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Episiotomy VS C-Section

(36 Posts)
pooh4utoo Mon 10-Aug-09 13:21:25

My baby is breech and I mayb I will be offered a C-Section or a Vaginal Birth,I understand it maybe need for a large episiotomy and chance of forceps needed. I've had previous normal vaginal births and not had stitches needed so have no idea if the stitches down there are very painful for long.
Which will be less painful to recover from? I've heard in longterm a lot of women have bother with their episiotomies and for many mths later if not always,as it's never seems right again down there.
Which is better option? Anyone 1 had 1 of each or care to give their opinion,any posts welcome.

RedDeadFail Mon 10-Aug-09 13:27:16

I had both. Episiotomy, very extensive for attempted forceps and/or ventouse and manual rotation. Didn't work and had an em cs.

I had no problems with either. Was discharged after 12hrs needing no pain relief. Few twinges and that's it.

There are people that will have had good and bad experiences of both. I was very, very, very, very lucky.

truthisinthewine Mon 10-Aug-09 13:27:39

Why have they said you would need forceps or a large episiotomy? It is perfectly possible to have a vaginal breech without needing either of those.

pooh4utoo Mon 10-Aug-09 13:33:20

Noone at hospital etc told me anything yet but I've read on main websites that if baby breech,it is possible that an episiotomy is needed and sometimes they use forceps for the head.

pooh4utoo Mon 10-Aug-09 13:37:51

I'm just over 33 wks also and know if baby does not turn by itself they might offer ECV and I guess on the day if it does not work,then I will have to decide what to try for. I'm presuming they may give me the added option of vaginal birth but I will probably need to decide there and then on the day and am very unsure. I have a lot on with other things at moment and would like to make a decision now on the ' what ifs'

fijibird Mon 10-Aug-09 13:57:26

Breech Birth by Benna Waites is a great guide to your options. Also if you are close to London & can afford it Donald Gibb is a consultant who specialises in natural breech birth. I found him to be fantastic & friends who have seen him agree. He will give you the best possible advice based on your individual situation but will always advise on a vaginal birth if he thinks it will work. In my case I was due to have a home birth but when he saw me at around 32 weeks his advice was a c-section he didnt think ECV would work & in fact the very experienced consultant I saw to perform the procedure didn't even try as my baby was large & I am small. Mr Gibb said I wouldn't go into labour naturaly either because of the baby's size/position & he was right. My beautiful son was delivered by c-section 5 days after my due date in a wonderful planned relaxed manner. I would only go down this route again if I was carrying a breech baby.

pooh4utoo Mon 10-Aug-09 14:32:07

I'm not near to London at all,I think they will recommend a C-Section over everything else as it's not the done thing really these days but am keeping my options open by asking here incase I do get some choices what to try.

YMC Mon 10-Aug-09 14:35:26

Google Mary Cronk. Breech does not mean huge epi and forceps. Look at www.radmid.demon.co.uk/breech.htm and emedicine.medscape.com/article/262159-overview

mum2RandR Mon 10-Aug-09 15:57:33

I have had both as well. Had the episiotomy with DS and even though it looked like someone had tried to drive a truck up my backside it actually wasnt too bad! Think it looked worse then it was. Was a bit tender for a few days and itchy as it healed but have luckily never had any complications.

Had emergency caesarean with DD 7 years later and even though I felt very stiff for a few days I never actually had any pain.

Not sure what would be the best option for you but I would think a planned caesarean would be less of a risk to both of you. I used to dread the thought of a caesarean but other then the scary 'emergency' part of the caesarean the recovery wasnt as bad as I expected, and with a planned section the incision will be smaller then what mine was. Hope everything goes ok for you x

mears Mon 10-Aug-09 16:01:12

There is a good chance that your baby will turn on it's own.

If you have had a baby before, it is less likely that you will need an episiotomy of forceps for a breech delivery if the baby does not turn.

