As dangerous as they say it is?

[Glitterbugsparkle]

Regular poster with a name change. I’m ttc dc2. I have some pelvic floor damage from ds age2. It’s considered a mild bladder prolapse and some stress incontinence
For this potential child I would like a c section. I really think avoiding natural childbirth might prevent worsening my problems.
However when I have mentioned this to my gp etc I get the whole ‘c section is major surgery’ and a list of awful risks/potential problems of c section. Then they say pregnancy alone can damage the pelvic floor so what’s the point of pursuing a c section.
Aibu to think this is rubbish and that they are trying to save money by pushing me into a further vaginal delivery?
Obviously I wouldn’t want to undergo unnecessary surgery. But if there are any other mumnetters who had pelvic floor problems after dc1 and then had dc2 by vaginal or c section id love to hear if your pelvic floor problems were the same/worse after dc2 however you delivered.
I just can’t trust the nhs to be honest at the moment. I think it would be anything to save themselves the bill.
Before anyone comments also, we don’t have the money to go private. It’s just not an option.

My hospital was definitely of the pushing VB camp.

I was consultant led mostly because I’d had a substantial myomectomy (open - biggest fibroid was mahoosive) 15 months before i got pregnant. While i didn’t get a clear steer from the surgeon about my prospects for birth, the consultant focused on the fact that none of the uterine incisions had been full thickness therefore my uterus should be able to stand normal labour . otoh, he didn’t seem to see anything significant in the mention of cervical stenosis in the mayo report - there being no obvious reason why my cervix should be unable to dilate, yet this had apparently been a problem during surgery.

i was a bit perturbed by how I was being pushed into VB, and the glibness of the registrar “oh, CS is just as bad for risk of incontinence...probably “. I didn’t recognise this description of a CS as a terrible, difficult op, mainly because I’d been through what is generally seen as ‘close as damn it’ to a CS with the myomectomy. Then, I’d been back to walking 5+ miles a time within a couple of weeks, and had no complications whatsoever (I had, however, had someone at the top of their game for the op - presumably skill of the surgeon for this kind of thing is crucial).

Then the consultant said he didn’t want me to go overdue because of my age. Normally in this situation things are got going with pitocin etc - which couldn’t be used because of my patchwork uterus. Surely this collision of rock and hard place called for the offer of an ElCS? Nope: just sweeps and being booked for RoM.

The RoM did get contractions moving. They kept squeezing against my bowels, and I constantly felt like i was going to crap myself. (i can well believe it’s this kind of thing that does damage to the pelvic floor - rather than just pregnancy or VB). However, complete lack of dilation meant that I didn’t seem to be believed on how strong the contractions were (which can only be measured via foetal scalp...which needs open cervix to access...catch22). Other stuff going on finally got me an EmCS, by which time I’d finally dilated a grand total of 2cm.

At the debrief with my consultant (at which I may have raised again my mystery stiff cervix ), he went so far as to say I should “probably be booked for an ElCS with my next pregnancy “.

Oh, and there definitely is a sense in staff of how things ‘should ‘ go. At AN classes, as long was spent on the totality of CS (under the heading of”When things go wrong “) as on one of the pain relief methods. (On BF, we had to compile a list of benefits on a flip-chart - but none of the downsides, nor of the advantages of formula.

Surely if it’s the labour prior to an EmCS that does much of the damage, the answer is to do more of these as El rather than blaming CS as such?

I feel I was given a balanced view on the risks of vb and csection. But I wanted a home birth and I fought for It, got the Ok, only for dd1 to never turn from breach. Her was an emergency section as I went into labour 2 weeks early. Again no aftercare, just here's a baby 9h later pain relief was stopped and it was get on with it. Constant pain after and couldn't lie on my front at all. However no bladder problems.
Dd2 I chose ecs went smoothly, bladder problems started during pregnancy and got worse during. After section recovery better this time, minimal pain, however 2.5 years later I still have isdues with my scar, not much though. However this time I was left with mild bowel incontinence. Dd2 was a cs with forceps and a lot of internal organs bring moved. I have a few isdues that have got worse with digestion and pain, but they did do a great job and I knew the risks. Oh and I have permanent lower back pain from spinal can't sit on bum with legs stretched out in front of me.
I have no experience personally of vb but was my sister's birthing partner (midwives were delayed on home birth) for 2 and both went well but again these are o my a few experiences. No one can guarantee your bladder won't be worse you could be left fully incontinent from either end but it's a small risk. Know what the likelyhood is and make a choice that works for you.
Sorry for blethering on all the best x

