Go on tell me the truth about vaginal vs elective C-section

[whatwasIthinkingof]

I am 28 weeks pregnant with DD2. DD1 was vaginal delivery, quite traumatic as it was long (over 16 hours) and extremely painful with only gas and air, then shoulder dystocia (which did get sorted quickly), had episiotomy which then got infected twice so on antibiotics for weeks and couldn't sit down due to pain and swelling so spent early weeks upset and in pain. Have spoken to docs about elective C-section but they are all discouraging me talking about the risks etc and there being no clear clinical indication to have one.

I am shitting it about two things: I would ask for epidural this time but been told I might not get it if labour progressing too quick or the anaesthetist called to an emergency so unavailable; plus will further perineal trauma weaken my pelvic floor and give me possible continence problems? These two things alone are making me seriously consider an elective c-section but I know it is major surgery so not taking it lightly.

I can only go on my own experience.

First, back to back so was a large chunk of time. Epidural, episiotomy, ventouse delivery.. was pretty traumatised.. especially as back then you didn't get stitches that dissolved and I had to have them removed.. I was crapping myself with mysecond.

second.. normal labour, not back to back which helped. Shorter and pushed him out with only needing 2 stitches with a natural tear.

Third.. induction.. decent labour, short pushing stage. In fact I almost enjoyed it in a weird way... no stitches.

Apparently, the body 'remembers' labour when it happens again and you remember how it was and can prepare for it better mentally and I'm glad it went down the way it did the second and third looking back.

After that epidural the first time.. there's not a cat in hells chance I would have another one and refused point blank with the induction.. despite the arm up the back by the midwives. You can't listen to your body properly with one of those things IMO.

I've had two "elective" sections. Hospital pushed for them due to DD being breech and DS being over due and refusing to induce me. So not like I had a real choice except to refuse their careplan outright.

They are fine. Calm and not unpleasant. Worst bit is the epidural. But recovery really does take longer. 2 - 3 nights in hospital post section, a week before you are really on your feet, and full recovery takes the fl 6 weeks, during which you can't drive. So depends on your support network and the impact that would have on your life.

This is a really difficult question to answer but I suppose the question is how long was your recovery after the vaginal birth? For me, it took far longer to recover from a vaginal birth than a c-section but the vaginal birth was very traumatic and, therefore, the decision to have a c-section was easy.

Snowmummy, this is what I am thinking - everyone says how long it takes to recover post c-section but tbh it took me weeks to recover from the vb as I was in so much pain in my perineum I couldn't even sit down on my backside, so am thinking what's the bloody difference!

SchmaltzingMatilda, I did wonder about incontinence issues being mostly due to a vb and i am keen to avoid this big time. Funny how the health professionals keep quiet about that and are pushing (excuse the pun) me to have another vb, really does make me wonder if it is to save the NHS money as am certain c-secs are much more costly.

I had a horrible birth with ds. They called it a natural childbirth. There was nothing natural about it! Went on for days, back to back, big baby. 3rd and 2nd degree tears. Exhausted doesn't come close! Generally really unpleasant.

Second time was a walk in the park. 3 hours from start to finish. Second degree tear only and nothing like as bad to heal up afterwards. It doesn't seem to have put as much pressure on my pelvic floor either.

I didn't believe it could be so different.

I can't really comment as I have only had one baby, via elcs (initially granted simply because I requested one, but as it turned out was necessary as DS was transverse breech) so I have nothing to compare it to. And I know recovery is different for everyone...

But for me it has been ridiculously easy. Actual procedure easy (spinal painless, actual op uncomfortable at times but fine). Baby was in intensive care for 24 hours so I was up and walking within six hours, and constantly wandering there and back, which I think really helped with the recovery. Had absolutely no pain within 24 hours but kept taking painkillers in case the lack of pain was due to them (although I did at one point on day two go ten hours without any). Within five days stopped painkillers totally. Now five weeks post birth and feel 100% normal and have done for a while. The hardest part has been forcing myself to take it easy!

I have friends who have recently had elcs who haven't found it quite as easy, so I know it can be different. But for me it's been a very positive experience indeed.

Good luck with whatever you choose.

I had an EMCS and to be honest. like Janey it barely took me any time to recover - I was in hospital for a few days as my DS was not gaining weight, so I guess I had enforced 'rest' which was good but as he had serious medical problems it was all emotionally fraught but physically I had no problems whatsoever - even no scar . As soon as I got home I was desperate to move about and walk / do light housework etc etc.

By the way, it is an 'urban myth' that you can't drive, I checked with my car insurer and they said there was no problem at all.

We are all different though, I can only speak from my own experience.

Oh yes, my scar is almost invisible too already! And having waited almost six weeks to drive, I called my insurer to check I can drive next week only to find out that I could have been driving already

Personally my elective was the worst birth out of 3.

Dd1 was 3 day labour, very long pushing stage, episiotomy, ventouse, 3 rd degree tear, surgery.

Dd2 induced due to meconium in my waters, epidural, 2nd degree tear, botched stitch up job, surgery.

Ds elective c section - very traumatic, reacted badly to drugs, huge blood loss, ds born grunting rushed off to nicu, long recovery (developed phlebitis in veins of leg and infection in scar).

