Having a Caesarean section with no medical need to have one?

[firstlittlebub]

I know so many people who have had really poor births, particularly first time around. I don’t fear birth but I do feel being out of control. I know there is a massive midwifery staffing crisis and have watched panoramas explaining how stretched they are right now, more than ever. I’m also due in one of the busiest birth months.

Read the stats for our local trust in one recent month:
200 vaginal
142 EMCS
97 ELCS
51 assisted vaginal

To me, that’s 50/50 chance of straightforward vaginal OR EMCS/assisted (which I want to avoid).

I know a section is by no means easier and is major surgery, but when the odds are as above is it favourable to just pick that so you at least know what to expect? It seems like there’s a high chance of ending up with a section anyway and an emergency one sounds more stressful than planned.

As I have APS delivery needed to be at 37 weeks. Doc recommended induction. I’ve never wanted a vaginal birth so asked for a sections.

The odds of a straightforward birth with no intervention at all are about 25% for first birth. That’s baby popping out smoothly with no tearing/cuts etc.

My demographic (35+, BMI 35+, 37 week delivery, 1st time mum) gave me a 40% chance of a failed induction requiring an EMCS, and that was after forceps etc had been attempted. There’s not actually a lot of difference, a handful of percentage points, for the average pregnancy ending in emcs . No thanks.

Both of my c sections were elective at 37 weeks. Recovery was excellent and I felt pretty good by day 5 both times. Day 3 was appalling but it drastically improves from then.

Thank you for this. 25% is really low!

I had two electives with no ‘medical need’ - I do have issues and was told natural would ‘probably be fine’ - I had no desire to wait and see tbh so asked for cesareans.

They were brilliant.

Loads of people (most of whom have never had a cesarean) will probably come along and tell you all kinds of made up shite about it (my personal favourite is you can’t breastfeed - I must have made up BFing both of mine) but if you want to go for it then do it, it’s personal choice. Totally anecdotal of course but most people I know who opted for natural birth ended up with some sort of intervention.

as I have quiet a few DC I have experienced all sorts of births and the fact is you do not know what will happen u til your in the situation. I recovered much quicker from my Emergency C sec then I did from my three planned ones. I also got infections from all my sections. My natural birth didn’t turn out natural as I ended up twice with forceps and lots of stitches. If I knew now what I knew at the start I would have elected a C section. But you may be like my friend who had 4 natural and did indeed sail though them

I dont think it is that low - my midwife friends always say most births would go smoothly without medical supervision. I don't really consider a small amount of tearing to be a problem, either, it will heal. I would not consider that a birth that didn't go smoothy.

My DiL was adamant from day 1 that she would have an ECS - and she did. Hospital didn't try and change her mind at all!

Yes I did judge at first- I am sorry to say - but I was proved completely wrong as it was v smooth / relaxed etc.

Well my question was actually more about what were my odds of getting away without stitches in my vagina.

A 3 in 4 chance of a birth injury (of any level) was too far out of my comfort zone. To be fair though vaginal birth was always out of my comfort zone, and that’s ok. I was very happy with the way my deliveries went and it was absolutely the right choice for me.

My cousin has 7 kids. Pops them out like she’s shelling peas (her words!), never had so much as a nick! A c section is her worst nightmare. That’s her comfort zone and she’s happy with her births too.

I think this is such a personal decision and one that every woman should be able to make with all the facts available to her and with no judgment. Of course a “natural” birth with no complications is something that may be preferable for many reasons - cheaper, no surgery involved, some proven benefits for baby. BUT the problem is that humans often do have complications.

Unassisted vaginal birth doesn't mean a good birth though. Women with 3rd and 4th degree tears will be in that category.

I think it's something like 90% of first time mums that tear 😳. Obviously some don't need stitching.

I decided I'd rather my stitches on my abdomen than my genitals, and would rather guarantee no ripping or cutting that I wasn't anethetised for.

I therefore opted for two absolutely wonderful c section's. If only vaginal birth was an option, I'd not have had children, so I'm glad the option was available for me and I have no regrets.

