Caesarian or Natural after a caesarian birth?

[Zak]

I had an emergency c-section for my first baby. I was in labour for 22 hours,was continually monitored and unable to move around duing contractions. I am now quite scared to have a second baby due to my experience first time around. The hospital should have detected that your baby was breach from your scans and also if it was a large baby. What was the birth weight? I think sometimes we should stick with our own instincts and do what we feel is right for us. Obviously you should listen to your medical advice but if you are not happy, don't be afaid to ask for a 2nd opinion.

I wholeheartedly agree that women should be able to give birth in whatever fashion they want be it home birth or c-section. It annoys me when people harp on about a mother's right to choose a home birth and then say that they shouldn't be able to choose a c-section. I've argued about this in other places... Personally, c-section scares the pants off me!

Anto, I had a 3rd degree tear with DS1 after a shambolic delivery where I worked out how to push at the exact moment they tugged the ventouse. DS1 shot out like a bullet (I can smile about it now after hypnotherapy...). 2 hours of repair work under spinal block later and I was fine. It seems from what you quote that I was one of the lucky ones as I have had no problems following DS1s delivery and DS2s subsequent "normal" delivery (episiotomy when old tear looked vulnerable).

If c-section is the right birth for you then there's nothing more to be said.

Thank goodness there are people out there who understand... I've just had to listen to a 'friend' harp on for an hour about how much better it is for mother & baby to have a 'natural' birth - b**ks - my 1st baby nearly died & would have done if it hadn't been for the C sect. Would I be a good mother to risk that all over again (and yes - I do know that 70% of women do give birth naturally after a c sect. - but that means that 1 in 3 have to have another emergency cesarean or other equally horrid intervention). OK, rant over, feel a lot better now.

anto, although I had an emergency c-section first time around and was desperate for a VBAC 2nd time around, (which I did have) I have to agree with you. My wanting a VBAC is no more valid than your wanting a c-section, or someone else wanting a home birth. There are risks involved in all of them and it should be up to us to make those decisions. I think it's sad how little support women get in the choices that they try to make regarding child birth. (maybe because all the consultants are men).

Aloha, thanks so much for the positive feedback on the elective caesar. Must say that now at 35 weeks I'm more scared of going into premature labour than I am of the actual section!

Soupdragon, I don't have massive incontinence problems, but my anal sphincter control will never be the same again. Funnily enough, it's been much better during pregnancy because I'm very prone to anaemia and have to take pregaday (high-dose) iron tabs so I am sooooo constipated it's not true. Never been so far from anal incontinence in my life!

Must just add one final thing and then I'll shut up I promise! One of the friends who gave me the hardest time about considering a caesar actually had cosmetic surgery last year. I don't have a problem with that, but I was soooo furious that she dared to lecture me on the evils of unnecessary surgery!

Needless to say she has no children and no experience of giving birth, yet was very happy to give me her expert opinion on why vaginal births are best. We haven't spoken since.

anto, I had a haemmorage after my VBAC (one of the pitfalls of "natural" birth) and they prescribed me large doses of iron to bring my heme levels back up. My father consulted with some of the top haemotologists (sp?) in the world and it seems that the latest research indicates that high doses of iron are not necessarily the best way to bring your heme levels back up. It seems that the "artificial" iron isn't absorbed as well as iron that is naturally occurring in food and on top of that it can interfere with your body's absorption of the naturally occurring iron. Conclusion: since iron pills constipate you terribly (not great at any time, but worse during pregnancy), perhaps you're better off just eating iron rich foods and skipping the high dose pills. You should still take a normal one-a-day with iron (at much lower levels).

Anto, I have to admit was a bit nervous of the spinal - it's painless and very fast acting but I am a bit spooked by feeling totally numb (don't like it when you wake up with a numb arm after sleeping on it, for example, makes me feel claustrophobic) so I insisted that the anaesthetist told me jokes, which he found a bit disconcerting! When I lost all feeling in my legs I lay there pretending I was at yoga, completely relaxed, deep breathing and immobile by choice which worked really well for me. But having said that, when ds appeared (10/10 apgar, very cross-looking) I completely forgot about the numbness and just cried with happiness, as did dh (a bit - he's from Yorkshire). If you want your baby given to you first before it is wiped and weighed, then make sure you say so beforehand. I didn't and had to wait a couple of minutes which was a bit frustrating - couldn't wait to get my hands on him! The feeling in your legs comes back quite quickly - a block only lasts about an hour IIRC, and wears off from the toes up. It's a bit of struggle to move around in bed the first night or even two - I was lucky and had an electical adjustable bed (if you see what I mean) so I could get to sitting just by pressing a button. But you'll be offered good pain relief and it should be fine. Take it easy for a couple of weeks afterwards and you could feel absolutely right as rain & back to normal - I did. I wish you good luck and as good as experience as I had.

Thanks for the info on iron, SofiaAmes. The tabs have been a real bugbear this time round but they work quite well. I'm only taking them every other day but I've been too nervous to stop altogether in case I have a haemorrhage with the c-section (I know there is a very small chance of this happening). However, it seems that the Solgar general purpose pre-natal multi-vitamin would be just as good and a more gentle option. The pregaday also gives me terrible tummy aches.

Aloha, I woke up at 4am and lay there wide awake thinking how much I'd like more details of your experience, so thank you! Last time they gave me a massive top-up of the epidural to deliver dd then to stitch me up so I couldn't feel my legs for 2/3hrs anyway. It wasn't nice but I'm not very claustrophobic. My problems only started when I could feel my legs and my whole perineum again!

