If you had the choice, would you go for an ELCS?

[GetDownYouWillFall]

I am only 14 weeks so have quite a lot of time to go, but the question has been posed because I had a very traumatic birth (vaginally) last time and my MW said I could have the option of an ELCS this time if I wanted, but I really don't know if it's what I want....

Basically my problems last time were long labour, bad tear, repair in surgery, haemorrage, blood transfusion and, to top it off, the lovely urinary incontinence. Was in hospital 9 days.

The trauma affected me badly for quite a while and ended up in a mother and baby unit for nearly 3 months because I became so depressed.

The advantages of an ELCS as I see it are:

• being able to plan childcare
• feeling more in control
• not starting off physically exhausted and depleted
• knowing the date you will have the baby
• lack of long labour and all the related agony and stress (I know CS are painful afterwards though)

But I am really aware of the disadvantes too:

• major surgery
• scar
• possibility of milk not coming in straight away
• risk of infection?
• pain and debilitation afterwards (we have a lot of stairs in our house and am worried about getting around)

So, I am left feeling totally at a loss about what would be best. DH definitely wants to go the ELCS route - but as I've pointed out - it's not HIS body being cut open! Am also aware that a second vaginal birth is likely to be a lot quicker and easier than first time round (is it?), and could actually be a very "healing" experience if all goes well.

Has anyone been in this position, and what did you decide?

I had a very traumatic labour with dd which resulted in an emcs and dd in intensive care. I will definitely be requesting an elcs next time.

I had emcs and then vbac. I didn't have your complications but would never choose elcs. The recovery is too long. Not being able to pick up my toddler for 6 weeks wax too much to contemplate. As I said, I didn't have your complications though and I am sure this has an impact on your decision.

Thanks, I see both your points. I am really 50/50 and undecided. DD will be nearly 4 by then so I won't be needing to pick her up like a really young toddler, but the thought of being incapacitated does scare me...

Yes but just for one reason, after 2 big babies, 9.15 and 10.6, my pelvis floor is completely knackered...hence I'm always leaking urine...Now I hear you I should do exercises !

summerfruit my pelvic floor has never been the same again either! It's quite a horrible embarrassing problem to have. I am hopeless at remembering to do the exercises. I have just had a referral to physio though - it's only taken 3.5 years!!

I had an ELCS when I had my DS. He was breech but I would have requested (and got) an ELCS if he hadn't been breech. Like you I had a traumatic vaginal labour although yours sounds more more horrific than mine.

My recovery period was pretty short and I was able to do most of things within a week or so.My physical and emotional recovery was much quicker from the ELCS, compared with the "natural" birth.

sorry, not clear. Previously, I had had a traumatic vaginal birth.

Thanks Ghost am very interested to hear about your experience - particularly that you felt your emotional recovery was quicker with the ELCS. This is something that is very large in my mind - I don't want to get PND again, and if an ELCS might go some way to helping then I would do it.

I had an emcs then a successful vbac. I never believed all the midwives who told me a second birth would be so much easier but in may case, they were absolutely right. I was adamant I wanted to do everything possible to avoid a second cs because my experience of the first one was so horrid. However, I do understand that elcs is supposed to be easier to recover from than emcs. I do sympathise with you as it's so hard to know what will be best - if only there was a cystal ball to refer to. Congratulations & good luck

I've had and emergency CS, an elective CS and a VBa2C.

I dithered endlessly through 2nd pregnancy, ended up with elective CS as overdue and just not committed enough to the VBAC project. HATED it, it was a long stressful wait (last on the list, DD born at 6pm, nil by mouth since midnight the night before no picnic when you are Still Actually Pregnant); some complications so had a drain; and it really took it out of me emotionally and physically.

The VBAC with DS2 was magic. Had a doula, really helped.

What does your instinct tell you?

I did have the choice and chose the ELCS and it was FANTASTIC.

My DD1 was 22 months - old enough to climb in and out of her bed, sit at a low child's table for meals and climb onto the sofa to cuddle me and to get into the car seat by herself so the carrying thing (for me) was a total non-issue.

I've had some conversations with Maureen Treadwell of the Birth Trauma Association and she said that very often women are pushed into attempting natural birth again by medics and they end up with a second traumatic birth.

That would be far too much to contemplate for me.

BUT, I honestly never aspired to have any kind of perfect natural birth first time round either, and still couldn't care less that I haven't had one.

I have a friend who had an EMCS first time round and a VBAC second time round and it seemed like her self esteem very much rested on managing to do this - she talked a lot about feeling a failure for not having a VB first time round and I honestly can't relate to that at all.

