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 similar experience to you and eventually was given the option of an ELCS.

I negotiated instead an midwife-led birth centre waterbirth where the midwife wasn't allowed to touch me and no VEs at any point.

It was an amazing birth. No drugs needed at all (although I didn;t expect that)

However, I would NEVER chose a medicalised VB over an ELCS.

YY to wot loopsy said

I had my VBA2C on MLU, was even offered waterbirth, had v active labour and birth. We had agreed that first sign on trouble would go straight to C/S no mucking about. If there is a consultant midwife at your hospital try to speak with them about your plans.

I had bad tearing after dc1, but I wouldn't have wanted an ELCS. I just really wanted to do it as naturally as possible for dc2. I don't know why, but as a matter of personal choice, I was very very keen to avoid induction, pethedine, epidural, anything like that.

I didn't want to be a martyr, and in the event I had a very easy birth second time (lucky me) but there's just something in me makes me really adverse to intervention.

Op, in your circumstances I would elect for a c/section.

I recently had an ELCS after a traumatic 1st birth - forceps, bad tearing, anaesthetic trauma, catheter at home cos of incontinence and then pnd.

ELCS was so much better. I personally found it less painful, and quicker to recover from than a forceps delivery. I was able to move more comfortably, was able to manage with my toddler (taking care not to lift too much) and felt mentally hugely better.

As it turned out, my daughter had to go to scbu for a few days, and didn't breastfeed till 36 hours after birth (I'd had a GA so didn't have skin-to-skin either) and we didn't have any problems with feeding at all.

As another poster said, I wasn't at all worried about missing out on a VB - tbh a forceps delivery didn't feel at all 'natural' and hasn't impacted on my bonding with dd at all.

For me, the main issue was the mental health side of things, and for me, ELCS really helped, and so far, no sign of pnd returning. hth.

I had an emergency section with ds1, after 30 odd hours of labour. It was shit, for many reasons very traumatic and contributed to both the PND I suffered then and the almost 6 year gap between my children.

I was determined to have a vbac (not 'try for', have) so I could do things properly, as I was still carrying a huge sense of failure from first time round. I spent my pregnancy being utterly terrified of the same thing happening again, but just couldn't bring myself to book an elective.

When my mw told me at 38 weeks she had a suspicion he was breech I could have kissed her! Decision totally taken out of my hands (given how long ds1 had been stuck in the birth canal for, before they decided on the section, and had to pull him back up and out, there was simply no way I'd risk a vaginal breech birth).

Had to be in for 8am and he was eventually delivered just after 1pm - dh had more of a problem with the nil by mouth than I did! Care fantastic in the hospital, and the recovery was so much quicker and easier second time around. Mind I had made sure I was in better shape physically throughout my pregnancy than I had the first time.

I've had an EMCS first time and have chosen an ELCS for the next.

I didn't struggle with pain after the EMCS, and in fact was up and looking after my baby the morning after and home after less than 48 hours. Breastfeeding worked fine and all in all it was a very positive experience.

i've had an elcs (for macrosomia), vbac1 and vbac2.

vbac1 - back to back, utterly exhausted, failure to progress, consultant decided to emcs, but i pushed ds1 out before being moved. spent a week in hospital having my undercarriage seen to...

vbac2 - 'normal' labour. dd2 has brain damage and cerebral palsy as a result of birth hypoxia.

i have been told to have elcs if i ever find myself pg again (and there is a consultant's letter on my med records). i'm not really cut out for natural childbirth.

Sorry, not read all the responses, but yes. I did, despite being offered a VBAC

At the end of the day my CS with DD1 (for placenta praevia) was so calm and lovely, that i thought i would go for the same again. I knew what to expect surgery and recovery wise and was all great

I breastfed both to a yr (6 months exclusively)

Thank you, ALL of you, such a lot of really useful experiences and advice. I am swinging more towards the ELCS now.....

crocdundee yours and my experience sound so similar. Sorry you suffered with PND the first time - it's hideous isn't it? But am greatly encouraged to hear that you haven't had it this time following your ELCS. I am really hoping I won't get it again.

It's also great to hear so many positive stories of successful b/feeding after c-section. I really want to b/feed this time, having had to give up at 3 weeks with DD .

madwoman so sorry you suffered so much, and sorry that your DD suffered brain damage.

Thanks liggerscharter earlier for that link to the other thread - looks very useful I will have a read.

My first labour was not dissimilar to yours, OP. I had everything but the haemorrhage. How bad was your tear? If 4th degree, I'd go for ELCS.

I had 3rd degree but what probably made the difference was my mental prep. I used an amazing hypnobirthing CD, which made me feel in control all the time. Recovery was long and arduous, but apart from that I felt confident enough to go for a homebirth with dc2. Much shorter labour, 2nd degree tear - which has healed fine, and again i relied on hypnobirthing.

oh, we're all fine now (other than the disability, obv, but we're all here and making the most of life )

good luck with your decision x

Too bloody right. DD was born by emcs after 24 hours of hallucinatingly painful labour due to undiagnosed breech presentation.

