Cesareans - advice and experiences wanted please

[saranga]

Can anyone tell me the truth about cesareans? I'm first time pregnant and have absolutely NO desire to go through labour. I know that cesareans are a major operation and that they have a longer recovery time, but can someone who has had one tell me what this means in practice, in regards to mobility and pain after the op.
I'm especially interested in women who have gone through labour and a cesarean and can compare the two.

Halp.

I've done both and there's no way I would have a C section through choice. The operation was fine but the recovery period was incredibly long, slow and painful.

Labour on the other end was easy in comparison (with maximum pain relief) and recovery reasonably quick.

I've had four caesareans. Three were elective and one was emergency after I was in labour for four days.

Recovery after #1 and #3 was ok but #2 and #4 was very difficult

So hedgehog, which would you prefer?

I have had 2 x long labours followed by emergency c-section

• oops first time I was in labour for 3 days - induced, hormone drip, the lot - babies head never fully engaged and I had to have mega strong drip and a stronger than normal epidural, can't talk much about the pain really as it was 7 years ago and I can't clearly remember! They topped up the (stronger) epidural before the op and baby was out in 2 mins - it wasn't a full on emergency, just a standard failure to progress job - stitch up time seemed a matter of minutes, then was wheeled back to recovery where DD / DH were waiting - they had waited to weigh etc until I was back, and let me choose outfit, then even offered to take a family pic for us - I was bed bound until the next day, when catheter was removed, took a shaky walk to the bathroom for a shower, the midwives hovered nearby for first walk, and I had to call them when done and they walked me back agian

wasn't too bad, was healed enough for day 2 day bits and bobs in about 3 days, but had to be careful for a couple of weeks - fine after that!

Second time was a natural labour but the same issues (turns out that my hips are the wrong shape or something!) I managed the labour pains fine (4 days I think this time - definitely longer anyway) baby had somehow got into a position where I was feeling an urge to push even though he wasn't engaged at all... so at 6/7 cm I was pushing without even realising it - I wouldn't say that pain was bad at all as long as I was going with the pushing.... when midwife checked and realised I was nowhere near ready they asked me to breath through it - didn't work, given gas and air and told to breath through it - didn't work! Eventually given epidural to stop me feeling the urge, and apparently I was still pushing a bit - oops

anyway - at around 8 cms it all stopped progressing, again and then DS got a bit distressed so was whizzed around for c-section, I wasn't worried as had done it before. However - and this is a minor risk, but something you need to know - the epidural was starting to stop working, I started to feel more and more -ending up in feeling quite sharp pains - the anaesthetist asked the surgeons to stop whilst they did something, but I had a minor heamorrage and they couldn't stop - so I was knocked out - DS had already been born (was just after this that I started to feel), but the second part of the op takes the time.

It did also take a little longer healing second time around and was in more pain for a few more days

good luck and hope you come to the right decision for you!

TY for input Jean. How long was the recovery?

I realise I'm more than likely going to Labour and I'm kind of resigned to it, but I think I'd feel better about it if I knew more about cesareans and how they worked.

Thank you MrDarcy.

It is very hard to answer that! With my first I had induction at 41+3, was in labour for four days (regular contractions that for the last 12 hrs got to 2 mins apart but only dilated to 2cm), waters broken then dd1 was distressed and I was rushed in for a cs so I didn't experience the whole 'normal' delivery experience.

I think if I could have chosen I'd like to have given birth at least once 'normally'. I had an epidural when I was in labour and gas and air which took the pain away so it was ok, in terms of recovery it would have been quicker I think.

Thanks hedgehog :)

I had 3 emergency caesareans and had not wanted any of them. I had longed for natural labours with as little intervention as possible. Ho bloody hum. However, having had lots of lovely counselling from friends some who only had natural labours and one a caesarean followed by a natural labour, it seems to be a 'six of one half a dozen of the other' kind of affair. Caesareans are hard to recover from, your abdominal muscles are fkd for a long time, if not forever and it is a major abdominal surgery. Natural labour is also hard to recover from, the afterpain is not necessarily surgical but you are left bruised, sore and sometimes a bit ravaged in your underpants. The friend who had both said she loved the process of natural labour and the bonding it enabled at the moment of birth but the state of her vag wasn't great afterwards nor since. I on the other hand would still have had the joy of the natural birth rather than the surgery. It is like being in a vets. You are not the thing the surgeons are concerned with - the baby is. And to be removed from the process of its birth while being central to it is a profoundly alienating experience.