Entirely up to you. I considered an elective c section for my first but in the end went for a vaginal birth as she was likely to have breathing issues and I wanted to maximise her chances. I had a 40 minute labour from first contraction. I could never have predicted that, so for me an elective section would have been far worse. I was with her in NICU shortly after birth and havjng breakfast in a hotel that morning (she was born shortly before midnight). Subsequent babies I went out for dinner as we left the hospital the same day.

On the other hand I could have had a horribly complicated vaginal birth or an emergency section. Elective sections are generally more predictable (though occasionally there are complications). It’s predictability versus the chance of a very easy birth and recovery and the balance of risk and comfort is different for everyone.

I had a fairly straightforward vaginal with one stitch that healed really quickly. Up and about after a few hours and pushing a buggy the next day. Wonderful, positive birth in spite of having ventouse. My C-section was horrible, a lot of pain and weeks of not being able to pick up my older child, drive or do anything much at home. Was very dependent on family help. I wouldn't wish the recovery on my worst enemy and the scar on my abdomen took ages to be fully healed. It put me of having more children sadly. I know that loads of people have really positive experiences of c sections but wanted to say that there is no telling how either type of birth will affect you.

11 births..
10 without tears /stitches /pain relief.. Different hospitals..
1 premature birth via emcs at 35 weeks due to undiagnosed clots causing a small bleed..
Def take those first 10 over the last one..

I had my children later in life; 3 vaginal deliveries (no tears or stitches) and one emergency Caesarian.

We are all so different that my experience cannot be extrapolated to to other women. Your body, the size of your baby, your age, your fears and your medical history. All unique to you. I’d have a nice chat with your midwife, and see what your personal risk factors would lead the medical professionals to recommend, rather than just looking at the raw data and listening to the opinions of randoms on the internet. Then you can make a better-informed decision.

good luck!

My first was a vaginal birth, 3 hours active labour, no drugs and no tearing.

I'm 38 +1 at the moment and the odds are in my favour for the same experience however if an induction is suggested I would refuse and my preference would be a c section! X

I absolutely loved my scheduled section.

Baby needed out due to being on insulin and I declined an induction.

The experience was very calm and lovely. recovery was fine (small suspected infection sorted by antibiotics)
Stayed on top on my meds in general and it made the pain very manageable.

Would choose this again 100 times over as I have no regrets.

My section was honestly the most magical experience of my life. Went into labour in late afternoon, had to wait a bit for a slot but had gas and air, birth at 2100. Was the most relaxing experience, had our own music, husband was holding my hand, saw them being lifted up like Simba!! Put on the breast immediately and latched, didn’t even notice being sewn up (scar is barely noticeable now 2.5yrs later and is under the bikini line).

I was discharged at 1500 the next day, would have been early but had to wait for a doctor and some meds.

Was walking around the park 40hrs later, had a pub lunch the day after. I didn’t take any painkillers apart from the first couple of days they told me to take paracetamol every 4hrs just in case. I fared better than my NCT friends who had vaginal births, one of whom is still having major issues, but I’m not sure that’s all that common.

Birth is so personal, don’t let people put you off from having the birth you want, it’s you that has to go through it.

Hmmn. Maybe worth noting that emcs stats will include 'you've been in labour a while now, let's get this baby out' as well as more dramatic situations. I think there are gradations of emcs.

Also that tearing in vaginal birth is very often minor, I had episiotomy with complicated healing and it wasn't that bad. Counted as 2nd degree.

I think there are things to be said in favour of both modes of birth, if advantages were that clear cut then everyone would do the same thing.

Vaginal birth has advantages for microbiome of the baby, which isn't noted much.

Personally I had one not very urgent emcs and one vbac, preferred vaginal birth because of the easier recovery.

I don't think there is any right answer or risk free option.

I’ve had two elective sections for no medical reason other than the sheer terror of the alternative. I feared it my whole life so for me there was no other option. I had to fight quite a bit to have it booked first time round, second time was much easier.

Both were amazing and exactly what I wanted. The only negative is that I’m now limited to probably stopping at 2 kids as they said my uterus was paper thin and I wouldn’t be advised to get pregnant again as the risk of rupture would be greater. I’d still do everything exactly the same to get my two though

Exactly, I just chose where my stitches went!