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. 💕

Loved my elcs. Had some presurgery nerves but it was calm, controlled, I was well looked after, listened to, not rushed, and my recovery felt no worse than an intense ab workout, and I just took paracetamol and ibuprofen prophylactically for a few days and made sure to be getting up and move about which wasn't hard given I had a baby to take care of.

I had no choice but to have an elcs as DS was footling breech and I have a bicornuate uterus, but if I did have the choice again I'd still go for ELCS. It was a dream.

I had elective C section and wouldn’t have it any other way.

I wouldn't because at least I can't see the scar! Tbf it was more painful because I was very limited on pain relief due to a transfusion.

I wouldn't trust that any kind of pain relief on arrival is a reliable option, tbh.

I had an epidural with my first labour, ending in an emergency c section. Elective c section with my second and it was an amazing, empowering experience. I had a lot of trauma around my first birth and had 2 miscarriages between my 2 babies and control was a huge factor for me. Recovery after both my sections has been fine. Mobile the next day and managing to move around slowly with no issues. I do have numbness around and above my incision and that has been since my first section.

Emergency c-section here after a very long back to back labour with DS. Because of the position DS was in the epidural wasn’t as effective and I was in quite a lot of pain and absolutely exhausted by the time he was finally delivered. Absolutely no recovery problems, up and about the next morning with just paracetamol for pain relief and driving again within a few weeks. My scar was a bit itchy as it healed but is barely noticeable now and hasn’t given me any issues.

Stop shaving your bush. Problem solved.

I chose a c-section with my 4th baby nearly 5 months ago, best decision for me as I had gestational diabetes and they were pushing for induction at 39 weeks (I was induced with my second child and found it a traumatising experience which I didn't want to repeat) , my c-section was calm and I got to breastfeed in the recovery room and was back on my feet a few hours later, in your position I would definitely choose the c-section as there is no guarantee an epidural would be available to you in labour but with a planned c-section I found everything was thoroughly explained to me beforehand so I knew what to expect and it was a lovely experience, the only downside was it is obviously harder to recover from but I was doing the school run a week after mine

You can have a supportive partner who does everything to enable you to do night feeds if you do want to breastfeed. That surely goes for any kind of birth.

It was important to me to try breastfeeding and the baby was latched on in recovery. It wasn’t all plain sailing at the start but we got there. I just don’t want OP or anyone else reading to think that ELCS means you can’t breastfeed. I was arguably more well-rested than other women on my ward who had gone through labour first.

I've had 2 c sections and my recovery was a breeze. That's not to say that everyone's would be, but I was pleasantly surprised by the ease of it all.

Oh and my milk came in no problem at all both times.

That’s a completely fair point. Totally hadn’t meant for it to sound like you can’t breastfeed!

I would take the advice of your obstetricians and midwife (the blood clotting disorder and it's antenatal (as well as postnatal) management needs factoring in to your decision making). There are national standards for the timely provision of epidurals and those are achieved more often than this thread suggests - if you are leaning more towards the vaginal delivery with epidural option then it's worth asking your unit how often they achieve that target (and perhaps what the causes of delays are....it's not terribly uncommon for the delay to be just that no one tells us a woman's requested onel!).

It's not exactly reassuring if the reason a woman was denied an epidural is due to the failure to communicate a very basic and straightforward message! Speaking as someone who missed out for this very reason.

The reality is that even in a perfect NHS with plenty of resources and a commitment to respecting womens automomy, which we clearly do not have, there's still a risk of labour progressing too quickly. It's never something that can be guaranteed. This is something that any woman needs to be aware of.

I've had both a C-section (unplanned) and a VBAC with epidural. For the latter, I got the epidural at about 3-4cm, just around the time active labour began and the intensity of my contractions really cranked up. It was a very positive experience for me, much better than the C-section. I also had multiple losses before my first baby was born and understand your anxiety.

I wouldn't worry about the thrush issues - I have problems with recurrent thrush, vaginal delivery made absolutely no difference either way.

