should I try and talk DSis out of a 2nd CS?

[viewsplease]

I am a regular poster but have name changed for this so that if I decide to, I can show my Dsis the responses without knowing my regular posting name (is that odd? probably a subject for a different thread )

Some background:
Dsis is due to have DC2 in April. She has DS who will be 21m then. Her labour with DS was progressing slowly - in labour for nearly 24 hrs when DS started getting distressed, so she had EMCS. Turns out the cord was wrapped around DS's ankle which was causing the problem. She recovered well but was pretty scared by the whole experience (as was her DH).

DS is now expecting DC2. Her FIL and SIL and BIL are all doctors and she has, as you would expect, seen a consultant re this baby. They have advised a second CS. I am so tempted to try and talk her out of this though, but am biting my lip because it is none of my business at the end of the day, but...I am really worried about how hard she will find it recovering from a second CS with a busy toddler and living where she does (up a mountain, only able to drive anywhere). Also the EMCS was because of unfortunate circumstances (the cord) rather than any problem with her ability to give birth IYSWIM?

To put my experiences into context, I had DS1 in birthing centre and DD at home, DS2 was induced at 37 wks and I was in theatre about to have EMCS when thankfully DS2 decided to come out, so I have some experience of what it feels like to be rushed into theatre (although I was in such agony at that point I would have happily agreed to have my leg amputated, unlike DSis, who was "only" in non-established labour so probably more with it and so more scared by it. Physically I bounced back very easily from all 3 births so I know I am very lucky...but I think DSis could do the same and that she should at least try the natural route....?

Please tell me of your experiences of births post EMCS, what would you advise? From friends I do know who have had subsequent CS's (through physical necessity), they say recovery is harder in itself, added to the challenges of dealing with other DC's, especially if they are too young to understand why they can't climb over mummy, be picked up etc. Their view seems to be that CS would be last choice.

I would leave well alone. I had a VBAC after an EMCS and it was not a good experience - forceps (mins from an EMCS), distressed baby and ongoing 'downstairs' problems for me. I am having an ELCS in 4 weeks time despite having a 2.5 year old a 5 year old to look after. I know my VBAC COULD have been brilliant with no problems but it wasn't and you shouldn't assume it will be for her. She may resent any pressure you put on her if it doesn't work out.

Also (unless she has told you otherwise)don't assume she was more 'with it' the first time round. I was only 2-3cm dilated but having been induced 12 hours earlier, was in perfect agony and absolutely shattered - I don't even remember signing the consent. Having experienced a VBAC I can compare the two and although I was never established the first time round, the pain was comparable.

I told my frioend how lovely my birth was and she decided to have a VBAC. Her scar ruptured!!!!!!!!! Although I didn't intentionally try to convince her I still felt bad. If she asks your opinion you should of course give it but otherwise don't get involved.

I do have another friend who had a very successful VBAC!!!!!!

I had an ELCS for DS1 and tried for a VBAC this time time round. It ended with EMCS. I had everyone* telling me to go for a natural birth and I wish the'd all kept their opinions to themselves. I felt like I would be letting myself and baby down if I had another ELCS. As it was I recovered just fine, but I wish I hadn't gone through 19 hours of agony first. Leave well alone.

• Not the medical professionals, they all allowed me to make my mind up.

Thanks for all the responses - except maybe the ones that called me "smug" or "meddling" - not sure why, I said that her birth was none of my business and that I know I have been very lucky with my own experiences. If I was so smug surely I wouldn't have asked for the view of people who have gone through something I haven't before wading in? With regard to helping her in practical terms, I would love to but that isn't really an option as I have three small DC's of my own to care for and we live 3 hours apart, as do most of our family, hence my concern for her recovery.

