Elective 2nd c-section - what do you think?

[clairemow]

I am expecting DS2 in September, and because I had a c-section last time (breech baby), I've basically been offered a c-section this time. I wondered whether anyone had any advice on the decision. On the one hand, I know the procedure, and am not scared of it, it was made as pleasant as possible last time, and I would know when the baby was going to arrive (unless it was 10 days early, like DS1...), so childcare for DS1 would be easy.

but would I feel like I'd never done the whole natural childbirth thing? Is it cheating? I'm v. scared of the pushing bit...

Thanks for any thoughts..

I guess it maybe depends on your hospital/consultant but I had to have a scan at 37 weeks (everyone who's had a previous section gets one here to check placental position) and that was when we had to decide and even then they gave me an extra week before I really had to make a plan so no rush (though I can't say the decision got any easier as time went on!!) Actually they thought this baby was breech too and so it was going to be a section for sure till the scan showed it's actually head down. in a way I was glad when I thought it was breech as it took the decision out of my hands! Was a bit of a shock when they said it had turned!!

CarolinaMoonfish, no I didn't complain as such. A community midwife came and collected the swab and made a report, so the hospital were made aware of the incident but I heard nothing more. When I was feeling crap complaining officially was the last thing on my mind, and I'm concious that worse things happen. At the end of the day both me and ds are fine ... an apology would have been nice though .

Clairemow, re what you say about it being galling to have to have a awful labour then an emergency section, my sil had twins last year - she delivered one naturally and then they wanted to section her for the second! Can you imagine, talk about the worst of both worlds! Luckily she summoned the strength for a few extra pushes!

how crap of them not to apologise

re the twins thing, that actually happened to someone I know (forceps for one twin, then her cervix started closing up so they had to get the other out by cs). And one twin couldn't latch on so she formula-fed that one and bfed the other - a whole spectrum of experience in one go .

Oh, thank God I've never had twins.

i had a c section because of breech with my first child. didnt want to go back to first hospital because of anti natal attitude of staff.So I looked about at 2 other hospitals who I liked much better. The consultant at the hospital i went to (35 miles away) was great and i had all my scans there and a good ordinary delivery.
If it had turned into another c section I wouild have been ok with it because i trusted the staff.
i would never have been trusting of the first hospiital again.
I guess what im saying is if you like the hospital then you will be ok with a c section or a naturalish birth, if the staff are unfeeling beurocratic jobsworths, then they will make the experience stressfull.
Best wishes

Oh this is all so interesting to me...
I had an elective for severe SPD first time round, I'm due again in Aug and not suffering badly at all so I'm having to make that decision too.

Not a day goes by when I don't wonder what to do! Last night I decided I would push to be allowed to go to the local birthing centre and have a natural birth, this morning I'm all for the elective section!
If I knew I could have a birthing pool for labour, and try for an active birth I would try for the regular delivery (the hospital currently have no 'equipment' at all!). The biggest issue is going overdue - I could make the decision not to have the 39 week elective, then get to 10 days past my due date and end up with a section anyway (they can't chemically induce if you've had a previous caesarian so they tell me)
I was never bothered about experiencing labour, before losing a baby at 15 weeks last summer - the labour was so horribly painful particularly because we knew the conculsion it makes me really want to experience it with the happy ending.
I also don't want to be seperated from my dd for a week in hospital after a section (and my dh is petrified of that also!)
can someone make the decision for me? Pleease.... I'm pregnant and hormonal and can barely make decisions on breakfast cereal at the moment

When I was facing this, I figured the best possible option was a great VBAC. Second best was elective c/s. Third was emergency c/s. Problem is, you can't try for the first without risking the third.

I went for VBAC - birthing pool, no epidural, the works - and ended up with emergency c/s. The second labour was also FAR FAR worse than my first (I dilated fully and pushed for 3 hours with no.1 before the c/s, but thought since I had done a whole labour the second time round was likely to be easier)... So after all that, I had an horrific labour, ended up with a c-section, had all the exhaustion and internal soreness from a bad labour, and the recovery time of a c/s... Definitely the worst of all worlds.

Only thing is that my bits are all still intact! :)

I also felt like I was taking an 'easy' option, which was part of the reason I went for VBAC. But then I went the hard way and I still (stupidly) feel a bit guilty for not having managed it ('how hard can it be?'). So my VBAC attempt didn't even get me off the moronic guilt trip.

Go the elective c/s, I say.

