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!

oliveoil, that's the option I was given with dd2 too. the only advice I'd give is to have an epidural in place BEFORE contractions start (if you go in for an induction like I did) because I'd only just had the canula put in when I was whizzed down for a c/s. so it was worse than the first one iykwim.

Thank you again for your kind messages - I'm really touched by everyone sharing their experiences and there isn't a negative one among them!

I have seen the consultant now who was really good, explained everything very well and wasn't at all scissor-happy which I was surprised about.

He has said that I can choose which way to go, i.e. try a home labour and see how it proceeds; have a late scan to check the size of the baby before deciding, etc. but ultimately there is a small risk to the tear if I try vaginally which could leave me anally incontinent.

So... it makes the most sense to go for an elective. I'm quite excited about knowing when my baby's birthday will be, the fear of pushing and wrecking my body has gone but then I have the odd sad moment about the preplanning, having subsequent babies by c-section, being in hospital, etc. (hormones!)

I'm going to try to stay in hospital for as long as I can, and see if I can get a private room. I'm looking forward to having some time getting to know D? but then I think about missing DS... I didn't think the sharing would have to start so immediately! Hopefully in a private room he can just come and hang out with some toys. He'd only last 5 minutes in a ward!

We have to go back to see the consultant in a week and let him know our decision so I haven't an exact date yet.

I'll post in mid February and let you know how it went though.

Thanks again.

Gem13
thanks for the update nice to hear from you. best advice I can give you now is relax and enjoy the rest of your pregnancy. It's quite normal to have these feelings about pre planning etc but try and go with the flow. At the end of the day I'm a believer in however they get here as long as they're ok and you're ok nothing else really mattersLots of Luck xx

Gem13, I had a private room but still felt pretty alone at night and going home was wonderful. Slept a zillion times better in my own bed. Could sleep alongside ds without being terrified he'd fall out of the narrow single hospital bed and it just being so much nicer. My advice would very much be, don't spend money on a single room - you'll probably get a side room anyway after a section. Try to get out of hospital asap (my friend came out after two days) and have a doula instead at home for the first few weeks - she will play with and entertain your older child, help you look after the baby and even tidy up, put the washing on and make you lunch.

I don't mean to sound bossy BTW. A private room is nice, but it isn't home, that's for sure.

Aloha - you didn't sound bossy but I know I would be if I was at home! I wouldn't be able to just let DH get on with things. I'd be issuing instructions about how to fold the laundry, what to give DS for dinner, etc. and it would make us both frazzled (based on previous experience after DS's birth). I don't think I'd be much better with a doula however great that idea is!

I think my in-laws will come down for a few days while I am in hospital. It'll give them a chance to help out which they would like to do, they can spend some quality time with their son and grandson, see their new grandchild and then go before I come home! That's the current plan anyway.

Hopefully, by being in hospital for a few days when I do come home I will be able to at least sit down with DS, read some stories, etc., hang out on the sofa and not be in bed too much.

and another advantage is that you don't have to do all the first few days nappy changes - miss all those black ones!

morocco - are you still in Morocco? Maybe things are better there. Last time (18 months ago) I asked the MW if DS needed his nappy changing, just a few hours after the birth and she looked at me as if I was a lazy cow! I think she told DH (a new dad) where the room was.

Had to ask 3? times for them to wash his face before his grandparents saw him 8 hours after he was born. Couldn't walk because of the anaesthetic. Oh, the joys of the NHS!

The MW were fine BTW, just understaffed and overworked.

Gem 13 I had a side room when I had dd and ds it was routine to have one post section 4yrs ago at my local hospital but when I had ds 8 weeks ago I only had it because of being staff. So if it's important to you( which it was for me), do ask for a private room. Just be forewarned in most NHS hospitals these are only given on an availability basis. The fact you have paid doesn't guarantee you the room so just clarify this so you're not disappointed. It is worth it though IMHO. I also think you're sensible aiming to stay in a few days, I came home much too early and paid for it. If you can get people to look after ds take advantage of it.

Morocco....someone to do nappy changes? In the NHS? You are joking! I had private care via my health insurance and I still had to change all his nappies myself. Nobody took him away so I could get some sleep except my mum and dh. And I admit I felt quite cut off from other mums, different midwives etc. The main advantage (and it was a good one) was that visitors could come at any time and stay all day. However, I was still alone at night and when your baby is crying that's a long time to be in one tiny room IMO. Also, if you are in a private room in a section of the hospital that isn't a maternity ward your agency midwife will literally be in your room overnight for the first two nights - and believe me, that is NOT conducive to sleep. She had a small side light on and was quiet but I was hideously aware of her presence. And as for a sofa - er, not in King's private wing there wasn't. And the rooms are small - no room for a child to play. I had more room in my NHS side room where I was before the birth. The food is better, but still not very nice really. This is my experience of going private after a c-section and home was better. If I do it again I will have my care at home! There really isn't much in hospital. I suppose the Portland might offer more in the way of pampering/nappy changing but at £10,000 for a birth I don't think so!

I had a private room after my section and agree with Aloha that at night it was lonely. However, being a bit of a Hyacinth Buckett, I was glad I didn't have to share the ward with the other mothers, some were scary. Also nice having your own bathroom and loo when orrifices are not behaving normally.

