ELCS purely due to preference - what would you do?

(48 Posts)
TwitchyTail Tue 29-Jan-13 18:10:50

I'm almost 33 weeks with my first baby. For months I've had problems with the placenta which meant that an ELCS was expected. But now the problem has unexpectedly resolved itself, and I was told that there would be no problem with me going for a vaginal delivery. The only caveat is that I will need continuous monitoring of the fetus and it will need to be in the obstetric unit (not MLU).

This has thrown my brain into complete disarray, as I was all geared up for ELCS and secretly was really happy with this plan. I'm not tokophobic, I haven't had any traumatic experiences, there is now no medical reason for me to have one... basically I have no excuse, but I just feel that I prefer to take the risks of an ELCS than the more unpredictable risks of a VB. I know C-sections aren't the easy option (I'm a doctor and assisted in both types of birth during my medical training - admittedly a long time ago), but virtually everyone who has had an ELCS has a positive story to tell and I've heard so many first-baby VB horror stories.

Consultant will still let me have it but her advice would be for VB because there's no reason not to and I can tell she thinks I'm a giant fussy pfb wuss .

I'd really appreciate some honest opinions as to whether I'm being daft/unwise to consider having an ELCS just because I would prefer one.

bonzo77 Tue 29-Jan-13 18:41:43

I would have a CS every time. Yes, there are significant risks. But same with a VB. Like you I have some medical training and although i had no other option but CS both times, it
was what i would have opted for. I think we tend to be more confident in the face of known risks of surgery than the relative unknown of trying to let nature take its course. For some reason more of my friends have had CSs than VBs. no complications with any of the CSs group, lots with the VB ones. My own procedures and recoveries were uneventful. Yes, post surgery you should rest up, but I think all mothers of new borns should! And my vag etc are unscathed!

My second baby developed respiratory distress soon after birth which was a foreseeable complication due mostly to the CS and partly to prematurity (4weeks early). It resolved in 12 hours, so whilst worrying for me was bread and butter for the NiCU staff.

Floralnomad Tue 29-Jan-13 18:44:41

I'd have a section , I had a VB with my first and an ELCS with my second and if I could do it all again I would have two sections!

ilikesweetpeas Tue 29-Jan-13 18:50:28

I had an elective CS for various reasons (not medical) which I discussed with my consultant. He backed me up completely with my choice and I was very happy with the birth. I didn't feel that I missed out on anything, I found it a really positive experience. Also, the recovery was nowhere near as difficult as I anticipated. Obviously there was pain, but then you can have that following VB too. I had two minor wound infections which cleared quickly with antibiotics. If I was able to have another child I would make the same choice. I certainly don't think you are daft to have an ELCS. Good luck with whatever you decide

RedToothBrush Tue 29-Jan-13 19:40:33

TwitchyTail here's an article from 2008 which might be of interest to you. www.guardian.co.uk/society/2008/jul/11/nhs.health1

Quote from the article:
One London study published in the Lancet in 1996 reported that 31% of female obstetricians would personally prefer a caesarean birth. In the US, the figure is almost 50%

If its so daft/unwise why are there such high figures within the profession? You definitely not alone in your preference for a ELCS.

Female doctors statistically tend to have small family and are far more likely than the general population to start a family after they are 35 because they spend so many years qualifying and practising first. Obviously the statistics for an uncomplicated delivery for first time mothers over 35 is a lot less favourable than in younger groups... and doctors are more likely to be aware of the downside of both EMCS, ELCS and VBs from their job.

There a lot of very logical, understandable and completely rational arguments to have an ELCS on the basis of pure preference. And the people making this decision overwhelmingly tend to actually be the best educated. Ironically the media seeks to label women who decide to do this - selfish, easily led, shallow, weak and very often stupid.

The reality and the myth simply do not match.

Do whats best for you and to hell with what anyone else thinks. Trust in your own judgment - other people do when you treat them.

TwitchyTail Tue 29-Jan-13 19:45:44

Wow, thank you so much for your prompt replies and sharing your stories. I was really expecting to get told to man up and deal with a "normal" birth if I had no proper reason for an ELCS. It's a huge help to get your views. I feel a bit more confident in requesting it when I go back at 36 weeks.

