to hospital at (say) Tuesday 10am is really REALLY wierd. Am not sure it's an advantage as you'd have yourself sorted out beforehand anyway, if you're the organised type. Honestly, I think it works out neutral.

However, my understanding is that if your terrified of giving birth then it's more likely to go badly. Could you get counselling/birth notes etc first? And I've only had ELCS under GA. So none of the above is a comparison.

KatMumsnet (MNHQ) Wed 29-Aug-12 10:58:23

Hi, we've moved this into Childbirth now. Thanks.

diyqueen Wed 29-Aug-12 13:28:30

I'd say that if all goes well you'll be feeling OK for Christmas. If I remember correctly 3 weeks on from my ELCS (for a breech baby), I still got twinges of pain getting out of bed/up from sitting, felt quite weak in terms of core strength, but could do things around the home like laundry, cooking etc. I couldn't lift the car seat or pram without feeling like I was going to do myself some damage, but this improved quickly and I think I was managing those at 4-5 weeks. I didn't feel 'poorly' after the first few days, just sore and tired. Hope that practical info helps!

For me the worst part of having an ELCS was missing out on the experience of labour/childbirth (the grass is always greener, lol) - but you've been there and done that so not an issue for you.

Annakin31 Wed 29-Aug-12 15:23:34

Message withdrawn at poster's request.

Olympicnmix Wed 29-Aug-12 20:57:24

Had a vb with no pain relief, an induced vb with epidural and also an ELCS and I would have no hestitation in recommending an ELCS.

Advice:
1) After the agonies of my first delivery, including post birth, I couldn't believe how well controlled my pain relief was with the CS and although it would be a lie to say I felt a nary twinge, I wasn't in any pain. Was also very angry in hindsight how much I was allowed to needlessly suffer with dc1.
2) Stock up on windese tablets and lactose pre delivery. It is very usual to a) get trapped wind - your stomach can feel very full and you can even feel it in your shoulders and chest where oddly it feels like a really bad pulled muscle but wind-relief tablets worked really well b)get constipated or even if not, with stitches in your lower abdomen, you don't want to strain, so taking lactose is a very good idea in the first week or two.
3) A pair of oh-so attractive Crocs will be your friend in hospital and after as you won't want to bend to put on shoes, can wear them in the hospital showers etc. In the first few days you'll be wearing surgical stockings so flip flops/anything with a toe-post won't work as well. Big stretchy yoga pants are also ideal
4) Buy big pants that come well up over the scar. If needed pad the area with maternity pads inside knickers to stop clothes chafing or anything pressing on it.
5) An ELCS can be excellent for BF, no one expects you do anything except sit or lie down. Prop nb on a pillow to protect the wound. You can still hold them skin to skin and use pillow supports arms. Or you can lie on your side in bed with baby facing nipple. Also after they have sewn you up you have to spend 30 minutes in recovery which is fab for putting nb on your chest - they kind of shuffle to breast, it's amazing.
6) There is a theory that the more you lie absolutely flat after an ELCS the smoother and neater the scar, less puckering etc and even less overhang. I thought I'd try it and scar is very smooth, straight & with no overhang - no proof of course it did work but I thought I'd mention it.

Obviously it's totally your decision but just wanted to you know there are practical things you can do that can make it an overall better experience. Good luck smile

StoneBaby Wed 29-Aug-12 21:17:48

I had an emcs first itme around after an induced labour which ended up with foetal distress and 35 hours labour.
We're ttc at the present and I have already decide that I will ask for a ELCS despites:
1- knowing I'll be in hospital for 5 days
2- that the recovery may take longer
3- that I won't be allow to drive for 6 weeks

It is your choice but listening to your concerns and past I would say that you should ask for one.

Good luck

elizaregina Thu 30-Aug-12 11:19:02

Mona

I was terrified of going to loo for about 10 days after Vb and had a small tear no stiches, it stung it was painful I didnt feel back to normal for a year!! That was an uncomplicated birth.

I would be frightened to drink liquids and need a wee.

I have swung between HB, epidural and ELC for weeks now.

What makes you afraid - what risks are you prepared to take....

for many who chose elc its a questin on the roughly known compared to total un known, and un known with great pain....or roughly known with a team around you to help you.