I had an assisted vaginal birth with my first baby including a severe tear, episiotomy and permanent damage (fortunately, my pelvic floor is not damaged and I do not have prolapse afaik). My recovery was extremely hard and I am still suffering the consequences of it. I'm having twins this time and due to my previous problems and the positioning of my dts, I have asked for an elcs this pregnancy but my antenatal team want me to try for another vaginal birth. It is not my intention to bash doctors and midwifes. My reference to NICE Guidelines and RCOG Guidelines are on the basis of recommendations a Consultant referred me to when I wanted specific information on the detail of each type of birth and the risks in relation to the birth of my dts.

C-section does not prevent any prolapse.

Yes pregnancy alone can be responsible for prolapse. A friend was also told it’s good to leave a fair gap between babies so you can work & improve your pelvic floor if you do have an issue.

I agree that vaginal delivery complications are glossed over & often woman have to suffer in silence. Unfortunately no one will be able to tell you what method will have the best outcome.

My 2nd birth was semi elective CS due to transverse position & other issues. I pushed for VB & the consultant and I had a plan to try induction & if that failed go for CS. I wanted to avoid an emergency CS. Would that be an option?

I was lucky to have a 5 hour labour with no intervention & a couple of stitches with DC1 (9lb) & I would always choose that over a CS. But unfortunately not every birth is like that.

I had an ELCS and recovered very, very quickly.

There's definitely a bias as the NHS offers information like- 'here are the advantages of VB vs the worst possible outcomes of a CS', I don't think I had any leaflet outlining the negative outcomes of a VB.

There's bad bits about both of them, you just have to try and make an educated choice and hope for the best really.

@Sprogletsmuvva I'm so sorry for all you went through. Our births were somewhat similar. I never dilated. I think I maxed out at 2.5, and then started getting smaller again. It was a nightmare. No one believed what I was physically experiencing with the labor pains because I wasn't progressing.

In my first birth, my DD's heart started to fail (after me being in labor for 62 hours). In my 2nd birth, my uterus started to rupture after 10 hours.

72 total hours of labor, and 2 emergency C-sections.

Speak to the obstetrician not the GP

Pregnancy alone causes many of these issues. But OP you are right in saying that you always hear "a c section is major surgery", as if anybody thought it wasn't! However truth is that vb is a major thing as well.

As PP said, doctors and hospital literature tell you the best possible outcomes for vb, vs the worst possible outcomes for cs, which is hardly a fair comparison.

It's complete bs and very unfair to women. Informed consent should give people all the known risks, not a few cherry picked ones.

When I moved hospitals just before my planned section birth with my daughter the new midwife told me under no uncertain terms that I would not be considered for a section due to cost and that was final.

I had a ptsd panic attack and fell apart. My doctor then booked me in with a surgeon who read my past history of near fatal births and booked in the earliest slot, apologising for the midwife who I'm sure got a hell of a bollocking for not reading my notes.

Section and recovery were a dream compared to my first birth. Nobody had to be resuscitated or pumped full of blood. There were no crash teams. The 4 week recovery was bliss compared to the eighteen months from my natural birth.

The surgeon estimated my natural birth cost the nhs five times more than a section too.

My opinion is that when assessing risk and cost and comparing VB with CS is that the full cost/risk of VB is not compared on a like for like basis.

An easy VB with no tears or intervention, in and out of hospital in a few hours, is going to be the cheaper option of course. Of course it is.

But this isnt something you can be given as an option. It is just down to the luck of the draw.

As soon as other things start to be added to the mix, pre-existing conditions, breach, progression of labour etc then the risks/costs comparing CS with VB then IMO they start to even up. Eventually the more that gets added to the mix then CS can become the lower risk/cost option.

My 3rd c section has left me with a whole barrage of pain, 17 years and a hysterectomy later. Adhesions. It's not a given that it'll be better.

