To ask what you would do - planned C or VBAC?

[Rebeccaslicker]

baby number 2 due in a few weeks and I need to decide if I want to plan a c section or have a VBAC.

First was technically an emergency c section following a failed induction (suspected large baby due to GD), but in reality there was no emergency; I waited a few hours between the decision and the operation, it was all v calm (apart from my epic projectile vomit, who knew they have a Henry the Hoover for sucking vomit off everything?!) and I had a quick and easy recovery. That was 2.5 years ago.

This time will be the second labour; the baby is so far measuring about 75th centile; and is so far in a good position for labour. The hospital calculate I'm low risk for rupture, blood transfusion etc.

Could I ask people who've had a similar decision what you did and why? I can't decide which is better!!

My first was an elcs for a "true breech". Terrible recovery. Hated it. I felt useless as I could hardly stand or walk, stitches opening etc. Yuck. I reacted strangely to the spinal block too and felt so drugged up afterwards I couldn't even hold my baby until the next day. Second was a vbac with no pain relief (not by choice!) and it was soooo easy in comparison. I actually felt elated afterwards as I'd been terrified of having another cs. That being said, no two births are the same. Go with whichever option is less scary for you. If you found the first cs easy then there is no reason to think a second would be any harder. Good luck!

Tableshack...for my three friends i know (18 months ago now) they couldnt bend and werent allowed to drive for 6 weeks. That is a fact in their case. Not sure how thats scare mongering as its fact for the three friends i had who had c section. Ive got a friend who had a sos c section three weeks ago and still in hospital now. She did get home for 24 hours about a week ago but had had to go back in. Hoping she go home soon as shes getting fed up of being in. Not sure if thats our hospital though.

My first birth experience sounds almost identical to yours. For my second I decided to go for a Vbac because I wanted to know what it was like to go into labour naturally and to have a different birth experience. Plus the potentially easier recovery. I ended up with a Vbac with forceps and a third degree tear (which upset me at the time but healed pretty well). Overall I’m happy with my decision but only because I would always have felt like I missed out on something otherwise. But a part of me definitely wishes I had gone elective c section as I now have some discomfort when having sex and more pelvic floor issues than I had after first birth. Of course an elective c section could have gone even worse - I will never know! If I had a third it would definitely be elective c section and I would advise friends to do the same for their second in a similar situation UNLESS they were really keen for Vbac.

I was home 48 hrs after elective section, driving at 3 weeks. No issues at all.

The 6 weeks no driving after cs is a myth. People have checked motor insurance policies and have not been able to find such a prohibition. The only requirement is the ability to do an emergency brake. I was able to do that after a week but waited 2 weeks just be to be safe before driving again. 6 weeks is only for very bad recoveries but the majority are up and about pretty soon.

I have had 2 cs, one emcs and one elective and spent time in the post natal ward with other women who have had cs. I am usually the worst, in that I cannot move for 48 hours whilst others were up and about within a day. But after 48 hours, my recovery was quick and uneventful. By the time the stitches were removed after 5 days, I felt 80-90% of my old self.

@londonrach We're talking about elective c sections on this thread, you're talking about emergency sections.

OP, you already have the sun roof. Might as well use it.

Assuming you are not planning on having any more children, take the elcs. It is like buying insurance. You will never have the euphoria of an easy natural birth, but you will have a calm scheduled uneventful delivery from which you will most likely heal well (since you healed well from your first),. Most importantly, you will avoid another emcs (the riskiest situation) and a bad natural birth (the worst outcome, IMO).

For example, here's Aviva's policy on driving

Even after my emcs I was walking 16 hours later, I could bend, I could drive after 2 weeks (insurance company weren't interested in how many weeks post op I was, more interested that I could properly operate a vehicle).

I'm in the same position as you op. 21 hour labour with dd after being induced. Didn't get past 3cms. Yes the pain was an inconvenience but all in all my emcs wasn't awful.

