Pros and cons - ELCS......

[M0naLisa]

Posted this in chat too.

I am pregnant with 3rd and I am shitting bricks about going through labour again. We always said number 2 was our last but then decided to have another at Christmas.
It was a huge decision for me as I have to get my kind round giving birth again. I am absolutely petrified of going through it.
I have thought about an ELCS and it's looking like an option but as I am due 1st Dec I don't want to be poorly and sore over christmas.

I want to know what the pros and cons of an ELCS are from you ladies as you say it how it is.

Please.

I had to speak to a midwife today as getting abit of bloody discharge and I mentioned to her my fears and I just cried when I got off the phone as that's what the thought of natural labour does to me :(

Now I know its not an Aibu but I could turn it into one

AIBU to ask for an ELCS as i am a wuss and scared of labour.

Oh just seen q. About bf. I bf ds1 for over 2 years after an elcs and ds2 is 20 months and still going strong.

Not sure about notes as no-one ever asked for mine - DD and DS were born in different hospitals too. Neither the Midwife nor the consultant seemed to think they were relevant (?) Also not sure about breastfeeding as I couldn't due to medication, but none of my friends who've had sections have had a problem. Probably something to discuss with your MW, though...

My elcs was wonderful and so much better emotionally and physically than my first vb with forceps and lots of drama. It was k

My elcs was wonderful and so much better emotionally and physically than my first vb with forceps and lots of drama. It was just a couple of weeks before Christmas and I was totally fine. I never really took bedrest once home and was doing long walks within a month and jogging after two.

I really don't know what to do

I had an ELCS under general anaestheitc. It wasn't my choice as such - medical condition meant it was the only sensible option. I found it horrific. Not at the time (obviously I was oblivious) but I can't remember anything of the following 24 hrs (when I had a morphine PAP), then had no pain relief until my DH wemt to supermarket for paracetamol the following evening.

a) statistcally women who want to BF but have CS are less likely to successfully BF than those with same desire to BF but who VB. I had no milk until 8 days after, and obv difficulty in finding a good position. If you've already BF earlier DC then you're likely to be less ham-fisted than first-timer (and know what you're doing) so maybe not an issue?
b) Will they give you a date? Or will they wait until early onset labour? Mine was teensy when she was born - she simply wasn't ready, but because of the GA they needed to give me a date. Having a "not-yet-cooked" baby (even though she wasn't at risk medically speaking) is v guilt-inducing. In your shoes I'd want to wait for waiting for labour to start if I could.
c) Babies don't get "squeezed" out so they're likely to be sicky-er for a while, and it never really felt to me that it was "right" for my DD. I felt like she'd had second-best birth-wise, which made me feel terrible.
d) Recovery - I can't compare as haven't had both, but it is hard with CS. Maybe becuase am older (38) but I definitely didn't bounce back. Even now (16 mnths on) am completely numb around scar with occasional odd, random twinges. I had a "good" CS, and am not suggesting that this is a dreadful thing, but I do feel that there's a generally feeling of "I'd rather have stitches in my belly than anywhere else" without realising that its a slice through big important core muscles.
e) People look down on you for having a CS, especially an elective. It's fairly trivial if the alternative is risking brain hemorrhage etc, but it still isn't nice.
f) Poo-ing. I didn't for 6 days.
g) Knowing the date is wierd. Most know/assume that their baby will be born before they go to about 42 wks, but to have an appt to turn up to hospital at (say) Tuesday 10am is really REALLY wierd. Am not sure it's an advantage as you'd have yourself sorted out beforehand anyway, if you're the organised type. Honestly, I think it works out neutral.

However, my understanding is that if your terrified of giving birth then it's more likely to go badly. Could you get counselling/birth notes etc first? And I've only had ELCS under GA. So none of the above is a comparison.

Hi, we've moved this into Childbirth now. Thanks.

I'd say that if all goes well you'll be feeling OK for Christmas. If I remember correctly 3 weeks on from my ELCS (for a breech baby), I still got twinges of pain getting out of bed/up from sitting, felt quite weak in terms of core strength, but could do things around the home like laundry, cooking etc. I couldn't lift the car seat or pram without feeling like I was going to do myself some damage, but this improved quickly and I think I was managing those at 4-5 weeks. I didn't feel 'poorly' after the first few days, just sore and tired. Hope that practical info helps!

For me the worst part of having an ELCS was missing out on the experience of labour/childbirth (the grass is always greener, lol) - but you've been there and done that so not an issue for you.

Had a vb with no pain relief, an induced vb with epidural and also an ELCS and I would have no hestitation in recommending an ELCS.

Advice:

