To ask for help deciding between ELCS and vaginal birth

[elm26]

Hello everyone

I am 24 weeks pregnant with my first baby and I'm 29 years old.

I've had multiple miscarriages (double digits) and this is the first time I've made it past the first trimester.

Due to my history of unknown cause of miscarriages, endometriosis and my history of anxiety and depression, my consultant has asked me to think about my birth and whether I'd like a planned, controlled ELCS or to allow myself to go naturally.

My placenta is currently low and nearly covering my cervix so of course this could take the decision out of my hands and I have scans at 30 and 34 weeks to see if this has moved up.

I love the idea of natural birth BUT I'm terrified of the thought of needing an emergency c-sec or an emergency in general. I'm naturally nervous of the pain, the length of time it can take etc. I'm equally as nervous for a c-sec as it's surgery and there are risks and the physical recovery is longer, pain etc.

However, if a planned c-sec I imagine it would be calm and controlled (unless something unexpected happened I guess), I'd know the date, I'd be able to prepare myself.

Please help! I'm giving myself anxiety thinking about the anxiety of either! 🤦🏻‍♀️ I really have struggled with this pregnancy, convinced I will lose her at any given moment because of our losses and it's really taken it's toll on me.

I would go for planned CS if it was me
I have had 2, DD was breech and I’m quite tiny so they wouldn’t let me try
DS was not thriving well in womb and they advised planned CS at 34 weeks
Both were very calm and low stress and allowed me to plan for early birth (DD was born at 37 weeks)
Recovery after first took a while but second time around I was prepared and it was much easier
Good luck and congratulations

I had a 5 day failed induction with my first child that ended in an emergency section, it was horrendous. I chose to go the elective route the 2nd time and literally no regrets.
It was calm and controlled, I was so well prepped, I couldn't have asked for more.
Only you know how you feel and what's best for you but if you chose the elective route I don't think you would regret it.

I have had a vaginal birth and two ELCS. I'd go for the ELCS any day of the week. Both times were calm, happy and lovely experiences. Yes you have the recovery, but it's nowhere near as bad as either labour or recovery from severe tearing (which I had from the vaginal birth). That's just my experience though, everyone is different.

I would go for a vaginal birth.

But I’m a woman who has never bore children. I don’t say it easily either as someone who suffered viginismus but when we really have to cope with stuff that is unthinkable we can get through it.

I say vaginal because the only link I get to a numb stomach and there being no help is from women who have had birth surgery and end up with numb stomach because their nerves are cut off. I would give anything not to live with this numb stomach and I don’t even have the delight of children. Only have surgery if the need is greater.

ELCS every time. 100%

Wait until 30/34 weeks and see if you have to have a c section. If you don’t, you can make up your mind then. I think deciding too early can sometimes make it worse because you have too much time to overthink it. I had a similar predicament the first time round and it was taken out of my hands.

I had a drug free vaginal birth .. it was a lovely calm experience - however my experience, or anyone else’s experience is of no significance, you do what’s best for you.

There can be good sections, there can be sections that go wrong, there can be good vaginal births, and vaginal births that go wrong. Recovery time for both can vary .. everyone is different.

You don’t need to justify yourself, listen to the Dr… and listen to yourself

OP in your situation I’d go for the ELCS. You’ve been through enough, it seems like in your circumstances it’s the safer option.

I was in a similar position with DS and I absolutely agonised over it. I spoke to my midwife (who, to be honest, I think recognised I needed the decision to made for me) and she said that, if I’m torn, to go for the vaginal birth because the statistics are on my side and if you’re stuck, go with the stats. I followed that advice, I ended up being induced at 39 weeks and, honestly, it was my favourite part of the pregnancy. I have no regrets at all.

I can’t give any advice on what would’ve happened if I’d had an ELCS, maybe I’d have preferred it. But, for me, the vaginal option was great.

You don't have to decide anything yet and, even if you do make a decision now, you can change your mind.

The lower part of the uterus grows so there is a high chance the baby's placenta will be positioned nicely by the time you are full term.

Aside from infertility and miscarriage induced mental health problems, it sounds like you might be quite an anxious person anyway. I wonder if you could ask your GP for some CBT sessions so that, whichever delivery method you end up having, you feel less anxious about it.

I would definitely go for the elective c section. I had one for my son and was really happy with my choice. It’s planned, calm and you feel in control and supported by the wonderful team caring for you. There is minimal unknowns and the recovery and procedure was fine. A great experience (sending best wishes from another anxious soul)

As the veteran of first delivery forceps (healthy primip with uncomplicated pregnancy) and a second delivery CS maternal request I'd say CS every day

My daughter had an ELCS - she was very very anxious throughout her pregnancy and spoke frankly to the midwives and consultant and they all agreed together not to go vaginal. Correct decision for her and she had a perfect little boy 8 months ago. She said she would make the same decision again

ELCS was a good experience but recovery was terrible. Had an infection which lasted months. Couldn't face that again. VB was fine. Not easy but nowhere near as bad as I'd been led to believe, but I wasn't induced. A lot of it comes down to luck and positioning of the baby. Read the NICE guidelines on CS. If you do opt for VB look at spinning babies and hypnobirthing for some tips. If I did it again I would opt for ELCS scheduled for 41 - 42 weeks. If baby came spontaneously before then, great.