The last 2 breech babies I delivered did not need either.

pooh4utoo Mon 10-Aug-09 18:13:38

mears - I've had 2 babies and they come out fine,I will need them to scan and weigh up the options I guess and if anyone willing to deliver a breech baby also,then it might be an option to go ahead,just don't want anything that I would find traumatic.

No3 fairly messing me about now,otherwise things have been fine,I'm even down for home birth.

mears Mon 10-Aug-09 19:33:38

The last lady I had who has a breech birth (unexpectedly ai have to add!) said that it didn't feel any different at all.

The main thing is to have a totally natural labour with no intervention. As long as labour progresses well without interference, all should be well. Best to deliver on all fours as well.

Depends what the option on offer regarding breech birth is.

Weegle Mon 10-Aug-09 19:42:41

are you certain your babe is breech? I only ask because from 30-37 weeks I was told DS was breech - had 3 midwives all say so. I went for a scan and he was well and truly head down (I thought so because of where I was feeling his hiccups! grin). However, my hospital weren't even prepared for me to try for a natural birth - they said it was a section regardless. Hacked me off no end because I was booked for a homebirth! DS ended up being an EMCS for totally unrelated reasons!

MrsHappy Mon 10-Aug-09 19:58:32

I haven't had an episiotomy or a breach birth (have had an emcs) but there are two things that I would be thinking about in your shoes...

- you might not need an episiotomy. I would balance the chance that I wouldn't against the certainty of a wound with a cs. I found my recovery from section pretty quick, but was on pain meds for a week and so was quite out of it which wasn't great.

- do you trust the midwives who will be looking after you during your delivery? If you do, and if they are experienced in breach births, then that would help me lean towards a vaginal delivery. If I didn't feel safe with them I might prefer to go for a cs.

pooh4utoo Mon 10-Aug-09 23:46:48

My baby was breech at 21 week scan,I had some shuffling about later on and was due a 28wk scan for another reason and at this 28 wk scan I was told the baby was head down,I was certain about a week before that the position had changed.
Anyway at each ehck uo until last week the baby was head down,but now they say breech.
I am under community midwife here at birthing centre,if the baby is breech,I need go to main unit,I will not have a delivery with any midwife I know.

They say the baby is sat kind of U shaped,bottom low down,the head is kind of under my left breast if I look down and I feel kicks under my right breast cos the legs and feet are like up.They say it's def the head at top and not a bottom as it's harder.

I'm back in clinic tomorrow,will ask about position again.

kitkatqueen Tue 11-Aug-09 00:15:35

pooh4utoo,

Have you tried any of the non invasive methods of encouraging your baby to turn? Its your 3rd so he/she could turn relativley late. All 4 of mine have been breach until quite late and then I encouraged them to turn.

DD1 I crawled about on hands and knees grouting the new tiled floor dp had laid...she turned very quickly.

DD2 I read lots of mags and did all telly watching on hands and knees. Found position very uncomfortable but it worked.

DS1 Hands and knees in deep bath of water ( have very big bath ) managed to strech into very comfortable position half floating on front with knees and elbows on bottom of bath, swishing from side to side - was blissfully comfortable. ds suddenly did a big flip. Saw midwife next day and he had turned

DS2 As with DS1 He's still head down now - and no chance of turning head up now!

I know people who have gone swimming for the chance to front float and even those who have even done handstands in the pool.

Your LO could even turn by himself.

Good Luck...

mears Tue 11-Aug-09 10:39:43

My second baby was breech up until 35 weeks when he turned spontaneously.

It really isn't anything to worry about being breech at 33 weeks.

If still breech at 36-37 weeks then ECV will be considered.

CoteDAzur Tue 11-Aug-09 22:31:46

I had both and would take el-CS over episiotomy every day.

It took three WEEKS of sheer torture to feel human, put on clothes, and stop crying from the pain after episiotomy. Months of problems, especially re sex.

It took three DAYS of very manageable pain after el-CS. No problems whatsoever. Lovely, calm experience, happy mother, happy baby.