I sympathise with your dilema Babylily - and agree with Bloss about the 3 options... One thing in your case is that the reason you had your first section shouldn't increase your chances of another iykwim - i.e. if you had ended up with an emergency section because of labour not progressing or baby getting stuck or something then there would probably be a high chance of ending up with another emergency one. Whereas SPD or breech (the reason for my first elective) means that you've got the same chance of any woman of ending up with a vaginal birth (still a chance of section of course...) Totally understand how you feel about the possibility of going over and then ending up with the section. I've compromised and have agreed with my consultant that I'll go one week over my due date then will have an elective. He originally suggested going 10 days over but it seemed too long to me (I know it's only 3 more days but psychologically it made a difference for some reason!) This way I feel as though I'm at least giving myself a chance of going naturally and avoiding all the recovery of a section.

oh bloss, just reading your post has made me think more for an e-c now! I had a similar first birth as you and pertrified for this one I think the baby has moved poss and is now breech. (i am 38wks) scan at 36 wks showed it was in head poss though. However i have an appointment with the docs this afternoon and i am really tempted to say PLEASE BOOK ME IN FOR C! i really dont want to go through with it now!

Babylily, I don't think it's usual to be in the hospital for a week following a planned section. I was in after my first one for 72 hours (which I found about a day too long) and in for a day and a half with my planned section (second baby) which I found abd 1/2 a day too short.

If you have good support at home, 2 days is probably enough. If you don't have anyone to pick up the toddler or help you get the baby in the night, then longer in the hospital is better anyway.

Oh, and fab advice, moyasmum on the importance of choosing your hospital well.

I also think a week is a long time. I was in last time for 2 nights after em c-s when I went into labour before due date and turning date. It was not long enough, and I could hardly walk when we went home! This time they have said they'd keep me in 3 days, which sounds better. Look on it as time to bond with the new baby perhaps without the need to worry about your first child babylily. Do you have anyone else who could come and help your DH with DD?

Sympathise with you on the inability to make a decision too - I feel exactly the same - last week I was going for the cs, this week I'm veering the other way, although I think I know where I'll end up - with a planned cs. I also have to go for another scan at 34 weeks, as they thought I might have a fibroid near the birth canal - if that grows, then there's no decision to make anyway, so maybe I should just stop thinking about it. I would have demanded a scan anyway, as last time they said the baby had turned, and my doctor said no, and booked me a scan. Guess what, he was firmly bottom down, with his legs straight up round his ears. Imagine giving birth to a head and two feet all at the same time... Doesn't bear thinking about.

I'm glad so many people on this thread aren't immediately saying go for a VBAC - I asked the same question on babycentre.co.uk the other day, and got a load of messages about the wonder of giving birth naturally and how amazing it is to have a VBAC. I'm sure it is if it all goes smoothly...

Intersting that you heard that on babycentre, claire. Last week, I went to dinner with some of my antenatal class from DD (babies are all 3+ yrs old now). Two of us who had emergency sections forst time around went for a VBAC about a year ago for second child. Both of them succeeded in having a VBAC. When asked which they prefered, one said "Neither! I never want to give birth either way ever again." and the other said "Section. Definately."

Then, of course there are a couple more of us who refused to be persuaded for the VBAC. So, I wouldn't say that everyone comes away from a VBAC thinking it was wonderful. However, some people do for sure.

Just do what you want, and don't let anyone pressure you into thinking you are any kind of failure either way.

Also, for taking care of the toddler, DD was 26 months when DS was born. DH had his brother come to visit and every day the three of them would go out on a day trip (zoo, transport museum, wherever) and leave me with newborn. It worked out very well. DS and I stayed in bed attempting to work out this breastfeeding thing most of the time while I typed on mumsnet. Ah, those were the days. Now he's all grown up. 1 year old this Friday!!!

ok i am having one of those days where i am feeling sick at the thought of having a vbac! Its been on my mind all morning. Said to dh about it and he said thousands of women do it ad come out the other side i will be fine having it natrally. Yes i know this but i also know i dont want to go through with it on the last exp, i was so out of control with wat was happening it was horrid. Now i think i should just opt for the more in control option and know i wont have any surprises this time. I feel i am explaining myself to dh as well as me!

Well, I don't think there are any easy answers, Dunnyjo, but I think that if you are feeling that scared 50% of the time, then I personally would go for an elective. I mean, I was much more gung-ho than you sound about the VBAC - I really wanted it to work, and didn't have that much fear about it because I thought I had a very good chance of succeeding. And even feeling that good about it going in, I still think it was (with hindsight) a mistake. If you're genuinely in two minds about it, I'd say go for the elective c/s. You may lose the opportunity for a fantastic VBAC, but the third option is a really, really bad option. However, if you're well researched and confident, you'll probably be quite keen to give VBAC a go.

