To Be Weighing Up Elective C-Section vs Epidural Birth

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Hi mama,

I know this is an old thread but I'm an expecting mama agonising over the same decision.

If by any sheer of luck you read this, I'm curious. What did you do instead. And if you were ok with it. I know it's nearly 2 years ago

I lived in a top floor tenement flat when I had a c-section - no lift either! I found it manageable post c-section though, but that could have been because I was in agony with pelvic girdle pain pre-delivery and the c-section recovery was a breeze in comparison. I would stock up on food so you don’t need to go downstairs for a good few days, but it should be fine.

I had an emergency c-section and it was awful. Infection in the scar, painful bloating from the gas, couldn't stand up straight for 5 months, hideous overhang... don't do it!!!

It really isn't an easy option. It's major surgery. With all the risks and recovery time that comes with major surgery. And a new born to look after too. Your milk may not come in either... mine never did.

Awful experience.

I had an epidural during an attempted vaginal delivery, which unfortunately led to an emergency c section.

I’ll 100% be going for an elective next time- the recovery was nowhere near as bad as I was expecting. But, just to offer an alternative opinion to a few other comments here, for others reading, I found the epidural fantastic. They gave it to me really promptly, it worked amazingly- I even managed to get some sleep after being in active labour for over 12 hours. It was honestly wonderful. If it wasn’t for my daughter’s heart rate dropping dramatically, I would have been quite happy attempting the vaginal birth on that.

Sorry jumping on this thread. Is an elective c section a really bad idea if you live on a second floor flat (no lift)?

I have diagnosed tokophobia (fear of childbirth) and was very unwell mentally when pregnant because of it and was under the perinatal mental health team. I had an elective c-section and we made that decision after I had a panic attack doing an online antenatal course, when the midwife was speaking about intervention during birth and how epidurals could make it more likely. I remember feeling like I was so trapped as this baby had to come out! My DH just turned to me and said “do we need to talk about c-sections?”. I remember feeling like neither decision was one I really wanted, but we settled on the section as I had more control over the situation.

My c-section was an amazing experience and recovery was fine - I was up and about the same day, discharged after 48 hours, first few days were rough (it’s major surgery) but honestly I was so surprised about how quickly I recovered. I was going for walks within the week! It was my birthday 6 days later and we were down the pub with baby having a meal! I did go into labour the morning of my section though! Surprisingly I managed ok, it was early labour but contractions were intense, but as I knew I was going into theatre in a few hours and I wasn’t going to have to give birth vaginally I was able to keep the fear at bay.

I had an epidural over a c section, twin pregnancy and wanted to avoid a long recovery if possible. It was a good experience, I felt very calm and in control. I was guaranteed an epidural though as chances of needing an emergency c-section were fairly high, the likelihood of getting an epidural on request is vanishingly low locally.

I had a previous birth that was pretty much pain killer free as took ages to get me to labour ward. My second stage was officially 10 minutes. That felt brutal though, I was vomiting due to pain. No chance of an epidural or proper pain relief, I did ask. I think unless they could guarantee me an epidural I’d say a planned c section.

I probably didn't understand "wouldn't because at least I can't see the scar!" I read it as "I wouldn''t go for an elcs because the scar is visible and episiotomy scars aren't".

That makes no difference, you cannot see it due to the angle.

I had an emergency section with my second and it was still a really positive experience so I imagine a planned one is even better. I had an epidural with my first which was great but it ended in forceps/episiotomy/large PPH, I think they say interventions more likely because of the epidural but she was back to back and I was on the hormone drip so struggled to cope with the pain. I imagine a straightforward vaginal birth is amazing and would maybe opt for that over a section if you could guarantee it, but i’d take a section over any intervention e.g inductions/episiotomy/forceps. My section recovery was fine, had minimal bleeding afterwards, kept dosed up on painkillers for the first 10 days but was mostly ok without after that. No issues with milk coming in on day 3/4, she latched while in recovery. I had a toddler at home so the worst thing about the section was not being able to lift her but i’d still absolutely have another one.

@meganorks NICE guidance changed a few years back and now women have to be granted a c-section if they ask for one. A consultant could say no, but they must refer you on to someone who will so I imagine very few are pushing a hard no these days.