I will of course respect DSis's decision whatever it is, it doesn't make any difference to me how her baby is born! It is just that the first thing her DH said after their DS was born was that if they have another child she should definitely just have a CS (understandably he was shaken by the EMCS too). The family docs are very much old school too, so I feel a bit uneasy that she is not hearing the other side of the choice. I kind of had the impression from previous threads that maybe more women had successful VBAC's, also the friends I have who have gone through this would be pro VBAC - but there aren't that many people I know to base that view on so the point of my post was to see if this was really the case. It seems it isn't so thanks for the insights and I will keep it zipped !

am glad you are not going to interfere in your sisters choice. It is her birth and her DHs too in some ways.
I had a terrible birth with DS 10 years ago and when i was pregnant with DD 5 years ago i opted for an elective CS, i was grieving for my mum and suffering with SPD and along with the bad 1st birth it was OKed. It was great and a lovely birth and recovery was quick despite me being a larger lady!
Im now 24 weeks pregnant and at my 12 week scan i was asked what delivery i wanted, i said ECS and consultant agreed and even gave me the date. Im so happy with my decision. I dont care what others think, its what works for me and my family!

First baby - CS due to breech. Despite being very very healthy and fit, recovery felt sluggish. Getting up stairs, carrying things and pushing a buggy etc. Itchey scar from surgery. Ideally wanted to avoid having any more major surgery and i partly wondered if the surgery/endless drugs had made breast feeding extra hard.

Second baby - VBAC. Straight forward birth of 4 hours with a fab recovery. Up and about very quickly. Breast feeding went well. Out of hospital quite quickly.

I understand that clearly you have concerns for your SIS but it's not your place to pass comment. Put it into context...would you like to be told / advised how you should give birth to your baby...and then have that reinforced via a mumsnet thread in order to prove your point.

Why not offer support in another form, turn up with some pre-made food, take the children out for the day or even have her children to stay few a few days after the birth to give her a good rest and time with new baby [bsmile]

Her body...her birth.

I have been to see the consultant (Actually, it ended up not being a consultant) who, instead of being sympathetic to my wishes, tried to convince me to try for a VBAC. Most other health professionals have been very keen for this too.

I want a CS due to severe trauma. I had an EMCS in 2009 to deliver my stillborn daughter and her premature twin sister. The thought of another c-section terrifies me, however the prospect of 'trying' to deliver vaginally and it possibly failing, then having an EMCS and being completely out of control of the situation, for me is a lot worse.

I am finding it tiring and frustrating having to continually justify my choice to the professionals. If my friends and family were the same, I would be very upset and angry. I'm glad you have decided not to pressurise her, she will have thought it through for herself.

Sorry if my comments have offended, you dont sound smug in your second post . It just did read that way a bit in your OP...but things dont always sound how you mean when written.

If you are busy with young dc's yourself and too far away to help how about pre paying for some ironing or cleaning service (ironing less invasisve of personal space i reckon) or could you offer to have her older dc's for a couple of nights whilst she has the baby (though a bit trickier that one if you not nearby)...or when you do visit then take some freezable meals to stock her freezer up a bit.

I had a horrendous labour (3 days) ending in an episiotomoy and ventouse delivery which damaged DD's eye and still leaves me in pain every month when AF arrives, at 20 months on...

So, given that experience, I am going to BEG for an ELCS if I ever pluck up the courage to have a 2nd baby. My recovery from the VB took over 12 weeks so I think I would have recovered better from a CS!

Of course, your Dsis situation is different because she had an EMCS first time around. But I think I would go for an ELCS if I was her. But then I'm biased because of what I went through...

I don't think you should try and persuade your dsil either way, it has to be her choice. I had a 2nd cs after my first was a medical necessity (ds was footling breech). I thought about it for absolutely ages.... I really wanted to try a vbac, if only for the birth experience. However I was realistic about my chances, I had never laboured and therefore I think my chances of a successful vbac were slightly lower than the 70% success rate across the board of vbacs.

In the end I was 10 days overdue and my placenta wasn't looking too healthy. My hospital do allow inductions for vbacs (some don't) but it was under such strict restrictions (continuous monitoring, not much chance of active labour, no pool, no bath, only 8 hours of labour allowed etc) that I felt my chances of a successful outcome were pretty low - Lulu is right here too, mentally you've got to want it, and I just didn't at that point. So I opted for a second cs, another big reason was I didn't want to exhaust myself attempting labour, have a cs and then go home to life with a toddler, new born and cs recovery on top of the exuastion of a failed induction.