Thank you yadahyadah,

I've had a couple - one emergency after a long labour, then begged for an elective the next time. I didn't find the recovery terribly difficult, and didn't take pain relief for long (couple of days?). Was up and out of bed same day both times - the more you move, the less stiff you are (or so they told me, and it seemed to work). i wanted that damn cathether out as soon as humanly possible so there was incentive!
I didn't give a fig about being removed from the process of birth - was quite relieved to be so, in fact. Absolutely no issues bonding, and they handed the babies over immediately while someone else was dealing with the stitching up.
Didn't find abs fckd for a long time either - was very fit going into labour both times so maybe that helped, & deliberately did a lot of post natal pilates / exercise expressly for post section. No overhang, minimal scarring. I highly recommend them.

I'm soon to experience my first ELCS. It was my choice this time initially due to previous pelvic floor damage - I didn't want to end up going down the surgical repair route later down the line. Now due to unforeseen issues with the pregnancy I don't really have a choice.

My second birth was lovely, I went home the same day and recovery was amazing. There is something about natural childbirth (in my opinion) that just completes the whole experience...as long as it's not too traumatic that is!

As time goes on I'm feeling more and more apprehensive about the whole surgical side, being in pain etc. I'm also a bit disturbed about the whole c-section "stomach apron" aftermath I've heard about so many times! I managed to escape with a fairly flat-ish stomach so far. I know that's very vain of me though.

Thanks both.

@springbaby: What is a stomach apron?

I couldn't give a toss about how I look afterwards, the main thing I am concerned about is the pain of labour, and although I am pretty damn certain I'll have an epidural I still don't want the pain (any of it!) of labour. I also don't want the risk of tearing, or a fucked up pelvis floor or any of that. But hey, it's probably too late now...!!

saranga, it's more commonly known as an overhang. It's where the skin above the incision/scarline hangs over the scar, iyswim. Some get it, some don't: age, weight/fitness (pre-pg and pg) and skill of the surgeon all seem to play a part.

I've had both a VB and ELCS. First birth (vb) was long, I pushed for a long time but the pain was never as bad as I had imagined it to be. I got through it on G&A alone (though if I was to do it again would have insistes upon an epidural because a) I could have rested and possibly slept for several hours instead of being awake and b) I had an episiotomy anyway, so the 'epidurals mean an episiotomy' argument was void in my case!)

I incured a significant tailbone injury that I felt was reason to request an ELCS for my next birth.

To be honest, I preferred the ELCS birth experience over my VB ... but that's because I am comparing my births. In a perfect world, I would have liked to have had both my babies in water with minimum intervention (dd1 delivered by ventouse in the end) and no tears/cuts anywhere. Breathe 'em out.

It didn't work that way. Anyhow, both recoveries for me were fairly long, but I preferred the predictability of the CS recovery.

However, we are contemplating a third child who I would request a repeat CS for and honestly, the idea of having another CS and recovering from it whilst having three children to care for and also being concerned about developing an overhang ... well, I'm very carefully thinking, that's all.

Beware that multiple CSs are not recommended. The more you have, the riskier they become. I think 4 is about the maximum recommended limit.

You might want to read Cesarean Birth : A positive approach to preparation and recovery by Leigh East, as she discusses the pros/cons, risks/benefits of VB and CS.

It's swings and roundabouts. As someone once said to me "there is no easy way to have a baby".

I'm due to have an elective C..due to major birth trauma from first time round. I'm still bowel incontinent (over a year later) and this affects me massively on a day to day basis.

I had a 3 day labour which ended in forceps and a generous episiotomy. I couldn't walk at all, or sit down, for about a week, and was still in a lot of pain 8 weeks later. I felt battered, cut open, bruised and very vulnerable.

I was also very angry at anyone who suggested that I'd had it 'easy' because I hadn't a c section!!

This time round I will be able to compare! Of course C section is major surgery, but when it's elective, it's controlled (as best as can be). My birthing experience had no element of control to it whatsoever and I genuinely thought I was dying at one point. I remember thinking my poor daughter and husband. The team can be better prepared for giving me pain relief.

I've been advised for a c due to the damage I already have, and the fact that giving birth naturally would make that 100% permanent.

