To ask for an maternal choice elective C-section?

[Miphy]

I am 20 weeks with first baby- name changed for this thread.

Prior to pregnancy I was already leaning towards requesting a section. I am a doctor, not working in anything related to it now but obviously spent time in obs & gynae placements.
In my obstetric placement we had to spend a week with the midwifery team so that we had a chance to see ‘normal’ birth. Without exception every single birth I attended went ‘wrong’ and either ended with assisted delivery- forceps, episiotomy, in one case horrendous tearing, or emergency section and massive postpartum haemorrhage.
In contrast elective section list was lovely- but wham bam baby out, happy well rested mums.
Then later in gynaecology saw clinic lists full of women with birth injuries and PTSD.
This massively influenced my perception of birth.

I had thought more more about water births, hypo birthing etc and thought I may as well give it a go vaginally.

However the more reading I do now about birth the more I read about horrendous birth injuries, and of my friends the ones who had sections all fully recommend it whereas some of my friends who have had a vaginal birth have told me some pretty horrendous stories. One still can’t have sex two years later. I know there’s a recovery after section but somehow surgical recovery seems more straightforward and I’m not short of hands on help and support- both our mums are retired, husband works from home, all very keen to provide hands on help.

It feels to me like an elective section involves known small risks, I know what I’m getting. Whereas with a vaginal birth I can have some lovely water birth, minimal tearing, quick recovery, or I can end up exhausted from a prolonged labour maybe with a wrecked undercarriage, maybe a distressed baby and then even potentially a high chance of needing an emergency section with even higher risks. And it seems I won’t know which way it will go until it literally happens. It really feels like the injuries by women after vaginal birth are minimised and you’re just supposed to deal- so they aren’t treated as ‘risks’ in the same way.

I find myself hoping the baby is breech so my decision is made for me. I’m thinking Of asking about maternal choice section at my antenatal clinic appointment. I wondered if anyone had any experiences or any advice?

I had an ELCS, be prepared for the consultant to try to talk you out of it & offer you the moon on a stick instead. I stuck to my guns & she signed it off, had a fantastic birth & recovery. No regrets. Wishing you the very best of luck.

From what I hear from doctors is they all go for c sections (sample size of doctors is small!!)

I would have an ELCS every time. I allowed my doctor to talk me into having a natural birth the first time round and it was an absolute nightmare. Every day I thank my lucky stars that my child made it out alive. Natural childbirth is a total lottery IMO and so much can go wrong. Elective caesareans feel so much more controlled and safer.

No, I don’t think any woman is ever unreasonable for weighing up the risks (and benefits) of vaginal birth against the risks of a c-section and deciding which risks she prefers.

My experience was that once a vaginal birth goes tits up, some of the risks are the same. I needed surgery (twice) to repair my tear. So I had the risk of blood clots (had to wear surgical stockings and take blood thinning injections, just like a mum who’d had a c section would); infection (had to take prophylactic antibiotics; catheter (had a catheter in for over 24 hours); and anaesthetic (needed a spinal for the first surgery, GA for the next).

The problem is there’s no way of knowing. You may have a section which may have complications.

The likelihood of having serious complications from a controlled elective c-section (both to you and your baby) feels minimal compared to those that can result from a natural birth or induction that goes wrong.

I still kick myself several times a day for listening to the ‘natural is best’ propaganda - I truly feel that natural birth is unsafe and induction is downright dangerous.

YANBU. My 'easy' water north left me with injuries which were overlooked for months because 'no you can't have that problem, you had an easy delivery!' Turns out I did have that problem and physio has done wonders, but it ruined my first year of parenthood.

ELCS with second and it was a much nicer experience (but giving birth just isn't fun). I felt more normal at 6 weeks PP from my ELCS than I did at 14 months after my vaginal delivery.

I was also swayed by the ‘c-section is major surgery’ argument, which I now realize is greatly exaggerated. I ended up having an (emergency) c-section anyway when my birth went wrong and instruments didn’t work. Physically I actually recovered from the c-section part very quickly, even though it was an EMCS. So it certainly didn’t feel like ‘major surgery’. Mentally though I’m scarred for life - in a way I know I wouldn’t be if I’d had a calm and controlled section.

@Draineddraineddrained - so, is the OP supposed to use statistics to help her make this decision or not? Because basically what you’ve said is that all the statistics regarding VD are useless and unrepresentative.

Which is beside the point anyway. The fact is that less than half of VDs do not receive intervention. Maybe some of that intervention is unnecessary, but it still happens, and OP has to make her decision in the context of actual reality and not in the context of some utopia in which only necessary interventions are ever applied.

• to clarify my last post - I’m mentally scarred from the birth going wrong, resulting in instruments which failed and then the stress of racing against the clock to get the baby out quickly. If I’d had an ELCS I wouldn’t have had any of that trauma. I’ve since heard that hospitals push women to have natural births solely to keep costs down.

