To have a second elective c-section?

[CSectionUncertainty]

I had my first child by elective c-section 2.5 years ago because he was breach. It was a good experience overall and although it did take 6 weeks to fully recover, it wasn’t too bad during that time. I got to go home the next day, I managed to breastfeed well, baby did well, etc. I definitely had a better experience than my friends who had difficult vaginal births that ended in forceps or emergency c-sections (at least half of my friends had this experience).

Im now in third trimester with my next baby and have been offered an elective c-section again, purely due to the fact that I had one previously. However I’ve had a late scan and my baby is a good size and in the perfect position for vaginal delivery. I was all set for another c-section but baby’s position plus the fact that recovery will be more difficult with a toddler is making me second-guess things. My trust’s c-section rate for attempted vaginal delivery is 30% so seems quite a high risk of emergency c-section if I did try, plus who knows whatever other complications. Not sure if I’m over-thinking it!

AIBU to go for the elective c-section again?

I've had one emergency section followed by two electives.

Questions to consider - how big was your first baby? My first was over 9lbs and when I looked into statistics the success rate of a vbac dropped with larger babies. I was right to pick an elective because DS2 arrived at 39weeks weighing 9lbs 10 I dread to think his weight if he'd arrived later.

I would ask about the conditions they expect for a vbac. For example my hospital wanted me to have continuous monitoring which would restrict my movements. This isn't helpful for a successful vbac. But I'm a nervous person so would have struggled to say no. Also meant consultant led so different birthing suites to midwife led. In my opinion not as nice.

Practical considerations if you have an elective it's easier to arrange childcare. I knew at 12 weeks so I was booked in very early. Meant I was first on the list on the day so baby arrived before 10am and there was time for my older children to visit and DH went home to take care of them.

I have no regrets at all and recovery for all three sections was fine. Longest with the last but I was caring for a two and four year old so that probably explains it.

I had an elective section due to a health condition and if I do have a second child, I’d probably do that again. I think the fact it was elective helped recovery (obviously just anecdotal but compared to friends who had emergency sections after difficult labours.) A friend just had her second, wanted VBAC and ended up having an emergency section. My thinking would be that if I was going to have a section anyway, I would want it to be planned. Good luck with whatever you choose xx

It will stop hurting in about week, just take it very slow and easy. Sit on the sofa with baby and snacks! Belly will be normal in about two months

Go for it OP! I’m not convinced vaginal birth is safer - if women got better care with more highly trained people and didn’t experience discrimination it would be different, but it’s not

You have to do what’s right for you. It’s your body and your baby.
A planned c-section gives you more control that’s for sure. You’re already planning for a recovery to take a bit longer, I think it comes as more of a shock for those ending with emergency c-sections. Plus as you say, so many planned vaginal births end with c-sections or forceps and it can come as a big shock to those people. The risk of ending in an emergency section is higher with a v-bac too… but plenty of people do have successful v-bacs.
I guess it depends on how important a vaginal birth is to you. For some women it’s something they are desperate to experience, others couldn’t imagine anything worse, others are pretty take it or leave it.

Thanks everyone, some great points and really helpful to hear different perspectives!

Is there a reason why vaginal delivery is riskier or less likely after a c section?

Because of the scar on the uterus, giving a 0.5% chance of uterine rupture. That chance is higher if labour is induced.
Whoever said you've already got one scar, why have another one meaning vaginal tears etc, has underestimated the amount of scars that a caesarean birth will give you - it's not just me what you can see on the outside

If you wanted to try for a VBAC you could always have a low threshold for switching to c-section agreed so that it's not done as an emergency. That's what I did. Any failure to progress, baby showing signs of distress etc it was agreed we'd switch to a c-section, which is what happened as my induction just wasn't working. So it was still a calm affair with a good recovery. It felt like the right balance for me.

Is this referring to the section wound or the placenta? If it's the latter that's a bit of a myth as after birth the uterus contracts down. If there was a wound the size of a dinner plate the woman would bleed out.