But I do think, in an ideal world, if you have a nice, 'natural' birth, it would of course be much much easier to recover from than major surgery.

I'm not sure, with first pregnancy, that no desire to go through labour is the right reason to request major surgery!!

Thanks guys.

I had an emergency section and would if I was ever going to do it again, want a C-section again.

I think the recovery / issues with a section are much more tangible than a natural birth, and most of my close circle of friends have ended up with emergency C-sections after laboring for bloody ages anyway which has got to be the worst of both worlds.

I had emergency section for a massive APH, I felt so shite for several weeks before I was just delighted not to be pregnant anymore and the whole thing was so quick - went into theatre at 21.50 and out again by 22.20.

Recovered brilliantly - DTs were in NICU and I was able to walk to see them less than 24 hours after. They were 31 weekers and pretty little and my scar is correspondingly narrow - I wonder if you need a bigger cut with a bigger baby that could make recovery worse?

I have had an emergency section after a long labour and three hours pushing. My next baby was a very quick labour and only a couple of pushes. I would opt for a section without a moment's hesitation. Recovery from the EMCS was much quicker and less painful than the vaginal birth.

i good vaginal birth is going ot be betetr than a good cs

the problem is theres no cyrstal ball, you dont know what the outcome of either birth will be

ive had both types and had 4th degree tear from vaginal birth still not right after almost 7 years

and ive since that had cs that went v v well

you will probably find hcp will tell you all the risks of cs and NONE of the risks of vb
which i don think is on really

so i suggest you find out all the facts yourself and make yourown informed descion

good luck op

Hedgehog are you me? We appear to have had the same birthing experience!!!

With second DD I went into labour naturally, but still ended up with an EMCS only after a few hours this time though.

Recovery long and uncomfortable and second time round my scar got infected. Unable compare to the natural way though and never will, not allowed another one

I always described it as having someone rummaging around in their handbag to find a lost key, or the last spoon in the washing up bowl. My first EMCS was extremely painful, I could feel EVERYTHING and it HURT, they offered to put me under, but I didn't want to miss it.

Second time round was much better although still immensely unpleasant.

Agree with Lizard re the overplayed risks of CS and downplayed risks of VB. Also, risks of ELCS and EMCS are lumped together, so ELCS tend to come out as riskier, statistically speaking.

I had a very hard time getting my ELCS agreed. That was in 2012 so things might have changed, but you'll need a stronger argument other than 'no way am I going to labour', unless you go private.

Assuming you are in the UK and/or not already private

But it's so difficult to tell you because everyone's experience is different. I haven't had a CS, but have had 3 vb none of which were traumatic. I'd be lying if I said they didn't hurt but I only had a tiny tear first time and none either the others so no stitches. I think statistically you are more likely to tear with an epidural because you have less control over how you push but the upside would be a pain free birth and, if you did tear, you wouldn't feel them stitching you either. Fwiw,I've had a 6hour discharge each time and was up walking around within the hour. So a good vb will always be better than even the best CS simply due to recovery time.

However, I have no doubt that some women have very traumatic VBs do for them a calm elective is a wonderful experience in comparison. I have friends who have had both. Two good friends had very difficult 1st VBs and opted for an elective 2nd time with no regrets. But I also have a friend who ended up with a CS with her 1st and had so much trouble with recovery inc infected scar that she opted for a vbac for her 2nd with an epidural and said her recovery was amazing in comparison. So it really is different for everyone.

If it's the pain that's worrying you, could you not explain to the midwife or see the consultant and have it written on your notes that the fear is making you so anxious that you want an epidural ASAP in labour without procrastination? If it's all understood before then they're less likely to try and make you wait or try to talk you out of it.

I'm sure you know this but the pain is not like other pain and you may surprise yourself by how you cope with it. I'm quite little all over and a real wuss with pain (hate dentist etc) and my babies have all been 9lbs+ but I coped as it wasn't pain as I knew it to be.
The bottom line is that nobody knows how they'll labour and whether it will end up with intervention. You could end up with body trauma either way but the crucial thing to remember is that most women do not retain any long term trauma either from a VB or a CS. You tend to only hear the horror stories from both. Good luck.

The pain of labour is short term & ends when baby is born. I know plenty of women who've had natural birth & gone onto have c-sec & would choose labour & childbirth over it.

I could not bear having to be cut open.