Do I choose to attempt natural labour or go straight for ELCS?

[Writerwannabe83]

Morning everyone, just a quick question as I'm in a quandary and am after some other perspectives.

I have 2 pre-existing health conditions and last week my Consultant told me that as soon as labour starts. I will be given an epidural as she doesn't want me to experience any discomfort in case it triggers off one of my medical conditions. She said she is also going to put a time limit on the labour and if the baby hasn't arrived in x amount of hours then I will have a c-sec. She did say however that when the time gets nearer to the actually labour (currently only 21 weeks) I can opt to go straight for a planned c-sec if I wish.

Part of me thinks if there's a good chance it will end in a c-sec anyway then why not just go straight for that option but have it done in a more planned and controlled manner? I know there must be advantages of a vaginal birth over a c-sec but I just don't know what option would be best. My husband would prefer me to go straight for c-sec as he is concerned about my health and thinks it would be the easiest/safest option.

I know I still have a way to go until I have to make the decision but my pregnancy is absolutely whizzing by and I'm the kind of woman who likes to have a plan in my mind

I soooo regret not having c section

Will expand now ds has settled...

I would need continuous monitoring with my second labour. This would in effect tie me down to bed and I was convinced I would then progress less etc so went for elcs which was lovely and calm and positive and completely
The right decision for me.

But I'd had an emergency cs before and knew what the recovery would be like. In the end I recovered far better ssecond time around.

But you will find people who chose non surgical
Route and were happy too.

Id suggest setting aside time for you to chat it through with someone you trust to work through what is right for you.

I had bad time first time round and was offered section second time round. Instead I asked to be induced so I didn't go over.
The labour itself scared me shitless.
Then I was rushed to high dependency as I lost 2and half litres of blood.
Ds is 4months and emotionally im still so raw over it.
Was in hospital nearly 2weeks

Absolutely horrible. Poor ds1 was left with his daddy even though he prefers me hes a right mummys boy. Ds2 was helpless too he was fed and put down couldn'tpick hhim.up.

Dont mean to scare you. Just dont want anyone to go through what I went through.

X
Nearly in tears writing that. Ive had 2 periods since having him and it really scares me seeing all that blood.Just reminds me of what jad hahappened

I had one 11 days ago and compared to my VB it was a breeze. Wouldn't hesitate if I had to make the choice again. No trauma, no shock and an easy recovery. I know not the same for everyone but having experienced both deliveries my ELCS wins hands down. Absolutely no trouble bf either.

I have to say I do hear far more horror stories about vaginal births than I do about c-sections.....

My consultant pointed out that when cs go wrong they go more wrong.

The anaesthetist however was lovely and said as I didn't have any complications it was extremely likely to be a positive experience for me.

I had birth trauma from ds1 birth which ended in emergency cs but the trauma was from the birth part before the cs. I thought I was going to lose him and people stopped communicating with me and it felt at times with each other.

In retrospect I was in shock for months afterwards. I spent the first months sobbing and sobbing.

With dd I sat beforehand with dh waiting for out slot and then walked into the theatre chatting to the midwife and was wheeled out holding my beautiful daughter. I lay in the recovery room holding her and laughing with joy. With DS I had been laying there in shock.

For me and my family it was the most positive experience and one I shall always treasure. In many ways it redeemed what happened previously.

That said, I spent most of my pregnancy mulling over the options til it became clear that I was going to be much more relaxed this way. I would therefore recommend making the time to process the decision with people you trust as its your body this is happening to.

The advantages of VBs tend to be where you wouldn't face the same dilemma next time round IYSWIM, or where a successful VB would indicate that future births could be VB.

You will presumably face this decision next pregnancy, and the one after etc. You're having an epidural anyway and it sounds like a trial of labour would be quite limited in what you can do, so in your shoes I'd opt for the ELCS.

If you have fears about natural labour, and I mean more than the normal ones, then you would probably need a doula or the like to help keep you calm in a natural birth situation. I think having a time limit with threatened c-section could be considered a stress!

However, in a way you've got nothing to lose by going for vaginal, to see how it goes, and then having the c-section as a backup, providing you don't spend the labour time fretting and clock watching. It could be the best of both worlds: you see what you can manage in a safe way and avoid a stressful crash CS.

I don't know if doulas work with those conditions, but it couldn't hurt to talk to one.

I had two vaginal births with big babies.Vaginal births are not always horror stories: those of us who had good, positive ones rarely talk about them publicly.

I don' have a fear of natural labour but I do think, "Why go through it if it's going to end in a c-sec anyway? If I chose to try a limited natural labour they would bring me in for induction as opposed to wait for it to start naturally, but I've heard some women say induction is not pleasant and can drag on?

I haven't got to consider future births as me and my husband are not having any more children due to all the complications. We said that if we get a healthy baby at the end of this pregnancy and I also come out of it unscathed then we would count our blessings and not risk doing it again

One thing: you probably hear more horror stories about vb that csections because people with good experiences dnot tend to shout them fRom the rooftops. I've had two brilliant vb, one with twins, all drug free. They were the right thing for me and my babies.

