To Be Weighing Up Elective C-Section vs Epidural Birth

[anonymousxmasposter]

Hi everyone,

I'm currently 24 weeks pregnant (first successful pregnancy after six losses) and trying to make an informed decision about my birth plan. I'm strongly leaning toward an elective c-section and would love to hear experiences from others who've had either c-sections or epidural births.

Why I'm Considering C-Section: I've given this a lot of thought, and here are my main reasons:

• I've had severe childbirth phobia since childhood - it was nearly enough to stop me from trying for children altogether. This isn't just normal nerves; it's a deep-seated fear I've carried for years.

• Several close friends who had vaginal births have told me they'd choose a c-section if they could do it again, which has really influenced my thinking.

• I know myself well enough to know I handle prolonged, manageable pain much better than intense, acute pain. The controlled nature of a c-section appeals to me more than unpredictable labor.

• I have a 20-year history of recurring vaginal health issues (chronic thrush and extremely sensitive skin), and I'm concerned about how vaginal delivery might impact these existing problems.

• After experiencing six miscarriages, Having a planned c-section feels like a way to regain some control over my birth experience after so much loss and uncertainty.

There are some factors giving me pause:

• I have a clotting disorder which increases my risk of blood clots post-surgery
• I'm worried about reduced mobility during recovery and the potential for isolation/depression
• The possibility of long-term nerve damage around the incision site concerns me

I know for certain that unmedicated birth is not for me. While an epidural birth seems like a middle ground, I have significant concerns about:

• The epidural not being available when needed
• The possibility of it not working effectively
• Missing the window for getting one

I'd really appreciate hearing from others who've been in similar situations or had to make this choice. If you've had either a c-section or epidural birth, what was your experience like? What do you wish you'd known beforehand?

Thank you in advance for sharing your experiences and insights. 💕

How many children do you want in total OP?

if it’s more than 2 I would be hesitant on c section. If it’s 1 or 2 do the elective

Oh wow sorry you’ve had a tough time too. What are you choosing this time then, I guess vaginal? I had a mega tear with the forceps, then (don’t read this OP!) elective section went wonky and the trauma (blood loss) gave me an autoimmune disease which took me 5 years to get a handle on! Then DC3’s pregnancy worked wonders and I felt much better during and after. It’s a crazy thing we put ourselves through isn’t it!

Stitches in stomach seems a better option than stitches down there.

I certainly feel the same as you. Scroll near to the end of this report and find your hospital and see where they sit for things important to you.
maternityaudit.org.uk/downloads/RCOG%20NMPA%20Clinical%20Report(web).pdf

I had an elective c-section. Very positive experience, no regrets.

There is a very slight bump and it doesn’t feel exactly the same as the rest of my skin. It feels like a scar The thing is, it is a scar. It won't stretch, so if you put on a weight you develop an overhang, But it goes away once you lose weight again.

In your shoes I’d absolutely go for the elective c-section. The most positive birth stories I know have been from women who chose this option. Yes it is major surgery, but my “natural” birth (with epidural) ended with a massive post-partum haemorrhage, third degree tear and horrendous GBS infection meaning I couldn’t walk without pain for weeks and couldn’t have sex for over a year. My SIL who had a c-section was driving again before I could! Be prepared to stand your ground when the NHS try and talk you out of an ECS though.

@LimeCookie thanks my hospital is over Fife percent for third and fourth degree tests! That's high!! Higher than most other hospitals

@Nc546888 due to age likely no more than two is possible and even that's possibly doubtful

@DifficultBloodyWoman DH is a blabber so it won't stay secret! I also don't care abit judgement it was more they made me doubt the choice

I had induction with epidural that ended in an emergency c-section.

I would say the negatives of a c-section are:

• if you want to get pregnant again they strongly advise that you leave it 18 months, and if you want to be pregnant many times it gets a bit riskier because of the scar tissue (I was one and done in the end but I don't know your plans).
• There's a bigger chance you'll end up with a tummy shelf that sticks out a bit, and a gap between your stomach muscles (which in theory can heal with exercise, but mine is better but not completely gone), weakened core strength etc.
• Nerve damage (I was numb around the scar site for around 2 years, but back to normal now),
• a scar along your pants line,
• you can't lift much whilst recovering (I didn't find this too bad but some women can't even lift the baby),
• Terrible constipation from a combination of pain meds and they mucking around moving stuff around inside. I didn't poo for about a week and they gave me medicine to get me moving again but it gave me the most diabolical farts ever. I don't know if everyone had this - I think they mentioned moving my intestines which I don't think they do in most cases.