Thanks Uwila. It sounds as though you had a great experience with your electives. My mum will definitely come and help with DS1 either way (have trouble keeping her away, and she isn't at all stressful to have around), so between her and DH, I'm sure it'd be fine either way. Interestingly, she said go for the cs, as she had so many stitches when my brother was born that she couldn't sit except on a cushion with a hole in the middle for 3 weeks! At least a cs would open up the same exit route as last time!

Happy birthday to your DS! My DS is 2 on Sunday - May babies are great. Our gap sounds similar to yours - DS will be 2 and 3 months. Am encouraging him to walk as much as possible to avoid carrying him, and moved him into the big boys' bed in anticipation of not being able to lift. Today is a veering back towards cs day...

Dunnyjo, remember DH doesn't actually have to do it...!! Although I expect he's trying to be encouraging. My DH is similar - says it's totally up to me, he'll support whatever I decide. This doesn't help! i can't decide!!!

Also, at my consultation with the consultant, he commented that VBACs after an elective were successful 70% of the time (depends on the reason for 1st cs I guess though), and in his experience, you had to be fully committed to VBAC for its chances of success to be v. high. Made me think...

hmm its making me htink too now lol
i have been in two minds for months now. Dh is not much help on that department but i know he is trying to be helpful with encouraging vacb. Will talk it through with doc this afternoon. I posted before 'should i have s-c becase i wont cope?' becuse my mum died i am still in an emotional turmoil that i dont think i could if things went wrong. Simply i think i am a hopless case for being able to fight anything let alone go through labour right now.

clairemow - I looked up the babycentre vbac message board yesterday and was far too scared to post anything! It's really quite reassuring to read here that everyone seems to go through being unsure of what to do.

The other thing that scares me is the complication risks of a c-s. I didn't even think about it last time, but ended up having a blood transfusion. I guess though that this means they will be more prepared and aware this time around.

oh god, i don't know! Final decision has to be made in 9 weeks time when I next meet with my consultant. That'll be 9 more weeks of indecision then.

And yes- like all of them, my DH is telling me to do what I think is best!

It was not a difficult decision for me. I knew before I was pregnant tha I wanted an elective. I knew for certain that I didn't want another emergency and all the horror stories I heard from midwives and the NCT all natural brigade simply didn't describe my experience. So I figured it all had a lot more to do with NHS budgets than it did my welfare. And I was as committed as I could be to getting a planned section. In fact, you can find some posts from me around April 2005 stressing out about the possibility of not getting the section.

So I suppose I had my share of worrying, but it was about the fear of not getting my request granted rather than which one I wanted.

My very wierd insurance company would cover me for an elective cs 2nd time round but not for an emergency cs. I had to choose btw trial of scar on the NHS and going private with elective so I chose elective. i thot I'd take some castor oil to get the contractions going just to see what they felt like. they were not much fun. For me, get the baby out safe and alive was my ultimate joy. didn't care how.

I am definitely having cs again this year. The pain control in my local hospital is so rubbish, I'm beginning to suspect they're trying to punish those who chose cs. Brighton and St Thomas' however were great with helping patients manage pain. 'Twas very nice, that morphine. almost saw pink elephants.

im 37 wks preg and have gest diab im only little and they have said that the baby is already 8lb.my ds1 was 6lb 13oz and 2 wks early i managed normal birth but ended up with 2nd degree tear which was r painfull. my consultant said i could either be induced and try and get this baby out but could go to e-csection or have a planned c-sect. i made the decision to have a planned c-sect this friday but im really nervous about it and worried how i will cope with baby and 3yr old at home. my dh isnt allowed to have next wk off work. ive got my mum and dh sister to help but im in 2 minds whether ive made the right decision.

Really interesting and useful thread for me. My consultant said last week (I'm 12 weeks) that we shouldn't even discuss elective v. VBAC until 34 weeks! So I'm guessing last minute is ok, at least in some hospitals.

I was induced at 39.5 weeks due to hypertension (not pre-eclampsia) with dd, whose head disengaged due to excess fluid, and I never dilated a milimetre in spite of three gels. The section was fine, but I did have an infection afterwards and recovery was slow.
This time, most OBs would insist on a section - I'm in my forties, dodgy BP, failed induction first time around etc. Mine (female, v. experienced) says she gives me up to 70% chance of succsessful VBAC if my BP is ok at the end.
I'm tempted to try...after masses of fertility treatment, I think I had a hankering for 'natural' something, but I really don't want to put myself or my baby at risk.
No point in agonizing yet, given all that can change between 12 and 39 weeks, but really useful reading this thread - its helping me let go of the 'guilt' thing!