Does anyone regret an ELCS?

[j200]

Hi am thinking of having an ELCS due to severe anxiety I have had in pregnancy (had to have fertility treatment) and concern that a traumatic birth will lead to PND due to history of depression in family.

I have my appointment with consultant next week (30 weeks) and am really struggling with what to do. I

have read mostly positive stories about ELCS and hoping that is the case, but I wondered does anyone regret having one and why?

I am not bothered about having a natural birth, just want him out safely as soon as possible!

TIA x

[MissYamabuki]

I think most of what happens during a V labour is out of your control. I certainly wouldn't assume that it's going to go just fine because you're fit and "preparing yourself". A lot of the risks will still apply regardless of how long you've massaged your perineum or bounced on your birthball for.

[blueshoes]

Gennz, I am afraid I am agreeing with you again!

It was the lack of predictability of the outcome of a first time vaginal birth which was the main reason for my choosing an ELCS. I was not prepared to take even the supposedly small risk of an assisted vaginal birth (forceps/ventouse) with 3rd/4th degree tear.

When I quizzed the senior midwives who were there to counsel me on the risk of a cs, I asked them what was the risk of an intervention/3rd/4th degree tear for vaginal birth for a first time mother. They had NO stats for VB (funny that ...) except anecdotal data from their experience which was supposedly 2%. Anecdotal data from my friends' experience was more like 50-50. They had stats on the risks of a cs but apparently, the risks of a VB were not important to gather . Guess women have always had to put up with mangled and leaky bits so what's the problem.

People don't talk about it and I don't make a point to ask but when the topic came up, a high number of my friends who have had vaginal births had some kind of horror story for their first baby which they kept to themselves, which mirror some of the accounts on mn.

[RedToothBrush]

They incentivise reducing CS, but they don't incentivise reducing tears.

It is just accepted that they are inevitable, and there is next to no researching being done into that area (if there was they would actually have statistics for it). Its accepted that its natural, without any thought to how it can have long term consequences or costs. And in actual fact because of the way the NHS is set up with these incentives, in trying to reduce CS then there is a danger that some doctors may be happier with severe tears.

Its simply wrong they are recording one set of information but not the other as its not in women's or indeed the NHS's interests.

Can you imagine that for any other area of health?

[teachermummy2b]

RedToothBrush its good to see you on this thread, you seem very knowledgeable.
It also seems to me (anecdotally again) that tears & damage to pelvic floor are just shrugged off as something women have to just put up with in giving birth. It truly horrifies me. This, together with many stories of women being fobbed off and refused pain relief, is what is making me seriously consider an Elcs. Awful that women are treated this way in this day and age

[RedToothBrush]

teacher, I spent a lot of time looking into it, and have a decent understanding of the information out there which is confusing and difficult to interpret.

Don't necessarily think that an ELCS is a magic solution either. I do think it is being pushed and hell up as that by many at the moment and that is just as wrong. Its not right for everyone. If I'm perfectly honest about it, I found mine tougher than I expected (though I don't regret my choice given my individual circumstances and risks). I think the biggest mistake people make is to look at stats and anecdotal evidence from friends and family but not look at their own personal set of circumstances. The generalised picture can look very different to the risks for an individual.

The risks of tears and other complications are not evenly distributed between women and the biggest flaw in the NICE guidelines currently, is the lack of data and research for subsequent pregnancies. For example if you compare the risks of a woman in her 20s with a woman over 35 they are vastly different, and the overall generalised figures for risk then look over stated for one group but understated for another.

What you have to weigh up in your own head are what your plans for the future are (are you planning more than one child) and what other things might put you in a higher risk group. If you are fit, healthy, in your 20s and want 3 or 4 kids I do think that an ELCS is a less wise move than a women who is 37, wants one child and potentially has a number of underlying health issues. The truth is there are a lot of women who do have uncomplicated vbs, and I think this is sometimes overlooked too.

I think I am very aware about the lack of transparency, honesty and understanding about the whole subject. Its unfortunately complex and mired in agendas, politics and ideology that distort the reality. If you want to make a properly informed decision then there is a hell of a lot of wading through crap and learning to understand the devil in the detail. We need a lot more balance on the subject in general.