OP, I chose an ELCS because I had a gynae surgery a few years ago and I felt a vaginal birth was more risky. I had an increase risk of tearing due to scar tissue and an increased risk of interventions being needed. I really didn’t want forceps or to risk a third or fourth degree tear because I was scared of developing incontinence as a result of it. Epidurals do increase your risk of needing an assisted delivery, so that was a hard no for me.

I actually went into labour at 37+6 and I chose to have the c-section still, which wasn’t a problem. I had GD and was on insulin so by that point I’d been told a c-section was better for the baby anyway.

I do have some nerve damage above my scar but it doesn’t bother me in any way (12 weeks post section). It just feels a bit numb when I touch it. That was great for the blood thinning injections after the c-section as I couldn’t feel them at all. I did develop a UTI, which the midwives kept telling me was a bruised bladder from the catheter. After 2 weeks of it, I went to the GP and got some antibiotics which sorted it so it must have been a UTI although I did require a second prescription as it came back after a few days. I didn’t experience constipation after the c-section, despite taking all the painkillers offered including codeine.

Baby had latch issues and although my milk came in on day 3, we couldn’t get breastfeeding off the ground. He did have a tongue tie but even getting that snipped didn’t solve the latch issues. He then went on to develop CMPA. I have felt a lot of guilt around not being able to breastfeed and the cow’s milk allergy, as I have often wondered whether those were a result of the c-section as allergies are said to be a risk of a c-section birth because the baby doesn’t get the gut flora by passing through the vaginal canal. But ultimately, I’ll never know the answer to that. Vaginally-birthed babies can still have latch issues and allergies, so maybe he would always have had those. And maybe a vaginal birth wouldn’t have gone well for me? It’s been hard not to dwell on the what-ifs, but ultimately I do keep in mind that I have absolutely no birth trauma. I look back on my c-section as being one of the best experiences of my life. And that’s more than can be said for most of my NCT group.

I've only had a c section but can answer some of your questions.
I'm also high risk for blood clots due to an inherited condition, I had Clexane injections to do for 6 weeks afterwards. They also encouraged me to walk up and down the ward in the first few days (I stayed in hospital 4 days).

I won't lie, the recovery wasn't easy, but I haven't had a vaginal birth to compare it to. Mobility was difficult. I had extremely swollen and heavy oedematous legs for about a week, painfully tight, apparently this was normal. I also had mastitis (quite common after any birth) so it was painful to hold and feed my baby, difficult to do skin to skin. I also had a couple of infections in my wound so was on antibiotics for a short while.

But: I kind of knew what to expect, and it was all manageable. I drive, and couldn't go to many baby groups in the early days, because I couldn't lift pram out the car but I also found it difficult to carry my baby due to a dragging sensation in my abdomen. Breathlessness when walking. Also sitting on the floor with baby (and then getting up again!) wasn't easy. So just be prepared that if you want to go to groups to socialise/get out of the house you may find it challenging if not impossible in the first few weeks.

Some people have a straightforward section recovery. I think I was simply unlucky in that regard.

Take all the help/support you can get from relatives and friends.

I'm now 5 months pp and I have postnatal depression which is slowly getting better. I wanted a midwife-led water birth, so my 'birth plan' got turned upside down at the last minute. Very difficult to deal with at the time. But I've come to terms with it now, it was out of my control and it is what it is. Part of my Pnd is the lack of control I had. So I think if this is a fear for you already, then it might be best for you to have a section, then it takes away some of the unknown.

Hope all goes well for you

@anonymousxmasposter C section all the way.I believe it’s called tocophobia and I have it too. Had a C section and it was fabulous.

I had a c section and it was the best decision ever. It was originally elective, but I ended up being an emergency c section, earlier than planned. It was kind of scary at first, but as soon as I was totally numb, and they started, I soon relaxed. The recovery wasn’t anywhere near as bad as I expected, and almost 6 weeks on, I’m pretty much back to my old self, just the odd twinge here and there, and still having to use the blood thinning injections. I’m still a bit more careful than I would usually be when it comes to lifting, and bending etc, but I found the whole process to be great for me.