I had as good a stay as you could get in hospital, the midwives couldn't do enough - changed nappies, picked dd up so I could hold her the first day, fetched my tea and toast, turned a blind eye to my visitor quota and generally made me feel THE most special mum on earth. Was an NHS hospital so didn't pay either. Couldn't wait to leave after 5 days however, home is still home.

Yes but Aloha compare that with being in a ward with four babies (one yours) crying in the night and people who've just given birth being wheeled in by their partner at 3 am etc. Thats partly why I'm going for a home birth. But I believe that at my hospital sections are normally given a side room.

I'm very sad to hear that you didn't all get your babies nappies changed for you - hats off to those of you who managed to get off the bed to do it then - I was a right little old lady for the first few days so it's lucky I got pampered.

come to morocco for your c sections!

I'd do anything in my power to ensure my own room if there's a next time. I didn't have a c section - and was in hospital longer than the "average" c section patient, which probably colours my view - but was stuck on a ward of six for nine days and it was a living hell! If ds wasn't keeping me awake constantly, every other mother and child was. One spent her entire two day stay wailing - and that was the mum, not the child. Another spent the time making loud phone calls to anyone and everyone whenever when we were supposed to be having "quiet rest" (e.g. no visitors or phone calls). New mums were constantly being wheeled in in the middle of the night... invariably just as I was drifting off to sleep. As for camaraderie - forget it. The few mothers who were feeling well enough to be chatty escaped off home before the first nappy needed changing. Those who were there for more than a day were there because they were experiencing problems of one nature or another - and were far too freaked out by the whole experience to do anything other than a zombie impersonation. Oh, and there wasn't room to swing a cat, let alone change a baby - so dh took all my flowers home apart from the one bunch neatly displayed in an old used sharps bucket! Just foul.

I had a similar experience to you, willow.
An extra annoyance was that the one time I could have got some sleep, during the 'quiet time' in the afternoon, the radio in the midwives station was played, quite loud. Inhuman, really.

Seems like there's no optimal solution. Was about to say that home birth rules but then remembered i didn't have an older child when dd was born - and yes I can imagine it would be great to have a chance to "relax" about looking after household chores, playing with no.1 etc for a few days. Sending older child away so you can have the same sort of first time around homebirth experience I had would be worse in other ways - couldn't imagine cutting dd out in that way. Soooo I guess the only passable option is to find somewhere as close to home as possible without paying for the Portland! Wouldn't it be fantastic if there were "mothers recovery" places - like a spa resort only less expensive. Doesn't need all the medical bells and whistles just nice rooms, some pampering and flexible visiting hours. Maybe like the NHS used to be "in the good old days"???

I had an emergency C section for my 1st child and a planned one for my second, who arrived when my 1st was 20 months. My expereience of both sections was GREAT and I was really pleased to have the opportunity to elect one the second time around. I have 2 friends who had the same - an emergency 1st time and then elected for one the 2nd time because they had discovered that it was an OK experience and better than the trauma of natural childbirth. The ability to plan was really useful (got my legs waxed, washed the bedclothes, cleaned the house etc etc)and it was a really serene and exciting experience. Hubby and I went out for a super lunch on our own the day before to celebrate the impending arrival and on the day we had a good laugh with all the surgery staff. It was very relaxed. It did feel strange, but in an exciting way - we know we were about to meet our baby! My recovery both times was quick and easy and although there was obviously some pain,I know people who have had natural births that have suffered a lot more. The pain was very manageable. Hubby took a couple of weeks off work to primarily take care of our toddler and by the end of this time I was picking him up and doing nappy changes etc (I think I was probably doing this from the end of week one although that was a bit naughty). To be safe, you may want to put hubby on standby for a 3 week period if you can. Although I haven't experienced a natural birth to compare against, I found it really easy to bond with my babies. After all, I wasn't exhausted and stressed out and I'd been able to get excited without the anxiety of going through labour. All credit to anyone who values a natural birth but I'd go for a c section any time - I think they have been unfairly given too bad a name. Good luck with your birth and with having 2 children - it's lovely to have them so close together. Mine are now 2 and a half and 9 months and already interacting together. Let us know how you get on.

Thanks parga for your good wishes. I am excited about it because I'm getting to that uncomfortable stage and just want to have the baby NOW! At the same time it feels strange still - esepcially in those tired, weepy, latter stages of pregnancy moments. It doesn't help that everyone I speak to moans about the hospital I'm going to and praises another local one. I could change but I've already chopped and changed a couple of time to use and abuse the system of having a nuchal fold scan so it would be a lot of paperwork for my long suffering MW plus the consultant at my hospital seems very good and it's nearer for my closest friends to visit.

It's all an unknown at the end of the day (whether the few days in hospital are busy, if there are nice MWs on duty, other mothers in, availability of a private room, etc.) so I shouldn't be too picky. The baby will be gorgeous, the c-section doesn't sound bad at all and DS will have a good time with his dad and grandparents and it's only for a few days. Plus I've done it before so I do know how to breastfeed, dress a baby and change a nappy.

I still don't have a date yet but I will let you know how it goes later next month.