Tmi: vaginal recovery v ELCS recovery

[ChocolateBiscuitCake]

Ive had three previous vaginal births (very large babies) with varying damage to lady bits...plenty of discomfort post birth from constipation/piles etc too. All long labours and resulting in vontouse as last attempt pre EMCS. A significant period of "healing" has been required! I think I may have a small vaginsl prolapse and I am currently suffering from enormous and painful varicose veins (down there). I feel like four pregnancies and three labours (so far) have taken their physical toll.

Seriously considering a (private) ELCS for a multitude of reasons but one motivating factor is "preservation" of my lady parts. I know it sounds ridiculous, but I don't want any more stretching, tearing etc. And I never want to have episiotomies etc, which thankfully I have avoided to far.

Am I right in thinking, there is no "vaginal healing" post an ELCS? I assume there is still bleeding (from the process of the uterus healing?) but the lady bits don't need to recover, as such?

I am trying to weigh up the recovery and long term picture...my bikini days are long gone, so a scar doesn't bother me and the appeal is that as a controlled op, the recovery should be straightforward?

Any thoughts and experiences would be so welcomed please?

Hi chocolate, I've never had a vaginal birth, only an EMCS so I've only got one side of the story!

There was still bleeding after the birth (naively I thought I'd skip that part!) but no vaginal "damage" or stretching.

My scar is very low down so I could wear a bikini if I wanted to - but I wouldn't inflict that sight on the world

I did find that I felt like an old woman for quite a while afterwards, which surprised me. The recovery wasn't easy for me although I've heard anecdotally that an ELCS is easier to recover from than an EMCS.

Good luck and congratulations!

Should clarify that I felt like an old woman because I found standing up straight quite painful and I spent a lot of time being paranoid that my tummy would fall out

The softening of ligaments that may contribute to a prolapse will still happen, because of the pregnancy hormones, so don't bank on your lady bits being entirely unaffected if you have a CS. Ditto piles and constipation probably just as likely.
How old are your other DCs, and do you have help? Recovering from a CS if you are trying to look after a newborn and 3 others is going to be quite a challenge.
Do what feels right for you. I think in your situation I'd be very tempted by a private CS if I could afford it.

I had an EMCS and a vaginal delivery.

For me hands down the EMCS wins.

I was up and about (although truthfully outside in the smoking area) four hours post op.

She was a very small ten weeks early baby. And I was 23.

With my vaginal delivery I could barely sit down for a week and I had to wee in the bath.

Thanks for your responses - really appreciated.

Good to know about the piles and prolapse (managing expectations and all that!).

I have plenty of help so am not too worried about a cs from that perspective.

However, I am very fearful (like I have been in all my labours!) of a long, drawn out process resulting in lots of intervention. To date I have just avoided the EMCS, but there is no guarantee of 4th time lucky!

The controlled aspect of ELCS is so appealing but I am not sure if I have understood the recovery! So thank you

I've had an emcs and having elcs shortly. You don't have the 'trauma' to your lady bits but as someone else said your ligaments and pelvic floor is still affected, just by the weight and stresses on bits of carrying baby. I found the first 5 days the worst but after that felt surprisingly OK. Obviously had to take it easy - no lifting, hoovering, or walking too far etc. A couple of times I over did it and paid for it the next day. You just have to accept that you need to take it easy for 4-6 weeks. I was driving after 4 and taking DS out for short walks after about 2 weeks.

Part of my reason for having elcs this time is because I think I'll have another big baby and if it doesn't end up in emcs again then I reckon I'll end up with forceps etc and fear for my lady bits. Elcs is not the 'easy option' by any means but at least you know what to expect after.

I had an elcs and I was utterly amazed at how it was - I was showering 10 hours later, and me and DS spent our first night wandering up and down outside the ward as it was noisy. I was very strict re painkillers, but stopped them about 5 days later when they, the strong ones, ran out. I also only needed sanitary towels for a few days.
ELCS's, in my opinion, are great!

Can you not talk to your hospital about your fears, if your anxiety is severe then they may agree to a section.

I can honestly say my elcs was lovely, can't lie I was sore after but was driving DS1 to parties after 10 days. I do still have the weak pelvic floor, i get adhesion pain every now and again but all in all ok.

Oh and one midwife gave me some invaluable info that no one told me after my first - concentrate on standing up straight the moment you are up and its stops the tummy falling out sensation, your back takes over the weight from your tummy muscles

You have too do what's best for you. With your past birth interventions I don't see any reason why you wouldn't be able to have an ELCS on the nhs rather than going private (unless of course you want too)

Good luck with whatever you choose OP.

I'm 8 weeks and keen to have a csection based on two assisted deliveries with episiotomies with both and 2nd degree tears with both - all in opposite directions!!!
I'm seeing my mw next week and nervous about requesting it incase they say no - I can't afford private!

I don't want anymore physical damage as still have sore scars and have scarred badly apparently!! Also this will be my last baby and I don't want the feeling of failure and the panick. I want a controlled positive experience.

X

One thing, they cannot say no to you. It is your choice! Read up on the NICE guidlines and go armed with the facts and your rights. :) I had an EMCS and have chosen a ELCS this time round. At no point did I meet any resistance and in fact when I met my mw for the first time and she asked about what I wanted for delivery and I told her I wanted a section, she said "I do not blame you" quite cheerfully.

