To think C section is the best birth option?

[LilacSky95]

I've had 3 vaginal births and 1 c section. The recovery from the vaginal births was a breeze, but I've been left with a host of issues from those that will last a lifetime.

My c section recovery was harder, but after the initial pain etc were off I was ok, and it was so nice to be intact 'down there' afterwards.

AIBU to think surely it's better to risk any of the problems that can arrise from having a section, over all the awful things that women often have to deal with for a lifetime after vaginal birth?

Yes I know c section is major surgery, but loads of women end up needing surgery to correct the damage done by vaginal birth too, and even then will never be the same again. At least your problems that come with a c section will be sorted out at least 12 months after delivery, and tour vagina is unscathed.

I've already had one lot of surgery to try and fix my prolapses, and will need more surgery in the future. I cant help feel jaded that if I'd had c sections I wouldn't have to go through all of this so maybe my views are skewed. What do you think?

I don’t think there’s any better way to give birth but I think that the risks of sections are often focused on and tbe risks of vaginal births downplayed. As a first time mum, your chance of an uncomplicated spontaneous vaginal birth is only 50% - the other 50% either have an assisted delivery (around 25%) or an emergency c section (around 25%). So even before you start, if you opt for a vsginal delivery you’ve got a 25% chance of ending up with a more risky c-section regardless.

You’ve got a 5-7% chance of having a 3rd/4th degree tear, even if the birth is classed as ‘uncomplicated’. One study found that 48% of vaginal births report some degree of urinal incontinence compared to 27% of c sections, so the risk isn’t removed but it’s much less. The increased risks relating to c-sections are actually very very small risks increasing to slightly higher but still very small risks. And as mentioned, these stats often combined with emergency c sections.

I’d love a guaranteed uncomplicated vaginal birth but it’s literally a 50/50 chance, and so I’m going to be opting for an elective section. Having said all this I think women must be allowed to choose.

The data I’ve used is from here:

www.nice.org.uk/guidance/ng192/evidence/a-the-benefits-and-risks-of-planned-caesarean-birth-pdf-9071941646

www.nice.org.uk/guidance/ng192/resources/appendix-a-benefits-and-risks-of-vaginal-and-caesarean-birth-pdf-9074971693

And this also makes for an interesting read, although not U.K. based - www.cmaj.ca/content/cmaj/193/18/E634.full.pdf

You haven’t included the risks and benefits for the baby in your calculations. Vaginal birth is far from perfectly safe, but it also helps clear lungs and guarantees that the baby is indeed ready to be born. Just as babies can suffer injury during a vaginal birth, they can be injured during a c-section.

I've had 2 VBs without any problems or long term bad effects (children are adults now). I agree that potential consequences of both VB and c section should be discussed so that people can make an informed decision.

The issue with the stats quoted here is that they are not personalised.

For every woman the risk profile is unique. Her age, physical health, baby's health, gestation, position for labour, previous obstetric history etc all feed into these risks.

My first birth, which was vaginal, was horrendous. My second, which was a section, was brilliant. If I were having any more, which I am most definitely not, I wouldn't even think twice about it, elective section all the way.

I’ll stand corrected as I don’t have evidence to hand but are babies not more likely to die/suffer hypoxic brain injury in vaginal birth, for example if they get stuck?

I agree that for the majority of babies who don’t suffer that fate, there is evidence of baby being more likely to be on NICU after a c-section.

Have had 2 VB, 1 was a 2nd degree tear, the other an episiotomy, and I was still healed and feeling better before my sister who had a section 5 weeks before I delivered (the one with episiotomy). I was able to be Up and about straight after birth, whereas she couldn't even lift her baby for a week and had to be handed him!
VB every time in my opinion! It's the way we're designed to deliver. Can't wait for my third!

This debate always makes me slightly annoyed. I really think the poor maternity care women receive leading upto, during and after birth makes it an unfair debate.

If we could guarantee that each woman giving birth had a dedicated, well qualified team around her during VB I wonder if the stats would favour VB more? Possibly not but that is something I wonder about.

So for example - if there were not pressures on resources the decision to go to CSec might be made earlier and not a ‘emergency’. Or there would be free physio for ALL women after birth.

Either way what is essential is that womens voices are listened to, that their right to choose is central to decision making and that their lives are valued. Unfortunately the current state of affairs is a long way off from this, particularly so if you are black or a woman of colour.

No it’s not easier , I had an emergency c section under general where I haemorrhaged and also got sepsis. I then got acute urinary retention where my bladder almost ruptured - excruciating. I also have adhesions causing me pain four years on.

Childbirth is hard either way.

