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Elective CS after VB

(7 Posts)
sycamore54321 Thu 01-Sep-16 00:13:42

I had an instrumental delivery with my first baby two years ago. It was largely fine, I had a lovely epidural and then required episiotomy and ventouse as he was in some distress from a nuchal cord. However I am now pregnant a second time and seriously considering requesting a c-section. My reasons are:
-increased understanding if the risks to the baby of VB and I'm more unwilling to accept those.
- after my last birth, I developed post-partum DVT at three weeks old which was awful and which now means for this pregnancy I am on blood thinners. The main impact of these will be an inability to receive an epidural or spinal for 12 hours after my daily dose. As my first labor was five hours from first contraction to delivery, this is a big concern. I have no interest in a delivery without adequate pain relief and it would mean any emergency CS would need to be under GA of within the 12 hours.
- a much more minor consideration is of a practical nature. I am due at Chistmas time. A planned date for delivery would allow delivery in a fully-staffed hospital with senior medical staff on hand, and would also allow me arrange a relative to plan a few days of a visit to help look after my two-year old. Unlike last time, my husband and I now live several hours flight from all my family.
- I developed moderate urine incontinence after my first delivery and had a year of pelvic floor regime to rectify this. I'm still not 100% reliable and do not want to risk worsening this.

The healthcare system where I am would seemingly support my request and apparently have very good standards of post-natal care while in hospital. My questions are around the downsides to a CS and recovery.

I found recovery after VB very painful with pain while seated for a fortnight, extreme fatigue when walking or standing, and then the horrid complication of the DVT three weeks later. I don't have a car so not driving post-section is not an issue. My husband will not be working for several weeks after the birth and can do the needful when it comes to lifting the toddler, etc.

So tell me what else I haven't thought of! Has anyone had this experience? I should also add this will likely be my last child so the risks of Cs history for future pregnancies are not a major consideration.

hopeful31yrs Thu 01-Sep-16 14:34:41

I am in a similar position. Vaginal birth which ended up forceps and very small episiotomy BUT I pushed for 2 hours prior to that and feel I suffered from problems from there. I have almost certainly got a rectocoele and bulging of my perineum now after giving birth - more evident now i'm pregnant again. Having really bad trouble going to toilet and don't want to end up with corrective surgery for this which might not help.

My main concern is this happening again with number 2. It was a concern going into my first pregnancy - family history of inability to push out babies (mum and her mother all had instrumented deliveries). I addressed it initially and was told it wouldn't happen and was not something they considered to be a hereditary thing. We are all petite (small feet and bone structure - not particularly in relation to weight) and so it ended up that DD 1 when she turned back to back in labour got stuck in a high position and wouldn't come down. I don't want the risks of forceps or distress for baby and the result being emergency c-section (which comes with higher risks for baby and myself).

Have talked to my obstetrician who feels this is unlikely to happen once again but after this and my birth experience which was a bit of a farce I am concerned about it. She has told me if I want a c-section she'll book me in for one but as a 'maternal request' only. Have been left feeling as though its an unreasonable request and am trying to do my research before making my mind up fully.

FantasticMax Thu 01-Sep-16 19:24:32

I had similar issues to both of you and have elected for a Caesarian. The consultant said my issues from the first birth were statistically unlikely to happen again, although of course he could not guarantee it.
I have ummed and ahhed about it, as I know an ELCS is not a walk in the park, and is after all major surgery, but have decided I cannot take the risk of another instrumental delivery and third degree tear, or worse, and found it took a long time to recover full control of my pelvic floor last time, and I don't want to go through this again.
My ELCS is in a few weeks. I'll never know if it was completely the right decision but I'm comfortable with my choice.

neonrainbow Thu 01-Sep-16 19:28:34

Interesting thread. I am erring towards requesting a c sec for my twins these are my first pregnancy but the right of everything that can go wrong in a vaginal delivery terrifies me especially with it being twins. Despite this my consultant has still written "aim for vaginal delivery" on my notes. God knows why she wrote that because we didn't even really talk about it.

Laineymc7 Thu 01-Sep-16 20:54:26

I am in the same position as you and also don't know what to do. I had an epistomy and third degree tear inclusion tear of the sphincter muscle. Preganany again and have been referred to a consultant to talk about things and possibly some tests to see if I can have another vaginal birth after the damage last time. I scared the same thing will happen again and I am going to try and push for a cs weather this will be the right decision I don't know.

Bertieboo1 Thu 01-Sep-16 21:00:43

I have had 2 emergency c sections after 24 hours labour each time and found the recovery not too bad from either. I have heard of difficult recovery from both vaginal births and c sections and easy recovery from both. I must admit not having any tearing down there has been a very good thing when I hear what others have been through.

SpookyPotato Fri 02-Sep-16 15:21:15

I just want to say my c-section was a very good experience and I'll definitely be having a second one. Yes it's painful for a week or two but it's controllable, nothing like the chaos and unknowns of childbirth. My midwife said everyone is allowed one and her and all her colleagues will be having one after the stuff they've seen happen.. Same with consultants wives. That says it all!

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