Elective c-section vs VB due to genetic condition. I really don't know much, can you answer some of my questions?

[Hedgehead]

I am being pushed to have an elective c-section because I have a rare condition causing tissue rupture/stretching which is often aggravated by childbirth. The condition is genetic, my mother has it, and when she gave birth to me she had severe multiple prolapses and didn't go on to have any more children.

I have been looking into the process of an elective C-section and I'm really put off by how unnatural it seems. Anti-biotics, anaesthetic, anti-emetics, drips, ant-acids, painkillers, recovery time. On top of that the idea of "cutting" my uterus makes me squeamish.

Obviously an "ideal" VB is what everyone wants, but knowing my family history and problems, that is probably not what I'd get.

My obstetrician says if I am prepared to take the risk of having more permanent damage, then he is happy for me to have a VB or a C-section - my choice. In assessing the risks, I need to understand what options are available to me to repair myself afterwards if the worst happens.

Here are my questions:

1. In C-sections, does the surgeon "part" the muscle or cut it? Does that mean they cut through the skin, tissue, uterus, fat, but when they get to the muscle they "part" it? Does this make recovery time quicker? Do they push the muscle back into place afterwards? Does it make pain from recovery less?

1. How does an emergency C-section differ from an elective C-section? My Ob says that we could start out with a VB and I can make a choice depending on how things are going, to have a C-section at any point. Is it messier (scar bigger)? Do they cut at a different point? Do they cut rather than part the muscle in this case?

1. If my vagina gets completely and utterly brutalized by this, are there surgical options to put everything back in place? There wasn't anything aesthetically available for my mother at the time she had me, which might also have contributed to why she didn't have more children (she never talks about it.) I have been doing a lot of yoga and a special diet and exercise to try to counteract the effects of the condition as much as possible. I keep thinking worse case scenario if I can't have anymore children after this, I could adopt or use a surrogate in the future. However, if my vagina gets completely and utterly messed up by giving birth, I would want it to look/feel okay again.

Hi, I had an emergency and elective CS my first was foetal distress so second time I elected as was so scared same would happen, no not everyone wants VB it's whatever safest option is, yes they can repair damage post delivery but of course will never be the same, CS was not traumatic for me I was home 2 days post emergency and less than 24 hours elective, yes you have more drugs but, pain was not a issue for either for me, I think they part muscle I have no problems with abdomen muscles at all.

Be guided by the experts they know best, also if you have a personal preference they will listen to that. I hope you get the answers you need think about what sits right with you and what your MW and Drs recommend. Good luck.

Hiya, I've had both VB and ELCS. I would like to say that, if I were you, my preference would be for the ELCS. It is a routine operation and had predictable outcomes. Any birth, regardless of mode of delivery has risks, but a VB for you carries extra risks involving prolapse issues. No thank-you, that is not something I would want.

Just because a baby is birthed vaginally doesn't make it a 'natural' birth. My dd1 was born vaginally after a long labour. She was not born 'naturally'. It was a medicalised, instrumental delivery via ventouse, where I had an episiotomy. I would be inclined to get the idea of 'vaginal=natural' out of my head.

The ELCS I had for dd2 was a very calm birth. I was nervous before but had done research prior. The book Cesarean Birth : A positive approach to preparation and recovery by Leigh East is a good place to start. Although it is major surgery, if all goes well (which it usually does), then there is a predictable recovery process.

Of course, CS can increase complications with future pregnancies, but current NICE guidelines (I think), indicate a 'safe' mark of up to and including 4 CSs. The associated risks rise with each CS. However, your DM had no more children after prolapse issues, right? And, you are being encouraged by your HCPs to have an ELCS? Both would make me think I should have an ELCS. HCPs would try to put you off if it wasn't medically indicated.

Your muscles are moved by the surgeon's fingers. Your tummy muscles are not cut. Gently moving them with their fingers is the best way to ensure they knit back together after the CS.

EMCS are different to ELCS, from what I can gather. EMCS are usually the last resort after.labour isn't working. Your uterus ia contracting with EMCS which makes harder work for the theatre team. With an ELCS, everyone is there, on hand delivering your baby. The uterus is still and the baby is born very quickly.

(Sorry, I'm on my phone and can't scroll up. I'm just going to refer back to your OP)

Yes, you can have your bits fixed after a 'VB gone wrong'. But why would you choose to go through all of that when a calm, safe, prophylactic ELCS that negates the over-stretching/prolapse potential is being offered?

You must go with your gut instinct but I will reiterate that if I were you, I would choose the more predictable odds of the ELCS.

Best of luck to you

If it was a case of "what would I do", I'd go with their advice and opt for a CS. I had an EMCS and know it can be scary and seems 'unnatural' but I agree with the poster above that says you need to forget vaginal birth = natural, therefore better. In this instance, it may not be. There are a lot of unknowns. I would also strongly think about whether you want to have more children or not in the future - I know it's hard to know now, but it will impact on your decision.

I'd have thought that whether your bits can be fixed or not afterwards depends on what happens to them. I'm no expert on prolapsed but I've read threads on here from women who are still struggling after years of treatment and some surgery. I think you need to ask your Dr how bad any damage could be and how fixable it is.

Agree with the other posters here, you also need to think more seriously about having additional children. Surrogacy and adoption are not at all straight forward, the way you've written your OP makes it sound like, 'I'll just adopt', a quick look on the adoption threads or surrogacy threads on here highlight just how difficult those options can be. If you are serious about having more children I think you need to do everything you can to minimise the risk of damage from this labour.

Issues arising from a CS rarely need surgical treatment and if they do, it's usually successful.

Prolapse surgery has a high rate of problems (either not working or causing other problems).

You have a medical condition that puts you at much greater risk... It is your choice but I'd go with the medical advice on this occasion!

I have been looking into the process of an elective C-section and I'm really put off by how unnatural it seems. Anti-biotics, anaesthetic, anti-emetics, drips, ant-acids, painkillers, recovery time. On top of that the idea of "cutting" my uterus makes me squeamish.

Should also highlight that the above are not exclusive to CSs, you could have many of these for a vaginal birth too.