Over all through - I was induced. I would absolutely choose caesarean over being induced again - in fact being told I wouldn't be allowed to do so partially contributed to the decision not to have a second DC, I know I could have fought, but I didn't want to be in that situation while pregnant with complications requiring an induction. Despite having a traumatic birth, I would choose vaginal delivery over caesarean outside of that.

Everyone's different, but I had very little pain post-delivery even with a third degree tear and extensive stitches. I've had keyhole surgery to remove an ovary and the recovery was considerably more painful, even with being able to take more powerful painkillers. I imagine a caesarean is painful to recover from, but I can't comment on that.

If you go for the epidural/vaginal delivery get the epidural asap. I wish I'd had mine sooner, but my birth plan was G&A with pethidine as back up as I wanted to be mobile - that couldn't happen as due to the induction the baby had to be continuously monitored and the slightest movement meant they lost his heartbeat - and the staff seemed determined to stick to the birth plan in that respect, despite my request otherwise.

I would go for the elective.

I opted to give birth in the birth centre in the pool. Most of my pregnancy was high risk baby was breech until quite late on and (wrongly) measured big. So, I was so pleased to have the birth centre as an option.

It was initially lovely but I wasn't progressing and was brought out to push on a bed with no pain relief.

They then scanned me, saw baby was at an angle and I had a spinal and ventouse delivery. It was wonderful. The spinal was pure bliss. If I ever have another I will push for an epidural.

However, in your case I would opt for the elective due the tokophobia. A planned c section will be much calmer and safer than an emergency, if you ended up needing one. Everyone I know who had an emergency section has said they would request an elective for the next birth.

Are you sure you get to choose? That wasn't how it was when I was having babies - although a while ago. If you can pre-arrange a c-section, I'd go for that. I had an emergency c-section for my first and then elected for my second. The recovery for the second, when I hadn't already been through 2 days of labour, was much easier. I'd say there's quite a high chance of you not getting an epidural if you go for a natural birth.

A friend of mine had an elective c-section for similar reasons to those you list and she was very happy with her decision and said she would make the same choice again for future births.

I hope that whatever you choose you have a safe delivery which you feel good about ❤️

I had an elective c-section. It was a very positive experience and my recovery was very easy. I made the decision to have section as I felt it was the safest option for my baby and me. My decision was based on the experience of a couple of close friends who had vaginal deliveries / had professional OB /GYN experience. There was also some negative news stories about my local maternity unit at that time, how accurate they were I don’t know but I did take them in to consideration.

I did have some pressure from the midwife and consultant to try a vaginal birth, but I had decided and was given an elective section. This was quite a few years ago so hopefully this has changed.

just one other thing to consider - my understanding is that an emergency section is very different in terms of experience & recovery for both mum and baby, so maybe focus on researching elective sections when deciding if that’s best for you.

Congrats & all the best for whatever you decide.

I had a c section and it was the best decision ever. It was originally elective, but I ended up being an emergency c section, earlier than planned. It was kind of scary at first, but as soon as I was totally numb, and they started, I soon relaxed. The recovery wasn’t anywhere near as bad as I expected, and almost 6 weeks on, I’m pretty much back to my old self, just the odd twinge here and there, and still having to use the blood thinning injections. I’m still a bit more careful than I would usually be when it comes to lifting, and bending etc, but I found the whole process to be great for me.

@anonymousxmasposter C section all the way.I believe it’s called tocophobia and I have it too. Had a C section and it was fabulous.

I've only had a c section but can answer some of your questions.
I'm also high risk for blood clots due to an inherited condition, I had Clexane injections to do for 6 weeks afterwards. They also encouraged me to walk up and down the ward in the first few days (I stayed in hospital 4 days).

I won't lie, the recovery wasn't easy, but I haven't had a vaginal birth to compare it to. Mobility was difficult. I had extremely swollen and heavy oedematous legs for about a week, painfully tight, apparently this was normal. I also had mastitis (quite common after any birth) so it was painful to hold and feed my baby, difficult to do skin to skin. I also had a couple of infections in my wound so was on antibiotics for a short while.