[WienerDiva]

Hi,

I had an ELCS with my only dc. I chose to have one because they thought dd was going to be HUGE! She's wasn't tiny but not the 11.5lb that they thought she'd be. She was also slightly wedged in my left hip but didn't know that until the CS. The ob who performed the surgery said I'd have ended up with an emergency CS had I have tried to have her vaginally (hate the term naturally).

Ultimately I'm a bit of a control freak and felt comfortable having my ELCS in the knowledge that it was more controlled that attempting the usual route.

The experience itself was almost pleasant! I felt nervous of course, who wouldn't be. But I was never in any pain, even in the recovery weeks. Just a bit tender and aware that I had surgery, but it certainly wasn't painful (breastfeeding was the most painful part for me).

I think at this stage statistics aren't that useful, I think of CS were that awful for mother and baby they wouldn't be on the increase and they would only be allowed in emergency situations or for pre existing medical conditions. My ob consultant who looked after me said that ELCS are ever so slightly safer for baby and ever so slightly more risky for mum. And that is on the basis of having a perfect, no intervention/tearing/stitches v birth.

Hth OP

[eurochick]

I do wish that I hadn't had an ELCS. It was very much not my choice - I wanted a VB - but my consultant doubted that my daughter would be able to survive it (my placenta was failing and she needed to be delivered early). I found the surgery itself awful - painful canula, needle in the back, ineffective spinal that wore off before the surgery was finished so I could feel them stitching me up, vilent shakes throughout the surgery, then vomiting in recovery pulling my stitches very painfully. I remember the delivery of my daughter as the worst few hours of my life. I was too ill to go to see her until the next morning. I recovered comparatively well, but it was still painful and I couldn't get up from the sofa or the bed easily for some time.

My scar is "good" and my recovery was swift, but my abs are still shot and I will always have the scar as a reminder of that horrific time. My daughter is here safely and I am thankful for that, but the CS was awful and I will never understand why anyone would choose that where a VB is possible.

I know many people have positive CS experiences, but that wasn't the case for me so in the interests of balance I wanted to add my less positive experience here.

[StarsInTheNightSky]

I had a c section five months ago with DS, it was planned as a maternal request ELCS but my waters broke early so ended up as an EMCS with steroids etc. I don't regret it for a second, it was absolutely the right choice for me and DS. I lost our first son late second tri and being induced to birth him was very traumatic (blood transfusions, went to that's as an emergency, pronounced dead on the operating table and then resuscitated twice, and so much more on top of the usual miscarriage stuff which is horrendous anyway). I was also abused when I was younger, so I flat out refused to give birth vaginally. Thankfully I had an amazingly supportive consultant.

Despite being five and early, DS was absolutely fine, apgars of 9 and 10, screaming in fury as he came out and no issues at all. My recover was also very smooth. I was up and waking about within two hours of leaving theatre (I do burn anesthetic off quickly though) and I could stand up straight and walk at my normal pace within five hours. I engaged that they take the catheter out as soon as I got back to the ward, the midwives weren't keen but I insisted and had no problems.

I also didn't feel any pain at all after the operation, and I refused all painkillers (including morphine). I kept thinking the pain would creep up on me but it never did, and DS is nearly six months old now. I didn't even have bruising or tenderness which I was pretty amazed about. I was driving again after ten days (would have been sooner but DH nearly had a coronary ) and I had no trouble picking DS up, changing him, carrying him even on the day he was born It is possible to have pain free and easy recoveries, I think it's maybe unusual though, but I wanted to share my experience. Birth was just a means to an end for me, I just wanted DS out quickly, safely and alive.

[StarsInTheNightSky]

Grrrr, that should have said five weeks early! Stupid autocorrect!

[Gennz]

Poor you eurochick it sounds grim. How long ago was your CS if you don't mind my asking? And how are your abs shot, do you think they will recover? (I don't mean to sound insensitive, just trying to (selfishly) gauge what it might mean for me.)

