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Elective C Section, advice please(36 Posts)
I’m 11 weeks pregnant with baby two, who will be our last.
DD1 was a natural child birth but I was induced, epidural, cut, ventose, stitches, and very close to forceps. Before I was induced I was in labour for 24 very painful hours.
This time it had crossed my mind to consider am elective c section. First appointment with the midwife this week who said that as I will be 40 when the baby is born I would be under consultant care and may be induced, if not early on the dot of full term due to increase in issues relating to my placenta.
I didn’t know all this was a thing post 40, although realise that there are higher risk factors. My thoughts are that a smooth natural birth is probably lots better that a c section and it’s after care....however, when you start getting into cuts, stitches and forceps delivery I think the gap between a c section being lots worse than the alternative closes a bit, or is this madness?
Anyone experienced a difficult labour and a c section, is the difference bigger than I’m thinking? Anyone been induced early as they were over 40? Anyone else pissed off that in 2017 giving birth just really sucks apart from the baby at the end?
You’re not wrong. This is literally just my experience, not in any way indicative of what you should do.
First time I was 40. They wanted to induce at term. Like you I had no idea this was a thing. i declined, and they sort of agreed to let me go over. (Just going to say that ‘agreed’ and ‘let’ aren’t words I think ought to be associated with healthcare but hey ho).
There was then a different problem which was deemed to require urgent induction four days before due date.
This was an entirely rubbish experience ending with Emcs. Recovery was a total bitch, wasn’t quite right still 6 months later.
Second time round, when I was older, there didn’t seem to be a need to induce before due date, they were quite happy for me to go a week over, although booked elcs fit that date. I naïvely assumed I would go into labour myself before that. I didn’t, so found myself getting ready for theatre crying my eyes out. (Literally cried for a whole day). No one came next or near meuntil I went to theatre late afternoon.
Theatre staff were absolutely lovely. Established why I was upset, took me through everything, took the time to understand my upset. Lowered the screen so I could see baby born (this was really important to me).
Recovery has not been a total breeze, it’s a big surgery and there’s a toddler around wanting cuddles, but I’d say three months later, I’m more normal than I was after 6 last time. And much more mentally well too.
TL:DR first time induction rubbish, emcs. Second time elcs which I didn’t really want, but was an entirely different & much nicer experience.
Suggestion. Ask for an appointment with your consultant to discuss options. You are allowed to request a cs if that’s what you would like.
Ask questions! Why? Is a good one, and ‘what are the risks’
Take a piece of paper and a pen.
Thanks so much for this, advice greatfully noted.
3 months seems like a long time to still not feel right, especially with a toddler (mine is just over two so I will be very much in the same situation). Recovery time from my unpleasant Labour was pretty easy to be honest, so I know that will be the biggest difference if I go elcs. Hope your fully back to normal soon.
My first delivery was an EMCS after a very long failed induction. My second was an ELCS. Both were great deliveries. The only thing I would change is the induction - I was a naive first timer and didn't realise I could refuse it. Both recoveries were also good - back to normal in 4-6 weeks
With the ELCS and a toddler the main thing is to plan ahead. It wasn't easy but it certainly wasn't anywhere near as bad as I feared.
If it helps, my reasons for ELCS were twofold: the increased risks of birth injury given my age if I attempted a VB and the risk of stillbirth being halved with CS. The RCOG website is a useful source of information as can be hard to get balanced information from your local hospital
Induction often leads to a birth such as you have described (cascade of interventions) and I personally would opt for an ELCS over an induction any day. Discuss your fears and concerns with your consultant. In an ideal world you would go into spontaneous labour, be mobile throughout and birth your baby without intevervention - and I do know many women who had a rubbish time the first time, having this experience the 2nd time.
I am having my 3Rd ELCS in a couple of weeks. If baby would have been head down (I have breechlings!), I would have tried for a vaginal birth as a section is major surgery and I'm not looking forward to recovering with 3 other little people at home - however I would have a comprehensive birth plan to try to avoid what happened with my first birth (mobile telemetry, pool, no augmentation) and there would have been a low threshold to go to section.