Even without the risks to myself, I would never try to VB a breech baby. No matter how good the consultant is, the risks to the baby are just not worth taking imho.

morocco Tue 11-Aug-09 22:56:07

whereas I had opposite experience to cotedazur - episiotomy was absolute breeze and c section unbearable painful for weeks afterwards. and I'd definitely try a vb with a breech baby (but 'hands off' approach not breech delivery) if it were me. dd was breech til about 36 weeks but turned by the scan. is still v early days

CoteDAzur Wed 12-Aug-09 10:29:05

My understanding is that one's experience of episiotomy depends on what we mean by "episiotomy" - a little cut of 2-stitches or (like mine) a large episiotomy that inevitably cuts through muscle and nerve.

I also know women who haven't even noticed their single-stitch "episiotomies". Mine extended to the back of one buttock and the scar still scares the poor estheticians giving me bikini area waxes (4 years on). OP says hers will be another "large episiotomy". In that case, I strongly recommend an elective CS. If you are going to have such a cut and so many stitches, trust me, you'd rather have it on your tummy and not in your lady bits where it's so sensitive and impossible to keep clean.

morocco Wed 12-Aug-09 20:35:26

but it isn't necessary to have a large episiotomy when having a breech birth
op is worried she might have one but like any vaginal birth it can't be predicted in advance

I have no idea how many stitches I had or how big it is apart from 'fairly big' when I asked the obs. all I know is it was no hassle at all and barely even registered as painful. c section was incredibly neat and lovely looking scar but absolutely appallingly painful. I'm sure there are plenty of women who had exactly the opposite experience. Ironically I had labial grazes with dd and that was appallingly painful for 3 weeks - I used to cry when I had to wee - yet that's the least 'injury' at all. but all those nerve endings. ouch

fijibird Thu 13-Aug-09 11:27:34

Its a shame you couldn't consider seeing an expert such as Donald Gibb as you are too far from London - he would only suggest a CS if there was in his opinion no way you could give birth naturally as he is completely pro natural birth. I really would try & read 'Breech Birth' if your baby is still breech closer to 40 weeks as it is the best possible guide to the situation and supports VB completely and gives you all the facts to base your decision on including all the different ways you may get Baby to turn. I tried all fours, acupuncture & burning Chinese herbs all to no avail!
My CS was fine and if you are happy with this route then opt for a planned as close to your due date as possible. Good luck!

Kyte Thu 13-Aug-09 17:55:31

With ds I had episiotomy and forceps...which caused a 3rd/4th degree tear and lots of pelvic floor problems. I've been told to have an elective cs this time. And I'd choose a cs over what happened to me, esp if I thought I might end pu having a cs anyway.

Arnica tablets really helped with the healing and I've been told the recovery time with what happened to me was worse than for a cs - but still managed with only having paracetamol.

WibblyPigRocks Thu 13-Aug-09 18:04:46

With my DS, I had forceps and a 2nd degree tear. As I'd already had an epidural and didn't have all feeling back, I didn't feel the doctor use the needle to give me a local anaesthetic. As a result of either/both of these things, I didn't feel the stitches being put in at all and it was a good few hours before I felt sore.

I walked like John Wayne for a few days, but I would def say sore rather than painful and it didn't bother me at all. I was a bit nervous about pooing, but I needn't have worried.

Within a week, I felt completely normal again and looked normal, too.

Obviously, everyone's experience is different, but all I can tell you is that I feel very positively about the birth and don't regret any decisions at all - epidural etc. My friend had a CS and had a few problems with her scar and it took her a long time to feel right again. Of course, this is not true for everyone - just thought our experiences were worth sharing.

I always say that the most important thing to do to make sure your birth experience is a positive one is to firstly, do everything you need to do to ensure you and your baby are safe and then, just do what feels right to you. Trust your instincts.

StarlightMcKenzie Thu 13-Aug-09 18:05:13

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