I would take i to consideration how many children you would like to have.

TwitchyTail Tue 29-Jan-13 21:00:41

Good point goodygumdrops - we were planning on just this one, or at the very most two. If I wanted more than that I would avoid a C-section if possible.

RubyrooUK Tue 29-Jan-13 21:10:46

I have to have a CS for medical reasons.

Would much, much rather have a vaginal birth because despite having an "awful" vaginal birth with massive blood loss, tearing etc, my recovery was extremely quick, no restrictions on lifting or driving etc. I have a toddler and the idea of not lifting him or the baby at first seems impossible.

Plus I am scared of the famous "CS overhang" as my stomach went back to normal after my vaginal birth. And clearly I have realised I'm a bit vain about it. blush

QTPie Tue 29-Jan-13 23:35:25

This thread is qiuite amusing because the OP is a doctor: to be completely honest, I have huge respect for doctors and think that they know everything (or at least most things!). So it is a surprise that you are uncertain...

I had an ELCS (breech): I would have had a VB (reluctantly really), but was relieved when DS was diagnosed breech and stayed breech.

An ELCS IS no walk in the park and there ARE risks, but I felt not comfortable with the risks than with a VB (I think that there is a lot more chance for "less serious" complications with a VB). A CS would be harder for a second birth (if you have a toddler to look after too), but I would still opt for an ELCS.

I drove after 4 weeks and was back in the gym/pool at 7 weeks. Not a huge hardship - since I basically sat and breastfed for much of the first 4 weeks... Did lots of walking from 3 weeks (well building up gently).

If you have the option ( sounds like you do), then weight up the risks for yourself and make your choice. Don't feel under pressure or guilty either way smile

QTPie Tue 29-Jan-13 23:38:37

That should read "felt more comfortable with the risks than with a VB". I felt that I has a better chance of "an ELCS without complications" than a "VB without complications"...

GingerJulep Tue 29-Jan-13 23:52:10

Erm, waste of NHS funds... go private?

TwitchyTail Wed 30-Jan-13 07:25:59

Haha QTPie, we like to think we know everything and maybe do when it comes to other people grin but when it's your own body it's a different matter! Thank you for sharing your ELCS experience. I feel the same way as you regarding being more comfortable with the risks of a CS rather than VB, which I think is a very personal decision.

Thanks Rubyroo, it's good to get another perspective. My sister (who also had an "awful" VB) feels the same - she would still have preferred it to a CS despite all the complications because her recovery was fast.

TwitchyTail Wed 30-Jan-13 07:49:07

RedToothBrush, thanks very much for linking that article (fascinating read), and for your helpful comments - I really appreciate it.

I'm a VB evangelical! But there is no way I would a)agree to continuous monitoring in a CLU in favour of a c/section.

If I have to be under the doctors, I believe their knowledge of natural VB makes the VB risky. They're better at c/s.

BUT, I would make absolutely certain that monitoring was essential and if not I'd have a homebirth or MLU in a stand alone unit.

Fairylea Wed 30-Jan-13 08:23:43

I chose to have a section with ds after a difficult birth with dd.

Personally I would choose a section over a vaginal birth anyday. The recovery was on a par to be honest but I liked the fact I didn't have the pain of contractions and also with dd I found I actually felt fed up with the whole thing by the time shed arrived and I wanted to sleep, whereas with ds I found the whole thing a lot more magical.

Ironically I would have needed a c section with ds anyway it turned out I had undiagnosed placenta previa... ! So not a straight forward section but still a good experience.

TwitchyTail Wed 30-Jan-13 08:41:44

Thanks StarlightMcKenzie - I actually agree with you there. If I had had a completely uncomplicated pregnancy I would likely have gone with the MLU option. I just feel that the continuous monitoring (and knock-on effects on my ability to be fully mobile in labour, use the pool etc) and complications so far mean the odds are already stacked against me having a successful VB. Unfortunately the monitoring is definitely necessary and for good reasons (no-one knows how the dodgy placental bloodflow is going to respond to labour). In the absence of (what I feel is) a decent shot at an uncomplicated VB, I would rather cut out the middleman and go straight to CS.

