Request for honest advice.

[lauralouise8]

Ladies, I am a newbie here and I apologise in advance if this has been asked before. I am ten weeks pregnant with a surprise (but wanted) first baby. I had always imagined that I would pay for a private elective c-section, as I have a fear of childbirth and am worried about not receiving the level and amount of care that I would ideally like. I could afford it, but obviously it would be money that could be spent towards something else (I'm not rolling in cash, but I have savings). I was very set on the idea of a c-section, but every medical professional I have mentioned this to has pulled a face. In addition, I had my booking appointment the day before yesterday with a very lovely and very competent NHS midwife. We ran through the very long 80 question (or so it felt) health questionnaire where you get a point for every condition/ailment/allergy you have ever had, and I came out with a risk score of zero, which obviously means that I am lucky to be very low risk. This, combined with the much higher than anticipated standard of the initial NHS care I have received, has made me question whether I really need to spend that sort of money for a private elective c-section, when there is medically no obvious need for it. I am now questioning something that I thought I had clear in my mind. Any genuine advice or thoughts would be appreciated.

It's quite early on in your pregnancy to be making these decisions. If you want a c section and you are willing and able to pay for it then go for it but if you're not sure, why not wait and see how your pregnancy progresses? You don't have to make any decisions yet.

I had a natural birth with ds1 which went wrong for a number of reasons which couldn't be foreseen and ended up with forceps.

This time, I'm having a c section (currently 25 weeks with ds2) which was confirmed at 15 weeks. Personally, I would opt for a natural birth if I could but I can't, that's out my hands.

Take your time to decide, you have weeks left and congratulations

It's difficult to advise because everyone feels very different about this, there is no yes and no answer.

What I would suggest is perhaps to look into the options for a private c-s and find out exactly how much it costs, when you would need to make a decision and book it etc. Then put that to one side. Book for NCT or hypnobirthing or Lazy Daisy classes, something like that, and I think you should also be able to talk to a birth counsellor/therapist or similar on the NHS and talk through your concerns about a vaginal birth. You may be able to get a cs on the NHS. You may decide that actually yes, you feel comfortable with giving a VB a go. If you are concerned about care during labour you can have a doula with you for extra support, for example.

But if you still have that background fear you know you have researched a private cs and have that as a back up option if you want to go for it.

I think most people are anxious about childbirth but it sounds like you are more worried than most.
I was terrified and had to be induced which is supposed to be worse.
However, I was able to cope for a very long time with just gas and air marvellous stuff it was only when the drip for induction meant that I was getting no break from contractions that I decided to have an epidural. It was fantastic and really took all the pain away.
They let it wear off a little for pushing and I managed to get her by myself. The feeling of euphoria, rush of hormones when she was born was unbelievable. I doubt there is a drug that could recreate the feeling.
I needed a few little stitches but they were ok too. I recovered quite quickly and was complete fine a few days later.
Now, preparing for my second, I want a natural but with pain relief birth. I will fight tooth and nail not to have a section.
It seems such a big op, you can't lift or drive for weeks later and have to stay in hospital longer. None of these things appeal to me at all.
People love to share horror stories but I, for one, found a vaginal delivery fine.

Generally people are home 24 hours after a c section because it's better for infection control if you go home. After my natural birth, I was in for a week.
People saying you can't lift anything for weeks... They advise that for a week to 3 weeks you take it easy and avoid lifting etc.

People will try to talk you out of a c section and throw "facts" at you. Have a look at the nhs website and get informed information.

Both c section and natural birth can go wrong! No one can tell you what to do or which is better because only you can make that decision and only you know what is right for you and for baby.

In your position I would start off by exploring where your fear of childbirth has come from and whether there are rational grounds for it.

It wasn't until I was expecting DC2 that I read (at a MNetters suggestion) Ina May Gaskin's 'Guide to Childbirth'. It is unlike any other child birth book I have ever seen, but it radically addressed my deep seated fears of childbirth that in her view have a large cultural component. A key message is that a labouring woman who is not frightened is likely to labour much more easier and with less pain. Caveat: it is a very hippy book, not at all 'me', but stick with it.

I'm sure you are already aware of the risks and drawbacks of c/sec, but if not make sure you understand them before going ahead with a planned c/sec, especially in terms of plans for future children.

I had an EMCS followed by a slow painful recovery with DC1 and a v easy vaginal birth with DC2, so I guess it's obvious where my preferences lie.

That aside, congratulations and good luck with whatever you decide to do.

I was in a very similar frame of mind when I first got pregnant. The first thing that changed is that I self referred to a good hospital with a very good reputation, which made me a bit less nervous about giving birth on the NHS. The second thing was of course the cost - £10k!

I was still set on having a c-section, but as the pregnancy progressed i became more relaxed about letting nature take its course. There's no "great way" to give birth... Either way will be painful, whether during the birth or after! Although I have to admit I was a bit disappointed when the midwife said baby was head down, as I was secretly hoping I'd "have" to have a c section....

If you do want a c section then just insist on it. It's your right and if your doctor won't accept it, ask to see another doctor.