I had a difficult induced back to back first labour and very sore stitches etc but second was water birth and no stitches, I am so glad I experienced a "normal" birth after the trauma of the first. It was a much more positive experience.
Second is very likely to be easier so I would go with the traditional route.
Dear all - 70% of pelvic floor damage done by the pregnancy weight not the actual delivery although this obviously contributes.

I had a horrible VB (36 hours, shoulder dystocia, 3rd degree tear) then an elective CS. The elective CS was much much better experience than the VB and I recovered much more quickly than the VB.

whatwasIthinkingof Thu 08-Aug-13 19:52:26
Have spoken to docs about elective C-section but they are all discouraging me talking about the risks etc and there being no clear clinical indication to have one.

Well according to the NICE guidance, clinical indication shouldn't be the be all and end all - especially since so many docs do not regard anxiety to be a clinical indication (NICE however say it should be considered). The NICE guidance now saying that if you want an ELCS you should get an ELCS ultimately, after risks have been discussed.

There is information about risks of planned VBs and ELCS in the NICE guidance, however this is flawed, from your point of view in the sense that it relates only to women who have had no previous children. This shows that on balance the risks between a planned VB and planned ELCS are more or less the same but had different forms. Babies were slightly more likely to end up in SIBU with an ELCS. HOWEVER and this is the big however, for subsequent births the risks reduce for women who have previously successfully had a VB so on balance a VB may look comparatively better on paper - but this really depends on what you are concerned about - it doesn't make an ELCS inherently risky, just not as favourable for a second time mother compared to a first time mother.

I am shitting it about two things: I would ask for epidural this time but been told I might not get it if labour progressing too quick or the anaesthetist called to an emergency so unavailable; plus will further perineal trauma weaken my pelvic floor and give me possible continence problems? These two things alone are making me seriously consider an elective c-section but I know it is major surgery so not taking it lightly.

Two things here. If you've given birth by VB before, your muscles will be already weakened. The evidence out there seems to suggest that in many cases, having an ELCS won't have the desired effect of protecting you as the damage has already been done. Plus an ELCS - even in women who have never given birth - only seems to reduce certain risks to the pelvic floor; it does not eliminate them as the pregnancy itself can be cause weakening and issues with continence.

I don't think there is a right or wrong answer here. You've just got to decide which set of complications or risks bother you most. Neither way is without risk, and though one may on paper look worse, thats purely academic. You have to live through it both physically and mentally not the doctors.

My 1st birth was pretty much the same as yours. I pushed for section on 2nd birth and was so glad I did. I made an excellent recovery and was so glad I made that choice. Good luck in what you do

Well, I've only had elcs's so can't compare... but they were great. V quick recovery, actually a very enjoyable experience (you get a baby!), v easy 100 percent BF each time...

Obvs experiences vary hugely, but I do get irritated by the silly dogmatism in the 'csections are ALWAYS awful, with a VB you'll be up and about and home the same day' comments. I'm sure OP having had a less than ideal vb, you'll take all that with a pinch of salt anyway. (anyway, I was up and about the same day as my cs's, albeit stiffly).

One thing - this 'you can't drive for 6 weeks' stuff - I rang my insurer, and was told it was nonsense. People have operations all the time, for all sorts of things - when I broke my foot, which obviously made driving impossible for a while, no one went on about their being 'laws' about not being able to drive for x weeks. Urban myth. If you had a back operation or knee surgery or your appendix out, wouldn't you just use your good sense and drive when you were recovered enough? csections are not a special case!

I had a vaginal birth for my first child and it ruined me physically and emotionally. It took me months to recover from. My baby had a broken clavicle and was an extremely fussy infant due to the traumatic birth.

The second time around I went private and had an elective c-section. It took me 2 weeks to recover from it. I was off pain medication and back to having sex by 2-3 weeks. The c-section baby was healthy and unharmed and much calmer.

I cannot recommend a c-section enough. To me the risks with a vaginal birth going wrong are too great. I personally wouldn't want to take the chance of ending up with an episiotomy/forceps/ventouse and possible issues like incontinence, pelvic organ prolapse and sexual dysfunction.

I have had 4 VBs and one ELCS and can tell you that each one was totally different.

First was long and very painful and I swore I'd never have another. On a drip, second stage of well over an hour and a half, episiotomy, retained placenta.

Second I was taken in for induction at 42 weeks only to (luckily) start on my own. Only in active labour for a few hours and second stage for about 30 minutes. Much better experience all round.

Number 3 was back to back and got stuck but was born only an hour after arriving at hospital, and fourth was smooth and easy and delivered in 20 mins. Number 5 was breech so was a ELCS.

It isn't an urban myth about not driving after CS. You have to be capable of doing an emergency stop and you need your GPs "approval". Mine said 6 weeks and wasn't budging so had I been in an accident I wouldn't have been insured.

You need to discuss with your midwife team what happened last time and your worries about this time. What really helped me when I was in labour with number 2 was when they told me "it won't be long" and I wailed "that's what they told me last time", and they very calmly said "this isn't like last time". It was amazing how much difference that meant.