Thanks for sharing your experiences Fairylea - it's really helpful to hear from people who've had both.

maxbear Wed 30-Jan-13 09:37:07

Most elective sections are relatively uncomplicated, having said that a woman where I work recently ended up on life support in itu after an elective for maternal request. Thankfully she survived but she missed our on her Childs first four days and no doubt will have physical and emotional trauma to deal with. the other thing with sections is that women can have significant pain long term afterwards (some have this after VB too) some women have a lot of pain when they are having a period, some when they are having a bowel movement, it sounds a bit cliched but it is major surgery and you have to be prepared that it might not go to plan. Also doctors see horrible difficult births so they have a squewed idea of what VB is. For many women they give birth then go home without any problems. Doctors don't see these ones.

TwitchyTail Wed 30-Jan-13 09:50:00

Thanks maxbear. Gosh that poor woman - hope she is ok now. It's definitely important to be reminded that it's major surgery.

You are absolutely right about doctors seeing the worst births - one of the reasons I started this thread was to get some "normal people" opinions, rather than asking my doom-mongering medic friends who all have a special horror story to tell hmm

RedToothBrush Wed 30-Jan-13 09:55:40

Twitchy, here's the thing. Whilst you don't have a medical reason to have an ELCS you do have at least one medical reason to at least consider an ELCS by the sound of it. You have been having complications which by the sound of it are pretty serious and have potential to cause problems.

Sometimes people phrase having an ELCS as a 100% chance of needing less risky scheduled surgery versus an unknown % of having more high risk emergency surgery. I think this is a very good way of putting it. Of course you might end up with an uncomplicated VB but its ALWAYS a gamble.

In effect what you are doing is trying to 'beat the odds' and guess what your most likely outcome is going to be with the hand you are given if you take that gamble. If your medical judgment is that the odds are stacked against you then I do think that considering an ELCS is a very reasonable thing to do. You are making an educated weighing up your risks of having an assisted VB or EMCS in effect. You do need to factor in how many children you are likely to have as part of that risk too but you've already done that from what you've said. You are not making a decision on a flight of fancy or out of vanity. I think all this nonsense about that type of thing makes people question themselves even when they are very well informed and I do think its quite nice to see even a doctor doing the same thing.

I do not understand why this weighing up of risk is not considered legitimate though. Not everyone is a gambler in life and there are a lot of cases where, if you look at all the factors in combination, certain women have a very low chance of ever achieving a successful uncomplicated VB even if they have no medical indication for an ELCS. If they want to give it a go, then fair enough but I think being realistic about these things is fair so either way women can emotionally prepare themselves.

I also notice the ignorant and rude comment upthread about cost. Truth is, if you really want to compare bare costs at point of delivery only, an ELCS is considerably cheaper than an EMCS.

(Not to mention NICE actually state in their guidance that a) cost shouldn't be used as an argument against an ELCS and b) the true cost of both planned ELCS and planned VB which actually includes EMCS, could not be easily calculated due to long term complications such as incontinence. So that argument, is quite frankly a load of bollocks and shouldn't be used as a weapon to beat women into guilt with).

I don't believe there is ever a 'right' answer to this question. Only whats 'right' for each individual woman in her individual circumstances.

CaramelBobbi Wed 30-Jan-13 10:04:04

I had two sections by choice, no medical reason for them. Mine were both a walk in the park, so civilised and calm and I was driving within a week. Hugely recommend, both children perfectly healthy and normal.

I've known since childhood that I would never give birth 'naturally' - the uncertainty, pain and lack of dignity - just not for me.

I met a young femal urologist recently who told me that she too was having an elective section. She knew she was biased but so many of her patients had serious damage from vaginal deliveries.

In fact, one of my closest friends, a medic herself, tore from vagina to rectum. Is horrible what she has been through.

I wouldn't hesitate if I were you.