@mynameiscalypso

Re my last post - mine was an emergency after a failed induction so your comment makes sense actually - maybe that’s why I had so many problems as it’s riskier. Perhaps an elective is better , still think I could of contracted the sepsis though , just awful 😩

1 of each. C section was tonnes better. Faster, less painful recovery and no long term issues.

On the whole I think c sections are a more civilised way of giving birth. I was fortunate to have the choice and even though the recovery was probably more difficult than a straight forward vaginal birth, the peace it brought knowing it should mean my dc was brought into the world safely was worth it. As it went I found the section recovery quite straight forward and was lucky to have no complications.

With my births, my c section was a million times better.

But recovery, vaginally birth was so much better.

It honestly depends on the circumstance and the person and (unless there are already known complications - eg my son was breech) - you're not going to know for definite until it's already happening!

My friend almost died from her vb. But another friend lost heaps of blood in a problematic cs. You just don't know what's going to happen.

I had one unmedicated vaginally birth with an episiotomy and forceps (so not great basically) and one cat 1 emergency c-section which was also not great. But I also understand that my recovery from the c-section was not typical (literally only allowed to drink 10ml of water every hour for 24 hours post op, on the HDU unable to close curtains for 48 hours after, catheter left in to monitor urine output for days, hooked up to continuous IV drips and monitors for days etc.) But frankly I preferred my recovery from the vaginal birth! I have complications from the c-section too sadly so I can't say that they are a better way to give birth. I don't think there is a 'better way' to give birth, other than the safest option for the mother and baby and that won't always be what the mother wants (I wanted a home birth with my second....got the complete opposite).

I’ve only had c sections, so can’t compare to vb:

dc1 - emergency CS for foetal distress (exhausting long labour).

dc2 - elective CS with big (approx 1200ml) haemorrhage (needed transfusion).

dc3 - the dream elective, no issues.

I recovered very quickly after all 3 though.

Biggest downside as far as I’m concerned is the risks in subsequent pregnancies. These increase the more cs you have and some of them can be very serious.

For me I had a planned CS: it was bloody wonderful.

@Ponderingwindow

difference to the baby is minimal

but it’s huge to the mother

I've been really interested reading this thread, currently expecting my first, 16 weeks and no midwife has mentioned the birth yet.
My mum had 3 relatively easy vb's (one born with cord round neck) and has no major issues now 25+ years on except bladder weakness which pregnancy causes anyway.
My sister had an induction, failed epidural, forceps, haemorrhage and a week in hospital. she's now 30, urinary incontinent and begging her GP to help her.
I've no idea what I want because I don't know enough about my options, C section was always made out by my mum to be a wimpy option but after seeing what's happened to my sister I know she's just arrogant because it was easy for her. Hopefully I can talk to my midwife and decide for myself what I want.

And if you had, and had still had your 4 children, all by c section, you would have been at significant risk of placental issues; praevia at best, percreta at worst. A friend had percreta on her 4 th section, died 3 times, had 24 units of blood, a hysterectomy and has ongoing bowel and bladder issues as a result of the placental tissue. The friend of a close friend died from percreta with her 3rd child. The baby was fine.

Multiple c sections are NOT better than multiple vaginal births. If you are definitely having just 1 or 2, maybe. Any more than that, it's more dangerous.

Two VB, one CS. No complications following the VBs, fast recovery afterwards, no ongoing problems with my vagina or cervix. Sepsis after the CS. No contest, VB wins every time.

@LuckySantangelo35
That is a bold statement to make without any evidence.

i am not an expert in this subject so I can’t make a definitive claim. I I only know that there are trade offs and that I personally was injured during my birth by c-section.

What are women’s experience of getting an elective c section with the NHS now?

I had heard it could be difficult, you would really have to argue your case, maybe have to ask to see a different consultant etc

have things changed? I hope so!

My induction with DD2 was better than my non-induced labour with DD1.

Obviously I know it's not like that for everyone, but just an example of how experiences are so varied, which is why I think OP is wrong to say there is a best option.

3 births, all vaginal - two instrumental (ventouse), one of those with an episiotomy and PPH; one as a response to fetal distress at the very end of a short labour and causing a second degree tear - and the third induced, no instruments, and very precipitous indeed. I had/have uncomplicated recoveries and no short- or long-term problems whatsoever, was on my feet again right away. All of those deliveries had the potential to be traumatising, I think, esp the first, but none of them were. That's partly, I think, to do with having had focused and responsive care. I imagine some PP think my births sound like complete nightmares, but I was glad I had them all and suppose I just wanted to put the other side - that even quite complicated vaginal births don't necessarily lead to devastating long-term consequences.