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.

DC1 vaginal delivery with forceps.

DC2 Section as baby was transverse.

Without a shadow of a doubt C Section.

I don't feel I missed out on any bonding with DC2, in fact I bonded with them better as first delivery was so traumatic i think I was in shock for a few weeks. No issues breastfeeding. Fully recovered quickly from the Section, was much easier and quicker than I expected. Have never physically fully recovered from the vaginal delivery. I really wish I'd had a C Section with DC1

Wish you all the best OP.

ELCS all the way! So much nicer, and pain free than a natural birth!

I wouldn’t risk having an natural birth with the issues you’re having. There are too many variables. ELCS is much more controlled.

My home water births were the loveliest, calmest experiences of my life. I would choose them over any c section ever.

But you have to be prepared to take the risk that it won't be like that. An elective takes away the risk, but also takes away the possibility of the absolute best outcome.

Only you can decide which of those matters more to you.

From my perspective, ELCS is the best thing ever. It was truly wonderful. Never had a vaginal delivery so nothing to compare it to. That said, I’m not one of those women who is pre conditioned to think that giving birth without pain relief is something to be proud of.

For my complicated pregnancy and health issues I had a home waterbirth. It was safer and calmer with less emotional or physical difficulty. Being in the water throughout labour meant I didn't tear or anything and was back to normal very quickly. I was in my own well prepared space with privacy, a midwife for me and one for baby. Getting straight in to my own bed after was the best thing.

I was in your position and went with a planned c section. I discussed it at great length with my consultant and consultant midwife and we all agreed that I was so stressed about something going wrong that this was likely to inhibit a successful labour and increase the chances of needing intervention. I also felt that due to my state of mind if something went wrong with the labour I would never forgive myself.

I was also told that interestingly the data re c section safety looks at c sections as a whole and therefore factors in emergency c sections. But in reality a planned c section has less risk of adverse outcomes than a natural delivery.

No regrets at all. The recovery was pretty simple for me luckily and I was able to establish breastfeeding.

One question I find helpful to ask medical professionals is "what would you do in my position?/advise a loved one in my position?".

I’d personally NOT go for an elective for a first birth.

I have a similar history to you - many miscarriages/ectopic pregnancies. Horrible anxiety.

I was told I could have a c section if I wanted, but also got offered counselling with a specialist midwife, a free hypnobirthing course, etc.

Ultimately I decided to try for a vaginal birth. I did end up with an emergency c section, after a long labour, but it didn’t feel scary at the time. I didn’t have much time to get into my head about the surgery, and by that point I was just so relieved that the pain had stopped to be honest. The c section itself was fine. Recovery was good - honestly, my boobs were sorer than my stomach. By day 4 we were out walking with the pram, going out for lunch ETC.

When I got pregnant again (after more miscarriages and another ectopic) I decided to have a planned section.

The section itself was HORRENDOUS. I had to be given anxiety meds every few minutes for the whole thing, I dissociated and was drifting in and out of awareness. My anxiety in the lead up to the c section was far worse than in the lead up to my (attempted) vaginal birth. I also ended up with horrendous shoulder pain, far worse than the section pain itself.

That being said, I did have a great recovery second time as well - even better than my first. He was born on the Thursday and I hosted a (smallish!) party on the Sunday night after being at the supermarket and at soft play en route home the day before.

No brainer, no drama, ELCS.

I would go for a vaginal birth.

But I'm not you.

I've done both. Before having kids I'd have always chosen the vaginal birth. Now I'd pick the C-section every time, which was a doddle by comparison. Recovery absolutely fine too.

There have been so many of these threads recently. They always go the same way, the OP has too much anxiety about vaginal birth, other posters re-enforce it with stores of horrific vaginal births and easy Elecs.

The OP goes with the Elecs.

Sorry OP I wish you the very best for your pregnancy it really has been a difficult road for you.

Personally I had a very hands off home birth, it was beautiful. A really empowering experience, I was
in awe of what my body could do and very much enjoyed being in the comfort of my own home. I wouldn’t of had it any other way.

Everyone should be entitled to try for the type of birth they prefer whether this is an Elecs, a home birth or anything in between. You don’t need anyone’s permission.

