To be unsure on ELCS...

[Keepontrudging]

Hi everyone,

Firstly I posted on childbirth forum and had no replies, hence why I am here.
I am really undecided how to go about things this time around. The birth of my daughter was traumatic for numerous reasons - though thankfully my dd was fine when (finally!) born. I am due to give birth again (just 20 months on from having dd) in Jan. Due to complications with this pregnancy (possibility baby could be small/ small amount of fluid around heart) and the fact I haemorraged after giving birth the last time and was so drained and weak (despite iron transfusion) I thought an elective c section would be best and it was agreed I could have of I liked by the consultant (thohgh they haven't said I need one)
I have done a bit more research and found that having a previous post partum haemorrage increases your risk by x3. However I just read having an ELCS increases your risk again x2! So now im thinking maybe an ELCS isn't best and maybe having a vaginal birth would be. But the thought of having hours of labour again and then having another instrumental delivery and haemorrhaging after it all terrifies me! I just don't know. What tempts me about an ELCS is the fact it will be controlled and I will be able to rest prior to it and then come home hopefully not too exhausted as I was in labour days with my dd on and off. Sorry for them ramble. I at a loss as what to do!

What does your doctor suggest?

Personally I'd think ELCS would be less traumatic and less stressful in that you'd already be in a situation where medical personal are around and prepared. Vaginal would mean they're need to "rush" you somewhere and may end up having to open you up anyway.

I think you could drive yourself batty with the "what ifs" so I'd plan for "worst case". I'd rather be in a situation where IF the haemorrhage happens it can be dealt with quicker and easier, i.e. ELCS.

I think if you are now unsure whether an ELCS is the best thing that you need to to discuss it again with your consultant. Can you contact his secretary and ask if she/he could contact you or maybe your GP or midwife could contact them?

If you don't talk it through and don't feel you have enough information to make the best decision then you are going to worry from now until the birth which would be sad. I think you need more info and to be able tell the people looking after you what your concerns are.

Hmm I can only share my own experience... and I could waffle on for days but in a nutshell I had a very long 3 day induced labour with dd ending in traumatic ventouse delivery with botched episiotomy. No way in hell I was having another vaginal birth... 10 years later with ds now aged 2 I had an elcs (had several appointments with nhs consultants to fight my case as they didn't want me to have one) best decision I ever made. Found the recovery far better than my vaginal birth and the whole thing was just overall better.

However... I had undiagnosed complete placenta previa with ds and had a pph of 2.5 litres and 3 blood transfusions. So it wasn't all plain sailing. Spend 2 days in recovery. So I know what it's like to have a blood problem during a c section - and even though mine was unexpected they dealt with it swiftly and it was all fine.

If they had expected it I'm sure it would have been even better.

I think elcs are fantastic. Yes there are risks but you have to weigh up those risks against everything else and for me the risks to my mental health of being put through another traumatic vaginal birth.

DD was delivered by ELCS 2 weeks early, as I was developing pre-eclampsia and DD was breech. Apparently they didn't want to take the risk of inducing as my blood pressure was already shooting up.

It all went nice and easy, down to theatre in the morning so a relatively restful day afterwards. There was some morphine for pain control during the op, I understand, but afterwards, not much pain control needed. I did take it easy for the next few weeks, but had a little help, and DD was my first so no having to sort out a toddler.

its tricky, i guess if you are going to heomargae where is the best place to do it..on a table with staff there prepared for it immediately, seeing everything, or in the rather more tricky position of baby being half way out and so on and perhaps more guess work going on...

I have two types of delivery and elc was by far the best, so much more controlled, relaxed, I felt totally safe....i was nervous and scared but it was a few mins compared to hours of labour.

if i was in your shoes I would do more research but probably go for elx

I had my DC by ELCS on strong advice from my consultant due to previous medical history. I was quite sad before, having imagined whale song, candles and spa like water birthing scenarios, and sulked for days. The reality was a stress free delivery, fast recovery and the fact that I can run for a bus and not piss my pants makes me grateful in a regular basis. Plus I can't see my scar anymore. I kick myself thinking about how much I feared what was in reality a very calm birthing experience.

