WWYD? Thoughts on home birth vs ELCS please.

[ArchangelGallic]

I'm 30 weeks with 2nd baby and just trying to gather my thoughts about the impending birth and would appreciate input.

1st baby was a planned home birth and was text book, if more intense than I'd been expecting. Reasons for not going to hospital were wanting to avoid intervention and not wanting to stay on post natal ward without support from DP. Baby was diagnosed beech late on but was turned with ECV. All went well but we had to be admitted for failure to gain weight when DD was a week old which just reinforced my views on staying in hospital.

Move forward 3 years and I'm unexpectedly pregnant and still a bit ambivalent about having a 2nd baby. I had mild depression and anxiety and came off ADs when I found out I was pregnant. Coped ok with this but have moderate PGP and I'm exhausted physically and mentally. At my last mw appointment baby was breech but I know there's plenty of time to turn. However I really don't know if I have the energy to go through another ECV and labour at home or whether I should seriously consider requesting an ELCS.

What would you say the pros and cons of each option are?

I'd say that's 2 very different options, with no half way house.
DS1 was fairly quick, but DS2 "fell out" - as in the 999 call to the paramedics just made it before baby (by 30 secs). DS2 was also breach for quite a long time - and the mw was supportive of a breach vaginal birth - tho the PGP may make that harder. He turned quite late tho.
Have you got any midwife lead units near you? That may allow a invention free (pool?) birth, and the water might help your hips. You can also get fairly quick discharges from normal births (under 6 hrs). An ELCS would not be a quick discharge.

I'm happy, sort of, with either option. Just trying to work out which would be better for me. I also recognise that I might have to fight a bit for an ELCS if baby isn't breech.

I don't mind getting a birth pool at home to help with pain relief. I suppose it's a bit of a "how long is a piece of string" question in that it's impossible to know how my tiredness and PGP will impact on labour until I'm actually in labour! I'm going to chat to a friend who had her second baby in similar circumstances by ELCS to see how she coped afterwards.

First labour was 14 hours with almost 2 hours of pushing so I don't fancy going through that again - mind you, I don't suppose anyone looks forward to labour!

You say you can't face labour, but obviously ELCS is just as tough, just differently so. It is really which challenges you can more cope with.

You are unlikely to push for two hours again fwiw.

Sorry 'have the energy ' not 'face'. On the app and miss remembered your wording.

Thanks Penguin. I recognise there's challenges with both options but have been through the first. Hoping to guage opinions on how those challenges differ I suppose.

I don't think your going to get the insight you are looking for here. I doubt there are many women that have made a similar decision. Or many that have decided even after a straightforward hospital delivery to then go for ELCS. It's definitely one extreme to the other, don't you think?
Would you really want to put yourself through an operation with all its risk followed by 6 weeks recovery to save pushing for 2hrs?

I'm 10 days post ELCS (my third section). The ELCS itself went really smoothly - absolutely textbook, unlike my first two which had varying degrees of complications (anaesthetic related, and a wound infection). Even after the most straightforward section imaginable, I'm not really sure that I'd recommend one to someone who has a good shot at an unassisted VB. The recovery is hard (and I hate not being up to full physical capacity in terms of dealing with elder DC), and the first 48 hours after delivery (in hospital for me - I know people do, but think you'd be doing very well to manage a quicker discharge) were pretty grim. My pain level was fine after about a week (has varied with each section - after my first I was a good fortnight or so before I stopped feeling very sore; after my second I didn't need painkillers after day 3), but the first few days were very uncomfy - I had to sleep sitting up until day 5.

It's such a personal decision, and obviously you could have issues after a VB, but you have a far better chance of feeling OK. 2 of my babies have spontaneously turned from breech to head down after 36 weeks (ouch!) so don't give up hope of that yet.

I have never had a section myself (forceps, then two homebirths). But I have quite a few friends who had a section for their second. The disclaimer is that this was usually after a complicated or traumatic first delivery - serious tear, retained placenta, etc.

They would say that the advantages were things like calm delivery, more foreseeable complications, known timing and therefore easier to plan. For most though, it would be that they then know that they will not have a rerun of whatever complication happened first time. Or that ongoing complications like pelvic floor weakness won't get worse.

The downside is basically the recovery. You skip the pain during delivery, but for most people there is a fair amount of pain afterwards. And the recovery can be very tough. Especially if you have an older child to look after. And, of course, you're going through that recovery whilst looking after a newborn.

I think that, for the majority of people, the intensity and pain of a natural, straightforward birth would be preferable to a section. But a section is preferable for most people to complications. The issue is normally not knowing whether you'll get uncomplicated or complicated if you try vaginal. You are in a fairly unusual group in feeling that a section would be less exhausting and mentally draining than even a straightforward vaginal delivery. (I'm leaving aside for the purposes of this analogy those with tokophobia, or health conditions or whatever than mitigate strongly for a ELCS. I'm just meaning your average Joanna Bloggs looking at outcomes). I'm not saying that you're wrong at all, but that you might have a limited pool of people who can tell you that they've been through a similar process.

If your biggest issue is staying in hospital, I'm not sure how a section helps. Wouldn't something like an early epidural compromise your desire not to go trhough unmedicated labour (entirely understandable) and your desire not to stay in more effectively? Or does that not appeal at all?

Good luck. After my first, rather traumatic, delivery, I was torn between homebirth and pushing for a section, but I tipped the other way.

I've had both - a elcs (For breech) and a home water birth (a vbac). I would personally chose the home birth 100 times over again.

Being alone on a ward with a newborn after major surgery is very tough going. Getting in and out of bed is very hard at first, you'll be very sore and still catheterised and all the medication made me
Feel rough and woosey. You won't b able to drive for weeks or lift much more than your baby for a few weeks either. Very difficult with another child around unless you have really good help that can be with you everyday for at least the first 2 weeks.

Compared to sitting up in my own bed with DH waiting on me hand and foot, lovely homebirth midwife team visiting daily and not having to be away from my toddler who I could pick up and cuddle straight away.

Thank you, this is all very helpful. I suspect I'm feeling low and lacking confidence so was perhaps hoping an ELCS would be an easy option. Thank you for reminding me that it isn't!

I'm guessing that if baby isn't breech then HB remains my best option. I'll have to think about what to do if he is breech and talk it over with MW. Maybe I can grow a backbone in next 10 weeks!

I had the same worry about dc2 being breech and was told by the midwives and drs the the chances of a second baby being breech are slim as your first dc has made lots of room in there! Dd was in perfect position for the entire pregnancy - try not worry
:-) hope your appointment goes well