To want a section(36 Posts)
I'm roughly 6+5 (according to my early scan). My DC1 is 6 months old and this pregnancy has come as a happy surprise. Anyway my first labour wasn't as traumatic as some people's I know, but both me and my baby were in distress and I ended up with a third degree tear followed by an episiotomy. A few days after birth I was passing very large clots and soaking quickly through pads. I had to have a speculum examination (with very fresh stitches) to show that I had an infection in my cervix. This pain was worse than anything I've ever experienced in my life!
Anyhoo I recovered physically from that. But I developed PND and anxiety. I've now been referred to a perinatal psychiatrist next week. I've read that I can ask for a section. I know every labour is different but if you were in my position would you ask for a section or try and have a vaginal birth again?
No harm in asking. I've not had a section so I don't know if there's a 'deadline' you can't change your mind by?
Yes I would ask for a section especially as the babies will be so close together. I had an episiotomy with my third and it took me a long time to recover. I did have a natural delivery with my fourth ( unplanned) but it was 2.5 years later. I still have problems with my posterior pelvic floor 14 years later and I'm sure it's to do with the episiotomy.
You poor thing. I had two sections: a dreadful emergency one and then a lovely calm scheduled one two years later with my second and final baby. Birth trauma (both physical and mental) should not be underestimated and if you feel an elective section is the best way for you to feel better about this birth then HCPs ought to take that very seriously.
FWIW I wouldn't have countenanced even a trial natural delivery after the mess of labour and emergency section first time around. Luckily consultant was in total agreement once I got to see them! In my case too recovery was a total breeze following the elective and I was home from hospital less than 24 hours after the op.
You wouldn't get an obstetrician to agree for medical reasons - unless it was a complicated 3rd degree tear. Cervix infection really rare and prob unlikely to happen again.
I'd try to get professional help in dealing with my fears, moving on from the past and see if I could get to the point of feeling positive about birth - but with the safety net of insisting on a c/s for mental health reasons if I remained tocophobic.
You have the choice - I'd say tell them you want a section.
I'd suggest pushing for a section now, just so it is documented; you can always change you mind (if you want) later. Whereas if you tacitly go along with the idea of a natural birth, it may take more effort to get a section agreed.
I was worried on the recovery time of a section compared to a natural birth. It took nearly two months the last time before I could go to the toilet without being in agony. I know a c-section is a longer recovery time and that's putting me off.
I requested one at my midwife booking in appointment at 10 weeks and I was referred to a consultant who agreed, I too had a horrendous 30 hour labour, my DS had shoulder dystocia (his shoulder was stuck so he couldn't get out) foreceps and a massive episiotomy that went into the top of my leg
Now for medical reasons none of this would probably happen again but explaining that I physically was terrified and couldn't bear to give birth again was enough for them to agree, definitely worth a try (my ELCS was amazing!)
I would decide what you want (in your shoes I'd absolutely opt for a section) and then make it clear that your mind is made up to your medical team. It is likely they will want you to have a VB and might push quite hard for it, especially if they sense any uncertainty on your part. If you decide on a CS you need to be absolutely positive that is how you will give birth and just stick to your guns.
I had a similar experience to you (3rd degree tear and episiotomy). Lost lots of blood and quite poorly afterwards. I checked I would be allowed a cs before I even got pregnant with dc2. I requested a cs at my booking in appointment with dc2. Nobody said no. They all read my previous notes and said that would be fine. I'm so pleased had a cs with dc2. Compared to dc1 it was a walk in the park. I recovered so much more quickly. For me it was 100% the right decision.
I had a fairly unpleasant emergency c-section and my recovery whilst not fantastic was considerably better than yours, you poor thing. Loo etc fine after about a week (lots of fybogel!) and I was able to walk around the shops 2 weeks later (albeit slowly) and 'normal' after 4 ish.
In your situation I would definitely ask for an ELCS - congratulations and good luck
Derry a ELCS isn't always a longer recovery. I was driving a week later and running 5 weeks later and they were almost totally pain free (both times). I have a similar age gap to what yours will be too.
I had an ELCS after having bad tearing and an infection with my first birth. My ELCS recovery was a walk in the park in comparison. CS recoveries obviously can be long/difficult, but I don't think that's the norm. It's either a bit of a myth thing or scaremongering to put women off asking for ELCS. I was driving after 3 weeks and comfortable around then too. My VB was like having been in a car crash.
It's worth looking at the NICE guidance regarding birth after a 3rd degree tear. And don't worry if MWs try to say 'oh, you'll be fine this time' just ask for a consultant referral as it isn't the MW's call.
I also don't think it is fair to describe the Op as 'tocophobic'. Phobias are irrational and I think that the OP's fears are entirely rational.
Just to add that my CS recovery too was so much easier than an episiotomy, at least you're still in tact down there and can sit without wanting to cry!!
My sil had a similar experience to you and was encouraged to have a section by her midwife. She was referred really quickly to a consultant and made her final decision at 30 weeks. Good luck!
Tocophobic simply means frightened of childbirth, in obstetrics. Not irrational at all.
"I was worried on the recovery time of a section compared to a natural birth. It took nearly two months the last time before I could go to the toilet without being in agony. I know a c-section is a longer recovery time"
I had a terrible time with 1st (vaginal) birth, ended up completely bedridden with torturous pain for three weeks.
2nd time, I pushed for an elCS and it was the best decision I have ever made. Recovery was much quicker after elCS. I needed no painkillers from Day #3 onwards, not even a single Doliprane.
Trust me, it is definitely preferable to have stitches on your tummy where you can keep them dry and clean, and don't have to sit on them.
I had two c-sections. No heavy lifting for a while (make sure you have/borrow a cot that raises right up so you don't have to drop down and then up getting your little one out of bed and dragging a car seat around is a no-no) but you can recover fast. Certainly quicker than the injuries you suffered first time round.
I had to have an emergency section first time and had flash-backs and nightmares after (due to the care before and after the birth, not from the operation). Second time round I was adamant I wanted a section and had a fair amount of pressure from midwives not to. I insisted, had to see a doctor at the hospital who listened to me and said fine, go ahead, and it was a totally different thing. Still a bit grim but I am very grateful. Good luck with it all
I had a nasty 3rd Deg tear and massive PPH with #2, and consultant has told me that while their default is VB, they will leave it to me really as there is clinical indication for a CS in my position. There are increased odds of bad tearing when it has happened once.
I think I will opt for a section, added to the tear I have strep B and will need antibiotics in labour, but if last time is anything to go by I probably won't get there in time so an elective section seems fairly sensible.
Your interaction with the perinatal team should help. I'm currently 31 weeks pregnant with my first and after consultation with perinatal psychologist and a couple of obstetricians I've had agreement for an elective section on mental health grounds (long standing anxiety and panic disorder).
It wasn't the easiest process, so I'm very glad I asked for a referral at my booking in appointment. I had to make it very clear that I understood the risks involved in the surgery and I did come under a fare amount of pressure to consider an induction but I was able to clearly and firmly explain my reasoning for the request (mainly that I'd be in no fit state to look after a new born if I started to panic during or after a hard labour, and that anxiety running up to the birth would leave me in no fit state for anything).
Having agreement has made a huge difference to how I'm feeling about the rest of my pregnancy so I would definitely suggest speaking to someone soon to get the process underway
Sat here with my 9 day old DD after emergency section. Fantastic experience and i am 100% already can do everything, wound is already mainly a scar and zero pain. Do it! Don't be put off.
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