I'm pregnant with dc2 (only 7 weeks) and already thinking. I'm leaning towards elcs, purely because I don't want to risk having the same experience as before. Being made to lay on my back on a monitor, a drip, blood pressure cuff etc. It fills me with dread. I know there is a chance it could go well and I'd have a successful vbac but I don't know if I want to take the chance. If only we had a crystal ball!

My first was an emergency C section. It went badly - the next morning it was discovered that I'd bled badly in the night and I had to have another op (to see if they could work out the problem, and they couldn't) and also have a blood transfusion.

I was in hospital for five days and very ill afterwards and at home I coudn't get out of bed for quite a few weeks and was very sickly and vomiting.

It was the most difficult and miserable experience and I still feel traumatised thinking back to that time!

Three and a bit years later I hired a private midwife as I was too frightened of going back to hospital after such a bad experience (the after care was awful there). I had a home birth with no pain relief and it was so much better to be able to bond with my baby at home without pain and sickness.

But if I hadn't had such a bad hospital experience then maybe an elective would have had more appeal.

OP you need to weigh up the pros & cons & trust yourself that you know whats right for you & your body.

I would go for ELCS! Unfortunately I was trying for a VBAC but that didn't happen. I had placental abruption during labour (10 hours of painful contractions, then suddenly was bleeding badly) so ended up with emergency cesarean under GA and my DD was kept in neonatal unit for 2 days. Scary experience. We are both fine but I regret my decision to do vbac.
Recovery took longer than with first CS and had to stay in hospital for more than a week.

After a LSCS- The general rile is when you can do an emergency stop. Doctors will tell you to check with your insurance company. Insurance company will tell you to check with your doctor. What does that rule tell you? Clear as mud? I think some common sense needs to come into play.
DOI -doctor

After much deliberation I went with a planned section second time. Mostly because I didn't want to go through planning to have VBAC and ending up with a section anyway. Plus most of the disadvantages seemed to be with having more children which I have no intention of doing. Reading this I am glad of my decision

First birth I was induced which didn't work. Doc broke my waters at 2 cm and I think I only ever got to 3 on the highest dose of whatever they give you. I had all the drugs, the alarm went off a couple of times when they run in to find the heartbeat but I had to be the one to say I wanted a section. All that took about 2 days so I was shattered when baby arrived. By comparison no 2 was easy and recovery much quicker. Which was just as well because DD2 was a terrible sleeper!

londrach I wish I could say that the pain stopped after my vbac. I was in severe pain (from the stitches) for several months afterwards and incapacitated from weakness for a similar amount of time from the amount of blood I lost from the postpartum hemorrhage. As I said above, my recovery from my emcs was far quicker. I was driving and shopping at the mall 3 weeks later. And it's my understanding that an elective cs is even less traumatic than an emcs because you don't have the labor preceding it.

Another thing, OP - because both my DCs were ELCS, we knew when they were coming so went out to dinner the night before and had a lovely time. I also got to pick my children's birthdates.

I know that a CS is seen as a major operation with major risks, but I'd take those odds any day over the stories I've heard from women on MN who have had serious tears during natural birth, and the lasting and deeply distressing consequences afterwards.

Table...my three friends who had c sections 18 months ago were elective for various reasons including one beech. They the ones who couldnt bend or drive. My friend in hospital still with her sos c section hasnt told me if she cant bend but cant drive as when shes out im hoping to visit her for baby hugs when shes says its ok

I had an ELCS eleven days ago. I can definitely bend, walk, feed my baby, bath my toddler, put my toddler to bed, light housework, cooking etc etc.

I met a woman at breastfeeding clinic last week who had a forceps delivery at the same time I had my ELCS. She could not walk, but had to shuffle. She was clearly in pain. One of the midwives even asked if she’d had pain relief recently. She said she had. Her husband was walking around behind her carrying a u-shaped cushion - not for breastfeeding, but for her to sit on. The midwife at the clinic said she was still better off than if she’d had a CS though .

Obviously, that woman’s situation is not the case for most women who have VBs, (I have had one myself and recovered pretty quickly, with minimal injuries. It was the infection due to waters breaking earlier than we initially thought and poorly baby following long labour, shoulder dystocia etc which were the problems).