I've had 3 natural births and bled badly for 2 of them so I went for a c section for my 4th pregnancy. It was so much better, it was calm and quick I wish I'd had c sections from the beginning I've recovered quickly and didn't have much pain. The best part of it for me was the fact you have team of people in the room compared to an overworked midwife popping in and out of the room. Everyone's experience is different though. The main reason I wanted a c section the last time was I felt it was unsafe to be looked after by one person pulled in too many directions I felt much better knowing I was surrounded by a team of people if things didn't go to plan.

I’ve had both an emcs and a VBAC and if I had another I’d had another VBAC. My VBAC was unplanned as I’d booked an elcs.
Yes it’s very painful whilst you’re in labour but the recovery is so much quicker. Yes you can have injuries from a VB but a cs can also leave you with longer term issues. I had a very good recovery from my cs.
I would go with the advice from your consultant and I suspect in your case you would be very carefully monitored during labour and they would move to a cs quite quickly.
I wouldn’t worry about worrying about the birth, although you probably will. I stressed about a natural labour all through my first pregnancy and then agonised over the VBAC/ elcs decision for a fair chunk of my second but then had a massive panic at the end and went into labour early and stuck with the VBAC. Totally my choice as the hospital checked and triple checked I didn’t want the cs!

I was you and the consultant said section without question.

I had a vaginal birth with a birth injury that did clear up eventually (after physio) and a ELCS where I have a numb stomach and overhang 8 months later.

ELCS was the right decision for me because my VB first time around was traumatic and emotionally I just couldn’t do it again. But it’s the ELCS which has left me with lasting issues. I don’t regret my ELCS as it was the right call from a MH perspective but I’ve made my peace wit the fact my body isn’t going to be the same as it was / snap back like my first.

Its such a tough call because my preferred option would have been to have a straightforward VB which no one can guarantee for you.

Do you want more children if possible?

Only had c sections so no comparison but mine was elective and a very calm and positive experience. Some friends who had natural births took longer to recover than I did.

Negatives - an overhang over my scar. Not nice. Feel like I hadn't given birth.
Positives - controlled, relaxed, was more awake to deal with baby as I'd not had a long labour

ELCS definatly.
53 years ago there was no choice at all.It was assumed everyone would have a vaginal birth, except as in my case twice when things went wrong then EMCS
I am 4ft 10ins, myDS1 and I both nearly died during his birth by EMCS when my very long labour ended with him going into transverse lie and the GA given during the CS nearly saw the end of us both. Two years later when pregnant with his brother I was assured everything will go well this time.It certainly did not, he got stuck my narrow pelvis during labour, and my uterus was on the point of rupturing by the time the EMCS was done.
I had the tubal tie done as I would never have this done to me or any future babies again.
You have a choice these days.50 or more years ago you did not.

Have you thought of hypno birthing to help with anxiety, whatever you choose?

The problem is, good vaginal birth is easier than CS, but CS is better than a hard vaginal birth. You don't know what you're going to get, it's a gamble. But risk rates of anything going seriously wrong are super, super low.

Your consultant has given you the option for a reason. I would go for elective C Section. Most people have 1 or 2 miscarriages before succeeding not double-digit losses. From experience I can confirm that it will be much more relaxed as an elective procedure. Best wishes 💐

I think I would go for the emcs. We lost two babies before my last and that was hard enough. Due to some risk factors I had an early induction. Early on in the induction they said they had concerns and offered a c-section.

I was so relieved that it was close to being over (waiting and worrying for my son) and we would safely been born soon.

I think having some control back would help.

I’ve had both a VB and a ELCS. With the natural birth I tore badly and ended up being in theatre with a 3rd degree tear. The pain was horrific - no pain relief other than gas and air for the labour & I genuinely felt traumatised afterwards.

Because of this I had an ELCS with my second. It actually was classed as an EMCS as I went into labour 2 days before my CS date so the CS happened there and then instead. I wont lie, entering the theatre I was terrified. The thought of the op was a scary one but it was better than I expected!

Recovery was hard, but that was because I also had a 2 year old. If it was my first baby it would have been no problem to rest and recover! I also had a long and painful recovery from the VB due to the tear but would prefer the CS recovery any day!

In your shoes I’d take the ELCS. Good luck & hope it all goes well! I’m

Another vote for elcs. I strongly pushed for this for myself after a different first birth ending in a crash section. My elcs was very calm and recovery from both c sections was fine, much better than I'd been expecting