Wish, wish, wish they/I'd known and I'd had an elcs.

Ho hum.

I had a traumatic forceps vb with DC1 leaving lasting pelvic floor and bladder issues.

Chose an elcs for DC2 and it was very healing. I wrote my story on the thread someone linked to above so I won't repeat it too much here.

It was gut instinct for me. DC1 was in an unbirthable position but the mw's error meant I had a 6 hour second stage in agony, then DC1 went into distress and it was an emergency rush to theatre for high rotational forceps. DD lucky not to be affected by the oxygen shortage they noted. I had 10 months of follow up with physio, urogynae and gynae consultants. Lots of trauma, lots of pain, catheters in and out, still ongoing issues (love tena).

I just felt strongly in my gut that DC1 was in the wrong position before I went into labour, I was brushed off by mw's and even during labour was not listened to at all. My gut instinct for DC2 was they would also get stuck and need assistance. I have a small frame and a tilted pelvis and I FELT DD move into her head side on position days before I went into labour.

I chose an elcs because:

There was more control for me.
I felt the risks were lower for DC2 than an assisted birth which I fully expected to need again.
I already have bladder incontinence issues and didn't want to be doubly incontinent.
I wanted to preserve the strength left in my pelvic floor and the episiotomy has permanently damamged one side already.
I want no more children after DC2 so I was not concerned about future fertility or births being affected by the cs.

I took a longterm view healthwise - in the short term I would be volunteering for surgery, but in an area of my body that had no previous issues and was likely to heal well, compared to an unknown vb risk in an area of me already functioning poorly. An elcs is nothing like an emcs as they can take their time, the stats are far better.

The elcs was calm, enjoyable, DS came out yelling, was shown to me straight away, quickly cleaned and then held by DH next to me while I stroked him and chatted to him, on my chest for skin to skin while I was wheeled into recovery. Catheter out after 24 hours with no worsening of bladder issues. Discomfort yes, but no severe pain at all.

My memories of DD's birth are awful, my 6 days on the post natal ward being checked for fistulas and recatheterised were horrific. The pain was immense and pain relief inadequate because I had had a vb and was therefore deemed 'natural'.

My memories of DS's birth are waiting to be called, then a sting from the spinal, excitment building, seconds later a yelling plump baby boy who calmed the moment he heard my voice, cuddles, breastfeeding in recovery, help from staff, and an enormous relief that I had my two children safely with me and never, ever had to do pregnancy or childbirth ever again!

This is a difficult decision, one that only you can make, but here's my opinion, FWIW.

Also had extremely traumatic labour and birth with DS (assisted delivery, episiotomy, 3rd degree tear, blood loss). It massively impacted me and the way I viewed his birth, and to this day I am still emotionally scarred from it. My son hasn't come through unscathed either - the ventouse actually cut his head open and he still has scars on his scalp

I doubt very much that I will have another child, but if I did, there is not a snowball's chance in hell I would ever go through a VB again. I would take my chances with ELCS and its associated physical risks any day over the potential emotional despair that accompanied my last experience.

I went for a VBAC. My first birth was different from yours: very very long, but in the end the baby was just stuck and so we had forceps and then emcs.

Because there had really been no trauma to either of us (not even episiotomy for the forceps) I went for a VBAC. The labour itself was very smooth, easy even, and quite healing because I felt so in control. It ended in another emcs, but this time the baby was distressed. I was really afraid my baby was going to be damaged (it took an age for them to stop faffing and knock me out) so if there was another time I'd have an elcs. I don't want to be that scared again and anyway the evidence is that no baby can get out of me the without help.

Having said that, if I had a third it would be my last child. I didn't think DD2 would be my last and am aware that cs isn't great for your innards and that it increases risks for future pregnancies, so that was a factor in trying for VBAC.

Good luck with whatever you decide. Either way, odds are it will be a different experience to last time.

It is a very difficult decision to make.

I had a bad 3rd degree tear with dd1

I really didn't want a cs with dd2, and had a 2nd degree tear.

With ds I started to suffer from double incontinence, and an elcs was agreed to, in order to avoid any further damage.

The most traumatic of the 3 births was the elcs.
I was so sure it would be calm and although recovery would be hard, I would have lots of help and cope. I read lots of threads on here and it seemed that the majority of women that had elcs had positive experiences.