CaramelBobbi Wed 30-Jan-13 10:10:28

Should have added that sections were not just calm etc, but absolutely magical!!!!! The best, highest moments of my entire life. I cannot recommend enough.

I do appreciate that there is a world of difference between an emergency section and an elective. But not having any pain or contractions etc, fantastic.

ChunkyPickle Wed 30-Jan-13 10:12:31

The trouble is that humans are notoriously poor at estimating risk.

I had an EMCS, and now pregnant with my second I'm really not sure what I want to go for next time. I found the actual CS really unpleasant - uncontrollable shaking from the anaesthetic (so bad I didn't feel safe touching DS because I would have hit him), the feeling of them getting him out was extremely uncomfortable and made me repeatedly throw up what little I had in my stomach, waiting an hour in recovery before I could go down and spend time with my newborn, and even longer while the numbness wore off and I could move again etc.

I know that that extreme unpleasantness was very short-lived compared to a VB but on the other hand my longer (very straightforward) recovery meant that I spent most of a week with uncomfortably swollen legs, being careful moving, walking, even opening the fridge caused stabbing pains from the internal stitches and these things are guaranteed, vs. the good chance of being up and home and walking around just fine the next day with a similarly straightforward VB.

It's hard - I can take the devil I know. Assuming everything goes well it's a few minutes of horrible-ness followed by a few weeks of discomfort and healing, or the devil I don't know, and a few hours or days of horrible-ness, followed by days of discomfort and healing. If everything goes wrong, then TBH neither is going to be good.

Personally, looking at the odds I am leaning towards trying for a VB, but having a CS rather than being induced.

TwitchyTail Wed 30-Jan-13 10:12:58

Thank you so much RedToothBrush - your post has really helped to clarify my thoughts about this. You've hit the nail on the head about the basis for my request and put it much better than I could have done.

ByTheWay1 Wed 30-Jan-13 10:17:00

If you were driving within a week it cannot have been on the advice of your doctor! There is a real risk of rupture both internal and external due to the positioning of the seatbelt - and an emergency stop or an accident could kill you.

I had a CS for my first - breech baby - and would never, ever, ever do so by choice again. Had an epidural which only "took" down half of my body - the side they tested to see if I could feel anything.... excruciating! They got it right in the end, but I will never, ever, ever forget that. My second child was VBAC.

Floralnomad Wed 30-Jan-13 10:24:33

I was driving within 10 days , my GP and insurance said if you could do an emergency stop that was ok . FWIW I have a very high pain threshold ( apparently ) and had no pain killers after the first day and made a super speedy recovery . On the other hand with my 'normal' first birth I ended up having blood transfusions and being unable to pick my rather large baby up for the first 3 days . Everyone's experience will obviously be different but my CS was a much more positive experience of giving birth than my VD.

TwitchyTail Wed 30-Jan-13 10:27:17

ChunkyPickle, thanks for sharing - totally agree that risk prediction is very difficult (even harder when doing it on yourself!) It's useful to hear the reality of CS experience and recovery.

Thanks CaramelBobbi - glad things went so well for you. Can I ask how your experience of requesting CS was? The consultant has actually been quite fair and reasonable about it, but I have seen two other members of the medical team who have really tried to dissuade me and made me feel bad for even asking, which has made me doubt my judgement.

Chuncky VBs rock. They really really do. 2 of my 3 were the best experiences of my life and I am sad that I won't be doing it again. But not if you are scared, unsupported, interfered with or in my case, ever touched.

The psychological aspect of birth is overlooked hugely and imo so much about what goes wrong/right can be attributed to this. With my 3rd I didn't have any pain relief at all. I bossed everyone about and told them what I was doing, when I was doing it. I even did my own internals. I was the star of my show and in control. I was not a lamb to the slaughter and I was not manhandled, talked down to, spoken about in earshot as if I wasn't there or told what to do.

It was fecking EASY and 'almost' pain free. I pulled my baby out myself.

I would shout from the rooftops if it meant every (or at least most) woman could have that experience. However, I doubt it is possible in CLU with a monitor unless the woman is VERY good at hypnobirthing.