Eventually the more that gets added to the mix then CS can become the lower risk/cost option

And vice versa - as myself and others are saying, CS can have complications, long term difficulties etc.

And that goes for elective Caesareans as well as emergency ones.

Yep was my first (and last) baby. There are no guarantees either way I'm afraid. And I would avoid a CS like the plague if I had a toddler. Some women recover very quickly. I didn't.

You won't be saving them any money if you have a vaginal delivery and then need years of help with incontinence issues. I had 2 x ECS and at 63 still pride myself on my magnificent pelvic floor, not that anyone knows ...

I do want another child. I wish someone (a professional) could assure me the pelvic floor problems won’t get worse if I have a c section.

But no professionals can assure you of this. The pregnancy alone may worsen your pelvic floor problems. A vaginal delivery which goes smoothly with no tearing may not make them any worse at all. However, if you have a c section and your prolapse symptoms get worse you’ll know it was the pregnancy itself and not the delivery. Conversely if you go for vaginal delivery and get worse, you will never be sure (but likely will always blame the vaginal delivery).

Yes I have a medical background - I’m an obstetric anaesthetist.

Sorry post went wrong.

And vice versa - as myself and others are saying, CS can have complications, long term difficulties etc.

Of course, and sorry about your experience. Unfortunately both vb and cs are dangerous and both can leave women damaged and disabled for life.

I've had one child (and only one pregnancy) through ECS due to other medical conditions. I had an infection after and had to stay in hospital for longer. Afterwards, I felt like an old, old lady for a month or so and that was really tough with a newborn. Longer term, I wasn't able to do any strenuous exercise e.g. cycling, running, for a year afterwards due to pain. 6 years on, things are good but I do have occasional stress incontinence and pain during sex.

You seem to think there's a massive conspiracy- but no one can say whichever birth method is used you wouldn't have a degree of worsening to your pelvic floor. You legally have the right to demand a CS if that's what you feel is right for you, but giving birth generally has risks and dangers, whichever method you choose.

I had a minor bowel prolapse into the vagina after my first born. During pregnancy with the 2nd this became much worse and my bladder also prolapsed.
I was terrified to give birth vaginally but was told the same as you and went ahead.
To be honest the birth didn't make it any worse, 4 months post birth I feel it's actually improved some in comparison to how it was when I was pregnant. I do feel just the weight of the baby has a massive impact on your down stairs.
I have hypermobilty of the joints due to having very stretchy ligaments, this is also a risk factor. Pregnancy second time out was horrendous I was in constant pain.
Never again.

I have similar issues to you and am currently having phisio to help. They explained that although damage like cutting or tearing can damage the pelvic floor actually the weight of the baby has already caused the problems as the tear or cut is repaired but the rest can't be. But you can strengthen it through excercise which should help with some of your problems. I'd recommend a phisio referral via your gp, I'm sad I didn't do it sooner.

There are different risks and benefits with different births. Plus every mother is different and willing to take different risks!

For some women a c section IS the right choice.

The NHS definitely provide bias information on c sections vs vaginal birth.

They also seem to focus on a straightforward vaginal birth, not the very real possibilities of episiotomies and bad tearing and forceps and so on

I considered an elective section after a horrific forceps delivery and agonising recovery with 1st baby. I decided against and had a lovely natural birth... BUT I know some women who have had planned 'non-medical' c sections and it's the best decision they have made.

It's all about getting all the information, taking into account your own pregnancy risks and deciding what is right for YOU, with INFORMED CHOICE

I just don't get why so many are against women having a choice and making decisions about their own bodies

Unfortunately there is a lot of silence around the long term physical damage that pregnancy and childbirth causes. There isn't a magic way of avoiding the issues. Some of us are just luckier I'm afraid

Sorry I've just read a few more of your posts, you really should seek some help from a phisio as I think they will clarify some of the things you are unsure about, she explained a bladder or bowel prolapse for that matter is a medical emergency yet people seem to think that's what they have all the time (I did) but it's a vaginal prolapse pushing on the bladder or bowel or both. I had issues with my first then twins, vaginal deliveries with all yet in the group I'm in lots of ladies have issues when they've only had c sections too. It is all about the strength and control of your pelvic floor, I'm doing this to hopefully avoid surgery.