Elective c-section medical reasons (Crohn's disease)

[Trickytricky]

Hi all,

I'm new to this board so go gently please! I'm 22 weeks and just had appointment with consultant to discuss delivery options. I have Crohn's disease (luckily it isn't active at the moment) but I have had two operations for anal fissures in the past (about 10 years ago). So I have some scar tissue in the requisite area. Consultant and I have decided (provisionally) that I should have a elective c-section to avoid any risk or my scar tissue ripping and any completions arising.

I have a few questions - has anyone else had an elective c-section for medical reasons? If so, when did they schedule it (was it at 39 weeks)? What are the risks for the baby that I should know about? Is it true that the baby may not BF as well as none c-section baby?

Finally I feel a bit like a cop out if I go for a c-section even though I know that medically its sensible (I definitely don't want to put myself at risk of being incontinent if I don't have to). Is it normal to feel like this?

Any other advice warmly welcomed! Thanks.

Hello!

Firstly congratulations.

With my first born I had a labour, but this resulted in an emergency c-section. I was absolutely gutted and felt like a failure for a long time.

When I fell pregnant with DC2, I was all for a VBAC but developed pre-eclampsia and DD was a csection at 38 weeks (this was an elective as it was decided the week before).

It was a very lovely and calm experience and it totally rid me of any guilty feelings from before.

I am expecting DC3 in July (currently 34+1) and I am booked in for an ELCS due to my essential hypertension, previous eclampsia, pre eclampsia and full lumbar spinal fusion. This time I will be asleep (due to back issues) which I am a bit gutted about, but happy to have another c-section.

I breastfed both of my previous children for 10 months without any issues so cannot say that a csection affects feeding as it certainly didn't affect me. I will be breastfeeding this baby, but mixed feeding (for different reasons)

There are of course more risks for mother and baby, but if you have existing medical options and a csection has been offered to you it is safe to assume this is the safest way for you to have baby.

This csection is scheduled for 39+2 as I did not want to got for 38 weeks again (DD had stomach issues and jaundice)

Best of luck!

Thanks Number3. A few friends have also said they felt similar after emergency c.

Anyone else had an elective?

Has anyone else had an elective c-section for medical reasons?
Yes, mental health reasons.

If so, when did they schedule it (was it at 39 weeks)?
NICE currently advise after 39 weeks if there is no medical reason to suggest this will put the mother or baby at risk. Before 39 weeks the risks of respiratory problems is much greater.

What are the risks for the baby that I should know about?
See above. Admission to SCBU is slightly higher. One of the main factors in this is, estimating gestation rather an ELCS itself, though there is a suggestion this could be down to labour squeezing out the lungs (There is not enough research for this yet really though).

Also, you should consider the size of family you are planning. NICE's current guidelines compare risks of a planned VB v a planned CS. The only difference for mother and baby was the risk of SCBU admission. However this is flawed as they fail to discuss the implications and risks for future pregnancies where a planned VB generally comes out better than a planned CS.

Is it true that the baby may not BF as well as none c-section baby?
Yes and no. The trouble with much research on the subject is that the data for planned ELCS is usually lumped in with EMCS so that it distorts the picture if you are having an ELCS. So be careful with this one about where you get your information from. I think it can be more difficult for some women for physical reason, but because an ELCS is planned there are fewer factor (such as exhaustion) to consider that might affect an EMCS. Having a CS itself shouldn't stop your milk though as its the removal of the placenta that releases hormones for milk production. Personally, I BF - not without problems - but none of these were related to how I gave birth.

Finally I feel a bit like a cop out if I go for a c-section even though I know that medically its sensible (I definitely don't want to put myself at risk of being incontinent if I don't have to). Is it normal to feel like this?
Is it normal to feel as if you have to justify yourself to others? Hell yes. I've seen a billion threads on here to that effect. The thing is though its a social construct and the only people who object to how you give birth are twats anyway. If you and your consultant decide between you its medically the best option why should you be bothered by none medically trained idealists who have bugger all knowledge about your medical history and don't have to live with any adverse possibilities? Blame the Daily Mail and ignorance and move on.

I have had two sections for exactly the same reason; perianal chrons and surgery on a fistula leaving me with scar tissue. First was 39 weeks, second 39+1. I have never regretted it or felt bad or cheated.

The reality is we won't stretch, we will tear through and the recovery would be far far worse than a section.

One thing I would say is that first time round they didn't give me enough pain relief for fear of interfering with my chrons. I don't actually have a problem with NSAIDS and if you don't either make that clear!

Good luck:-) Ask me any questions if you have them!

Thanks all! Really appreciate your comments and honesty.

Bean - I don't have an issue with NSAIDS so will make sure I get enough to painrelief!

So most people had elective at 39 weeks. Suppose that's the norm then! Thanks so much for your comments you've put my mind at rest.

I have crohns disease. I have a peri analysis fistula and anal fissures. My first was a ventous delivery with a quick recovery time (pub lunch the next day) and my second was a home birth approximately 2 hours long. A flare up of crohns disease is the worst pain I have ever felt in my life. Labour was no where near as painful.

Hi, I had an elective c section this week at 39 weeks; previously had an emergency c section. I felt slightly cheated after the emergency section, but not after this one. It was such a lovely calm experience, and so far breastfeeding has been easy compared to last time. We had skin to skin in recovery, and the baby seemed to start feeding himself just like in the videos! All the best for the birth.

Thanks all for your lovely responses. I am feeling much more calm about the c-section now.