TwitchyTail Wed 30-Jan-13 10:30:49

Thanks for all the other replies - can't keep up and am cross-posting like mad grin

RedToothBrush Wed 30-Jan-13 10:34:28

The trouble is that humans are notoriously poor at estimating risk

Which is why you probably shouldn't ask people on the internet about their experiences anymore than you should ask friends who are medics tbh.

You'll generally attract polarised experiences and the people answering may not reflect your demographic or risk group either.

Best to stick with cold hard statistics on the subject where you can, whilst checking methodology carefully. Take the emotion out of it as much as possible.

bringmeroses Wed 30-Jan-13 10:35:43

I've had both and if you don't like the idea of monitoring during labour - if you are sure it's essential - id go for a elcs in your shoes. My recovery was the expected six weeks and sex was painful afterwards till dc2 arrived by vbac oddly; but the elcs was incredible and as others have said you are beyond knackered after a vb.
Worst part of elcs was spinal injection but this is v short lived compared to an uncomfortable labour hooked up to monitors. There are so many pros and cons to each, not an easy call.

ChunkyPickle Wed 30-Jan-13 10:37:44

I don't understand why UK hospitals would restrict movement when under fetal monitoring as it can only help the mother to move, and if I was told I would be strapped into a bed for a VB I would be thinking twice too - moving was all that kept me sane while I was being induced (pessary was OK, syntocin was very painful for me - probably because I wasn't progressing)

They monitored me, but they had wireless ones which I could even wear in the bath - perhaps that would be possible? Or persuade them to go intermittant?

Starlight - I totally agree that the mental aspect is what makes or breaks you in a lot of cases - telling you that you'll be stuck in a bed I think breaks you before you've even started. My care was absolutely brilliant, but I still regret letting them persuade me into an induction, and that will not be happening again.

LubyLu2000 Wed 30-Jan-13 10:39:40

I was in a similar(ish) position myself. DS1 was an ELCS as he was breech. This baby was breech the whole time and I was absolutely convinced he would remain like that as I have a heart shaped uterus so got the shock of my life last week when the scan confirmed he'd turned! I almost started crying because I was quite happy with having another ELCS and this suddenly meant I had to make the decision myself. Talked it over with the doctor (he was very good in that he made no attempt to convince me either way) and decided that on the basis of calculating the risk I have a lower chance of having a successful VBAC so am going to stay with an ELCS - Redtoothbrush has put it perfectly.

Anyway, now that it's decided and I have a date I feel like a huge weight is off my mind. I totally understand the feeling of pressure that you feel like you "should" have a natural birth but if you would feel better about having a CS then go for it. I mentioned this to my doctor and he said it was noone else's business at all and if it bothered me I should just tell everyone he was still breech cos noone would know! Some people will wear their judgy pants but just let them get on with it and do what's right for you - most important thing is that you and baby are fine.

HeyHoHereWeGo Wed 30-Jan-13 10:42:32

Hi twitchy, I am similar to you, but in my case I had already the LSCS booked (maternal request dressed up as breech) when baby actually moved into breech!
My first was really really easy. Mimimal pain, a beautiful experience, great recovery. Like most doctors I was having my first in my late 30s so it was not my youth playing a part!
My second was "complicated" with a wound infection, and even so I would still say it was much easier than those I've seen post vaginal with stitches.
I needed a bit of help for the first couple of weeks, doing laundry/ cooking etc but was driving short easy trips after that.
Section births, electives at least, feel far more like Births than Surgery.
I would go for elective section, I really would.
I think post vaginal complications are very common, long lasting, and hidden. No-one speaks of them, yet I remember the urology clinic and all the shocking stories.

mouseymummy Wed 30-Jan-13 10:55:57

My first dd was a vg birth, no complications, I was induced but labour progressed well and after 22 hours in the hospital my dd was born and I went home.

Dd2 was a section due to her being breech. Give me a section any day!! Dd2 was undiagnosed as breech so she was classed as a "planned emergency" I didn't actually find out til I was In labour!

