To request an elective section for my first baby?

[Catlady90]

Just looking for some opinions/experiences!

I'm due my first baby soon and am thinking about asking for a maternal request section. Ironically I originally wanted a home birth, but at my last appointment they said it would be against medical advice because of my weight (BMI was 30 at booking...I would have lost weight prior to becoming pregnant had this been planned). Also, I have had reduced movements and growth scans as he has been a bit up and down centile wise - all fine now, on the large side...(I do not have gestational diabetes though).

My reasons for thinking of a section are:

• I really don't want an instrumental/assisted delivery and my chances of one as a first time mum is 1 in 3 according to the RCOG.
• I've been told I'm higher risk of a larger baby and shoulder dystocia - although I have had differing views on this from professionals.
• Partner and his siblings were large babies needing assisted deliveries that were traumatic.
• My mum had babies with large heads and ended up with a prolapse.
• We don't plan on anymore children, so some of the section risks I terms of subsequent pregnancies don't necessarily apply.

I'm not anxious about labour per se, it's the after effects. It seems that women are just expected to deal with incontinence as standard, and the more severe birth injuries which seem to be fairly common but not talked about. On balance I feel I would rather recover from a planned section than end up with a traumatic vaginal delivery or end up with an emergency section anyway.

I know it could go smoothly - but it seems statistically there is a reasonable chance it won't. I also feel bad as I know how much more a section costs the NHS.

Any thoughts or experiences much appreciated!

OP doesn’t need to factor in cultural trends or ideology or philosophy or her influence on others when it comes to deciding her preferred mode of birth Twizbe.

She only needs to decide what’s best for her.

I have had 2 sections.

Whilst many women seem to be fine after a couple of paracetomal and are doing pilates classes two weeks after their section you also need to be prepared for it to be harder than that.

My first section required a 5 day stay in hospital. I was in significant pain for several weeks and on strong pain killers for about 8 weeks. It was a pretty miserable existence recovering and took at least 3 months before I felt myself again.

My second section resulted in post-op complications and I was in the high dependency unit for 5 days and hospital for 10 days. The next 4 weeks were a hell of wound infections that had to be dressed and packed at day by the district nurse. I was on major pain killers for 3 months and did not feel normal for about 5 months.

Your reasons are sensible. My baby had a big head and it basically couldn’t drop down so I ended up with an emergency c section.

Before the section I went through lots of rounds of pointless painful induction and with each exam they kept saying how high the head was. I had a feeling it wouldn’t get better but trusted the medical professionals and just went along with it, which was foolish of me. If I could again I’d do an elective section and would for future births due to the likelihood the baby would be stuck again.

@Totallydefeated

OP doesn’t need to factor in cultural trends or ideology or philosophy or her influence on others when it comes to deciding her preferred mode of birth Twizbe.

She only needs to decide what’s best for her.

Sorry that wasn't the intention of my post.

OP should talk through her options with her medical team.

C sections are life saving operations, no doubt about that.

There have been posts here talking about the pressure to have a vaginal birth. There are places where there is pressure to have a c section and that isn't right either.

First births are hard to judge in terms of risk because you have nothing really to compare against.

Also just to add. I am 7 weeks on from my c section now but I’ll never forget those first few days in the hospital. It is very scary not being able to physically move or sit up/ walk, I almost fainted walking to the bathroom the day after. There were times when I cried and wished I’d tried for a natural birth. I had two babies and had to buzz constantly to pick them up/ put them down to breastfeed. It was really bad. Visiting hours were shit. DH was only allowed in 1-7, I think for twins they should have made an exception and by the second day shouted at them to let him stay. It caused me to discharge myself after only two nights when still in serious pain. The midwife even asked if I wanted to go home after 24! I was in disbelief as I could barely stand up at that stage and needed the extra pain relief.

With my natural birth I never felt scared afterwards as I was sore but still completely mobile.

Lilyfalls was it not explained to you that the spinal would affect your mobility and feeling temporarily, but that it would wear off? It really should have been, it shouldn’t have come as a shock.

Fair enough Twizbe.

If Op is in the UK she’s not going to come under pressure to have a c section without a physical reason. More like the opposite - insistence on natural birth even if risk factors suggest an unassisted birth isn’t that likely.

I agree that it’s impossible to predict with complete accuracy how any birth will go for any women. We can only rely on stats across the population.

I wish I had requested an ELCS first time round.

I had an instrumental birth which took months to recover from, has lasting damage to my pelvic floor and I am still medicated for the effects 11 years later.

I went for an elective CS for my second and it was a walk in the park in comparison.

People are keen to list the risks of CS and call it "major abdominal surgery", but rarely fully explain the risks of VB. By the time you've torn badly and been stitched up, that's pretty major, fairly uncontrolled surgery itself, with infection risks too. They claim pelvic floor damage is the result of pregnancy, not birth. But my pelvic floor was awesome right up to the salad tongs dragging my DD out. I ended up with nerve damage from birth - some resolved, some is permanent. That wasn't in anything I read about before birth, and I read every mainstream book on pregnancy and birth going.

And I'd ignore anything midwives have to say on birth. They discharge postpartum women after a couple of weeks and never see the women who experienced the most damage again as those women are too damaged or traumatised to have another baby.

There have been posts here talking about the pressure to have a vaginal birth. There are places where there is pressure to have a c section and that isn't right either

This is the key point, I think. Choice. Women need to know the risk/benefit for each delivery method for their particular circumstances up front and be the ones to make the decision on how to proceed. Pressure to attempt any delivery without clear information can be extremely damaging.

Is caesarean delivery routine for twins these days?

I did OP- had to jump through hoops but got there, and did the same for no 2.