What I find a bit silly is when HCPs and some others insist that VB is the best outcome, when sometimes it clearly isn’t.

@londonrach I simply don't believe you. You have an agenda. There's just no way three people who had elcs can neither bend nor drive after six weeks. I think you need to make up a more realistic story.

When I was trying to decide what to do for DS2 I found that looking up the stats for my hospital really helped - mine has a 50/50 chance of ending up in emcs when attempting vbac and for me that was far too short on the odds so I decided to opt for an elcs so I don't risk hours of labour just to end up in emergency surgery later on anyway. Mine is due in a week or so and I feel much calmer about the elective than I thought I would.
I did also put into my notes though that if I went into labour spontaneously before 39 weeks I would give vbac a try. I can't be induced because my body had a massive over reaction to the pessary with DS1 and it is probably the reason we ended up in emergency surgery in the first place.
Check out the stats for your hospital on which op, it might make the decision easier to settle on 😊 and fingers crossed for a smooth pregnancy

One of my friends had an ELCS the same time as me in another hospital. She really struggled & didn’t really leave the house for 5 weeks (she had help so wasn’t forced too). She didn’t feel physically capable again till at least 3 months. I also had another friend who had a tear & forceps & had to sit on a round cushion for 10 days.

Everyone is different & every birth is different.

Get a c-section

Comments phrased like this really irritate me. Fine to say your experience but don't dictate to the OP what she should do. It's not always a straightforward decision (...which is why it's the subject of so many MN threads).

OP, one thing to bear in mind is that on the whole, MN seems to be unusually pro c section. Compared to people I talk to in real life. That obviously isn't to say ELCS won't be the right choice for you personally but it's just something to bear in mind. I do think the advice on here can be a bit unbalanced on this topic.

Table. Its the truth. No agenda. Why would i. Maybe i was lucky but i had dd by vbac and was working as self employed a week later for one hour whilst dh looked after dd. I did consider c section but weighed up than apart from the last week id had a healthy pregnancy. Theres risks and benefits with both.

Im sorry you had a bad time Sofia. In our group maybe weve been lucky but the only ones who struggled where those who had c section. I think in your case sofia id go for an elective ashaving both you and baby ok is the best result, who cares how it happens.

My first was born by C-section - Not planned but no real emergency either , just a bit stuck ( not distressed), and had been in labour a while so they decided on C-section.
I had ds2 18 months later by VBAC. I don't actually remember being given a choice to have another C-section , it seemed to be decided for me to have a VBAC which was fine and was all straightforward except for ds2 being born at 34 weeks. The actual delivery was fine. I then went on to have 2 more VBAC's including one large baby ( Nine pounds four ). All 3 VBAC's were unproblematic.

I had an emcs in 2006 for failed induction also (induced due to preeclampsia). I had my second baby in 2008 and went for vbac, but I remember thinking thst there was nothing natural about it, as I was to be strapped to monitor for the whole time and I wasn't looking forward to that. They didn't want me to go over due as risk of wound rupture was higher and induction out of the question (there was 23 months between births) so I was booked for an elective at 40 wks if I hadn't gone into labour by then.

I just went with the flow, not really knowing what to expect but I went into spontaneous labour at 39 wks. Contractions were all over the place with no regularity. I was triaged and they found that I was 2cm so under 'normal' circumstances would have been sent home.

Luckily they found me a room as I was fully dilated within an hour and my body was pushing involuntarily. They had no time for monitors etc and dd was born within an hour.

All in all it was a good birth in the end, but you can't really know what is going to happen, so I'd just suggest thinking about what you'd do in each scenario to feel in control. As soon as you feel out of control, birth can be a scary experience.

I say went with the flow, but I'd written a birth plan to cover the details that I could control in either scenario, such as skin-to-skin, vitamin k, etc.

For me it was definately about 'accepting the things I can't change, having courage to change the things I can, and the wisdom to know the difference!'

If you can feel more relaxed about it, it will help you x