I think you need to discuss this with your doctor and get a better understanding of the risks as they apply to your case. 'Increases the risks x2' doesn't mean much, for example if the risk is minuscule to begin with doubling doesn't really make it significant.

My advice would be to follow consultant advice. Things can and do go wrong in child birth, and I would want to minimise that risk as much as poss.

Hi I had a normal pregnancy but traumatic birth with dd 1 so was a no brainer to have elective c section with dd 2! Best decision ever! You know your date can plan everything! My friend had emergency section with her first child but wanted to try a normal delivery for second child, she ended up with another emergency section! Hope all goes well whatever you decide!!

Thanks all. I have a scan with consultant this month so I will discuss my fear about haemorrhaging after an ELCS. I think the risk is 6% for anyone. If you have had a PPH it rises to 3x that, then an ELCS raises it another x2. So I am basically looking at a risk 30%. However if I don't have a ELCS I may need intervention anyway (induced) and that increases risk. I just feel much safer and in control having an ELCS given my experience the first time. My recovery period after labour was terrible too. I was so weak as I was anaemic and never had a chance to recover from the days of labour I was in! I was religious with my kegal exercises and have got everything down there back to near normal. This is in spite of having a ventouse and episiotomy delivery. If I have another vaginal birth soon after I don't think of be quite so lucky! I have to consider all of that too.

keep I am also grateful to have spared my under carriage the trauma of labour and mine was pretty normal and not physically traumatic, it was an un expected bonus shall we say, I also cannot see my scar but have slight over hang, but that doesnt bother me one jot.

I wouldnt care about any scarring. I would like my stomach to be able to go relatively flat again in an ideal world... But I am realistic and it's not a major worry obviously!

Not to show off, but my stomach went flat again following a CS, after a few months without very much work. Just to say it is possible.

I have to be honest, my stomach is completely fucked after my section. I had a fairly flat stomach before after dd but I did have separated stomach muscles.. having the section with ds has left me with a real "shelf" and protruding tummy that I cannot shift.

But I still wouldn't have changed my elcs. I just accept my flabby bits :)

I have heard of this stomach distortion after a c section. Is it not more down to the pregnancy than the way the baby comes out ?

This is quite an interesting thread... (very old now though).

www.mumsnet.com/Talk/style_and_beauty/a1229042-C-section-shelf-overhang-saggy-bit-how-to-deal-with-it

I didn't have an overhang after my first ELCS and although it's only been 4 weeks since my second one it doesn't look like I'll have one this time -I am not saying this to boast or make anyone feel bad just information for the OP that everyone is different.

I've had 2 sections, first emergency and second elective. I had separated abdominal muscles too and had physio after the second one which sorted that out. I had a very minor overhang after the first bit none after the second (slight now but nothing that wouldn't correct by losing half a stone)

Having had previous surgery you would (currently) be likely to be approved for an abdominoplasty to correct any overhang on the NHS as long as your bmi was less than 27. If it ended up being a big problem. Although this might change and also an abdominoplasty is not a small operation...

And yes keepontrudging the separated abdominal muscles are due to the pregnancy not the mode of delivery, but cutting through your abdominal muscles to do a section weakens them further so it can be harder to sort out.

I have separated abdominal muscles but it's from having very tight muscles which got stretched by the pregnancy. Despite the CS my lower abdominals were completely knitted together a couple of years after the operation.

Thanks everyone. So basically physio or surgery can correct it of it's really bad?

This is a really reassuring thread, thanks for starting it OP. I'm in a similar position in that I had a traumatic birth ending in an EMCS. Mentally, I just can't face an other birth like that again, I can feel myself becoming anxious about it already and I'm not due until April. I had hoped that a ELCS might be the way forward and it sounds as though it might be.

mine isnt bad at all and worththe savingf of the trauma of labour