A personal account of elective caesarian(76 Posts)
I appreciate this can be a heated topic, but having just recently (12 days ago!) given birth by elective caesarian, I thought it might be interesting to share my experience. It's an entirely personal account and I strongly believe in everyone's right to make their own medical choices, whether they be for an unassisted home birth or for an elective caesarian.
My OH and I chose a caesarian based on research we came across that seemed to indicate that although an unproblematic natural birth carries the fewest risks, an elective caesarian is less risky than either an emergency caesarian or a natural birth with complications, and since no one can guarantee an unproblematic natural birth we went for the next best thing, an elective caesarian. We were lucky to find a sympathetic doctor (incidentally his wife had had a previous natural birth result in an emergency caesarian, with the baby being deprived of oxygen and having, as a result, serious mental disabilities - exactly the sort of scenario we were worried about) and we booked the surgery for 38 +3.
37 +3 and as luck would have it my waters broke! Not that I noticed as it was nothing like the movies, but popped into the hospital just to make sure, and before I knew it I was being wheeled into the operating theater! Slightly in shock at the speed with which it was all happening, but not much I could do about that!!! The epidural was fine, lovely anesthesiologist gave me a great massage first and then OH was allowed into the room on the promise that he would not faint! The baby was out after about 5 minutes, I did feel some tugging but it wasn't at all unpleasant, she breathed on her own straight away, was a healthy 3160grams and then she was placed on my chest for the remainder of the operation so time flew by. I had to spend 2 hours in the recovery room under observation until I could move my feet and then back to the room where the baby was brought to me, so that was lovely, and we started calling relatives.
I stayed in hospital for 4 nights, they left the epidural in for 48 hours for pain medication, I was up on my feet on day 2, taking walks on day 3. I did need someone to hand the baby to me for the first 2 days which was a bit of a shame, but I pestered the OH and the nurses. By day 5 I was at home, and by day 10 I didn't even need paracetamol anymore (I think that I needed paracetamol for so long was more of a function of having to be up and about sorting things out, if I had been able to rest a bit more I would have tried with less paracetamol). According to the doc I can start Pilates two weeks after the op, and then six weeks after the op I should be pretty much back to normal. The only restriction for now is no heavy lifting, but I couldn't do that towards the end of my pregnancy either so I can live with that!
All in all, this was an extremely positive experience for me and I would not hesitate to chose it again. Hope this helps someone else with making their own choice!
What fruitybread said, including the recovery and hospital stay. I think the basic point being made by the OP was that ELCS can be very positive.
I'm afraid I had a dreadful time of it with my elcs
My bp plummeted, I lost loads of blood, I was allergic to the pain meds, so had to rely on a combination of paracetemol, codeine and morphine. After the op I was too shaky to hold ds, I couldn't eat for a whole day afterwards, as i was throwing up all the time. I felt like I have been sawn in half for weeks everything ached, and I felt shaky on my legs for days afterwards. Because I had to be up and about, I developed an inflammation of the veins in my leg, which was very swollen and painful.
Ds was born with respiratory distress syndrome, he was taken to SCBU before I could hold him, I couldn't hold him for 3 days,and he was in for 8 days (I was transferred there after 3 days on postnatal ward). He was on cpap, tube fed and antibiotics for a possible infection. He had jaundice and a heart murmur. He was 8lb 9oz when born, but had lost 12% of his birth weight in the first week.
I was quite shocked at how appalling I felt, because I had heard mostly positive things about electives.
I had lots of anxiety and panic attacks after the birth, and nightmares about ds being taken out before he was ready. Physically i didn't feel like the same person. I sought birth trauma counselling and am on ads for ptsd and pnd.
hazey - was yours a full term elcs for a non-medical reason? Sounds like you had an awful time of it.
Respiratory distress is the one risk that is apparently higher with ELCS. I think the risk is twice that of VB but overall the risk is still very small - don't quote me on the stats though, I'm trying to recall what I researched 3.5 years ago.
I don't think there's anything that would connect jaundice, infection and heart murmur to ELCS.
Not everyone needs much pain relief after a couple of days anyway. I was up and standing 6hrs after my emergency section and apart from morphine of the first night and paracetamol for a couple of days after I didn't get much pain - walked round a shopping centre on day 3, felt fine. drove at 2 weeks.