I say not back to normal after three months. I suspect that my standard for normal is quite high iyswim? I have very occasional twinges to the right of my scar.
I suspect that’s because I didn’t totally totally rest and do no lifting afterwards (see : toddler). I did my best and managed quite well. With an older child (mine was just 18 months & really couldn’t understand that I couldn’t lift er up) it will be easier to teach them to climb & that mummy’s not well.
Otherwise, really I just feel a bit weak & pathetic, which I suspect is more an affect of being older & having two pregnancies close together during which I didn’t have a great deal of time to keep as fit as I’m used to being. And not having had time to get fit again.
I had EMCS after a difficult labour and failed venteuse. The CS was fine and recovery easy. I was 39. At 41 with baby #2, I decided for ELCS. As an older mum we had a referal with consultant and we chatted about what went wrong the previous time and we agreed that ELCS was the best thing. It was a brilliant delivery very chilled and a great atmosphere. Perfect and easy recovery. As PP have said, it was difficult recovering with a toddler to run around after but I think that’s the case for anyone who has two children close together! I’m so glad I made that decision as I enjoyed the rest of the pregnancy so much without worrying about another difficult delivery. Important thing is to think hard, take consultant advice, don’t be pressured by other people, and do what is best for you, as at the end of the day the most important thing is that mum and baby are safe.
I had a difficult first natural birth following induction, huge cut and stitches so I opted for ELCS with DC2 and the recovery was much easier. Stitches on your tummy are much better than down there! I was much more comfortable post op as I could sit down! I have no regrets at all.
Thank everyone for such helpful responses.
Atsea - this business of where the stitches are is exactly my point, there is a lot of chatter on NHS and website guidance about recovery for c sections, as if there is none for VB and you hop out of the delivery suit without a care in the world. Stiches down there are no joke!
Duggee - thank you for the suggestion of the RCOG website, some very helpful info on there, and it seems like the profession as a whole they a bit more open to elsc than I thought in my situation. Do you mind me asking how old you were when you had yours?
Lumpy - although the spontaneous labour might seem like the ideal, one of my concerns is that I found it extremely painful last time. I know nearly everyone does, but I am normally very hardy and thought I had a high pain threshold-I very rarely take pain killers, I’m a ‘just get on with it’ sort of person and I was knocked for six by how painful contractions where. I had a day of it before I was induced, when the midwife told me at that point I was only 2 cm dilated I honestly lost all hope. I thought if this is 2 cm I know I can’t do ten. As it turned out that’s when the decent pain killers were given so actually the whole thing was a lot easier to get a handle on. Thing is though that I think it’s unlikely that I wouldn’t need an epidural again - there was honestly no option for me and this really invites the complications of ventouse and forceps.
Cold - who has the time to get fit with two little ones! If I have any time free it’s sleeping time and I only have one at the mo!
Pen - sounds exactly how I want mine to be. It’s given me hope!
I’ve had babies at 41 and 44. First time around was advised to have induction close to term but chose to wait (and was made to feel v uncomfortable by Drs who used quite threatening language). Natural labour at 40+7(ish) but ended up with cascade of interventions anyway (induction, forceps, episiotomy, feeling rubbish re recovery)
At 44, I was pregnant again and concluded I wasn’t v good at pushing babies out so requested Elcs. Put forward strong case and I’m v v glad I did. DD2 born just before term and was a whopping 10.5lb (no indication of large baby beforehand). Surgery not a walk in the park but overall felt more in control and much more able to manage the practicalities around the birth
Wish I’d spent more time resting afterwards but we were in the midst of a major building project and I just kind of got on with it. I would make the same decision again, mostly because my body isn’t very good at pushing out —massive— babies
Phew - whose is Eagle!
That’s one massive baby. Thanks for all that I think one thing I have read a lot is to rest more than you think afterwards.