I have had 2 natural deliveries and was home the same day. I personally would not choose a Caesarean unless it was medically required because of the possible longer hospital stay, risk of complications and risk of long term problems such as scar tissue and c section overhang.
What is it that worries you about childbirth? Is it the pain? If it is the pain then it's worth bearing in mind that there are ways of effectively managing pain during childbirth.
If it is something that you really feel strongly about then a caesarean might be best in order to not spoil your experience of childbirth.

I did go privately and was in your mind set too, although the decision was taken away from me in the end and I had to have an ELCS, not that I minded in the slightest.

Anyway, the consultant I used was very honest with me from the start (quite matter of fact to be honest) and I felt that it was beneficial as he was giving me information not just based on NHS guidelines and goals that have to be met but what he deemed was best for me as the mother and the baby.

I also have family members (that are gps) that opted for an ELCS too, that made me feel 100 times better about my initial thoughts.

Congratulations btw

Thank you all very much: I very much appreciate you taking the time to share your experiences. It is the pain that worries me, so I will bear in mind the helpful suggestions regarding pain management and analysing the root causes (including the book recommendation), as well as the suggestions to wait and see how the pregnancy develops. I am grateful too for the positive experience stories both re natural and c-section. It is lovely to have impartial, honest opinions - best of luck with your pregnancies and babies.

well, I guess it depends what it is exactly you fear about childbirth?

if you're afraid of pain or of sustaining damage in your womanly areas - having a very low risk pregnancy is absolutely no guarantee that you won't end up needing forceps or tearing badly, in fact I suspect it has nothing to do with it.

but if you're afraid of something going so catastrophically wrong it'll endanger your life or your baby's life, then imo the probability is so low (esp. if you're very low risk) that a CS is a little overkill.

If it's a possibility, I would go for a natural birth. I had an epidural for my first birth and it was brilliant. Pain gone - was even able to read the newspaper. When it was time to push, they did cut down on the pain relief so that you can feel what you're doing and I'm not going to lie, it was painful, but it was only about 15-20 minutes before DD was out (and she was a big baby - 10lb 7oz). Was so pleased afterwards to be able to walk without pain out to the car, and be fully mobile on the same day with no issues re lifting my daughter up, etc,

Oops, just saw that it's the pain you're afraid of. In that case - I don't think that being assessed as being very low risk has anything to do with the levels of pain during childbirth. So I wouldn't let that affect your decision, specifically. The much more relevant question is the number and availability of anaethesists in your hospital!!

I was scared of the pain, in some ways I would have gone for a private elcs if money had been no object. I was worried that I wouldn't be able get an epidural - that is something to consider if it is the pain that you are most concerned about, as there is always that chance that no one is around to give the epidural, your labour has progressed too quickly, the epidural doesn't work etc.

Having said that, I had a very, very long and painful latent stage with no pain relief which I coped with better than I thought I would. You do sort of phase out for hours on end. But I never got to transition or pushing, which was what I was really scared of.

There's nothing wrong with deciding you want an elcs. I had an emcs and will be fighting for an elcs if there is a next time. I didn't find it difficult to cope with and didn't feel too bad after the surgery. But I would recommend trying to talk to a health professional about it and finding out the root of your worries so you can make the right decision.

I had the Fear of childbirth, but this was coupled with a real fear of having my belly cut open in a CS! My mum had a bad scar from a poorly stitched and cared-for CS (she got a haematoma in the scar that then got infected - made a real mess) and I just didn't really want to have one unless it was medically necessary. I also REALLY didn't want an epidural because I have a bad back anyway, and the thought of what could go wrong with an epidural was actually worse than the childbirth Fear.

It's actually amazing that I bothered to have children at all under those circs but I have 2...

To counter the birth Fear, I did private hypnobirthing (one to one) with a friend (trained hypnotherapist) and I found it very useful. I can't say it helped much with the pain relief, but it did get rid of the Fear, and made me understand how fear actually impedes you body from doing its job on the day. So to that end it was well worth it! So, when stage 2 of labour hit, and it was bloody awful (but quick), my first instinct was to fight it - but my hypnobirthing stuff came back to me (let your body do what it needs to do) and I gave in to the contractions and just let them happen - 25mins later, DS1 popped out.

I did have pethidine with the first labour,hich as far as I am concerned made fuck-all difference; and ditto with the gas and air I had with my second labour (although they kept telling me it was "taking the edge off it" and it must have been working as I wouldn't let go of the mask - I said that was because I was hoping that it would start to work at some point!

It is, of course, up to you - but why risk the operation, with its up to 6w of no driving and potentially having difficulties lifting the baby, to say nothing of infection risk, having your stomach muscles severed and hoping they re-align them properly and so on.

I understand your fear of childbirth but, wouldn't you fear a C-section as well? I felt like I wanted a C-section but the inconvenience of the fact you can't drive legally for about 6 weeks afterwards, the recovery is so time consuming especially with a new baby. I have had three natural deliveries and I currently have another one on the way and although you feel as if you ache down below you are up on your feet straight away afterwards where as with a CS you will be in a wheel chair for god knows how long and trying to stand up straight is just not going to happen.

