Would you have a Caesarean if you were me?

[SproutMuncher]

I’m due next Spring with my second baby, and am terrified about the birth and the state I will end up in.

My son (about to turn two) was delivered with forceps and since then I’ve been in pain from the episiotomy and have a moderate bladder and bowel prolapse, which I’m very depressed about, and don’t really have any confidence any more.

I want to deliver vaginally as I know Caesareans are major surgery and The midwife has really scared me about the risks, but I’m really scared another vaginal delivery will make my problems worse which I am desperate to avoid. Surely a section is better than spending the rest of my life with even worse birth injuries?

Anyone been in a similar situation or any thoughts on what you’d do if you were me?

I had my second by ELCS after a dreadful first vaginal delivery and if I could go back and do things again I’d have both by section , it was excellent , driving within 3 weeks and definitely a much quicker recovery than the first .

I had an EMCS (although not an "everyone was inches from death" emergency, just a "bugger it she's hiding in the corner and won't come out" type one that was pretty calm) followed by a VBAC that was handy enough in the end after a long night of slow progress. Got away with a small tear that healed very quickly. I think I would go with ELCS in your case but definitely, definitely get a consultant appointment. I was automatically offered one during my second pregnancy (don't know whether it was just cos of previous section or whether also due to being old) and am surprised of they haven't already offered you one.

I had a c section at 38 weeks and it was the best decision I ever made. I think I was fortunate in that I recovered very quickly but it was a very calm, really amazing experience.

I have had two c sections. One emergency and the second planned. I was walking about the following day, home after one night in hospital, and the biggest issue was needing to hold my tummy when my DH made me laugh. Recovery was fine. I made a point of standing fully upright the first time I was out of bed, took my time but far better than walking hunched. I made sure to eat prunes and dried apricots so the first bowel movement was soft and had a tip of using a wrapped up towel against my incision. All in I wouldn't have a problem with another c section if required.

I've had a normal delivery and a planned section and work in the NHS.
In your situation I would 100% have a section. The staff are under pressure to reduce section rates so you will need to discuss with Consultant. Good luck.

I had severe tearing after my first (had to be patched up under general anesthetic following delivery) and a post partem hemorrhage of 3.5 litres. Had an elcs 10 weeks ago with my second - what a different experience! Calm, controlled, relaxed. Recovery very smooth. Pain free after 10 days. No complications. After my vaginal birth I was a wreck for months. I'd highly recommend a c section - fantastic experience.

I would 100% have a section in your position. I've had two (one emergency, one elective) and recovery from both was fine.

I'm annoyed on your behalf that your midwife has laboured the risks of a section. Obviously there are risks associated with a section but there are also risks associated with a vaginal birth (particularly, I imagine, given your history). Did she mention those too?

I haven't had a vaginal birth but have had a section (emergency). My midwife told me that recovery from a planned section is easier - you're prepared and I think they prepare you.
I did get an infection, as well as an incredibly rare issue with the spinal block that needed a return to hospital for a second epidural type procedure. I also got a mild infection that needed a course of anti biotics. So far I've had no further issues (five weeks now). It was sore (they give you anti coagulants to prevent blood clots that you inject and I was bruised and battered from those) and you are very restricted in movement which is difficult with a baby (especially if you already have one at home). However - I would probably do it this way again if the alternative is permanent damage. Five weeks on I'm well on the way to recovery and back to normal and thrilled that I don't have to worry about tears and bladder problems. I also think that when it's planned they start you on antibiotics in advance in some areas to prevent future infections, and when you know what's to come you can put plans in place to make life easier when you get home.
Good luck OP - even though it hasn't been a walk in the park I'd still opt for a section over what you've described.

One natural (hideous) birth here, then an emergency section and finally a planned section. In your shoes, I would grab the planned section with both hands. Do not agree to natural birth, which will more than likely make your existing problems worse, don't do it to yourself x

I think it is worth remembering that midwives treat women who are pregnant or very recently gave birth. They don't see women 2 or 3 months later when birth injuries are still not healed. They don't see the women so traumatized that they choose never to have another baby. They don't try to patch up incontinent 45 year olds or those with serious prolapse issues. They are really not qualified or experienced enough to comment on your long term prospects.

Very naughty of your midwife to scare you with the risks of ELCS while not making the risks of VB (higher than average in your case, given your history) just as plain.

