Stuck between a rock and a hard place?

[CosmicMouse]

Just wondering if anyone has been in a similar position and can offer advice?

I'm (very) newly pregnant with DC2, and already bricking it about the birth :(

I had a horrible birth with DD. Felt utterly degraded. Ended up completely out of control with the pain (only had G&A, and it was too late for anything else when I needed it most) and ended up birthing on my back with legs akimbo resulting in a 3rd degree tear. Surprise surprise. Had to be taken from my baby to get stitched in theatre and then spent an awful 72hrs in hospital trying frantically to get her to breastfeed. She just wouldn't even try to latch. In the end I couldn't take any more and took her home, where when faced with the prospect of pumping or sleeping at letting my DH bottlefeed, I caved.

It took over 3 months for me not to be in excruciating pain when bending over or lifting my legs from a sitting position.

Still living with major regret over the whole thing. The fact I didn't breastfeed being the most hard to bear. Still lose sleep over it 2 years on, more so now I'm pregnant again.

Fast forward to now, and I'm really stuck as to what to do this time around.

Do I...?

a) Try for a nice natural birth again, this time with a Doula. Potential for it all to go beautifully. Also potential for another awful experience, and also a chance of another bad tear and problems with incontinence.

b) Go for natural, but have an epidural. Again potential for a lovely birth. But more chance of needing intervention, and still no guarantee of no tear. Also a chance of bad timing meaning no epidural at the right time whilst in labour.

c) Push for a c-section. Takes the uncertainty out of the whole thing. Protects me from chance of incontinence. But it's obviously got its own set of risks. Plus it's not the best start for baby, nor breastfeeding.

I think I've accepted that I care more about breastfeeding than I do about having a 'lovely' birth. I'd happily sacrifice the latter for the former. But none of these options seems clear cut.

WWYD?

I feel like my head is going to explode!

I had similar feelings, I only had G&A for DD because I arrived too late for anything else.
Managed the birth fine in my case but had to go to theatre for an manual removal of placenta which meant being taken from DD for a number of hours and being kept in hospital for longer than I had hoped for due to being given spinal. The MROP was very degrading and I felt very vunerable.
I struggled to breastfeed and spent most of it resenting my little girl and in floods of tears everytime she cried for a feed because I knew what was too come. In the end like yourself I stopped and went to bottle which was hard to do, but after being diagnosed with PND which I put down to the struggling to bond due to feeding problems I felt I had no choice.

With DS I discussed all my options with the Consultant, mainly to do with GA rather than spinal if it was to happen again, I was very keen for a VB so never mentioned other options for birthing.

Anyway DS progressed well and I arrived pushing and never got any further after 3 and half hours of pushing G&A again DS was diagnosed as brow and was becoming very distressed so I was whisked off for a EMCS, due to the rush my spinal blocked failed and I was knocked out, so I never got to see DS and when I did I was very groggy and in alot of pain, as there was no spinal block to block out the pain around my scar. I decided there and then that I wasn't even going to attempt to breastfeed as I felt I had enough to deal with mentally surrounding his birth that I didn't want to add another failure to my list.

I am currently 36+5 with number 3 and I am down for an ELCS at 39 weeks, however if I labour before this date and I am progressing well I am going to try for a VBAC as I personally couldn't stand the thought of another section in a rush and the spinal failing again.

I have been very shocked about how easy it has been to discuss my worries with the consultant and anaethatist which has made me get things sorted in my head (well as best I can).

I understand your worries regarding the breastfeeding thing, I know a number of people who have managed to breastfeed their 2nd irrelevant of the birth experience they had, they just made sure they had a good support network in place and plenty of contact numbers by their side to get professional advice.

I am yet to know what is a perfect birth if there is such a thing. I have two healthy children and hopefully a 3rd one in the next few weeks, and that seems perfect for me.

I know I haven't been much help really, didn't just want to read and run though.

Congratulations.

I had not brilliant births with ds1 and ds2 (not as bad as yours, but attempted home births that ended in c/s in not very pleasant circumstances), and when pregnant with dc3, i felt very similar to you, yoyo-ing between trying again for a 'good' natural delivery, or going for an elective c/s.

in the end, mainly because i had a terrible ragged scar from ds2, i opted for the elective c/s at 39 weeks. for me it was a very positive experience, and dd ironically was in far better shape despite not being 'ready' (i had had no signs of labour at all) than her big brothers had been.

i was insistent on immediate skin to skin contact with her (which i hadn't had in previous births), which was easily arranged because there was no emergency situation, so there was time to get the midwives/obstetrician/anaesthetist on board to make this happen. she breastfed immediately. if you do decide to go for the c/s, i would really recommend you try to get the skin to skin in the theatre as i'm sure it helps with establishing b/f.

I really feel for you.
I heard a really interesting article about Doula's on Woman's hour recently - whereby some northern hospitals are using volunteer Doulas as a matter of course & intervention rates & rates of difficult labour have reduced massively. Perhaps you could consider this with a water birth as they too reduce the risk of tearing.
There is another drug (not advertised as it's expensive) but has been used for over 10 years now with great effect including far less c-sections than with epidural (I.e. It's an alternative to epidural). It is called Remifentanyl. It is an opiate BUT does not affect the baby, does not make you out of it, it is not complete pain relief like the epidural BUT it is significant pain relief & better still you are still able to move & have a connection with the pain so that you can feel what your body is telling you.
Good luck x

Thank you ladies for sharing your experiences.

nunnie - Did you find it straightforward being referred to a consultant in the first instance? I've got it in my head that I'm going to be poo-pooed and have to argue my case to see a consultant

mrsravelstein - It's nice to hear you had a positive ELCS experience and no problems breastfeeding. Having unexpected turned in a raging hippy mother since having DD, I am now surrounded by Doula/Peer Supporter/LLL types which I know will make a huge difference this time around...no matter how I deliver. All I had last time were some overstretched midwives on the ward, who really didn't seem to give a toss whether we breastfed or not as long as we didn't starve DD or bother them too much.

redclover - Yes, thanks to a friend suggesting it, a Doula will be must if I go for a natural birth. I think it would have made a big difference to the whole affair last time. You live and learn.

I still don't have a scooby what to do. But it's early days. I'm just keen to get a plan in place so I don't spend the whole of what is likely to be my last pregnancy terrified about the birth. I'm off to let the Dr know I'm pregnant tomorrow, so I'm hopeful the GP I see can give me some idea of the procedure...although I think I may be seeing a locum, in which case I'll try and see my GP at some point soon.

Thanks again ladies, and any further input from others is still very much appreciated!