I'm 10 weeks with number 2, aged 40.
Ds was a long back to back labour (75 hours), failed forceps and an emcs. Recovery was easy, in fact the bruises on my back from many attempts to site an epidural and down there from the forceps were more irritating than my wound. Within 24 hours I could walk unaided to NICU and the difference between labour when I was begging for pain relief which I didn't get and post surgery when they were trying to shove a ton of the stuff I didn't need on me still annoys me.
They've decided that Ds getting stuck was mostly his fault and that I could try for a vbac if I wanted. I laughed at the midwife. To me the "control" of an elective is far more appealing.
A friend has recently had her second section with a toddler in tow and what worked for them was showing him the bandages and explaining that Mummy was sore. For the first few weeks he was really careful around her which helped a lot.
Exactly OP. There's also the lovely midwife who visits every day to check your stitches. As well as the continence issue, which is no joke, who would choose to give themselves permanent bladder weakness (or worse).
Indeed Atsea. An older lady I know who has had 3 children is beginning to suffer from a prolapsed womb. I can’t imagine how awful this must be and it’s from the damage sustained over the three labours. It’s been 20 years since her last one. They don’t list those kind of long term effects in the pros and cons list!
I think if we all knew the real pros and cons list we'd all get a surrogate!
@April I was 37 with DS and 39 with DD, who is almost 4mo now.
You're right about changing attitudes. It is well over a year since the RCOG said that women should be informed of VB risks in the same way they currently are for CS. The pro-VB lobby are delaying as they know that, given all the facts/risks, many women would refuse VB.
Atsea - you got that right ;)
Duggee a powerful article - that last paragraph....is quite impactful!
“Beattie says ultimately only the woman herself can decide which risks are most important to her. “You might say to me: ‘I could cope with a wound infection if I had a C-section but I could not cope with faecal incontinence from a bad vaginal delivery’,” he says. “You should be allowed to make that choice but you can’t if you don’t have the information.”
It certainly is. And it was one of the risks that swung it for me. An 18%+ risk of tearing leading to faecal incontinence? No, thanks!
18%. 18. It’s huge, considering downs screening 1 in 250 risk is considered high.
18% is huge and, on top of everything else, just made me more determined not to go through a VB.
It makes me so angry that women's choices are trampled all over once they're pregnant/they have to justify and prove themselves, as though they can't make sensible decisions for themselves
@dugeehugs I just wanted to come back on and thank you again for the article you sent. I had a meeting with a consultant last week who - exactly as suggested in this article sent me a away with loads on information on the dangers of an ECS no mention of the risks of VB and basically dismissed everything I said. We agreed to discuss again when I see her in 8 weeks, I will be taking this with me along with me, and a stern resolve. She took me by surprise last time I was without a decent come back. Not next time!
It’s so useful reading all this. I’m 42, first pregnancy, about 8 weeks I think, unplanned and totally unprepared. I’m trying to read lots of stuff online but it’s making me really queasy, how pathetic is that!! The thought of childbirth in any form literally makes me go wobbly right now, like a vertigo feeling. I’m not even a squeamish person, I really need to get over this.
So thanks to OP and all respondents for useful info and insights. And best wishes x
@April229 I'm glad you've found the article useful. The RCOG website has lots of VB risks tucked away in it so is worth a trawl as you prepare for meeting your consultant again. It sucks that she's been dismissive so far, but I've got my fingers crossed for you getting her agreement next time. Hope your pregnancy is going smoothly otherwise
If you had a good recovery first time then I'd consider trying for a natural labour again.
I had a horrific first labour. But it's the fact that 2 years later I'm still not recovered that I would consider a section next time.
Following closely. I was also induced which took 5 days ending in forceps with an episiotomy. Followed by infection in said wound. In agony I had to practically crawl back to the labour ward and ask for help as the pain was so awful
I thought I was dying. So erm... I think I will be asking about ELCS if we have a next time. I know there are risks with both approaches tho. Tbh going through it all again scares me.
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