My consultant was amazing and my dh has said the midwives were brilliant with him too.

For my next baby, I'd like to try a vb but if I need another section I'd be happy!

ByTheWay1 Wed 30-Jan-13 11:52:37

Normal VB without complications is the MOST common type and outcome in England....

You need to check the figures at your actual hospital to see the risks as they stand for yourself. For instance in the US CS is much more common and consequently less risky than the UK - but most people quote the US statistics when talking about CS over here....

Trouble is very few people actually talk about the easy, non complicated births that don't actually have any future problems..

RedToothBrush Wed 30-Jan-13 14:45:40

The official NHS Maternity Statistics for 2010 - 2011 for the NW NHS strategic authority (as an example) show that the percentage of unassisted vaginal deliveries as follows:

Wirral University Teaching Hospital NHS Foundation Trust 46.3%
St Helens and Knowsley Hospitals NHS Trust 39.6%
Mid Cheshire Hospitals NHS Foundation Trust41.2%
Liverpool Women's NHS Foundation Trust 38.7%
East Cheshire NHS Trust 44.9%
Countess Of Chester Hospital NHS Foundation Trust 39.1%
University Hospital Of South Manchester NHS Foundation Trust 41.7%
Salford Royal NHS Foundation Trust 48.1%
Royal Bolton Hospital NHS Foundation Trust48.1%
Tameside Hospital NHS Foundation Trust47.6%
North Cumbria University Hospitals NHS Trust47.9%
Wrightington, Wigan And Leigh NHS Foundation Trust45.6%
University Hospitals Of Morecambe Bay NHS Foundation Trust 49.4%
Southport and Ormskirk Hospital NHS Trust41.3%
Central Manchester University Hospitals NHS Foundation Trust52.1%
Pennine Acute Hospitals NHS Trust49.6%
Stockport NHS Foundation Trust 46.8%
Warrington and Halton Hospitals NHS Foundation Trust 41.1%
Blackpool Teaching Hospitals NHS Foundation Trust45.8%
Lancashire Teaching Hospitals NHS Foundation Trust48.0%
East Lancashire Hospitals NHS Trust51.1%

NHS Information Centre maternity dataset definition for Normal Delivery:
Normal delivery is one defined as normal delivery as spontaneous vaginal birth. The following elements will constitute a normal delivery:
•labour is not induced
•oxytocin is not given to the mother
• method of delivery is spontaneous vaginal (excludes caesarean, use of forceps, vacuum extraction)
•no artificial rupture of membranes
•medicated pain relief assistance (ie narcotics, regional anaesthesia, perineal infiltration) is not given to the mother
•episiotomy is not carried out.
An assisted delivery therefore would be one where one or more of these factors are used to assist the mother to give birth and the baby to be born.

Therefore if you give birth in the NW you are statically more likely than not to NOT have a 'normal' unassisted delivery unless you are under the care of East Lancashire Hospitals NHS Trust or Central Manchester University Hospital NHS Foundation Trust.

Not to mention that those figures are for women as a whole group. As soon as you start to break down those figures into various groups, by whether you are a first/second time mother, by BMI or age some come out a lot better, but some come out much, much lower.

Women who are first time mothers, with a high BMI and are over 35 for example would rate worse than women who have already had a child, have a normal BMI and are in their mid twenties for example.

So its all about working out what risk factors are relevant and important to you, rather than going on some pie in the sky number that actually doesn't mean anything to anyone as is based on the mythical 'average woman'.