I had a forceps delivery (very difficult) with my 1st baby but then had 2 amazing deliveries after that, felt amazingly empowering birthing a baby. I don’t think one week can dictate how all births go. I will say though between me and my friends it’s around 50/50 between no complications or an emergency C section

health professionals can be very "this is what we're going to do" to labouring women and you need to have gumption to stand up to them and remind them it is YOUR choice, always

This. I didn’t have the confidence to stand up to them and I now have to live with that.

But, a month after each I was pretty much physically recovered and well enough to cope alone (husband worked away all week) and enjoy the babies.

A month?!

I was up and walking miles after 2 weeks after an EMCS

The fact is that less than half of VDs do not receive intervention

That does not mean that those women aren't left with permanent damage

It's your body and your choice it's not unreasonable at all.
The problem with birth is that women are often pushed in directions they don't want to go in for fear of their baby and stress does the exact opposite in labour same with a lot of the drugs too early. You have to be pretty damn determined to stick to your guns!

I absolutely refused to be induced for instance was told I had to which was a lie more regular scans can be offered instead for monitoring. I think many mums also don't get told if baby is back to back. Mine was for weeks leading up to his due date but my midwife told me so I did spinning baby exercises to get him to shift!

I had a very quick birth of less than 6 hrs start to finish and used the pool, my baby was big as well. Other than contractions stopping when his head was out and he needed a bit of a tug by the midwife there wasn't many issues. I did have labia tears (didn't know that one was possible!) and a very small perineum tear but that was it.

I'm very stubborn and in future when/if that happens it will be the same water birth or an elcs if they put me on a red pathway. Go with your own mind, read up but also stick with your guns and instinct!

A month?!
I was up and walking miles after 2 weeks after an EMCS

Is it a competition?
I had a good CS recovery & VB recovery but it's ok to rest & let your body heal. Do what's right for you.

Absolutely not unreasonable It’s your birth and your choice! But I do think you have rose tinted goggles in regards to csections, I had a bad vaginal delivery I ripped half my flap off if we’re gonna really get into it. I had to be stitched internally first then externally and it was definitely more painful than the birth it’s self. I was a little uncomfortable for around 24 hours but otherwise fine in fact I was back in pre pregnancy jeans 5 days later and had a little walk around town with my new pram. Second baby was a csection, emergency if that makes a difference and oh my Christ the recovery. I had to be given Oramorth the first 2 nights I had to be showered by my partner for days I could nearly stand through the pain every movement was like my insides was about to fall out. Horrendous pain honestly and I’m not even a wimp my pain fresh hold has been considered quite high by multiple health professionals. I went for my first little walk 7 days later and got a bastard infection that was just the icing on the cake tbh. Oh actually no where my scar indents it’s caused my stomach to form a ‘pouch’ lovely...my labia scar on the other hand is practically invisible.
If I have no3 I’ll be trying vbac unless it’s absolutely out of the question I’ll be trying for vaginal 100%. Couldn’t pay me to go through that again.

YANBU. Go for whatever birth you want. 4 labours all vaginal, 2 inductions, 2 spontaneous. I was pressed for a C-section with dc3 after induction failed to progress and partly as it felt it was more convenient for the Labour ward. Pressed for a C-section with Dc4 too. All but one of DC’s births were lovely, active, no pain relief, without complications or injury during or after (one was a drip induction, rather fast and a hospital cockpit). I had Gestational diabetes with 3 of my pregnancies and was given the grim scenarios at every appointment whilst being pressed to go for either surgery or induction. Whatever you go for, don’t be swayed but keep an open mind, do what’s right for you & baby and good luck.

@itsjuly is spot on, never experienced any different
Wish I had, had the confidence and attitude I had with Dc4 with my other labours.

Oh actually no where my scar indents it’s caused my stomach to form a ‘pouch’ lovely

I had this after my EMCS, but it disappeared after a couple of weeks. My stomach is now as flat as it was before pregnancy. I’m not trying to brag - just saying that it’s not always like this!

@nonono1 do you have zero indent where the scar is?

@notapanday zero. It just looks like a faint line on my skin now.

that must be unusual though? I've never seen a scar on the body that doesn't indent the skin in some way.

@spinningspaniels

Having had 2 emergency C sections (def not through choice) I've had 20 years of chronic pain from surgical adhesions.

It makes me really angry when people discuss major abdominal surgery as though it's a breeze.

This. Emergency c sections are traumatic. Especially when you know the only safe way your baby is going to be delivered means getting cut open in a matter of minutes. The pain after is horrible, i don't care what abybody says. The worst part for me was watching my baby scream and i couldnt move fast enough and novody was answering the buzzer! Think very carefully because its not any easier

It makes me really angry when people discuss major abdominal surgery as though it's a breeze.

I was actually quite shocked how blasé the hospital were about it. At 17 I had my appendix out & was in for 5 days & on morphine. CS, sent home the next day with paracetamol & a new born!! 😆

No, I don't agree. I admit I was in a lot of pain the day after my ELCS ( although could still walk to the bathroom etc.). The day after, minimal pain (and I went home that day). It was easier turning in bed for example than when I'd been heavily pregnant. I went shopping the day after.
Obviously this may vary but an E Ok CS CAN be very quick to be recover from.