Elective Caesareans - lots of questions

[Gem13]

I am going to see a consultant next week to discuss having an elective Caesarean for the birth of my second child. Apparently it is now advised for women with a prolapse or a third degree tear and I have both

I have only just found this out despite having spoken to various professionals over the last 8 months, no one has raised this before now. I am in a bit of shock especially since I was planning on a home waterbirth!

There are so many pluses and minuses that I'm trying to sort them out at the moment...

My first labour was pretty grim and so in one way I am quite excited about the thought of not having to go through that again. But then I was hoping this one would be a much more positive experience.

However, it would make looking after DS on the day and for a few days afterwards easier as we would be able to arrange care. But then how easy is it to look after an 18 month old when you've had a c-section? When are you able to look after your first child again (i.e. changing nappies, bathing, lifting into carseats, etc.) and with the 2 children on your own (no family nearby)?

Is it really strange knowing you are going in for an operation? Everyone I have spoken to who has had a c-section has had one after trying to deliver naturally and they were relieved something was being done to get the baby out. Epidurals, drips, catheters, etc. weren't an issue for them as they were in pain already but I won't be and I'm wondering how 'scary' it is to be in an operating theatre in that situation when you are fit and well?

Did those who had a one natural birth followed by a c-section find a huge difference in their experience of having a new baby, e.g. difficulties with feeding, bonding, recovery, etc.?

I'm not really worried just intrigued by this potential change in plans and would like to hear of others' experiences so that I can be fully clued up. It is not an absolute certainty that I will have one but reasonably likely.

BTW - I am 34 weeks so this could be happening in 5 weeks!

I had an emergency c section after 21 hours labour and complications with first dd. advised to have elective next time and it was the right choice - it was fine. Very odd, knowing the day, surgery etc. The doctors were brilliant and made it a really positive experience. I was fairly fit and can't remember many/any downsides - apart from not lifting dd1. Got back to the gym v quickly, found bonding fine - but as didn't have a first natural childbirth not sure how it compares. But dd2 was given to me virtually immediately - after all the checks. Had a catheter again - but you don't have to get up to wee ... you ned to be careful, obviously because of the stitching inside which I tended to forget about, think I was lucky, but the problems of a c section - ie what you can and can't do, for me were over-exagerated but was lucky so apologies to anyone who found it hard.

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I didn't have any family around for help either so understand the worries. Did get a mother's help for a few hours some days which was great.

I had an elective section for my first (and only), due to a large fibroid blocking the usual way out!

It was a doddle!

I had a spinal anaesthetic, not an epidural, which was painless, and the whole thing was over in less than 30 mins.I did have a catheter and drip, both of which were removed the same day, as soon as the spinal had worn off. I wasn't scared by the operating theatre (but then I work in a hospital)I'm sure you would be excited, rather than scared- there is so little time between them starting, and the baby being out, you don't have time to worry!

I was taken to recovery where dd was b/fed, then washed and dressed, then back to the ward, where I pigged out on hospital lunch (I was desperate- the heartburn had been so bad, I'd eaten virtually nothing for the previous 2 months!). My one big tip would be NOT to pig out- my bowel went on strike for a couple of days and my stomach inflated to pre-delivery size, and I was pretty uncomfortable- take it easy!

Post-op pain relief was 1 dose of diamorphine, which made me feel woozy, so I didn't have any more, and then voltarol. I stayed in hospital 5 days, but could have easily managed a home after 3, though of course there were no other kids to worry about. My wound healed fine, and I had no problems with stairs, or walking within a few days. I was driving in 3 weeks, though I think I could have done so sooner.

Got to go now, may post more tomorrow. Don't worry the only problem you may have is persuading people that you are NOT "too posh to push"!