But that's pretty much it. The op was fine and I imagine an elective would be even better. You can't see what's going on and the anaesthesia worked well. You get the fun moment when they lift the baby out and hold them up like the Lion King. No vaginal birth injuries, which sadly seem incredibly common with vaginal births. So no regrets from me.

Elective c section 100%

I've had four births. One epidural birth. I got my epidural before I even had a contraction as I was getting put on the drip and just didn't fancy all that. Once everything was sorted ect I slept until I woke up feeling the need to push had a couple of stitches to sort after but wasn't bad. Showered straight after. No further problems like back pains ect.

I was up and walking to visit grandparents the day after and walking the school run. Honestly with all my vaginal births I've been up and fine within the day.

Just a positive story that you don't often hear 😊

I had an ELCS 10 days ago - first baby. I am SO glad I went down this route. The actual surgery, and recovery, has been significantly easier than I expected.

I also think it is easier to accept a scar & physical changes that you chose, rather than something like an episotomy or 3rd/4th degree tear.

Had it been an option, I’d have chosen a textbook natural birth, but of course no one can choose that! I certainly wouldn’t choose forceps, episiotomy, EMCS, so an ELCS was next best option.

I did a lot of reading before coming to my decision and would recommend the “considering a caesarean birth” document from the RCOG, as it compares risks of VB and CS.

www.rcog.org.uk/for-the-public/browse-our-patient-information/considering-a-caesarean-birth/

my first birth was a quick unmedicated one because there was apparently not enough time for an epidural. Everyone in my family has had slow births so this came as a shock. It was extremely traumatic and caused quite a lot of physical issues that had to be resolved after birth. Second birth was a planned c-section due to the trauma I previously experienced and was wonderful. The recoveries were quite similar between the two of them.
I would just make sure you are prepared for any post surgery complications that may occur so you aren’t completely shocked if anything out of the ordinary occurs, maybe ask the hospital how they would deal with it if it happens especially as you have a clotting disorder, you need to know how they would treat it if it did occur.

Have you been told an elective section is definitely an option?

I agree with this. I’ve heard of people who regretted c sections because they struggled to get pregnant again (adhesions). It also can make breast feeding more difficult if that matters to you (my milk didn’t come in easily/well, though eventually I managed to persevere with a lot of help - but weirdly many of the people I know who struggled with breastfeeding most also had c sections 🤷‍♀️).

However for me an elective c section was the obvious choice from day 1 - with an IVF baby and being over 40, it was always most likely I was only going to have 1 child so I wanted to get him out in the safest way possible for him and research told me that was a section. I have no regrets about it- and as a bonus for me, I knew I’d cope better with stomach pain than I would with tearing or stitching in my vaginal area (as I’d managed kidney stones and regular horrendous period pain fine but found smear tests/IVF embryo insertion agony).

Anecdotally the c section pain was no big deal imo- I took the daily max dose of ibuprofen and paracetamol for a week or two , but by about 3 or 4 weeks I was sleeping on my stomach again 🤣 I’ve heard from others who took that long to recover from vaginal births too.

Based on your post (multiple miscarriages, vaginal issues) I’d say that if you think you are only going to have 1 child (or 2 if lucky) then I’d definitely go for a section. Be absolutely sure to mention the clotting issue though to the docs as there may be extra things they can do to help with that (you already get stockings and injections but there might be more), as obviously that’s a concern.

Potential nerve damage on the incision site is always a risk , but on that one I’d say there’s risk too for nerve damage from vaginal tearing - the major risk of c section is bleeding, for most everything else afaik the risks for c section are similar or less than for vaginal births. But when weighing up the odds, vaginal births seem to be the way to go if you know you want multiple children.

I've had an epidural vaginal birth and 2 elcs. TBH, they were all pretty easy and painless, but I've found pregnancy and childbirth easy in general (and also have never had other issues like miscarriages) so they would probably have been fine whatever method I chose. I didn't have any other interventions, no tears or stitches with my vaginal birth, and was able to breastfeed easily with all 3. I was able to be discharged next day and dcs were all healthy and have never needed any additional medical support. Had a minor infection with cs wound the second time but quickly sorted with antibiotics.

Recovery period was a standard 6 weeks after elcs but it flew by, and I had DH to help the whole time so I didn't struggle with trying to do things and wasn't lonely at all. My scar is very visible but hidden from view so it doesn't bother me. Very occasionally I'll get twinges (not really painful) from it but my youngest is 2.5 now, and I'm sure it will get better as time goes on.