My recovery was slower second time round. I experienced much more pain and it took me many months to be completely pain free. It wasn't toe curling pain, but enough to be noticeable. I think I tried to do too much too soon and slowed my recovery. Didn't help that we were snowed in for two weeks after I got home from hospital and had no help, plus the mw couldn't get out to see me for a week (heroic midwife walked an hour carrying scales to see me for my first post birth visit!) so I got a teeny infection in my wound.

Would I do it again? A year later I think my answer would probably be yes. It was hard and painful to recover, but I did at least avoid starting life with 2 dcs utterly exhausted by a strenuous vbac. I have friends who've done it and they were almost broken before they'd even started the weeks of night feeds etc. I think mws often don't think that there's life beyond the birth, mine were so focussed on getting me a vbac that they forgot that I have to go home and live life afterwards too.

I hope your dsil has a good birth whatever she chooses.

sorry, just realised she's your sister, not sil -I was up a bit too early this morning :o

Speaking for myself, I recovered much faster from my caesarian than from the vaginal birth- despite having a lively 3yo to look after after the section. So you can't predict these things with 100% accuracy. I also found you get more support in hospital after a CS - which helps recovery. (They seem to take damage done by men in green coats more seriously than "natural" damage.)

Agree with cory - pretty much my experience too.

I was damaged less and recovered better & faster from my elective section than I did from my first VB, even though I also had a toddler to look after.

Let her make her own mind up. It really isn't your decision to make.

She is probably trying to avoid a miserable EMCS and the only way to do that is to have a planned CS.

Assuming her partner is able to take some leave from work she won't need to pick up her other dc for a while, I didn't pick my toddler up for 2 weeks.

I had 2 CS, first EMCS (took me weeks to recover), second delivery 23 months later - I asked them to wait till my waters broke and my consultant agreed
waters broke at 5 am, DS was born at midday, I was very calm and happy about the whoel experience, recovered very quickly
I would let her decide for herself as she has enough worry for you to be adding yet another one
is not a light decision to go for a second CS so she had her deal of sleepless nights I am sure
she'll be fine and she needs as much support as she can get

having recently experienced a successful vbac, I can say that for me, the recovery from the vbac (with 2nd degree tear) was so much better than the emcs first time round. However, I can completely understand why a woman would opt for an ELcs to avoid the possibility of needing a another EMcs. If you've not been in the situation of having an emcs and facing the decision about how to deliver a DC2 it's hard to understand what your sister is goin through in making her decision. Just be there for her - if she wants to talk about it, listen and support her.

To be honest, I think its nothing to do with you and you seem a bit judgey, Why not just respect her decision and help her get through it

You're not a doctor, so your opinion isn't really relevant.

I've had 2 emcs, and tbh the second was hard to recover from. My friend had an emcs followed by an elcs and recovered very fast. Your sister has been advised by her consultant to have a cs. She is sensible to follow the expert's advice.

Another angle: my first emcs happened because the baby was fine but stuck. My second baby was stuck also but in her case her heart rate was slumping and recovering only immediately before the next contraction, at which point it went down again. The medical people looked scared, and I was on a doppler so could hear every beat and, even worse, the silence in between -the slow heart beat was minutes at a time. I thought I would be taking home a brain-damaged child at best. I screamed to be knocked out.

I think that these choices are different when you have been in labour, fearing for a baby's life. From what you describe in the OP your Sis may have had some of that. So don't worry about her choice - she is following advice and psychological health is important too. If she doesn't want a big family she is fine - cs is pretty safe the first couple of times.

I am very pro VBAC, but not if the woman doesn't want to. She has to live with her decision and so must do whatever she feels most comfortable with.

You need to read some the birth trauma threads on here.

Her decision may not have anything to do with her chances of achieving a natural birth or recovery times, but protecting herself in some way from the truama of another natural birth attempt gone wrong.