Women have been giving birth naturally for hundreds and hundreds of years, it is the best way to have a child it also has benefits for the baby. Yes CS is on hand if you have any major problems but anyone I know who has had one says they wish they had a V delivery because of the recovery afterwards.

If you want a vote I prefer natural and I've done it three times so it can't be that bad. Good luck on whatever you decide and congratulations on your pregnancy.

not that I'm voting CS (I'm not), but be aware that you're not guaranteed to have an easy recovery if you go the natural route. I found the birth bit ok, it was the recovery after a bad tear that was hell, I couldn't sit without pain for about 2 months, let alone stand.

I guess the difference is that with a CS you're guaranteed a long recovery, while with natural birth it's just something that happens occasionally.

I have 3 dds 2 of them were back to back vaginally deliveries. The only experience I have with c section is when a young girl was in the next bed to me after having one. She looked awful and couldn't do much with the baby. I was in and out within 10 hrs and feeling great afterwards. 2 of the labours were 12 hrs long and very painful (only had pethidine and gas and air). I am the opposite as I am terrified on needles so wouldn't have an epidural or a c section. What I can say is the pain went away as soon as I delivered and I went on to have 3.

although you feel as if you ache down below you are up on your feet straight away afterwards where as with a CS you will be in a wheel chair for god knows how long and trying to stand up straight is just not going to happen.

Not being deliberately picky, but I have friends who definitely felt more than an 'ache' and weren't up and about immediately. And with a cs you are encouraged up on your feet within 12 hours and you aren't in a wheelchair.

I just wanted to say that a fear of the pain of childbirth isn't something to be quite easily shrugged off and given the unfortunate unpredictability of birth, the OP should investigate all the options suggested here and come to her own decision, as no one else's experience is really going to be that relevant to how her labour might go.

Yes it doesn't matter what our experiences are as anything can happen which is what happened with me with the 2 back to back labours. Had I known DD3 was back to back I might have looked at other options. DD2 was so quick and easy. DD1 AND 3 were 12hrs+ and very painful.

And if you can get a doctor to certify you as fit to drive within the 6 weeks, you are allowed to do so, but you need that certification to be insured.

My sister was up and about and had very little trouble with her CSs - she started driving after about 5w in both cases. My best friend, otoh, could barely walk and couldn't get up or down stairs for 2 weeks.

Scheduled C-sections can be painful, too. And can go badly or not be calm at all. I have a friend who had 3 emergency CS without negative repercussions then a scheduled CS which traumatised her. I wish that we could give you easy answers.

the pain relief they can give you in vaginal-delivery-planned labour (epidural) is the same form of pain relief usually used for C-section. The difference is that you also need morphine for a few days after the CS because it was a major surgery, which isn't normally provided for significant damage to the undercarriage (which often doesn't happen, anyway). Typically only OTC or perhaps co-codamol afterwards if VB.

So my feeling is that if it's pain you're worried about, a birth plan that ensures early epidural should be the main concern, not CS vs. VB.

No one could tell you what to do or how to feel. Good luck whatever you decide.

That's very true. It's a difficult weigh-up, isn't it?

VB with an epidural could be relatively pain free - but opting for a VB includes the chances that you can't have an epidural for one reason or another and may have to have a pain-relief free birth.

CS is major surgery and doesn't avoid pain; it's at a lower level, certainly, than actually giving birth, but it will last longer.

I suppose it comes down to control, really. I understand where the OP is coming from as I might very well have gone for a private cs myself if I could have. The CS at least seems a more controllable pain, it is more predicatable. A VB could be better, but you have almost no control over what is going to happen.

OP from your posts it sounds like addressing your fear of pain and possibly loss of control with a lot of research, some hypnotist thing and a doula would be helpful.

There are no guarantees, but I personally would take a VB (which we are built for) over major surgery. I know not everyone had a good birth, and not everyone has a long recovery after a CS, but playing the percentages I'd go for the bestVB I could have every time.

And as a final comment - I do think labour pain is different to other pain. It's productive, and by the time you get to term you're so huge and exhausted I think you're glad to be getting the baby out.

yes that's what I was trying to say too - individual experiences that go "oh well VB was a breeze for me" aren't particularly helpful, because you can't promise the OP that it'll be the case for her, she could be one of the unfortunate ones who are denied an epidural and/or have a traumatic birth that takes months to recover from.

when you have a deep fear like that, feeling in control is really important, so I really understand how the unpredictability of VB could freak you out. CSs are not entirely predictable either, but still more so than VB, it seems to me.

OP, where abouts in the country (if you're in the UK) are you?

I'm happy to PM you my private experience and who my consultant was.

The consultant I saw is pro doing what the mother to be wants to do as and she is free to make that decision armed with all the information necessary.

As I said before the decision was taken out of my hands but had it have been left to me, I would have had the ELCS anyway.

The dr signed me off at 3 weeks for driving, I had no issue lifting/climbing stairs/walking etc. And you can't see my scar so I'm pleased. But like someone up thread said, not all c-sections are the same and neither are all v. deliveries.

Only speaking to an impartial professional will really gel you decide.