I had an elective c-section. It was a very positive experience and my recovery was very easy. I made the decision to have section as I felt it was the safest option for my baby and me. My decision was based on the experience of a couple of close friends who had vaginal deliveries / had professional OB /GYN experience. There was also some negative news stories about my local maternity unit at that time, how accurate they were I don’t know but I did take them in to consideration.

I did have some pressure from the midwife and consultant to try a vaginal birth, but I had decided and was given an elective section. This was quite a few years ago so hopefully this has changed.

just one other thing to consider - my understanding is that an emergency section is very different in terms of experience & recovery for both mum and baby, so maybe focus on researching elective sections when deciding if that’s best for you.

Congrats & all the best for whatever you decide.

A friend of mine had an elective c-section for similar reasons to those you list and she was very happy with her decision and said she would make the same choice again for future births.

I hope that whatever you choose you have a safe delivery which you feel good about ❤️

Are you sure you get to choose? That wasn't how it was when I was having babies - although a while ago. If you can pre-arrange a c-section, I'd go for that. I had an emergency c-section for my first and then elected for my second. The recovery for the second, when I hadn't already been through 2 days of labour, was much easier. I'd say there's quite a high chance of you not getting an epidural if you go for a natural birth.

I would go for the elective.

I opted to give birth in the birth centre in the pool. Most of my pregnancy was high risk baby was breech until quite late on and (wrongly) measured big. So, I was so pleased to have the birth centre as an option.

It was initially lovely but I wasn't progressing and was brought out to push on a bed with no pain relief.

They then scanned me, saw baby was at an angle and I had a spinal and ventouse delivery. It was wonderful. The spinal was pure bliss. If I ever have another I will push for an epidural.

However, in your case I would opt for the elective due the tokophobia. A planned c section will be much calmer and safer than an emergency, if you ended up needing one. Everyone I know who had an emergency section has said they would request an elective for the next birth.

I wouldn't worry about the thrush issues - I have problems with recurrent thrush, vaginal delivery made absolutely no difference either way.

Over all through - I was induced. I would absolutely choose caesarean over being induced again - in fact being told I wouldn't be allowed to do so partially contributed to the decision not to have a second DC, I know I could have fought, but I didn't want to be in that situation while pregnant with complications requiring an induction. Despite having a traumatic birth, I would choose vaginal delivery over caesarean outside of that.

Everyone's different, but I had very little pain post-delivery even with a third degree tear and extensive stitches. I've had keyhole surgery to remove an ovary and the recovery was considerably more painful, even with being able to take more powerful painkillers. I imagine a caesarean is painful to recover from, but I can't comment on that.

If you go for the epidural/vaginal delivery get the epidural asap. I wish I'd had mine sooner, but my birth plan was G&A with pethidine as back up as I wanted to be mobile - that couldn't happen as due to the induction the baby had to be continuously monitored and the slightest movement meant they lost his heartbeat - and the staff seemed determined to stick to the birth plan in that respect, despite my request otherwise.

I've had both a C-section (unplanned) and a VBAC with epidural. For the latter, I got the epidural at about 3-4cm, just around the time active labour began and the intensity of my contractions really cranked up. It was a very positive experience for me, much better than the C-section. I also had multiple losses before my first baby was born and understand your anxiety.

It's not exactly reassuring if the reason a woman was denied an epidural is due to the failure to communicate a very basic and straightforward message! Speaking as someone who missed out for this very reason.

The reality is that even in a perfect NHS with plenty of resources and a commitment to respecting womens automomy, which we clearly do not have, there's still a risk of labour progressing too quickly. It's never something that can be guaranteed. This is something that any woman needs to be aware of.

I would take the advice of your obstetricians and midwife (the blood clotting disorder and it's antenatal (as well as postnatal) management needs factoring in to your decision making). There are national standards for the timely provision of epidurals and those are achieved more often than this thread suggests - if you are leaning more towards the vaginal delivery with epidural option then it's worth asking your unit how often they achieve that target (and perhaps what the causes of delays are....it's not terribly uncommon for the delay to be just that no one tells us a woman's requested onel!).

That’s a completely fair point. Totally hadn’t meant for it to sound like you can’t breastfeed!

Oh and my milk came in no problem at all both times.