Now you are a different version, with different risks nefits and worries. What is right for you can only be decided by you with advise from your consultant. The only thing I would say is you'd have nothing to lose going for the trial of labour if they're doing it under suchccontrolled conditions. An emergency section in that case is quite different from others experiences. But really op, none of us know your situation, hopefully just doing this post will have clarified something inside you. And goods luck, the next bit is the really important and lovely bit

I think putting those conditions on a natural labour is setting you up to 'fail' tbh
Are they definitely necessary? You know you can decline monitoring or epidural if you don't want them?
I would either try a non medicalised vbac or the ELCS but I wouldn't want the vbac you have been offered.

I absolutely definitely want the epidural and monitoring One of my conditions is related to my heart and I definitely don't want that playing up during labour There is also a 15% chance of my other condition (which is currently controlled) being triggered by labour and if that does happen it will have huge consequences on my life. Between both of those factors I just want the baby out as quickly as possible so I can be healthy enough to look after him when he is born The hospital I'm under are absolutely fantastic, they have been so thorough and my Obstetrician is just really lovely and reassuring. I have absolute faith in the whole team (I see 4 different specialists with regards to my pregnancy) and am happy to go along with whatever they advise. It is great they are enabling me to make my own choices too (where appropriate) but I hate making difficult decisions

Writer, I think you've got lots of really good reasons for wanting to opt for a c section and it's so great you've got a positive relationship with your health care team. Have a Google on YouTube for a women centered c section. There's ssome lovely ways you can adapt a planned section so you have an amazing birth. I found it very helpful to get my head round it when I was having the twins. Turned out k didn't Ned it, but it might help you with your decision.

Well I saw my Obstetrician again this morning and discussed things further. She said that although she isn't professionally allowed to advise me to go straight for ELCS she said she is 100% behind my choice if that's what I want. It can't be formalised until I'm 36 weeks pregnant but she is willing to 'off the record' accept my choice. She told me it will be when I'm 39 weeks pregnant but if that my health deteriorates in anyway nearer the time they will perform it at an earlier date. She started me on some medication today to try and help stabilise one of my conditions so I'm feeling much more positive about things. Is it possible to love your Obstetrician? My husband hasn't met her yet, he is coming to the next appointment, and I can't wait, I'm sure he'll love her too

Oh that's great Writer. I totally fell in love with my ob when I was having my twins. She had so much respect for me and was kind and clever. Makes all the difference. Good luck and stay well the next few weeks.

It is a difficult choice. I decided to have a second section mainly due to the fact that it was likely to end in a section anyway? I did go into labour early and it had not been agreed. I was five cm before I had the op. I found the labour to be a very painful experience and I wanted to move around, but wasnt allowed due to the monitoring.
The section had complications and i lost alot of blood. I have took longer to recover also. However it was the right decision.

Sounds like there are potential positives and negatives to either choice. I think I'm worrying about all the potential issues of how to manage the baby at home after a c- section, I.e walking up and down the stairs, will I be able to handle the baby effectively etc, am I going to be bed bound etc? My best friend had two c-secs, the first was emergency after about 13 hours of a hellish labour resulting in the baby getting stuck, her whole tale is horrifying, her second c-sec was planned and much, much better. She actually went to a dentists appointment 3 days after she got home

I think you have been handed a gift by having the option of a c section.

All consultants have their own views and ideas. I cant see how a section can go more wrong than labour going wrong!

For a start you are straight away in a medical environment with surgeons and highly skilled people all around you monitoring you.

Anyway, I think its a gift, I loved mine and have very positive thoughts on it, in spite of a tough ish recovery.

What is the reality of a c-section recovery? I hear people reporting they can't get up and down stairs, they can't pick their baby up, they can barely life themselves out of bed etc.....it doesn't sound like a very fun way to start new motherhood and makes it sound like I wouldn't be able to care for my baby unless I had someone with me 24/7

Writer, labour is scary!

Do you know yourself well? I was scared enough but also very calm once it started, of all the other things that can happen to you in labour, there is simply no way I would have gone into labour with a heart condition on top of that.
Are you in a totally shit hot crack team hospital?
I would look at that very very carefully.
I know of a lady in my local H that I wouldn't touch with a barge pole had a heart condition that she went in early to monitor, it was never monitored she was injected with the same drugs the other ladies on her ward needed, but not her, when she went into labour she was told was wasnt, LUCKILY it was her second...so she kind of knew what to do....
I know from chatting with my consultant, they are on a different level and often not aware of the chaos on the ward. I had nice chats with her and the head MW about coming in and given epidural etc.
The reality is, bun fight chaos. That anaesthetist may be called to back to back life threatening emergencies, the person looking after you maybe a newbie and hasn't read your notes properly...
I just dont think its safe on our wards for any mothers let alone one with extra issues. They are under staffed, staff are stressed....
Labour is un predictable and very painful. An ELC is more of a known quantity.
Sorry, as for recovery, everyone will be different. I had an added injury from pulling or breaking a muscle twisting too soon after the op, if it wasn't for that it would have been painless.