Glad your section went well booboostoo and congratulations
my section was at 39 weeks, and was done to avoid any further damage (I had 3rd degree and 2nd degree tears with dd1 and 2), apart from low bp and varicose veins I was/am in pretty good health.
I think it is good to remember that everyone responds differently to these things (as they do with vb) and that not everyone is off painmeds and back on their feet in a few days.
Interesting about the low BP hazey. I read on another thread that having very low BP can be a contra-indication for spinal block / epidural and a GA may be required. That said, I had low BP and had no problems with spinal block.
Just to give another caveat to c-sections. I had a crash section with my dc and ended up with internal bleeding. Lost over 8 litres of blood (eventually, obviously they were pumping more in at the time) and ended with a hyterectomy.
Total disaster. Obviously it was a crash not an ELCS but I was told at the time that it was the stitching up afterwards that was the problem, a time when the emergency was over so presumebly an ELCS would also run the risk of this happening. It is very rare though.
What owl said highlights a key point - ELCS is safer for the baby but not necessarily the mother. Complications are rare but can happen as it is surgery and therefore carries risk.
Yeah I didn't mean to scare people. I think something that people do need to consider before going down this route (especially for a first child) is how many children they want.
I was quite naive when pregnant and actually asked for a c-section and was told firmly "they won't give you one" and left it at that.
But even if I had researched it I might not have gone for it (even if I'd been able to get one on the NHS) due to the risks associated with having multiple sections if you want several children. And obviously I have no idea how I would have felt if what had happened to me had happened after an ELCS for no medical reason (but no doubt really terrible). Though I think ELCS after a traumatic first delivery is an entirely different matter as by then you have a much better idea how your body copes in labour (though obviously every labour is different).
You could argue though that every attempt at vaginal birth carries the risk of an EMCS with all associated risks (plus the risks associated with VB). Whether a vaginal birth is straightforward can only ever be seen afterwards.
I'm sorry for those who have had bad CS experiences (hazeyjane, I know I've read yours before and thought what a rough time you had of it - it seems particularly unfair after your previous traumatic VBs) -
I think the bad experiences are of course every bit as valid, and the mothers have every right to articulate those experiences, as those of us who had positive experiences.
Re: risks of repeat ELCS's - it's hard to build an accurate picture, as the big problem with nearly all reputable CS info is that EMCS's and ELCS's are lumped in together. Obviously ELCS's carry a different and greater set of risks than planned CS's (although it's also true that the vast majority of planned CS's are carried out because there is a medical risk to mother and/or baby).
I'm ALL in favour of informed decisions - it's frustrating that accurate info is hard to come by. Those of you who do want to stay up to day with uk info will find the new draft guidelines on CS from NICE interesting - here - www.nice.org.uk/newsroom/pressreleases/CSectionUpdateConsultation.jsp
A new piece of info to be included is "women who have had up to and including four caesarean sections should be informed that their risk of fever, bladder injuries, surgical injuries and rupture of the womb is the same with a planned CS as it is with a planned vaginal delivery."
Of course there are other risks associated with repeat planned CS. Different women will place different values on different risks. This is an obvious point, I know - but worth mentioning, as discussion of CS often gets very heated when we fail to take into account that what is very significant for one woman doesn't hold the same significance for another. Some women only want one DC. Some want more. Some women worry hugely about the appearance of their body after CS. I don't at all, but I appreciate that it IS a concern for others. Some women have an overwhelming fear of a needle in their spine/a hospital environment - again, I don't, but obviously those that do are dealing with a different set of risks and fears. And so on.
(and this isn't unique to CS, I know - VBAC is also a very heated and emotional debate, where different risks hold different values for different women. )
The question of risk versus benefit is always going to be a very personal one.
I am very much with fruitybread on this, risk assessment is a very subjective matter and no matter how we assess the risks, no one enjoys the experience when the risks actualize. Unfortunately every kind of birth can go wrong, all we can do is choose for ourselves what we think might be the best option given individual circumstances and hope for a bit of luck.