Good luck! I'd have a CS any day of the week!

I have had an emcs and a elcs and had complications with both surgeries, with my first emcs I haemorrhaged during procedure, bleeding was stopped but had to go back to theatre 12 hours later as they thought I was bleeding again. Ended up needing blood transfusions and think it took about 3 months before I felt better. My second elcs went better in terms of actual procedure but I went on to have a horrible uterine infection which took several weeks to clear.

It is not a always clear cut that an elcs will the best/least traumatic option. From a lady bits point of view I was left with a recto and cystocle and piles from pfbs birth that I am dreading having repaired. I also had long term loss of strength in my abdominal muscles.
Obviously love my dc but wish the their arrivals had been easier.

I have never had a vaginal delivery but have had an EMCS. Surgery at 10pm, T1 delivered 10.09, t2. 10.10 and back in recovery at 10.40pm. I had a placental abruption so it was very emergency if there is such a term.

I was up and in the shower at 11am and able to walk to the NICU at lunchtime.

My scar is practically invisible now, could easily wear a bikini - not that I would inflict that sight on the world!

No damage to pelvic floor or lady bits even with the weight of a twin pregnancy.

This is interesting.

I had episiotomy and a third degree tear. It was awful. Ds was 6Ib 3 so not big. Stitches only came out at three months. Ds is five months and we still haven't had sex. Not sure what I will do for number 2. I can't run due to poor pelvic floor muscles whih is really sad for me as I run part of my journey to work to cut down travelling time. I know it can't take a while to recover but I would consider Elcs for my next one although I would worry about ability to breastfeed after Elcs as I love breastfeeding .

Just my thoughts

It's not ridiculous to potentially favour ELCS due to a wish to preserve your lady bits! Goodness me, women are expected to just suck it up with incontinence, prolapse, damaged sexual function etc. and I think that's so wrong!

I have had two sections (emcs and elective). I had a slight prolapse after the first pregnancy, as well as piles and constipation and those lovely afflictions with both.

I recovered well from both sections. I was up and about within 24 hours both times, out and about for short walks to the shops etc within a week the first time, a few days the second time. I have no vaginal labour to compare to, but it wasnt a hard physical recvery. Maybe I was lucky? I was chomping at the nit by my six week check to get back to exercise!!

I think for you, you also need to weigh up the psychological effects of both options, OP. You cant underestimate how surgery can make you feel. With my first section, it was quite terrifying. I felt totally out of control. The shock of having to recover from surgery with a newborn was also quite brutal - having a catheter, a drip, feeling very much that I had been cut open (not pain wise, but the whole area just felt so raw and weak). It did make me feel quite shocked and brutalized the first time (second was fine as I knew what to expect).

I'm not trying to scare monger you! I adored my elective section. It was so serene and recovery was quick. But will surgery - ie. a new, quite invasive physical experience - really be an easier option for you? I dont know. I think you are absolutely within your rights to discuss this as much as you need to with a consultant, though, after having quite rough previous vaginal labours.

Good luck x

OliviaRinHearts - a section won't give you a breastfeeding problem - I BF'd DC1 for a year, no issues at all, milk came in around about 3 days I think. Its the removal of the placenta that triggers milk production so a CS makes no difference whatsoever to that.

Thanks muffin mclay. Useful to know.

Did I make it up (I do that sometimes) or is that what some people say?

I don't think you made it up olivia - sometimes when you've had a CS your milk may be delayed in coming in by a day or two (my milk came in on Day 5, usually people experience milk coming in on Day 3).

Physiologically your body mightn't "realise" as quickly that you've actually had the baby because of the method of birth.

Also with a CS, you might find the initial few days uncomfortable because of your wound. Pillows help!

Fwiw, I fed DS for 13mo and only stopped because I was pg again

Olivia if you have a traumatic birth it can delay milk coming in, obviously those having emcs are more likely to have had a traumatic birth. Also people having cs are more likely to be those whose baby has a problem and needs time in scbu, thus affecting bf. That's where this idea of cs causing bf problems comes from.

Delivery method in itself makes no difference what-so-ever as its the placenta being delivered that triggers milk production. However trauma experience during or shortly after birth or being unable to have skin to skin does effect it, regardless of delivery method does.

threeshoes, check out the KellyMom website - "when will my milk come in?" article has some references to studies done regarding delays in milk coming in.

On phone so can't link.

I have had an emcs and elcs and both were fine. I found the recoveries straightforward - obviously you've had an operation so you need to be prepared to take it easy, I mean it does hurt obviously. But yes fine.

So in answer to your question:
No damage to vagina or other ladyareas as baby didn't get anywhere near them
Going for a poo / wee afterwards I don't remember as being monumentally awful. Uncomfortable maybe?
Sex with DH was off the table for a while as you need to heal right up inside and we tried it and it was uncomfortable deep inside but then my sex drive fell off a cliff anyway so it wasn't an issue
You do still bleed out getting rid of all the gumph inside

Agree with others that 1. preservation of ladyparts is no way frivolous. You'd never get a man being told that wanting to avoid something that could totally ruin his penis and testicles was frivolous and 2. you should be able to get on NHS esp with your history.

For Olivia, I BF both mine in the recovery room after the CS, and fed both for over a year, so IME no probs with BF due to CS.