I've had an emergency and an elective c/s.
I had a good experience with the elective and nice memories of it. Music playing, chatty staff, laughing.
As soon as ds was born he was put skin to skin and we were like that for ages, so no probs bonding.
I was up and about (slowly) the next day and home after 3 days. You just need to do things slowly and my dh had time off to help. Looking after the new baby was no prob. but a wriggly 18 mo- is different. My dd was 7 so diff. circumstances.
Bf- I couldn't, despite frantically trying- but that's just me. If you managed 1st time round, sure you'll be fine.
Also remember with no2 you are much more chilled about things.
I

I don't know about caring for another child and no experience of natural birth - I had an elective cs for my first due to placenta praevia. I was a bit nervous but no more than that. The operating theatre wasn't any more scary IMO than the other hospital delivery rooms (saw the inside of a couple of those when admitted with bleeding). I had zero problems with bonding, recovery was fine, and my only problem was that my milk took a couple more days to come in than it probably would have otherwise. But I breastfed my ds for over a year, and looking back probably would have refused formula for him in hospital as I was producing colostrum. I was also in very good shape compared to some friends after the birth as I was well rested and hadn't had a long labour to exhaust me. Every experience is different I think, but I actually liked my cs. BTW the epidural didn't hurt me, and the catheter went in after the spinal block so didn't feel that at all. Good luck!

Gem13,
I had two emergency C sections, each was very different - first almost pleasant, second very traumatic and brutal, for me not the baby and I have had no trouble whatsoever bonding with babies.

I would advise anyone who has a hint of difficulty with a second birth to go for elective C and not try for VBAC (not that you are doing that) but what I mean is I wish I had an elective for DS2 ( I have big babies and a stubborn anterior lip).

Sorry this ramble is not exactly what you asked for but the bottom line is 'lucky you being able to plan ahead and don't even consider the bonding to be an issue'

HTH

Hi Gem13,
I had emergency section for dd after 48hrs in labour and was quite traumatised afterwards and exhausted. Recovery was great though and I'm not in paticularly good shape. As a result wanted to try VBAC desperately for my 2nd but was advised by my consultant and midwife that elective section would be better for various reasons. Best decision, really lovely positive experience, bonded with my ds straight away, had lovely staff, my community midwife came in with me to take ds, had my dh and dsister with me. Just lovely. Odd to know when he was coming etc but great to be able to sort out care for dd, tidy house, shave legs, hair done, manicure etc
If you do have to have one I would ask to see an anaesthetist prior to the op so you can discuss the options for anaesthesia, this was worried me most and being able to express my fears prior to surgery really helped and it helps to be informed. It is uncomfortable but certainly bearable and IME you manage what you need to manage when at home. It is strange going into theatre when you are fit and well but exciting as well to know you will be meeting your baby within 30mins. i had a drain, catheter and IVI but managed to hold ds(sadly dh had to change most of the first meconium nappiesand feed him. Sorry if this is a bit rambling just wanted to try and answer all your questions. agree with Tissy beware of people sticking their oar in on the too posh to push line. If that's the decision you and your consultant come to so be it, no sensible person opts for abdominal surgery unless there's a very good reason. Good luck.

Meant to say 4-6 weeks for driving, check with your I nsurance company but i drove after 4 weeks, just taking dd to pre school and back but after 8 weeks am now back to 'normal'.
Think about your car seat though, I was quite aware my first one was very heavy so opted for a much lighter one this time to minimise the 'load'. Even though driving at 4 weeks, didn't carry car seat until 5 weeks, just lifted ds in and out. Will shut up now

Thanks everyone for your positive experiences. It's been really helpful and encouraging to read them. I shall be disappointed now if the consultant says I can try for a natural birth

I forgot to mention in my original post (it had to end somewhere!) that I was up and about very soon after having DS and that he fed and slept really well and I didn't want to jeopardise that part of having a newborn.

Luckily I don't know what I'm having so there is still that surprise!

Encouraged by the early driving experiences too.

Thanks all.

Just one thing to add, my first slept brilliantly - c section, second didn't, c'section too - theyr're their own little people, so if he/she doesn't sleep, might be not the c section.

agree with sykes dd nightmare feeding never slept unless with us(love her!) ds very chilled and sleeps really well(touch wood!)Very much down to the baby.