Bytheway in fairness to you I think what you are referring to is slightly different - you mean births that result in a VB that doesn't require a CS or instruments. The figures for this for the NW are (CS, Instrumental VB and VB:
Wirral University Teaching Hospital NHS Foundation Trust21.7%13.4%64.9%
St Helens and Knowsley Hospitals NHS Trust 22.3%9.0%68.7%
Mid Cheshire Hospitals NHS Foundation Trust22.4%13.4%64.0%
Liverpool Women's NHS Foundation Trust24.3%15.4%60.2%
East Cheshire NHS Trust23.4%12.1%64.5%
Countess Of Chester Hospital NHS Foundation Trust25.2%14.2%60.5%
University Hospital Of South Manchester NHS Foundation Trust25.6%14.5%59.8%
Salford Royal NHS Foundation Trust18.5%15.1%66.4%
Royal Bolton Hospital NHS Foundation Trust22.1%11.9%66.0%
Tameside Hospital NHS Foundation Trust21.0%9.3%69.7%
North Cumbria University Hospitals NHS Trust24.3%10.8%64.9%
Wrightington, Wigan And Leigh NHS Foundation Trust22.8%11.5%65.7%
University Hospitals Of Morecambe Bay NHS Foundation Trust22.9%12.3%64.8%
Southport and Ormskirk Hospital NHS Trust26.5%12.2%61.3%
Central Manchester University Hospitals NHS Foundation Trust17.9%15.0%67.1%
Pennine Acute Hospitals NHS Trust23.4%8.6%68.0%
Stockport NHS Foundation Trust23.8%14.4%61.8%
Warrington and Halton Hospitals NHS Foundation Trust24.6%13.0%62.4%
Blackpool Teaching Hospitals NHS Foundation Trust26.0%9.7%64.2%
Lancashire Teaching Hospitals NHS Foundation Trust22.4%9.2%68.4%
East Lancashire Hospitals NHS Trust23.8%10.8%65.4%

So women who get a VB without instruments ranges from 59.8% to 69.7% across the NW.

But I do think the first set of figures are actually more relevant (and these are the ones they are using on the NHS Choices website) so that women can be realistic about what to expect with their experience.

The word 'normal' is something that is being thrown around a lot at the moment by strategic planners and isn't being used in the same way by everyone. Its a pretty important thing to understand what we are all actually talking about here. There's about 20% of women who are falling in between those definitions so obviously are needing an induction, episiotomy or pain relief.

ByTheWay1 Wed 30-Jan-13 15:17:12

But even those who have a birth with instruments don't all end up with horror stories - I had a forceps VBAC with my second and would still chose that over the CS I had with my first.

No complications at all after the birth - straight back to normal taking care of 2 little ones.

I just get a bit fed up of the "ooooo VB = complications after the birth, tearing, bladder weakness etc", when we get very little of the "CS = complications after birth, bladder cut , infection of wound and increased risk of future pregnancy placental problems" as well as the recovery period.

And there are just as many problems for older overweight women having a CS as having a VB.

LivingThings Wed 30-Jan-13 21:29:46

Both my DC were ELCS. By maternal choice. No other reason. Tbey were botb wonxerful pain free experiences with quick pain free recoveries. Was driving within 8 days and running by 5 weeks.

elizaregina Wed 30-Jan-13 22:19:58

for me it was a question of where i would rather be hurt...and what sort of injuries i would be able to cope with.

i was in alot of pain down below from VB - that was straightforward - one small tear - my back hurt for years after, and the mental strain and pain of VB was too much for ME to cope with. I had a fab labour in the sense i was not monitered except for short periods - i moved round when i could - got on balls - my DH massaged me throughout - the two MW were wonderful.

The section was obvisouly so much calmer on the run up to it - the going to theatre was scary but you have expereinced that - it was a shock for me - the section it self was fine - I was nervous - the most nervous they had had for a long time apparently - but it was all over so quickly.

My recovery was a good six weeks - 8 weeks but inspite of having major surgery I feel more intact and well - than after an no complications or interventions VB.

For me - it was a case of =- can i cope if something goes wrong in labour - no - can i cope in surgery if something goes wrong - probably not but deifnalty much better.

atrcts Fri 01-Feb-13 14:50:28

I'm in a similar place to you. I have birth (induced + forceps) with major problems afterwards - severe SPD lasting 2 years and faecal incontinence (only once but it felt pretty dangerously close many times after, and even now I don't dare hold on too long).
As I result I feel that I am balancing the scales - on the one hand risking VB with all it's potential 2 year recovery problems, vs 6 weeks surgical recovery. Hmmmm... 2 years or 6 weeks?!!!!! grin

I know just because I had a tough birth the first time it doesn't mean it will happen again, but I am not prepared to take any chances thank you very much!