So, in short, I'd say it depends on what would bother you more - having another traumatic birth, or not having a natural birth.

HOpe that makes sense!

Thanks maxpower for your congrats, as well as your advice!! It IS really hard to know what to do for the best. Obviously my preference would be for a trouble-free smooth vaginal birth. But I know that there is no guarantee of that. The last thing I want is incontinence, blood transfusion and all that crap again.

Thanks Meryl - interesting to hear from you as you've experience of them all! Interesting that your ELCS was not a great experience. Sorry you had to wait so long and were starving. That's not great is it. Glad you had a wonderful VBAC. How much did the doula cost, if I may ask?

I think DH might be a bit offended if I say I want a doula!

liggerscharter thanks for putting that down, yes it does make perfect sense! I suppose because I had a VB first time, I am not particularly "bothered" by feelings of must have a VB to feel like a "complete woman" - I feel that as long as I am ok and the baby is ok that will be enough for me. I do understand womens' drive to have a VB after a CS though. Some women just feel it's what they have to do and that's fine.

For me, I just don't want another traumatic birth. So maybe the ELCS would be the best option?

Oh, I second what ghost says about not carrying the trauma around.

Even with a C-S recovery to cope with (compared to forceps recovery first time) I felt amazing after the second birth. I felt elated, incredibly happy, like a weight had been lifted from my shoulders. I'd spent the entire 8 months previously reliving my forceps delivery, couldn't sleep at night. It was awful.

The instant the ELCS was done I was just so happy and relieved. My ELCS was the BEST experience of my life. My VB was hands down the worst.

But - it's a lottery - no guarantee with either mode that there won't be complications.

Getdown - I agree, I've always wondered if I'd had an EMCS first time if I would have felt less strongly about ELCS.

That's amazing you felt the ELCS was the best experience of your life!! Like you, I felt like my VB was one of the hardest experiences of my life, so the thought that birth this time round could feel so good is really, really encouraging. Thank you.

Feel bad now because I am married and my wedding day was also wonderful! But I found getting married quite stressful, my ELCS was just such a relaxed, positive, happy amazing experience

Wow, it sounds fantastic! Were you allowed skin-to-skin contact straight away? Were you able to b/feed?

It wasn't straight away but very soon after she was born, while I was being stitched up.

Yes, I breastfed her but only for four months - that was due to a tongue tie though, nothing to do with the c-s.

Sorry for all the questions but how many weeks were you when you had the CS, and did your milk come in straight away or did you have to wait a few days?

No problem, ask me as much as you like

I was exactly 39 weeks - milk came in quite quickly I think - I was discharged 48 hours after the ELCS and I know it had come in by the time I was going home - I think it must have been the day after the ELCS. Certainly was a lot, lot quicker than with my first which was more like 4 days.

this is a great thread by the way.

OP, they were a few of the issues I had with my emcs. No skin to skin partly as I was having a reaction to the epidural - in fact, I didn't even get to hold DD for an hour. I had mine at 41+6 (after failed induction). My milk didn't come in for 8 days - by which time, DD was being formula fed because of concerns that she wasn't getting anything from me (which she wasn't) so bf was never established.

My doula cost £350, for 3 sessions before birth, the birth itself,2 sessions afterwards. She is also a reflexologist (and homeopath) which was really wonderful. She was marvellous, as much as anything I wanted her
around so that she could support my wishes in labour at the hospital (so DH could concentrate on ME) but as it was we only got there an hour before DS was born.

Wanted also to say I had no problems at all with breastfeeding after either of my sections. But I really think the labour hormones helped me through the EMCS.

I had induction with DS1 which turned out just fine (no stitches even) but ELCS with DS2 on a sort of emergency basis (waters went 35 weeks, scan showed he had IUGR and only a few days to live).

CS was fab, TBH. I hated the spinal block but had that with first birth anyway. Pain afterwards very manageable (excellent drugs), I had the op at 7.45pm and was walking about by early afternoon the next day - and only waited that long because nurses refused to remove the catheter any earlier.

By day four I'd mostly ditched the painkillers and only felt a bit sore.

Milk came through just fine, in fact had loads more than first time round. Am EBF even after DS spent three weeks in SCBU.

Downsides: no skin to skin, but that was because baby was rushed straight to SCBU. No driving, which was a real problem because the hospital was miles away. Couldn't do as much for DS1 (3.6), pick him up etc.

You need good backup around you, I think, for lifts and things. But def was a good option for me. I bounced back far quicker than with natural birth.