One thing that worked for me was presenting all my arguements in a letter and sending it to the consultant. Which didn't turn up. Good job I had a copy in my bag

If you've done your research and can set out why you want it, and especially that you have considered and accepted the risks, then there's far less wriggle room.

FWIW, both 'easy', BF'd straight in recovery, and no issues, so would do it again. Not that I am ever planning on having any more!

Absolutely go for it! If you want to, that's reason enough.

I can only speak from experience but I had one and it was perfectly, utterly marvellous. Would never do it any other way.

Yes you can ask. But I’ve had both natural birth and elective csection (not my choice)
Would choose natural every time.
Felt incredibly disconnected from csection. Like the baby was being removed rather than giving birth. Hated feeling like I was being burned by a blow torch on my stomach for 3 days afterwards. Literally felt excruciating after pain relief wore off and I tried to stand.
Nothing to say you won’t have a straight forward natural birth - as long as your baby is head down and not back to back. Leave nature alone. Don’t get induced unless 100% necessary. Try to look into making it a positive experience rather than thinking so negatively about it. Not all women have problems afterwards! Vast majority don’t have any!
In my experience I’ve found my csection has left me with a life time of back problems Becuse my stomach muscles were cut and my core has never been the same

@Pottedpalm

Is caesarean delivery routine for twins these days?

No, if twin 1 is head down they recommend natural. Wish twin 1 could have been head down in my case 😭

I am currently on day 5 of recovery from a vaginal delivery. I am healing a deep second degree tear. I had a home birth, and my midwife advised a transfer for stitches because she was concerned it was a 3rd degree tear. Thankfully it wasn’t, but it was veeeery close.

Recovery has been shitty. I’ve been really sore and have basically been bedridden. But this afternoon I have been feeling much better and I reckon tomorrow will be the day I turn a corner. In contrast, my friend had a section 5 weeks ago and is still not allowed to pick up her toddler. She has found recovery from a section long and hard.

I always found the thought of a section to be pretty terrifying because of the recovery involved. I know some people bounce right back, but you also hear about people who have 2nd degree tears who popped a paracetamol on day one and were fine after that (I hate those people right now). So I guess my point is you just don’t know what your situation will be. For me, on balance, I decided that vaginal delivery would probably mean a quicker and more straightforward recovery, but my babies are relatively small. If on balance, with all the info, you have more of an ability to prepare and deal with a c section, then that is probably a good idea. Birth is such an unpredictable thing you just have to weigh up your own personal odds.

I had emergency c section after failed induction where I was in labour for almost 24 hours. The C section was as lovely as it could be and I was so grateful for it. I recovered really quickly and breast fed immediately without any problems. If I have another I will have an elective c section.

@Pottedpalm

Is caesarean delivery routine for twins these days?

They are very open minded. My first twin was head down, second breach and at 34 weeks I just asked for one and she booked in straight away. Never any issues. May just be my hospital but they were more than willing to just go straight to section on my request. I really don’t think many would push for natural?

There was no way I was going to risk some doctor putting their hand in me to turn the second twin! Plus all the damage.. I’m happy with my choice for section for sure.

@OnTheBrink1 my consultant never recommended anything. Just went through risks but it came across that she’d prefer section if anything. Hope you didn’t have too bad of an experience

@Totallydefeated

Lilyfalls was it not explained to you that the spinal would affect your mobility and feeling temporarily, but that it would wear off? It really should have been, it shouldn’t have come as a shock.

Of course but it’s always going to be a shock when it happens. You can never know exactly what recovery is going to feel like.

I was told right from the start that I'd have to have a c-section. I had keyhole surgery to remove a fibroid attached to the side of my womb shortly before I fell pregnant (by accident - long story). The decision was out of my hands and it was a relief actually. I had no FOMO. I had an epidural so was awake and involved as much as I could be. DH was allowed in the operating theatre and took pictures (at my request). Recovery was quick (I was 41 so not some young thing that easily bounces back) and was out of hospital the day after and took baby out in a sling the following day. The scar was neat and barely noticeable.
An elective c-section is a far different experience to an emergency one, which is quite dramatic, full anaesthetic, longer recovery, incision may not be neat. My DH ex had one of these and he said (quoting her) it was traumatic for baby and her and recovery was slow. He was sceptical my elective would be as easy as it sounded but he couldn't believe how calm it all was. My only priority was having a healthy baby and not rupturing my womb.

..

Prior to having my baby, no way would I have considered an elective C-section. After all, billions of people have given birth vaginally! And it's what's best for the baby.

Having given birth, which included an episiotomy and forceps after being induced... Good for anyone who makes an informed decision to have a C-section!

I haven't had both so can't compare, but I found recovery with vagina stitches no walk in the park. At times I felt I couldn't look after my baby properly because I couldn't get up/sit down easily with the painful infected stitches. And my lady parts will never be the same again.

People don't talk enough about the shitshow aftermath some women face after a "natural" vaginal birth.

Of course but it’s always going to be a shock when it happens. You can never know exactly what recovery is going to feel like.

I agree you can never know exactly what something feels like until you actually experience it.

I don’t agree that ‘it’s always going to be a shock’. Not generally, if you know it’s coming. It wasn’t for me. I was expecting it, so it wasn’t a shock. Not criticising you for your reaction btw - just pointing out it won’t be universal. I hope you weren’t left with any lasting trauma.

Your decision, so YANBU.

I had 2 CSs. Amazing experiences. First was after failed induction (didn't go into labour at all) and the CS was great. Second was ELCS and I loved knowing the date/time DC2 was arriving.

There's so much bad press around ELCS, which I don't understand. I felt back to normal within a week of the op, started driving after 2 weeks. I'm the only one of my friends who doesn't have birth injuries (nearly all vaginal, two had a fairly traumatic EMCSs). Vaginal births can be brutal in terms of after effects.