Personally if I were to choose again I'd have a slight preference for elcs, simply because the vagina is never quite the same after childbirth (even with no injuries), but that's quite a vain reason.

OP given what you've told us, I would suggest c section, despite having never had one myself.

There's too many unpredictables with a vaginal birth. I've had 2 extremely quick vaginal births, the first one was so quick I missed the opportunity to get an epidural. I got through it on gas and air, and thought it was fine.... until my second when I got an epidural and realised how crazy the first birth was. It is a horrible feeling being half way through thinking "I can't do this" but there's no way to stop and you just have to carry on!

I would say though to prepare yourself for the small chance you go into spontaneous labour before your date for a section. I believe it's a small chance but I could imagine being 100% set on a section and then having to birth vaginally would be a mindfuck!

Edit to add, my epidural birth was amazing, there isn't pain as such - it's more of a pressure but very very bearable.

Paraphrasing here but NICE guidance is that a maternal request c-section should be granted as long as the patient is aware of the risks. I requested it at my booking appointment and had the c-section date by about 18 weeks.

OP I had an elective c-section and would choose it again. All of my NCT group ended up with some level of assisted birth (episiotomy, forceps, over half had a c-section).
I preferred the predictability and control. I wasn’t looking forward to the surgery but it felt better than the alternative (NHS attitude to pain relief and childbirth generally plus staff shortages plus covid times).

One thing - you say DH is a blabber. I would be having words with him now that YOU are the one who is pregnant so you will decide who knows your medical information. Even if you’re generally a sharer of information as your pregnancy progresses you might have symptoms that you would rather not tell everyone about. And if you do go for the vaginal birth and there is any loss of dignity that you would prefer not to share there is no point waiting to have a conversation.

It was important to me that no one knew the date of my planned c-section (which I knew from about 18 weeks pregnant). The hospital also said if I went into labour beforehand to just let them know and they would book me in as an emergency c-section. It felt for me the safest way to get my baby out.

Whatever you decide good luck.

From what you've written it sounds like you've thought about it a lot and researched a lot to try to get the best outcome for yourself and your baby.

What stood out for me is that you put all the positives for the c section first. So I think that is the option you truly want. So in my opinion you should go for the elective c section. All the points you made (for and against) were well thought out and justified, but ultimately you have a phobia of giving birth naturally, you need to take the worry of a natural birth out of your pregnancy and just enjoy being pregnant (not always enjoyable at every moment, I remember! 🤪) and look forward to meeting your little one. Women have a choice these days, so make the one you want and don't feel guilty about it. I do think there is still some sort of 'too posh to push vibe' for women that opt for, or even have no choice about, having a c section. Though it is a lot better than it used to be.

Just to let you know I've never had a c section, I was induced with my 1st child in hospital and had an epidural (was very grateful for it!) and 2 subsequent homebirths.

I'm not trying to say natural births are wonderful or the best, but they were right for me at the time. And that is what is important, doing what is right for you at the time with the information you have to make that decision.

Anyway, wishing you a happy pregnancy and a wonderful birth, whatever you decide.

I would choose a C-section. I was hoping for one but didn’t feel like I could advocate for one. A week after my due date I ended up going in because my back waters had broken, then they broke my actual water hoping it would maje labour happen quicker. That was at 5am. At some point I had gas & air, then pethidine, then around 12pm I had an epidural (I think I was lucky as it happened pretty quickly). They’d also put me on the hormone drip. I got to about 5cm dilated by 5pm so they then told me they’d do a c section and oh my god I cannot tell you how relieved I was. C section happened, baby arrived 7pm (after an epidural top up), I don’t remember loads about it but I was so happy.

I had a really easy recovery too. It’s not always the hard road! It does help if you’ve got a supportive partner who will do their share of night feeds in the first few weeks. And also helps if you’re happy to bottle feed or mixed feed so you don’t have to exclusively breast feed.

Sounds like you were very lucky with your trust - based on the pregnancy boards here (and my own experience) many trusts won’t give you a date for elective sections until you are at least 36 weeks along. I suspect they hope you will go into labour early 🤣 as it totally adds to the stress.

I mentioned I wanted a c section at my booking appointment too but it also seems to be really common to have to insist on/ask for a c section at every review appointment (and they will do everything they can to put you off, so stay strong OP if its what you want). Personally I only found they stopped trying to push vaginal birth once I developed extra risk factors (like too much fluid, GD and reduced movements), then they seem to accept it.