I had a prolonged, difficult labour followed by an emergency section. The worst of both worlds, though the CS was a relief and the end of suffering.

I'm mentally scarred and will never choose to conceive again.
In a different scenario, I would fight tooth and nail for an elective section.

The thing that makes me less keen to say go for an elective is that it’s so final. If you choose vaginal, you can always change your mind as labour progresses, but if you choose elective section you can’t exactly say stitch me up and let me push mid section.

The answer to that is if you have a vaginal birth, you have no control over the outcome. If you don't want an emergency cs or forceps or ventouse, you could not say nah, I'll stick with no intervention natural thank you very much. By that time, it is an emergency and all choice goes out of the window.

With ELCS, the theatre is properly stocked with staff and the outcome is calm.

My post was in answer to Gneiss who said a elcs is final.

This is a very tricky decision and I really feel for you. I've had both a natural and an ELCS. My first natural birth was very long (4 days) and resulted in a forcep delivery and a bad tear which required theatre treatment. No way of sugarcoating this but there was also damage to my bumhole - whilst being sewn up the surgeon recommended I do not have a natural birth again. However recovery was good. For my second I was offered a elcs due to the damage caused and also there were concerns of may suffer from incontinence from both ends 😢. Yes you are right in that it was a much calmer experience going in for an elcs and a quick delivery, but my goodness I found the aftermath excruciating. I was in debilitating pain for over a week and bled terribly. My DC2 is now 6 months and I now feel I'm turning a corner. After the awful pain wore off I was left with deep aches, very strange numbness / pins and needles sensation on the scar site and could not bare the area to be touched up until about a month ago. I also have the c section overhang. It's definitely no walk in the park. But it's one of those crystal ball moments that I will never know what the outcome would have been if I had gone for natural. BUT I have lots of friends and posters on here that have had excellent c section experiences.

You will be monitored very closely and like you say the decision may be taken out of your hands. Easy to say but try not to worry, you don't have to make this decision for a good few weeks and the more you speak to others / read about positive birth stories, the choice will slowly come to you. Good luck 😊

I had an ELCS only a few weeks ago and I am satisfied with my decision. To help with my decision, instead of thinking about which way of having the baby was better, I looked at the potential negatives of both and which negative I would absolutely hate the most. So for me, in an ideal world I would have liked a vaginal birth but having a episiotomy or the baby delivered by forceps was my worst birthing nightmare, so I chose the ELCS.

Thank you all for sharing your experiences with me.

When I said a natural labour I meant I'll take pain relief and any intervention they would need to do to get her out safe, didn't word that very well in my post.

There is a lot to think about.

To PP who mentioned home birth, whilst I think this must be lovely and serene and comfortable in your own home if you are that kind of person who can relax and trust in your body, it's my worst nightmare.

You've been through enough, I'd go with ELCS. Take the worry and uncertainty away.

I've had two CS, yes there's recovery afterwards but if you know ahead you can plan for it.

Sorry for your losses and congratulations on your pregnancy. Given your journey to get here and a low lying placenta that may or may not move I would plan for a ELCS. I haven’t had one, but it can be planned for much better than a vaginal birth. Good luck!

Also forgot to mention that I carry strep B so baby would need antibiotics after birth if I went with vaginal delivery and we'd have to stay in for 48 hours so the hospital stay wouldn't be a lot different in length to a c-sec, this is what I've been told anyway.

This, you won't regret it at all.

I would opt for a vaginal birth. I am a FTM and my waters broke day before due date and baby was born 12 hours later. If I had to go down the induction route for whatever reason then I think I would've seriously considered ELCS just because of the statistics for inductions that lead to EMCS in first time parents specifically. However what I would choose should not dictate what you should - trust your gut and do what it right for you x

Same situation as myself, and I went for ELCS for my 2nd due to this as well as other factors. I dont have a number stomach and my lovely female surgeon spent a long time on my elected section to ensure I had no problems post birth and I don't.

Given your anxiety and previous losses etc I would go ELCS. I've had 2 due to anxiety and it really helped me to feel it was a controlled environment. The chances of a completely uncomplicated non-tearing vaginal birth are reasonably small and that was enough for me.

Congratulations and good luck. Sounds like you've really been through it to get to this point x x