Should I go for a c section?

[ohsobroody]

Ive been diagnosed with cholestasis in my first pregnancy, I'm finding it pretty miserable with the itching and pain and emotionally challenging knowing the risks and implications for me and my baby.

I hd been planning a natural birth, ideally a water birth. I've been doing hypnobirthing, exercising and perineal massage for best chance of this going well.

All the evidence (and consultant) advise that I won't be able to go to term, the risk of still birth given my levels is too high.

I can either push for 'natural' or planned c section.
Vaginal birth comes with much higher risk of baby inhaling méconium and I will be on constant fetal monitoring. I'll be induced early which also carries higher risk of emergency c section and intervention.

I'm very worried about the recovery from c section though so feeling a bit lost with it all, just wondering what others would do if presented with those options

I’ve not had experience of a birth with constant monitoring, but I have had three sections.

The recovery isn’t that bad as long as you rest and take it easy, but you would be resting anyway.

In your shoes, I would go with a section. But you need to weigh it all up for yourself.

Thanks @Arsebucket I'm just mulling it all over in my mind and it's helpful to get it all out, albeit anonymously online. I can't talk about the diagnosis with my family yet without crying so just trying to get my head round the options. It might be in the next few weeks so need to have my mind straight ideally before I have to make the decision

I had emergency c section, and recovery wasn't bad at all. I really felt gutted that I didn't go for planned c section in the first place.
If I was in your shoes, and with more risk for natural birth in your case, I would definitely go for planned c section.

I had a section and honestly I thought it was really calming .. I knew what was happening there was no rush to anything the team in the room were AMAZING.. kept me laughing loads .. yes first couple of days are a bit rough but I managed everything myself.. I was out walking within 5 days and back driving in three weeks.. so recovery wasn't bad but I can't compare.. up to you want you do

Thanks all some really reassuring stories here

I'm sorry to hear you're going through this, it's really hard to find you can't get the birth you had hoped for and are facing possible complications.

I haven't been in your situation, but I had a planned C-section at 38+1 for my third child nearly 2 months ago - she was transverse lie so no prospect of a vaginal delivery. I was terrified of the C-section, but the team.and particularly the anaesthetist were very helpful in answering questions and dealing with my worries. Recovery has been hard and painful, I've had some problems with incision healing which tbh is probably linked to doing too much, I have found it hard as I have a 2 year old so not lifting was difficult! How much help do you have? I found it difficult to do the school run for my eldest as not able to drive or walk the distance but had a lot of help from parents who lived near walking him home. If you can take time to recover, it helps. By week 7 I've noticed a lot of improvement, and was still getting pain with tearing and episiotomy at that point from my previous births, so you will take time to heal whatever happens.

Are you thinking of breastfeeding? I was really worried about that but everyone was very supportive, there was lots of skin to skin time and I actually found it better than after a traumatic vaginal delivery in terms of being able to start feeding.

My first child was a spontaneous labour and vaginal delivery but had some complications so I had tearing and needed assistance with delivery (ventouse). I was monitored throughout so wasn't able to move or do anything as I had hoped. My second baby was a vaginal delivery but induced at 37 weeks because of potential issues, again I was monitored throughout and had an episiotomy. What I'm getting at is that you don't always know how labour will go - my first was a low risk, issueless pregnancy until I went into labour! I was upset at needing the C-section for my most recent birth but in hindsight at least I was able to prepare ahead of time, and the whole process was very easy and relaxed. My DH found it by far the least stressful birth!

What does your consultant think you should do? Mine was really good at leaving the decision up to me and explaining the pros and cons but when I questioned her about the second baby she said in my place she would opt for induction which helped me decide.

I had no other option than a C-section which in a way made it easy as no choice to make. It's rubbish that you can't get the waterbirth you wanted, but don't let the C-section seem further away from what you imagined than a medicalised vaginal delivery, I'm probably expressing this badly but I would have done anything to avoid a C-section but actually I felt more in control than at my previous births and it really wasn't a bad experience.