If I had my time again, knowing that I know now, I'd have asked for a c section. The beauty of hindsight!

Like you, I found it hard not to take on board other people's criticism. I had an obstetric registrar frown on me for asking for a C-section, which felt unpleasant but hasn't deterred me from asking to see the consultant about it. I don't want any regrets this time!

TwitchyTail Fri 01-Feb-13 16:06:41

Thanks to everyone else who has replied and shared stories - I really appreciate it and it's been incredibly helpful. I'll take the next couple of weeks to have a hard think about things before I see the consultant at 36 weeks and try to come to a decision.

lljkk Fri 01-Feb-13 16:39:25

It's a gamble no matter what you choose. You are taking chances no matter which you choose. You may prefer one risk profile over another, but have no doubt there are risks either way.

I have a friend who had 3 EmCS that went fine followed by an ElCS that was Hell. She didn't expect that, either.

CaramelBobbi Fri 01-Feb-13 18:08:54

Sorry not to come back to the thread earlier. To be honest, I went privately for the first and my choice wasn't questioned. With the next, I went to book in for a private delivery and was told, "no need to pay, you've already had a section, you don't need to go privately, I'll do it on NHS for you. When would you like me to put it in my diary?"

1944girl Sat 02-Feb-13 00:43:22

All of you ladies who had ELCS on your own request without any medical reason are very very lucky girls indeed. I envy you all.
I am an old days -'69 and '72- mother and had no choice at all as then it did not exist.As a result I had one crash and one emergency section which could have been avoided if I had been able to demand one before labour.
The result of this was having a tubal tie at the age of 28 because I could not stand the thought of another long and complicated labour which ended in a dash to theatre.When I developed complications the second time I remember asking why I was made to go through labour again.The answer was ''We like to try before operating''.Well I had to make sure nobody ''tried'' on me again.
Good luck girls.I am thinking of you.

Beatrixpotty Sat 02-Feb-13 08:28:06

I would consider how many children you think you want,and how old you are.ELCS heads you towards the section route for subsequent pregnancies..and I'm not really looking forward to my 3rd one in a few weeks!Nice calm way to have a baby but didn't appreciate the impact recovery time has on everything especially when you have at least 1 other child to look after.My fault though..I decided to have 3 children and chose ELCS for my first..also a Dr,had seen too much,was "old"(36) and had family Hx of stillbirth at term that terrified me so wanted baby out at 39/40.Good luck!

WillowB Fri 08-Feb-13 20:40:06

Quite a bit has been mentioned up thread about foetal monitoring. I think it's important not to lose sight of why its sometimes needed. I know CM can be uncomfortable & a PITA but I'm absolutely certain it saved my baby's life.
I'd prepared myself for a 'natural' VB. tens machine, pool, breathing techniques etc.
I lost some blood when my waters went (had also bled all the way through my pg. due to placental probs) so they hooked me up to a machine for about 1hr. Started to get very cross at went point as my NCT teacher had said no more than 30mins at a time was necessary. Was all set to ask them to unhook me when baby's heartrate dropped through the floor. Will never ever forget that sound. Just a thud followed by an agonisingly long wait for another. They got baby out quickly but he needed Resuscitating and the oxygen levels in his cord were low but was fine after the initial first few minutes. I've since often wondered what would have happened if they'd not monitored me.

In hindsight i should have perhaps pushed for an ELCs due to the bleeding (they found out during CS that I have a prob with my uterus that prob caused the bleeding & caused baby to get stuck) but I was naive & the docs/midwives were fairly dismissive. I will choose an ELCs next time & if I was to labour before my CS then I would def want the monitoring (not that I'd have a choice). However I realise that this is purely down to my own experience.

TwitchyTail Fri 08-Feb-13 23:36:00

Thanks guys. WillowB - how scary, am so glad your baby got out ok in the end. I am completely with you on the continuous monitoring - I do believe it will be necessary in my case if I go for a VB and will not dispute this, as I know how quickly things can change.

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