I lost a lot of blood, my bp crashed, I was very sick and allergic to the pain meds, so ended up on tons of morphine. Ds was born with a severe grunt, and was admitted to nicu with respiratory distress syndrome, he was in scbu for 8 days, and I was away from him for the first 3 days. Whilst staying in scbu I developed an inflammation of the veins in my legs, the whole thing was a nightmare tbh. I hadn't factored in just how traumatised my body would feel, i felt like a woman who had been sawn in half. I managed to b'feed, despite ds not having any suck reflex. But 8 weeks after cs I got an infecton in my scar, which combined with mastitis knocked me out completely.

My gp has recently referred me to a birth trauma counsellor and I am on antidepressants. It would seem that although my cs was at 39 weeks, ds was premature in many ways. My dds were both born at 42 weeks, and the consulant thought that this fact combined with the fact that maybe my dates were wrong meant that he really wasn't ready to be born.

I really hope that you don't mind me posting my experiences, but I wish I had read more about negative experiences of cs, because I really expected to feel so much better, and felt awful that I just didn't seem to be bouncing back.

If I had to make the choice again, I would probably still choose a cs, because there is no predicting the outcome of any birth, but the one thing on the table at the time was that any further damage would almost certainly lead to a lifetime of double incontinence. However, if I had had a crystal ball(!), I may have chosen a vaginal birth.

Good luck with whatever you decide.

Haven't read all the replies but thought I would share.

I had bad tear with DS but I healed well. I had the choice with DD of ELCS. I really really didn't want it.

However DD was breech so I ended up with one anyway.

It was bloody fantastic and a far better birth experience than with DS. The recovery wasn't anything as bad as I thought it would be and I really wanted to do the whole natural birth thing again.

If I did have anymore, I would definitely have another ELCS.

Good luck.

lovethesea thank you for sharing your experience, I will have a look at the other thread too. I'm so glad the ELCS was a healing experience for you after the trauma of first time round. I am really hoping this will be my experience too. I too remember being re-catherised countless times One time they had to get the gas and air whilst they did it as I was virtually hysterical by then. I also remember absolutely begging them with tears streaming down my face to not move me again (they had me move beds at least 3 times because of "more urgent cases")

NoWayNoHow that's awful your poor DS still has scars from the ventouse. It upsets me that pain could be the first experience a baby has of this world. If it actually cut his head that must have really hurt. So sorry you were traumatised. I hope, in time, you will find you come to terms with what happened. Maybe in the future you will feel able to have another DC, if that is what you want. For a long time I thought we would just stick with one, but now I really really want another!

RancerDoo well done for trying for the VBAC, at least you know you gave it your best shot. Must be a relief in some ways to know what your decision would be if DC3 ever came along.

hazeyjane I can't believe all that you suffered after your ELCS, it sounds horrendous. Thank you for sharing, it's useful to hear ALL experiences. And I know that ELCS are not always the easy option. I hope that you are recovering emotionally now. I was on ADs for quite a long time, but am happy to say have been off them now since end of last year and am very well now. Just wanted to say you can get better and although you will never forget, the pain does ease over time.

Thanks CrapBag great to hear your ELCS was a good experience. In a way (and I know this sounds bad) I would find it easier if my baby was breech - then at least the decision would be taken out of my hands. At the moment I am still undecided but you've all given me a lot of food for thought.

Haven't had a chance to read all of this.

I had a bad first birth, a third degree tear and just an awful experience. When I found out I was pregnant, I felt very stressed about labour, though I was only 4 weeks pg! I worried about it constantly, had flashbacks etc. GP talked me out of ELCS and I decided to have a home birth. Then, at around 17 weeks, I found out I was having twins. So I couldn't have a homebirth (without making a lot of fuss). Then 'luckily' for me, the lower twin was breech so I had to have an ELCS.

I just have to say it was a completely wonderful experience for me. I didn't really notice the pain of healing too much, it healed well and with no complications, no issues with milk. And the actual process of having them was pain free, I could enjoy the babies straight away. Yes, there was a tiny bit of discomfort as they were getting them out (more for getting the placenta out), but compared to labour, it was laughable! I hardly noticed it, I was so focussed on seeing my babies and then holdint them. I just couldn't recommend it enough to anyone...though I know that is going against the MN grain.

Something a wiser GP said to me when I went for me 6 week check with DS1 was to figure out why it had been so hard for me to push him out, and required forceps etc. She said it sounded like he got stuck in my pelvis cos have v narrow pelvis. If this had ever been established, I would never have considered a natural delivery second time round. I think if you can work out what went wrong the first time, you may be able to decide if you are in a position to control those things this time round.

I can't tell you what to do, just that I am still happy with my ELCS and grateful I didn't have to fight for one because of the twins situation. If you've been offered it, I would go for it.

Read whole thread now, and sorry to have misjudged MN as ELCS seems to be the overall consensus here...

Hope your pregnancy goes v well, OP, and that you have a wonderful experience whatever you decide to do.

Just because one gets stuck doesn't mean they all will. I know lots of people me included who have emcs for stuck baby but subsequent labours are fine.