I have never had a natural birth but have had 3 c-sections. The first one was elective because baby was breech and i have a funny shaped room so baby couldn't be turned. Yeah it was quite strange knowing what day you would have your baby but definatly good for arranging childcare e.t.c. The atmosphere in the theatre will be very relaxed and the only sensation you usually feel is a bit of pushing and pulling. The best way i can describe it is that it's like someone washing up in your stomach. As for afterwards, you will usually be expected to get out of bed the same day or next day depending on time of delivery. This can be very scary but it is honestly better to get as mobile as you can as soon as you can. As for lifting other children, it will be difficult for a couple of weeks. The best thing to do is to get a little stool that your child can stand on to be at your level and if you need to change them get then to climb and lie on the settee or bed. My 2nd section was an emergency one but not really much different to the first and by my third i wasn't even nervous. Hope that is helpful. If you have any more questions feel free to ask

Also meant to say about pain relief 'If you are in pain ask for it' With my 3rd section i had to have ds at a bigger hospital due to complications, and there they do a thing called SMACKS, which is Self Medication. Basically they give you a bag with vials of morphine and various other pain releif and then you decide when to take them. It's all explianed so you don't od, and they check them every day to keep track of what you've taken. I was very worried about it at first but it was brilliant and i was hardley ever in pain.

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take the painkillers!

good luck with it all - wow - just a couple of weeks to go - almost the same as me - strange feeling isn't it?

Hi Gem13,
Ds1 was emergency c/s under epidural, ds2 was elective under g.a. Regarding the weirdness of knowing the time etc, electives are put to the bottom of the list and when I was due to go in there were 9 other c/s that day - 7 of which were emergency. Plus a couple of "high" forceps which also take 45 mins in the theatre. So having been admitted at 8am I didn't get down to theatre until 6:45pm, and even then they thought that I might have been sent home! As I was nil by mouth pre-op I was put on a drip at about 3pm.

Feeding was a bit slow and I did top up with formula for 4 or 5 days, but dropped the amount of top-up by 5mls per day. I then fed both for 6 months, so seemed to be OK. Holding the baby etc is fine, though the most difficult bit was getting in and out of bed - it is advisable to use a stool to help for the first week or so.

Ds1 was/is a daddy's boy, so he was very happy in Dh's care whilst I was in hospital. He was a very lively 25 month old, so I found the 30 mins per day visit quite enough whilst in hospital.

As for recovery, in each case I would say that I felt "normal" in just under 4 weeks, so able to drive, lift ds1 (2 and a half stone) and generally able to manage by myself. I have to say that I did have someone around most of the time for the first 4 weeks though! The one occasion when I half lifted Ds1 at about 2 weeks post-op I did feel as if I might have pulled something, so made sure i didn't do so until closer to 4 weeks ago.

Comparing recoveries with friends, I seem to have had an easier time than those who had had episiotomies. But I agree with morocco - do take the painkillers.

Hi Gem13
I had 3 natural deliveries followed by a caesarian. The caesarian was done at the last minute after I failed to start contractions when my waters went, so wasn't elective but wasn't emergency either. I had an epidural anaesthetic.
I had absolutely no problems at all bonding with my baby and from that side of things it was no different to a natural birth. It was actually a big relief to know that I would not be going through the pain and trauma of childbirth for the fourth time, and although it is undeniably painful to get over a caesarian, the pain is much miler than that of full-blown contractions and can be well controlled if you take all the pain-relief you are offered.
You won't feel it when they put the catheter in, so I wouldn't worry about that. I found the whole experience quite exciting and fascinating, but was quite nauseous/sick for about 10mins after they numbed me. This is quite common apparently and a bit disconcerting when you can't move yourself without help onto your side.
The recovery period is longer and you do need to be careful in order to give your wound and underlying stitches the best chance of healing properly, but I was totally relieved that my nether regions were completely intact after having given birth. No stitches or bruises etc .... bliss!!!! I did get an infection and needed lots of iv anti-biotics, but that is all a distant memory now and didn't interfere with the bonding process. You can get infections, sadly, whatever way you give birth.
The only downside for me has been the overhanging tummy flap which is the little-known legacy of a caesarian. It can be controlled by extreme sit-ups so I've been told, but I am too lazy.
Good luck with your birth xxx

Hi Gem
Like you, I had a third-degree tear with my first delivery. Recovery was slow & hard & I was so shocked at how ill I felt. I didn't get to hold my dd1 for nearly an hour after she was delivered as first of all she was taken away to be checked out by the paediatrician and then when she came back I was vomiting (too many drugs) & being stitched up by 2 people (nice!).