When looking at CS statistics I found it quite useful to look at very recent studies, especially from the US and China which have high rates of electives and can for the first time compare electives vs natural and other options, rather than CS in general (where statistics are skewed by co-morbidity issues in emergency CS). As a general summary the level of risk seemed to go:
natural with no complications
natural with complications such as forceps
although even this is misleading as different options are riskier for the mother and different ones are riskier for the baby.
Also the risk to the mother will differ depending on the mother - I was in my 20s (just), a healthy weight and have never smoked. The risk of CS to a 45 year old overweight smoker would be higher.
Even hearing bad experiences as per above, I still believe CS to be a very positive choice for a lot of women. I would much rather have had the outcome that hazey and owl had than have had VB go wrong and result in brain damage to an otherwise healthy baby.
Well of course nobody would want the outcome of something wrong with the baby. But when you make the choice to have a cs, no-one conveniently offers you a glimpse into the future, 'well Mrs Hazeyjane you can choose a cs and avoid double incontinence, or you can have a vb but your baby will be brain damaged...'
Also as it turns out, ds has developmental delays, the cause of which we don't yet know, but it could have been something that occurred at birth, or it could have been something that would have been worse had I not had a cs at the time I did, I'm not sure we will ever know.
I agree that on a purely objective risk weigh up cs for pretty much everyone might be a good plan, but also think that a lot of the time women have a gut instinct on what they should be doing - which is why for a lot (most?) women a VB is still the right thing to do - as long as the woman is confident with what she's doing.
What society today (and especially the medical profession) doesn't do i think is trust a woman's instinct enough.
Before I attempted my vb I asked for an ELCS because I sensed something was wrong. I was given short shrift but was proved right almost immediately (it was an induction and I had a very severe placental abruption after insertion of the gel).
What I wished the medical profession did was listen more to women and I'm sure some birthing disasters could be avoided.
I had a very straightforward and dare I say it pleasurable elcs 6 weeks ago and very pleased with my decision (first baby was crash section so chose an elcs at last minute for number 2 as worried about not being awake for her birth).
I was up and about the next day, home after two days, walking around the garden centre with the buggy after one week and travelled 180 miles to a wedding at three weeks. I also managed to breastfeed straight away with no issues.
Is it just me or do you suspect that women are being fed misleading information to put them off c-sections? I read on a mummy blog the other day that the mother to be in question was in tears at the thought of a c/s as she wanted to able to b/feed, she needed to be able to take pictures of her new baby before they were ten days and that her husband wouldn't be able to take four weeks off work to look after her ... four weeks? My dp took off two days!
I saw two or three different consultants to discuss my options, two were very understanding but one was very anti c-sect and might as well have said that vbacs are risk free (as she listed all the risks of c-sect but never once mentioned vbac risks). I understand they are a financial burden on the nhs but to to dismiss them for this reason would be at what cost?
I was told that our trust area (surrey) has a reputation for being too posh to push and the hospitals are under pressure to reduce cs rates. Im reading ths thread with interest a im due to have a ELCS this wednesday for medical reasons and im petrified!
I'm 35wks preg now and booked for an elcs at 38wks. I had a low risk pregnancy with DD and I think this is why the midwives failed to spot what turned out to be a horrendous placental abruption. The bleeding was concealed and they didn't realise until it was too late for a c-sec. My daughter was basically stillborn as a result with apgar of 0-0-0. She has severe CP as a result of her birth. I am healthy, young, non smoker and it stil went terribly wrong! Elcs for me please!
I'm so pleased that you had such a positive experience, and I'd be really interested in hearing more about your story (in particular, the difficulty you had in finding support in France).
I run the website http:www.electivecesarean.com and also write the blog http:www.cesareandebate.blogspot.com, and I have spent the last 7 years trying to balance the reporting of ELECTIVE cesareans. As many of the posters here have recognized, there has been a tendency for all cesarean (health and cost) data to be merged together and then used to criticize women who choose to have a cesarean.
I am not an advocate of cesarean birth - I am not interested in trying to convince anyone to choose this birth plan - but I am working hard to ensure that women are equally fully informed about the risks of planning a vaginal birth. I believe that it is unethical and unhelpful to over-exaggerate the risks of cesarean birth and completely under-estimate the risks of vaginal birth (just look how many injured or traumatized women write: 'No one told me this could happen with natural birth'). The car insurance myth is just one example of the misinformation at play - I have checked with both the DVLA and the ABI, and they both said that women do not need to inform them of having had cesarean surgery.
