To be so indecisive about birth?

[forgotthewords]

I’m going round in circles and need to decide so I can start to prep.

I’m due to give birth in one of the busiest months of the year. I am low risk at the moment. Everyone I know of who has had a baby in the last 2 years at my hospital has not had a fantastic experience, apart from one person who had a Caesarean due to breech position. The others have mainly experienced failed inductions, poor postpartum care, and traumatic births to the point of needing debriefs and in some cases physiotherapy.

I understand that straightforward births can and do happen, but statistics say that’s less than 40% of the time for a first time mum. A larger proportion than this either have assisted deliveries, or inductions that are lengthy, painful and fail resulting in EMCS. A remaining smaller percentage elect for a section.

I am wondering about maternal request section and how that might be for me. Sections carry risk for future pregnancy, and a longer recovery time. I imagine they must be very painful afterwards. Planning one seems like the 2nd most desirable option after a vaginal delivery though? Predictability to an extent, avoids the risk of an emergency situation. To me it removes layers of ‘unknown’. I could deal with the unknown better if I trusted maternity care in this country more but the fact is I just don’t, not after reading the reports and knowing it’s a nationwide crisis. It seems like a coin flip situation anyway where you’re actually relatively likely to need an emergency section, which seems the worst of all worlds.

I have been recommended to look into hypnobirthing. I have looked, and may consider a course but ultimately I feel like a positive vaginal birth comes down to luck and chance and a lot of factors that are unknown until you’re actually having the baby.

Posting I suppose to see others’ birth experiences, ideally recently, so I can inform myself slightly more.

I’ve had a vaginal birth and a C-section and I would choose the vaginal birth every time! I was induced with my first, had an epidural as I was in labour for a few days but she was out in a few pushes and I was up and about almost straight away.

Csection was planned but I just found the whole thing so traumatic and the long recovery time was awful.

Bluntly, in the moment you don’t get necessarily much choice. A lot will come down to how your body is behaving - eg if your contractions ramp up very quickly, maybe no time for epidural; if your contractions tail off then may need induction or c section; if your baby gets stuck/distressed then episiotomy or C section; etc. “Birth plan” is a bit of a myth and IMO leads to many women feeling disappointed or failed because a different course was taken rather than the one they’d chosen.

I had a vaginal birth, needed very little painkiller and easy recovery for me - but my DC got stuck and has lifelong issues as a result. Wish the midwives had told me I should have a C section.

In short, I agree with you that a planned C section is probably the safest option, especially given resource shortages (which also contributed to DD’s birth issues).

My baby is not quite 4 months old, and if I did it again I would choose a C section.

I was induced (at 38 weeks, due to health issues I've had for years) which I thought would give me some level of control of the situation but it absolutely did not. You mentioned long inductions in your post, mine went far too quick.

Labour lasted 1 hour 11 minutes in total, with no pain relief except gas and air as I couldn't have epidural (health issues) and it was too far along for morphine. I ended up delivering via forceps under GA because baby couldn't breathe as there was no break between contractions and I couldn't push fast enough. C section wasn't an option as he had moved too far down. He needed to be rescuitated and we both spent 4 days in hospital before coming home.

Obviously my experience is an unusual one so might not be very helpful.

There are no certainties with birth .. some people have great vaginal births, some don’t .. some have great sections.. some don’t.

I had a drug-free vaginal birth (first baby), used Hypo-birthing.. it was fine, but it won’t be fine for everyone.

Personally I'd rank it vaginal birth, C-section, induction in that order - every person I know who was induced had a bad time of it. But personally is the operative word here! If you feel most confident with an ELCS then that should be your choice. Fwiw I had a long (not induced) labour ending in an EMCS, recovery was a breeze, and this time (I'm pregnant now) I'm going for an ELCS.

There’s no way to manage out all risks. But I agree that a CS does eliminate a lot of them. All the best, however it happens.

It's a massive decision, so don't beat yourself up OP.

Are you close enough to travel elsewhere to deliver? You have a choice of where you can go. Or perhaps a midwife led unit elsewhere if you're low risk

I'm also pregnant and I completely understand the worry about not trusting the NHS when it comes to maternity care

The likelihood of a positive vaginal birth isn't purely luck. It's also educating yourself about the process, being informed and knowing how to make informed decisions, understanding the cascade of intervention and advocating for yourself.

The positive birth book by Milli Hill is a great start and gives a balanced view of all different types of birth and how to give yourself the best possible chance of it going smoothly.

'why home birth matters' is a also a fantastic short read, even if you're not planning a home birth I learnt loads about the birth process which gave me so much confidence x

I had an ELCS because everyone I knew seemed to have traumatic, awful births and I didn't want that. I was happy with my decision and it was a lovely, calm experience.

Everyone has different experiences with recovery. The first couple of days were very painful getting up and down but I was out of hospital the next day and up and out of the house shopping by day 5.