Second time round, the consultant suggested a c-section pretty early on but was very happy to let me make the final decision, after he had outlined the pros & cons. The risks attached to an elective c-section seemed less to me than the risk of another bad delivery, bad tear & increased damage to perineum. I ummed & ahhed for ages & was pretty chicken but eventually went for the c-section. I was actually terrified I'd go into labour early & have to have another vaginal delivery.

The operation was absolutely fine, not all at scary. And I think I bonded with dd2 so so so much quicker than with dd1. She was delivered straight onto my chest & I held her and cuddled her for the first 15/20 mins, instead of lying there vomiting & feeling totally shell-shocked.

Getting home to a lively 2.5yr old was quite hard because I felt quite fragile but it was all fine apart from the problem of getting her out of her cot -dh goes to work v. early so I'd have to do it myself - in the end I put the toilet step in there and she had to stand on that and I'd drag her out inelegantly but effectively! Our insurers said I could drive as soon as my doctor said it was OK - I was back in the car after 2.5wks.

Didn't have lots of pain but the first 12hrs when you're pretty immobile can be hard - my baby wanted to be picked up & fed and I had to call the midwives every time and they were busy & not that nice about it.

I would have another elective c-section again tomorrow - it was a really positive, pleasant experience and beats a bad vaginal delivery hands down in my opinion! Good luck.

My experiences and reasons were practically identical to Anto's. I had a hard first birth, and compared with that, my memories of DS2's elective c/section delivery are lovely. The only person in the room screaming was the baby! Everything was smooth, efficient, caring and un-scary. Bonding was exactly the same, but faster, IMO, because you are not recovering from shock and pain, they just give you your lovely baby and you cuddle him!
The pain was completely controlled afterwards, with a few twinges the day after, but nothing serious.
At home, I was in better shape to look after my 2 year old than I had been after my first vaginal instrumental delivery. I had no help from DH (long hours) and was thoroughly pissed off about that, but it was fine.
Don't worry, I'm sure you'll find it much better, Gem13.

Like norma, I didn't feel them put the catheter in. I didn't experience much pain at all. I can vouch for the annoying little stomach pouch too (thought it was just me) but am also far to lazy to zap it.

I meant not much pain after the c/section, not the catheter. No pain at all for that - doh!

I've had 2 emergency c/s - once for failure to progress when dd1 was becoming acidotic; the second because my bp was dangerously low - just as they were about to induce me at 42 wks - and dd2's heartrate dropped too. that time I had to have a general anaesthetic because it was a real crash situation - she was born 15 mins later, no time for epidural. to be honest, the general was the worst thing and so having a planned procedure would be my choice if I went through it all again (I had been persuaded by my consultant that a VBAC was possible - but we had agreed a time limit on labour so I didn't get too tired/scared about dd's delivery). make sure you have a private room afterwards as you'll need plenty of rest. get the catheter out asap after and get mobile too - but take it gently. my dd1 was nearly 3 when her sister was born but I just had to remind her to help mummy and had my mil, then mum to stay when dh was away on business only a couple of weeks after the birth. not driving is a pain but you can always get people to come to you and order supermarket shopping online.
i too breastfed just after delivery and had no problems bonding/feeding.
good luck and please don't worry too much

Hi Gem- I'd just like to reinforce the really positive experiences of both my CS deliveries as everyone else has done. And despite 2 CS's I dont have an overhanging tummy bulge, and didnt do any strenuous situps/abdo exs after either! Just bf, general childcare and getting active asap helped with returning my body to its usual shape. It did take a little longer 2nd time around despite less weight gain with ds2. I'd recommend pilates if you're into exs... definitely not sit ups. Awful for your back anyway and not great as a first off abdominal exs post pg.
Good luck with your decision making.... here's to the new arrival!

Gem 13 - really glad you started this thread, I had an emergency c with my dd and am now 9 weeks pg with my second baby. Doc says I can have a 'trial' labour of 12 hours and then would be given a section. The thought of having 12 hours and then rushed in like last time doesn't appeal so I might go straight for a section. However, I also want to know what it is like to give birth 'normally' >oh no you don't, I hear you all cry<

Unlike you however I have another 7 months ish to make up my mind, not sure if that is good or bad.

Good luck with whatever you decide.