Let women have all the information and then let them make their own informed decision about their birth plan - based on their own perception and tolerance of the different risks.
If you'd be happy to, please contact me via my website, or equally, I'd be happy to learn more via this discussion thread too. :-)
Thanks for your supportive post (I hear from many women who feel alone and isolated in their thoughts and feelings about planning a cesarean), and congratulations!
Pauline McDonagh Hull
My insurance too wanted a verbal OK from the GP - GP was entirely chilled about it and basically said that since I was driving a big automatic 4*4 she had no concerns as long as I felt OK with it.
OP - do I take it this was your first DC? Most people I have met have (as I did) had ELCS only after previous EMCS.
Just wanted to thank you for your website - it really helped me to prepare for my discussions with doctors prior to being allowed an ELCS on the NHS. My ELCS was a great birth experience. I wish more women were given objective information about birth options, instead of being misinformed, and bullied into supposedly low-cost VBs.
Thanks for all that information PMHull. I completely agree with you that an informed choice should be everyone's goal.
I am not a medic, but I am an academic and have worked in medical schools and with doctors for the past 10 years, so when faced with birthing options I went on Google Scholar and did some research. On the whole I was inclined towards the ELCS, so I wrote down my references, printed my abstracts and went off to discuss it with the docs, fully prepared to be convinced otherwise.
Gyneacologist no1: patted my hand (literally) and said 'Don't worry dear you'll be fine giving birth naturally', that was the end of the discussion.
Gyneacologist no2: OH and I thought that maybe we should go private so that there would be more options...gyne 2 told us it was her choice whether she performed a C section or not, she would never consider an elective and neither would anyone else in her hospital. She went as far as saying that it was too risky but would not elaborate on the risks. She never discussed the risks of other options.
Gyneacologist no 3: at the large, public hospital. She was the most willing to discuss her decision not to offer ELCS (which was also the decision of the entire team at the hospital so no point in trying another doctor). She said ELCS posed thrombosis and infection risks for the mum and respiratory distress for the baby. However, she could not give any statistics for these risks, nor was she aware of any of the literature I was referring to (she did not speak English and did not seem to be aware of any obs&gynea research in English). She did not mention any risks associated with natural birth and when asked about risks for forceps, lack of oxygen, etc. she said they were not worth considering. She did not seem to be responsive to the argument that an elective is safer than a natural birth with complications and no one can guarantee an unproblematic natural birth - she just re-iterated that I would have an unproblematic natural birth. Overall I found her approach very set, not amenable to reason and one-sided.
From what we found ELCS is not available practically anywhere in France, either privately or in the public sector.
My ds is now five weeks old today. I had an elcs due to previous section so knew roughly what to expect.
Very positive. Ds was born at 10:02am on 10/5 and I was up and walking about by 8:30am the next day. Breast feeding was ok and I was in very little pain. I was released on 12/5 and rested for a couple of days at home. By day 7 I was feeling fab and by day 16 I was back to normal and with gp consent I started driving again ( insurance just needed gp consent) now five weeks on I feel fab and am back to normal.
Thanks for your posting, i found it particularly useful that your experience is not from a uk perspective. Due to a disability I'm to have my CS in 5weeks. The planned op was meant to be happening in Germany but due to complications I'm having to travel home to uk and have it there under my regular Hospitals care. I've read peoples advice on lifting, washing and driving, but do you or any others know about travel, eg how soon can you fly after op? Is it 6 weeks as well?
Any advice welcome as hubby will only get 2 weeks in uk before returning to work abroad and don't want him to think he's escaped the joys of sleepless nights or a hormonal wife!!
I was told both the baby and I could fly after 7 days. I was told I would have a very slightly increased risk of thrombosis and might want to wear the special stockings during the flight because of that. I was told the baby would be fine with flying as such, I might want to breast feed during take off/landing to help pop her ears, and that the biggest risk for her would be catching a cold from one of the other passengers because of the re-circulated air. As it turns out getting her a passport is turning out to be a huge nightmare due to Greek bureaucracy so we haven't been able to leave yet, but that's another story!
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