But: I kind of knew what to expect, and it was all manageable. I drive, and couldn't go to many baby groups in the early days, because I couldn't lift pram out the car but I also found it difficult to carry my baby due to a dragging sensation in my abdomen. Breathlessness when walking. Also sitting on the floor with baby (and then getting up again!) wasn't easy. So just be prepared that if you want to go to groups to socialise/get out of the house you may find it challenging if not impossible in the first few weeks.

Some people have a straightforward section recovery. I think I was simply unlucky in that regard.

Take all the help/support you can get from relatives and friends.

I'm now 5 months pp and I have postnatal depression which is slowly getting better. I wanted a midwife-led water birth, so my 'birth plan' got turned upside down at the last minute. Very difficult to deal with at the time. But I've come to terms with it now, it was out of my control and it is what it is. Part of my Pnd is the lack of control I had. So I think if this is a fear for you already, then it might be best for you to have a section, then it takes away some of the unknown.

Hope all goes well for you

@meganorks NICE guidance changed a few years back and now women have to be granted a c-section if they ask for one. A consultant could say no, but they must refer you on to someone who will so I imagine very few are pushing a hard no these days.

OP, I chose an ELCS because I had a gynae surgery a few years ago and I felt a vaginal birth was more risky. I had an increase risk of tearing due to scar tissue and an increased risk of interventions being needed. I really didn’t want forceps or to risk a third or fourth degree tear because I was scared of developing incontinence as a result of it. Epidurals do increase your risk of needing an assisted delivery, so that was a hard no for me.

I actually went into labour at 37+6 and I chose to have the c-section still, which wasn’t a problem. I had GD and was on insulin so by that point I’d been told a c-section was better for the baby anyway.

I do have some nerve damage above my scar but it doesn’t bother me in any way (12 weeks post section). It just feels a bit numb when I touch it. That was great for the blood thinning injections after the c-section as I couldn’t feel them at all. I did develop a UTI, which the midwives kept telling me was a bruised bladder from the catheter. After 2 weeks of it, I went to the GP and got some antibiotics which sorted it so it must have been a UTI although I did require a second prescription as it came back after a few days. I didn’t experience constipation after the c-section, despite taking all the painkillers offered including codeine.

Baby had latch issues and although my milk came in on day 3, we couldn’t get breastfeeding off the ground. He did have a tongue tie but even getting that snipped didn’t solve the latch issues. He then went on to develop CMPA. I have felt a lot of guilt around not being able to breastfeed and the cow’s milk allergy, as I have often wondered whether those were a result of the c-section as allergies are said to be a risk of a c-section birth because the baby doesn’t get the gut flora by passing through the vaginal canal. But ultimately, I’ll never know the answer to that. Vaginally-birthed babies can still have latch issues and allergies, so maybe he would always have had those. And maybe a vaginal birth wouldn’t have gone well for me? It’s been hard not to dwell on the what-ifs, but ultimately I do keep in mind that I have absolutely no birth trauma. I look back on my c-section as being one of the best experiences of my life. And that’s more than can be said for most of my NCT group.

I had an emergency section with my second and it was still a really positive experience so I imagine a planned one is even better. I had an epidural with my first which was great but it ended in forceps/episiotomy/large PPH, I think they say interventions more likely because of the epidural but she was back to back and I was on the hormone drip so struggled to cope with the pain. I imagine a straightforward vaginal birth is amazing and would maybe opt for that over a section if you could guarantee it, but i’d take a section over any intervention e.g inductions/episiotomy/forceps. My section recovery was fine, had minimal bleeding afterwards, kept dosed up on painkillers for the first 10 days but was mostly ok without after that. No issues with milk coming in on day 3/4, she latched while in recovery. I had a toddler at home so the worst thing about the section was not being able to lift her but i’d still absolutely have another one.