I serisouly considered a HB and did loads of research including on here -but my MW put me off funnily enough....she said " when it goes well its truely lovley and wonderful, but my goodness....when it goes wrong......" and pulled an extremely horrfied face.

Also for me, a transfer in labour would be impossible.

i really wouldnt worry about what anyone else says in terms of judging you for ELC.

its your body you have to live with for the rest of your life and being in trouble down below might well be a drain on you mentally.

elizaregina Thu 30-Aug-12 11:23:17

btw - I couldnt talk about my birth without being in floods either and going back to the labour ward and seeing the lifts - and rememebering the pain i was in the last time i went in them also reduced me to tears.

my consultant is part of birth trauma assoication and didnt brutally force me to fight for ELC. once she said i cuold have one - a weight was lifted and i have been able to relax and enjoy my pregnancy - and also consider other options too.

i think its medieval and brutal to force any woman to go through the process of labour if they dont want too.

thankfully women are waking up to this misgogeny and are sharing more information about differernt modes of deliervy - and we are hoping seeing a more enlightened time coming, a long way off yes - but the more women wake up to this misogeny the better....

Olympicnmix Thu 30-Aug-12 11:29:45

Stonebaby, are those timescales specific to you? Women often out on day 3 or 4 and can drive, I think, after 3 weeks although you might have to check with your insurers.

elizaregina Thu 30-Aug-12 11:37:25

they usually say six weeks as the longest time you proably cant drive - however lots of ladies have said they are driving within two weeks -its totally dependant on you and your recovery - your insurers and your docs.

they have to give a rough long time like that.

youngermother1 Thu 30-Aug-12 12:18:48

Have you read the NICE links I gave you above? These seem to suggest the risks of VB and ELCS are about the same.
As you are scared of the VB, I would go down the ELCS route.

Then you also have a totally valid comparison for your third grin

HmmThinkingAboutIt Thu 30-Aug-12 13:14:55

RE: NICE guidelines. I'd caution about using them to say that the risks are about the same. They are useful, but you should properly understand them. There are some flaws to NICE's conclusion and methodology. And the risks between a planned VB and a planned ELCS are different and some may be accept or unacceptable to different people for various reasons. They are therefore not the same.

NICE also only used data for women who have had one child. Why is this important? Well risks are different for women who have successfully given birth by VB. And there are risks to consider if wanting more children too.

Its not quite as straighforwards as the guidelines appear.

victoriassponge Thu 30-Aug-12 17:17:14

Hi M0na

Can only offer my sympathy I'm afraid. Am also currently trying to make this decision after DS1 was born via induction (which was horrendous due to rare hyperstimulation reaction) followed by 24 hour labour and emergency csec almost 3 years ago. Am now 37 weeks and hosp says I can have elcs from 39 weeks.

Had been planning vbac all through this pregnancy (due to concerns about recovery post csec with toddler to look after) so have currently got elcs booked for 41 weeks.

Have also got acupuncture booked for weeks 39 and 40. Am on the raspberry leaf tea, bouncing around on yoga ball etc...

However a certain consultant at my hospital has (really helpfully!) made me feel like they are just humoring me and I will end up with the same thing happening again. So, have seriously been considering an ELCS - as can see the bonus of being bale to be organised and have time alone with baby before returning home as well as remaining intact below... its just so hard to know what to do for the best! confused

Sioda Thu 30-Aug-12 18:12:47

I wouldn't worry about the breastfeeding. The difference in rates is small and almost certainly accounted for by the fact that EMCS and ELCS statistics are mixed up and that many of the reasons why ELCS or EMCS are needed are also reasons ppl have trouble breastfeeding. e.g underlying health condition meaning uncompatible medication has to be taken, traumatic labours with haemorrhages and anaemia, underlying conditions like PCOS that may lead to IVF pregnancies and therefore more CS risk and that are themselves associated with breastfeeding difficulty. It's the removal of the placenta that triggers milk production not labour so CS shouldn't cause a problem. Positioning though can be a problem - you could ask the midwives to help you learn to feed lying down if you haven't done that before. It's invaluable in the first few weeks anyway.

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