I had to have an elective section and it was tough to get my head around a much more ‘medicalised’ birth than I wanted (had been planning a home birth). But the birth itself was very calm and the recovery much easier, in all honesty, than many friends had from vaginal delivery.

I had a planned section at 37 wks due to placenta praevia. I was initially gutted, but it worked out really well. Recovery was pretty easy (I was out of hospital the next morning), but I have had abdo surgery before so vaguely knew what to expect.

I did struggle with breastfeeding, don't know if that was because he was early/tge section or not. We did crack it eventually though and am still bfing 2 years later. Plenty of my friends who ended up with sections had no problems bfing.

Personally, if there's a risk to you/baby for a vaginal birth I would err on the side of a section. I am very risk averse though.

Whatever you decide, I hope it all goes smoothly and you enjoy your new arrival!

I haven't been in the same situation but I have had a vaginal delivery and an ELCS. I would choose a c section any day of the week. A lot calmer and easier and frankly the recovery was much much better than my vaginal birth (it is not the case that you snap straight back from a vaginal birth - I was in hospital for much longer and in pain for weeks yet after my c section I was home the next day and pain free in under 10 days!). It all sounds very stressful for you - good luck with whatever you choose and I hope everything goes well

I've had 2 sections - 1 emergency, 1 planned. Although not for cholestasis. Recovery from both was straightforward and didn't take long. The first couple of days are a bit rough, although I presume they often are with a lot of vaginal deliveries. Obviously with both methods there is a chance of complications, but a good chance of a straightforward recovery.

2 out of my nct group had cholestasis and both had induction then emergency section. But both had straightforward recoveries and happy healthy babies.

In your position I would have a section. Although I appreciate it seems more scary if you haven't had one before.

I had a planned section on Thursday last and I honestly haven't had any pain so far. Take the pain killers that they give you in the hospital and you'll be fine. I'm in Ireland and they keep you in for 3 nights after a section, the midwives took the baby for a couple of hours each night so I could sleep.
I had an emergency c-section 2 years ago with my first and I refused pain killers as I wanted to breastfeed and was worried about the drugs effecting the baby. This time I copped on to myself and realised that a happy and pain free mother was what my baby needed so took ALL the painkillers. Much better recovery, much better mental health.

If having an induction before 40 weeks, the likelihood of your labour not progressing and ending up with an emergency c section is high. If induction after 40 weeks then there’s less likelihood of you ending up with a section. So I’d 100% go for the planned section

I was overdue with mine and induced. I had constant monitoring with my induction due to her heart rate. It was very painful in early labour as you don’t get proper pain relief on the inductions wards here, nor do you get the mobile monitoring devices so I ended up having back to back contractions stuck on a bed with some paracetamol whilst worrying about my baby. Not recommended! She did inhale meconium as well so we were in hospital for ages as we both ended up with an infection.

The emergency c-section I ended up with was fine as a procedure and I would absolutely take a planned section over the induction, emergency section and my baby being poorly when born. That is even with my post c-section overhang (which seems to be pretty permanent now).

That is just one experience though but I would suggest that a section warrants some thought.

Thank all, I'm definitely leaning towards the c section.
It would be a harder choice if it was between the birth I wanted and a section but it's not, that is already off the table. At least with planned c section the risk is controlled and managed.
I'm sure I won't care about all this once he's here 💙

I had an emergency c section with my first and planned with my second; I found the planned one a really positive experience. There was a lot of anxiety around risk factors in my pregnancy which is why I had a c section second time and it made it all feel a lot calmer and controlled
The first few days of recovery are hard but it can be like that with a natural birth too and overall I’d say it wasn’t too bad

A long labour with the drip and then an emcs at the end is no fun. That was my first labour. My second was an unplanned VBAC much easier but that was luck. I’d book the cs. The choice in my opinion is pain during or pain after neither is an easy option

I've had 1 emergency and 2 elective c sections and they're not that bad.

With my first I walked around the supermarket on the way home from the hospital on the second or third day. I was hunched over a bit and it wasn't pain-free but it was manageable.

Keep up with taking painkillers every few hours and make sure not to do too much physical activity. After a week it's much better.