I was not one of the " i was up driving and skiing two days after".Itook it easy.

So with my added injury I was certainly able to walk upstairs so did all the other ladies who had sections.

For the first two weeks, I couldn't walk for more than ten mins without feeling tired and wanting to rest. A week after the op, I went to a market, walked round, bending down, moving round, and managed half an hour.

Two weeks after the op, I had a gentle stroll in London.

It was a good two months before I felt more like myself.

Immediately after the op, I was stuck on the bed. I had the baby with me, not in the cot, and could lift and manouvre her very easily. I kept her with me by using v pillow and other pillows, they dont move, you cant move....it was actually very cosy and lovely being tucked up with her! I was in a mentally and emotionally far far better state than after my first so called text book labour. For a start, I had a good sleep the night before so no, three nights up with labour contractions! I wasnt in pain, as I was after small tear first time round, and I wasnt totally in shock after labour nor was i phsycailly drained like I was after first labour.

So I was in much better shape to address and care for and concentrate on the baby.

I BF straight away and am still BF now. Baby was very calm and peaceful....I was able to change baby and do everything she needed from my bed in hospital.

At home I made life easy for myself with one of these. www.mumsnet.com/reviews/nursery/cots-cribs-cotbeds/9963-arms-reach-universal-co-sleeper-bedside-cot

This 100% made my life easier and help to aid my recovery because I didnt have to sit up at night to get baby. And I could sleep properly without fear of squashing her. It could be personality but this baby has slept soooo much better than when I had moses then moved to own cot at 6 months.

I would say its a no brainer. I saw the ladies in my NCT group misty eyed with the candles, thinking about getting the love hormones going. and the total shock and horror of the reality of her labour, compared to her section before...a haunted look in her eyes, crying for weeks after, compared to her talking about being monitered as she wanted to move round in labour.

I just think of my different circles of women who have given birth I know, and thats personal friends, nealry all would have died in labour, two nct groups, ONE happy labour between us all, rest horror stories with some life threatening ones thrown in, ladies from other groups, the good births def seem to me to be the exeption, I do know the birth stories.

sorry feel like I am really going on here.
On my ward I seemed to be the only planned section, the other ladies who had section seemed to have had emergency sections and had nasty labours before hand. Bearing that in mind, I was still the one in most pain! This was due to this twisted or torn muscle. They were all happily chatheta free after the first time, walking up right and seemed fine! Ironic it was me who was shuffling and demanding the oramorph!

Yes I could have just about managed a dentists appt in spite of my pain in my side.

Remember with labour you can end up in more pain, I was still in more immediate pain after my first text book labour! I think you have been handed a gift.

If something goes wrong where will YOU feel most safe.

In my first labour I could not move a foot half an inch. I would have been in a terrible state if something had gone wrong and they had to even get me onto a bed or wheel chair!

For me I was much happier in surgeons hands knowing if something went wrong in the OP, i was right there on the table with professionals around me.

Thanks clementine for your detailed post it was really helpful and interesting to read.

The hospital I'm under is very, very good - it isn't actually my local but I was referred there to have the baby as they are much better equipped to deal with my pregnancy. I am under the most fantastic team, I really can't praise them enough. I have 100% faith in them! my Consultant Obstetrician is the most reassuring woman I think I have ever met and I'm so excited about my husband meeting her at my next appointment
As well as my Obstetrician I'm also under a Consultant Cardiologist and Neurologist (both of which specialise in pregnancy) and I'm also under a Specialist Nurse. I have regular reviews with all of them.

I'm happy to trust in their decisions but you're right, I think I'm very fortunate to be given this option and know that my Obstetrician is completely behind whatever choice I make.

Hi Writer, I had a friend who was under very high care due to past tragic loss.....however when it came to the day she went into labour, she had to wait a few hours for her epidural and the consultant nor anyone else she had spoken to were there on the day she gave birth.

The team you are dealing with now, are they going to be there when you give birth? If you go into labour in the middle of the night, who will be there.

Can you guarantee that should there be emergencies at the hospital, your level of care required will not falter. These are what I would be asking your medics.

I told my consultant one of my fears for labour was being turned away from the hospital. She made a funny face and sort of mumbled that wouldnt happen.

Then I spoke to the head MW and she said " its in the best interests of the ward if we turn people away and yes it does happen"!!!!
That hospital was notorious for turning people away.

I also loved my consultant and because i had ELC I knew she would be doing it.

Well my CS will be planned so hopefully not booked for the middle of the night My Obstetrician said she will do it at either 38 or 39 weeks gestation. Obviously there is the risk of me going into labour naturally before then but that risk is there for every woman who is down to have an ELCS and not something that can actually be avoided I guess. I'm next seeing her for a routine appointment in 6 weeks and I will ask her what would happen on these circumstances though, it's a good point, thanks for the tip. I'm going to write it down in my diary so I remember to ask