Have you thought about a home birth?
It's what I'm doing with my third. I'm actually prepared to spend money we don't really have to get an independent midwife.
My first birth wasnt a great experience and my post natal care was diabolical.
Second one I refused to go to hospital until the last moment and gave birth in a corridor then had a horrible over night stay...so this time I'm just not going 😂

Edit: unless there's a good reason, obviously

I’m not sure I’d want to. If anything went wrong 10 mins could be all the difference. I suppose with your 2/3rd baby you’d know how your body responds in labour a bit better

I assume you’re due September as that’s statistically most popular birth month. I’m due October. And honestly - why are you putting pressure to make decisions and prep? I’ve got some ideas about my preferences but it’s ages away, lots could change, and I have no idea what it’ll be like, how I’ll find the pain etc. I think going into it with rigid ideas is only going to end in disappointment.

id Check ambulance response times in your area before planning a home birth

No not September. Sept, Oct and Nov are all the busiest months according to our local stats. X

You choose whatever works for you. If needs be argue your corner and get a second opinion if you disagree. I went to maternity triage and they tried to send me home. They told me I wasn't in labour. I refused to go home and ask for a second opinion. The consultant then confirmed my waters had broken and gave everyone a look explaining how he knew. I was put in a side room and told C-section would be in the morning because baby was breech. I delivered feet in triage. I went from 0cm to 10cm in 28mins. I had an emergency C-section under general. It was all very stressful. I was traumatised after.

My second was also breech and done as a planned C-section. It was so calm. I was emotionally well after.

Physically both section were hard and the recovery was hard. My SIL had a vaginal birth and was out and about in a week but it took me 6 before I was able to go for a walk round the block.

I had a c section with my first, hoping for a vaginal birth with my second. Everyone I’ve spoken to says c section recovery is much harder than vaginal recovery. A c section also increases the risk of complications in future births, and the more c sections you have the greater the risk.

However, your feelings and concerns are really valid and there is no wrong choice if it’s the one you’re happy with. Hypnobirthing is a good idea. You could also consider things like a home birth - although fractionally higher risk than a hospital birth for your first birth there is some evidence that home births are less likely to lead to interventions including an emergency c section.

Instead of thinking between c section / natural (as it seems it's the hospital that is the issue) - could you maybe look at a different hospital or midwife led unit?

My local hospital is appalling - so I chose to go to one 30 mins away by car. Delivered naturally and went on to have another child at the same hospital 10 years later - while the local hospital hasn't changed much in its reputation lol

It’s tough OP as there’s no way of predicting what outcome you’ll get.

I was induced and I’d never agree to it again. I’d insist on having a scheduled c-section. I spent 48+ hours in labour going through the whole cascade of interventions resulting in a forceps birth.

I know other women who were induced and it was fine.

@2sisters depends on the vaginal birth - I was debilitated for several weeks after mine. No one had mentioned that in NCT…!

So some months are busier than others on a maternity ward?

Hi OP, I would opt for a vaginal birth over a c section BUT only if I went into spontaneous labour. I would never be induced after hearing so many awful stories about induction from friends and family. Similarly I’d avoid any intervention during childbirth (forceps etc) as far as reasonably possible and would opt for a c section in those scenarios too if it was an option

Planned C-section was amazing for me. The best decision I made, recovery wasn't anywhere near as difficult as people scare you with. I think it's much worse for those who go through labor first.

It was obviously a surgery but I didn't take anything more than regular pain meds and was up and walking after the spinal wore off and they let me - around 8 hours later I think.

It was much easier than vaginal tearing or any of those complications. Look into both and make the right decision for yourself. I'd do it again in a heartbeat.

This is what I am thinking I will do. Maybe see if I can book a section for close to 40 weeks, and just go with that unless I go into labour naturally before

With my first baby I was induced, it took ages, baby was back to back and it ended in forceps and a large PPH. I found the episiotomy recovery really painful. Two weeks ago I had my second baby, I opted to try vaginal again thinking i’d have a better experience but I went quite overdue, caught an infection and had to have an emergency c section. If I could go back in time I would 100% have gone with the elective section, although scary at the time because mine was an emergency, the surgery itself was still such a calm experience and so far the recovery has been smoother than the first time and no issues with breastfeeding. I have friends who have had incredibly straightforward vaginal births though so while you should always be educated/advocate for yourself, I do think an element is down to luck unfortunately!

I don’t think it’s realistic to say ‘I’d refuse forceps’.

I can assure you that they aren’t the top of any woman’s birth plan. But at the point they’re used it’s usually too late for a c section.

There was no choice for me - it was that or probable harm to the baby.

My first birth was a straightforward spontaneous vaginal birth with an epidural and no instruments, it was pain-free with no tearing or stitches. Recovery was fairly immediate although there was obviously a change to my intimate areas.

Second and third births were elcs, no real pain as the epidural was effective and I used paracetamol afterwards. Recovery was slower, a few weeks, but I was lucky to have DH on paternity for several months so didn't affect my life too much and I was happy to be in a little bubble with my newborn. No ongoing issues with the scar or general health. Much more convenient to have it planned and it felt less intrusive, and I suspect my pelvic floor is in better shape than if I'd hadn't opted for elcs. Bonding has been fine with all dc and all have been breastfed for 3+ years and all have been very healthy with hardly any GP visits and have never needed to go to hospital.