1. After the agonies of my first delivery, including post birth, I couldn't believe how well controlled my pain relief was with the CS and although it would be a lie to say I felt a nary twinge, I wasn't in any pain. Was also very in hindsight how much I was allowed to needlessly suffer with dc1.
2. Stock up on windese tablets and lactose pre delivery. It is very usual to a) get trapped wind - your stomach can feel very full and you can even feel it in your shoulders and chest where oddly it feels like a really bad pulled muscle but wind-relief tablets worked really well b)get constipated or even if not, with stitches in your lower abdomen, you don't want to strain, so taking lactose is a very good idea in the first week or two.
3. A pair of oh-so attractive Crocs will be your friend in hospital and after as you won't want to bend to put on shoes, can wear them in the hospital showers etc. In the first few days you'll be wearing surgical stockings so flip flops/anything with a toe-post won't work as well. Big stretchy yoga pants are also ideal
4. Buy big pants that come well up over the scar. If needed pad the area with maternity pads inside knickers to stop clothes chafing or anything pressing on it.
5. An ELCS can be excellent for BF, no one expects you do anything except sit or lie down. Prop nb on a pillow to protect the wound. You can still hold them skin to skin and use pillow supports arms. Or you can lie on your side in bed with baby facing nipple. Also after they have sewn you up you have to spend 30 minutes in recovery which is fab for putting nb on your chest - they kind of shuffle to breast, it's amazing.
6. There is a theory that the more you lie absolutely flat after an ELCS the smoother and neater the scar, less puckering etc and even less overhang. I thought I'd try it and scar is very smooth, straight & with no overhang - no proof of course it did work but I thought I'd mention it.

Obviously it's totally your decision but just wanted to you know there are practical things you can do that can make it an overall better experience. Good luck

I had an emcs first itme around after an induced labour which ended up with foetal distress and 35 hours labour.
We're ttc at the present and I have already decide that I will ask for a ELCS despites:
1- knowing I'll be in hospital for 5 days
2- that the recovery may take longer
3- that I won't be allow to drive for 6 weeks

It is your choice but listening to your concerns and past I would say that you should ask for one.

Good luck

Mona

I was terrified of going to loo for about 10 days after Vb and had a small tear no stiches, it stung it was painful I didnt feel back to normal for a year!! That was an uncomplicated birth.

I would be frightened to drink liquids and need a wee.

I have swung between HB, epidural and ELC for weeks now.

What makes you afraid - what risks are you prepared to take....

for many who chose elc its a questin on the roughly known compared to total un known, and un known with great pain....or roughly known with a team around you to help you.

I serisouly considered a HB and did loads of research including on here -but my MW put me off funnily enough....she said " when it goes well its truely lovley and wonderful, but my goodness....when it goes wrong......" and pulled an extremely horrfied face.

Also for me, a transfer in labour would be impossible.

i really wouldnt worry about what anyone else says in terms of judging you for ELC.

its your body you have to live with for the rest of your life and being in trouble down below might well be a drain on you mentally.

btw - I couldnt talk about my birth without being in floods either and going back to the labour ward and seeing the lifts - and rememebering the pain i was in the last time i went in them also reduced me to tears.

my consultant is part of birth trauma assoication and didnt brutally force me to fight for ELC. once she said i cuold have one - a weight was lifted and i have been able to relax and enjoy my pregnancy - and also consider other options too.

i think its medieval and brutal to force any woman to go through the process of labour if they dont want too.

thankfully women are waking up to this misgogeny and are sharing more information about differernt modes of deliervy - and we are hoping seeing a more enlightened time coming, a long way off yes - but the more women wake up to this misogeny the better....

Stonebaby, are those timescales specific to you? Women often out on day 3 or 4 and can drive, I think, after 3 weeks although you might have to check with your insurers.

they usually say six weeks as the longest time you proably cant drive - however lots of ladies have said they are driving within two weeks -its totally dependant on you and your recovery - your insurers and your docs.

they have to give a rough long time like that.

Have you read the NICE links I gave you above? These seem to suggest the risks of VB and ELCS are about the same.
As you are scared of the VB, I would go down the ELCS route.

Then you also have a totally valid comparison for your third

RE: NICE guidelines. I'd caution about using them to say that the risks are about the same. They are useful, but you should properly understand them. There are some flaws to NICE's conclusion and methodology. And the risks between a planned VB and a planned ELCS are different and some may be accept or unacceptable to different people for various reasons. They are therefore not the same.

NICE also only used data for women who have had one child. Why is this important? Well risks are different for women who have successfully given birth by VB. And there are risks to consider if wanting more children too.

Its not quite as straighforwards as the guidelines appear.

Hi M0na

Can only offer my sympathy I'm afraid. Am also currently trying to make this decision after DS1 was born via induction (which was horrendous due to rare hyperstimulation reaction) followed by 24 hour labour and emergency csec almost 3 years ago. Am now 37 weeks and hosp says I can have elcs from 39 weeks.

Had been planning vbac all through this pregnancy (due to concerns about recovery post csec with toddler to look after) so have currently got elcs booked for 41 weeks.

Have also got acupuncture booked for weeks 39 and 40. Am on the raspberry leaf tea, bouncing around on yoga ball etc...

However a certain consultant at my hospital has (really helpfully!) made me feel like they are just humoring me and I will end up with the same thing happening again. So, have seriously been considering an ELCS - as can see the bonus of being bale to be organised and have time alone with baby before returning home as well as remaining intact below... its just so hard to know what to do for the best!

I wouldn't worry about the breastfeeding. The difference in rates is small and almost certainly accounted for by the fact that EMCS and ELCS statistics are mixed up and that many of the reasons why ELCS or EMCS are needed are also reasons ppl have trouble breastfeeding. e.g underlying health condition meaning uncompatible medication has to be taken, traumatic labours with haemorrhages and anaemia, underlying conditions like PCOS that may lead to IVF pregnancies and therefore more CS risk and that are themselves associated with breastfeeding difficulty. It's the removal of the placenta that triggers milk production not labour so CS shouldn't cause a problem. Positioning though can be a problem - you could ask the midwives to help you learn to feed lying down if you haven't done that before. It's invaluable in the first few weeks anyway.