I had an elective section for my second because I had an emergency one first time round and I just thought it would be easier because I'd had one before and could plan around it etc and I was scared of the complications possible with a vaginal birth. They found once they were in there that all my organs were adhered together from the first section, and there would have been no way to know that beforehand. The operation took so long that the spinal nearly wore off, and I haemorrhaged. I was stuck in hospital for 5 days with a surgical drain in place but had to do everything for myself overnight despite that. The wound from the surgical drain took weeks to heal and I was back and forth from the doctors worrying it was infected. All this is to say - elective cesareans can have horrible complications too and should not be taken lightly.

It’s up to you, what do you want? Personally having that two sections (both breech babies, both sections very much unwanted) I wouldn’t ever ever have another one. It’s harder to recover with a toddler. And it means you can’t do anything for the older one for weeks. It really affected my relationship with my son for a few months. But I know people who have enjoyed their sections and would have more. Only you know how you feel about it.

I meant externally obviously 😃

Who knows what's done inside, but externally I have one faded neat line across my pubic line and a totally intact, never repaired vulva. From a purely cosmetic perspective, why damage both?

They were also painless and easy and I avoided labour pain. I've had worse periods than my sections.

I'd go for a c section. I've had 2. Recovery for my last in October has been very straightforward.

OP I went for a VBAC and ended up with a ruptured uterus, intensive care for 4 days and asphyxiated baby. I’d go for c section every time.

Gosh @QueenAstrid im really sorry to hear that. It’s stories like this that do tip me toward the c-section.

I had an elective section for a breech baby for my first and then a successful vbac with my 2nd have no regrets having the vbac went into labour naturally (I had said I wouldnt be induced I would have had a section if I had gone a week over) and generally had a good experience recovery was def a lot quicker than my c section
They did tell me it was better to try for vbac if we were thinking of having any more children as there are more complications the more sections you have so might be a consideration if you are thinking of another pregnancy after this one

I just had my second. Both maternal request electives.

I think pp has made a great point. If you want more than 2 children try for the vbac.

I am sticking with 2 so went for the elective and now I am done.

This recovery has been SO much easier. Both psychologically and physically. But i think there’s a lot of different factors that it’s impossible to tell for anyone whether will be better or worse.

No birth is risk free. There will be horror stories of both. And no one has a crystal ball. Just go with your gut instinct and try to make peace with it.

I was in a similar position and had 2 electives after first was breach - recovery quicker second time around armed with knowledge and experience. Would do exactly the same again.

Zero regrets having an elective section with my second, after a crash section with my first. Recover was better second time for me as hadn't had labour, it was very chilled, I could pick the day and the time, healed well and avoided the potential problems of vaginal births. Recovered well after about 2 weeks. Also no labour which I found really quite bad

My trust is 75% of successful vba1c id attempt vaginal ( and did)

Same, recovery from the second c section was much better than from the first. Once you have a c section, it's hard to imagine putting yourself through a vaginal birth 8 think! They are so smooth these days.

Go for it.

First poster nailed it : why chance it?

I was in your shoes. Had an elective for a breach. Pregnant again and I just couldn’t decide what to do, the decision consumed me. My hospital was 30% success for vbac, the odds just didn’t seem in my favour. It got to 35 weeks and they wanted to know my decision, I still hadn’t decided when suddenly I just went in to labour. I went with it and feel incredibly lucky to have had a really successful vbac. Up and about an hour later, the best recovery I could hope for. I feel so so lucky and still can’t get over the fact it actually happened and that I haven’t had to recover from a c-section.
A midwife did say to me to not let the stats of 30% come in to the decision making, as my previous need for a c-section was to do with the babies position. Had it been to do with my body not progressing in labour (basically an issue to do with me, not the babies position) the need for repeat c-section would be higher. I found a university study online where you could input your information and that gave me a vbac success rate of 90% instead. So I do think there’s some truth in not putting yourself in the 30% success bracket, as everyone has an individual story & need and we’re not all “30%”.
i would always say go with your gut. Unfortunately for me, I just could never work out what my gut was telling me. So when my body went in to labour, I accepted and went with it. I honestly don’t know what I would have decided otherwise.

I've just had my second C-section. Recovery has been straightforward - I took dihydrocodeine for the first couple of days, have myself reasons to get up and potter about and I felt surprisingly well and had to remind myself to slow down. When it wore off in the evening and I was on paracetamol and ibuprofen I had to take it a lot slower.

Maybe one thing to consider is how many children you want long term. My doctor advised that two c-sections is fine, three is fine, but no more.