Someone said earlier that they would be again having an ELCS for a first baby. For me, it's the opposite. I am keen to have an ELCS and prevent the onset of labour in order to maximise the pelvic floor benefits. If I went into labour spontaneously and ended up having a VB, I'd probably be more incentivised to avoid a CS in the future as I'd rather try to avoid the damage sustained by both labour and a CS. It's also relevant that I am 33, this is my first child and I will likely only have 2 kids (will probably be 36 by the time I have the next one - it's v unlikely I'll have 3 but obviously I'd be knocking on near 40 by then). If, like me, you would have preferred a medicalised VB (in a hospital, epidural etc etc) anyway - these factors all up the odds that you'd end up with a CS.

[eurochick]

It was 14 weeks ago.

My abs are just really weak, resulting in backache. I'm doing post natal Pilates to try to retrain them now. My consultant advised no abs work for 12 weeks so I have only just been able to start. The area above my scar still feels quite sore and bruised. I assume that is where the internal stitches are and I pulled them when I was vomiting.

I had an excellent consultant at a top London teaching hospital and no infections or complications. But it's major surgery and recovery is going to take a while.

[SchnitzelVonKrumm]

I had a planned CS with DC1 because she was breech (very much so - consultant said afterwards she couldn't have been delivered naturally given the position she was in). I was very anxious about it in advance - wanted a lovely waterbirth - but it turned out to be such a positive experience that I elected for CSs with DCs 2&3. Healing was very quick all three times and no complications, breastfed in recovery though babies were a bit sleepy, all had 9/10 or 10/10 Apgar scores.
I still think a straightforward VB is the ideal but I know very few women who had that and am glad I had ELCSs rather than, say, forceps or ventouse deliveries.

[fingermousey]

I had an ELCS with DC2 as DC1 had been an emergency CS. I regret the decision bitterly and my life has never been the same since. It was a dreadful decision and I am now permanently in pain from the c-section and have bladder problems as a result of the surgery. The whole of my lower abdomen feels welded together and, although it has never been confirmed, I suspect I have very bad scar tissue formation.

I wish I'd tried for a VBAC, the whole experience with DC2 was horrible (major mistakes were made with my aftercare due to the midwife not reading my notes) etc. I suffered with PTSD for years afterwards and will never be the same again both emotionally or physically.

[MrsFlorrick]

J200. I've had an emcs and an elcs.

Don't regret the elcs for a moment!! The long looooong labour trauma and resulting emcs from the first birth ensured that.

If I could do It over I would have pushed for an elcs first time too.

So if you feel you want an elcs. Read up about the realities of it (surgery, post op and healing etc) and obv ask here on MN.

How you ensure you get one with a first birth, I don't know. But it certainly isn't impossible.

[MrsSpencerReid]

I don't regret either of my sections and would have asked for one if it hadn't been offered with ds2!
Just wanted to say though that forceps can still be used in a section although not vaginally, ds2 was covered in bruises as his head was very well lodged int pelvis (no long term problems from them)

[Stripylikeatiger]

I had an elcs booked as my baby was measuring between 11 and 12 pounds and I was refusing induction as I had read that an induction of a large baby has a 50% chance of ending in an emcs.

I actually went into labour the day before my booked section, ds was born after a very easy quick birth, he was just under 11 pounds but very very long so easy to birth.

I would have regretted having an elcs as my baby wasn't massively huge.

[thomasstockmann]

I don't know about ELCS but I know there are a few things you can plan to lower your chances of PND.
Practical help: arrange for a small army of people to come and help for the first month maybe the first two. People who come with food ready to eat, who change nappies while you shower, who bring you water if you're breastfeeding, who wash and sterelise bottles if you use bottles or mix-feed, who deal with your laundry, who "escort" you to medical appointments if there are any etc. If family and friends aren't suitable for whatever reason, could you afford a mother's help? Could your family chip in?
Having said that, if the "helpers" then start telling what you're doing wrong then show them the door. Really not what you need.
Managing pain: pain is a factor in depression so knowing how pain will be managed postpartum is important. A weekly medicine box is really useful to make sure you don't miss the drugs.
Debrief, debrief, debrief: talking again and again about the birth and how you felt/feel until it all starts to make sense to you is crucial. So talk, talk, talk. Again turn away anybody who's not really interested/listening.
All the best.

[Pengyquin]

It's easy, relaxed and the entire op takes about an hour, start to finish.

The recovery is easy too. Far easier than some of the R ecovery stories I've heard from natural births.

Sorry, but another one here who did not find this to be true.