CS is ‘major surgery’ in the sense that it involves opening up the abdominal cavity. But it is a very safe and routine operation. The risks are different but about the same overall as a VB (slightly less risky for the baby, actually). The truth is there is no completely risk-free option, but you have the advantage of knowing that VB is likely to cause more problems for you than CS.

In your shoes I would go for ELCS without a second thought. Why risk future incontinence?

Don’t forget that HCPs may push VB because the trust wants to get its CS rates down, rather than because it is objectively the best option for you personally.

I defining would in your shoes, yes.

My son turned 4 this week and injuries from an epesiotomy, forceps and a third degree tear are still amusing me pain during sex and issues with controlling my bodily functions. I can't even use tampons anymore because it's too uncomfortable. So without hesitation I would have a c section. I've decided to go to the doctor in the new year and see if there's anything they can do because it's really getting me down now and affecting my relationship. Don't let the midwives bully/scare you in to anything you don't want to do.

Causing not amusing

I’m currently 6 months post c section and still recovering. However, I have no gynae issues and the recovery from the c section is manageable and no potential loss of bowel or bladder control. Mine was an EMCS due to foetal distress and was therefore more rushed than an ELCS. I think this hinders recovery.

Given your past, I would go for ELCS. You will have time to prepare mentally and practically which will make all the difference. Good luck.

I've had 1 emergency C section and 2 planned ones now. I don't think they are something to be scared of, taken seriously yes but not feared. I also think it is not a coincidence that a relatively high proportion of female obstetricians opt for elective c-sections. Definitely ask for a referral to an obstetrics consultant to discuss

I had an EMCS and at worst I felt discomfort, never any pain. The wound grossed me out, but once healed it was all fine. My personal experience was very positive.

Prolapses once created don’t heal without surgery (doctors won’t perform this until after menopause if at all as often it involves a full / partial hysterectomy and isn’t guaranteeed to work) - exercises can keep them the same level but a second pregnancy (note PREGNANCY not vaginal birth) can definitely make them worse. It doesn’t really matter how you give birth - it will be the second pregnancy that causes the harm.

Yes definitely, if only to protect your bits from any further damage. If you had already had repair surgery you would have been told to not have any further vaginal deliveries. Stick to your guns & refuse to accept any arguments that a natural delivery is better for you.

I had an episiotomy and tearing with my first, along with fairly major pph. I said I wanted a Cs at my booking in with my second and just repeated that every time I saw anyone. My consultant was quite happy forme to have one and it was a great experience. Went in at 7, baby delivered at 11.10, all nice, calm and peaceful. Went home the next day. He's a year old now and the scar is barely visible

I'm usually all in favour of vaginal birth (had all my DC that way, some at home) but in your situation I'd want a C-section. And physio.

A friend has a prolapse and it really knocked her for six mentally.

Wishing you all the best with this.

I had an EMCS after some complications inc haemorrhaging. I followed the post surgery advice about taking regular pain meds even if you don't feel like you need them. We were in hospital less than 48hrs. Day after discharge I was out walking and pushing the pram quite a distance. Possibly not the most sensible thing to do as I slightly irritated my scar from my trousers rubbing but I needed to get out for my emotional well-being (not true that baby blues is necessarily delayed with CS compared to vbac!) Also gives you an idea of how I was feeling physically that a long walk felt fine that soon. I followed all the advice about driving, lifting etc but because that's what the professionals said. I could have done these things much earlier. The only negatives I've had are the over hang (which is probably more weight and fitness related now) and some numbness in the area about an inch or so above the scar (this has reduced over time but still there faintly).
Everyone is different in their recovery and experiences. I know quite a lot of people with serious long term health problems from vbac tearing etc and only a couple of much more minor ones from EMCS.

My first 2 births were almost identical, foetal distress, meconium, episiotomy and a Retained placenta for both, one removed under GA, the other removed without anaesthetic by a male doctor

Number 3 was born by elcs with the consultant's support as I couldn't cope with the risk. As it was he had a true knot and the best birth and recovery I had

I've had 2 planned sections and to be honest I wouldn't choose anything else even if I had the option. Yes it's major surgery but surely no worse or painful and stressful than what you've been through. I can't even imagine it

Yes I would.

I had a forceps delivery with a third degree tear. My friend had a section two days before me. Within a week she had overtaken me in recovery. It took me 6 months to feel well again.