I also had to have a catheter in for about 8hrs during/after the birth, so that doesn't worry me too much either, although again, it wasn't very nice. The thing that I can't imagine is having to walk into the operating theatre knowing my baby is about to be delivered. I find that really freaky - a bit like walking to the executioners block! The other thing I am worried about (bit stupid this) is having to lie down after having the spinal block/epidural, because since about 25 wks, lying on my back makes me feel extremely nauseous and faint, even if it's only for a few minutes.

My best friend was so nervous during her elective c-section that she was shaking like a leaf and the doctor asked a nurse to go and make her a strong cup of tea! The nurse returned with a cuppa and a bendy straw and Georgie was so distracted by the midwife trying to show her how to drink the tea while lying flat on her back that she missed the whole rummaging round and taking the baby out bit and only realized they'd done it when her ds started howling and appeared above the screen, looking very bloody and very cross indeed - like your ds!

Also, do you know the difference between an epidural and a spinal block? Why would they choose one and not the other? Does it just depend on hospital policy?

Thanks for the info on iron, SofiaAmes. The tabs have been a real bugbear this time round but they work quite well. I'm only taking them every other day but I've been too nervous to stop altogether in case I have a haemorrhage with the c-section (I know there is a very small chance of this happening). However, it seems that the Solgar general purpose pre-natal multi-vitamin would be just as good and a more gentle option. The pregaday also gives me terrible tummy aches.

Aloha, I woke up at 4am and lay there wide awake thinking how much I'd like more details of your experience, so thank you! Last time they gave me a massive top-up of the epidural to deliver dd then to stitch me up so I couldn't feel my legs for 2/3hrs anyway. It wasn't nice but I'm not very claustrophobic. My problems only started when I could feel my legs and my whole perineum again!

I also had to have a catheter in for about 8hrs during/after the birth, so that doesn't worry me too much either, although again, it wasn't very nice. The thing that I can't imagine is having to walk into the operating theatre knowing my baby is about to be delivered. I find that really freaky - a bit like walking to the executioners block! The other thing I am worried about (bit stupid this) is having to lie down after having the spinal block/epidural, because since about 25 wks, lying on my back makes me feel extremely nauseous and faint, even if it's only for a few minutes.

My best friend was so nervous during her elective c-section that she was shaking like a leaf and the doctor asked a nurse to go and make her a strong cup of tea! The nurse returned with a cuppa and a bendy straw and Georgie was so distracted by the midwife trying to show her how to drink the tea while lying flat on her back that she missed the whole rummaging round and taking the baby out bit and only realized they'd done it when her ds started howling and appeared above the screen, looking very bloody and very cross indeed - like your ds!

Also, do you know the difference between an epidural and a spinal block? Why would they choose one and not the other? Does it just depend on hospital policy?

Anto, yes it is a little odd, but I didn't find it frightening. The room is brightly lit but didn't feel like a terrifying operating theatre. In fact, it didn't look that different to the labour rooms. There are quite a few people around - the surgeon, anaesthetists, nurses etc so it will be fairly busy, but I found everyone friendly and of course you will be able to have your dh with you all the time to hold your hand and distract you with amusing animal impersonations, or descriptions of the lunch in the hospital canteen that you weren't able to eat because you were about to have an op. Oh, yes, as you are an elective, not an emergency you may have to wait quite a while for your op as any emergencies take your place in the queue - which is understandable I suppose, though I got very hungry!. I was scheduled for the morning but didn't get seen until after 6pm. By the way, you won't actually be lying flat during your section. You will sit up to have the anaesthetic then you will be asked to lie down and will be tilted on the bed to one side, with a sort of wedge under you on one side. You won't be so tilted that you fall off the bed (!) but you shouldn't feel faint etc.
An epidural is a constant drip of local anaesthetic so you remain attached during the op. A spinal block is a single injection of anaesthetic and works faster and wears off faster (usually about an hour). I really wanted one as I wanted to get the sensation back as soon as possible. I don't remember feeling any pain whatsoever the first night (lovely morphine I expect!). You will have a catheter, but I have to say it didn't bother me, and you will be attached to a drip for a while too. I insisted on getting rid of my fairly swiftly as it was annoying me. I had my section at 6.30pm and was up the next day, feeling rather sore and walking like Quasimodo, but otherwise fine. The stitches are nothing really, and so low down in your bikini line that your scar will be hidden in your pubic hair (at least mine is) so it's nothing to worry about either.
I was at risk of blood loss too as had placenta praevia, and indeed, did lose quite a lot of blood apparently, but I ate a lot of steaks with a glass of orange juice beforehand and took Pregnacare tablets (from Boots) which kept my iron levels really high and didn't make me constipated. I did the same afterwards and got my iron levels back up pretty fast.

Any more questions? Happy to answer if I can.

Oh, yes, take a walkman or a book or some mags into hospital with you. As I say, you can end up waiting hours and if you don't have much to do you can end up feeling more nervous. Distraction is the key, I think.

anto - thanks for posting. I completely relate to what you are saying, but have never had the guts to post in as much detail. If you ever feel like chatting privately my email is [email protected]. It would be good to talk to someone who has had the same problems.

I had my secone elective c-section 11 weeks ago now, it was a fantastic experience, although, most of my pregnancy was ruined by worry that my consultant wouldn't let me have another c-section. I had a spinal block, I was first down to theatre at around 8:15, baby born at 8:50, it actually takes quite a while to 'finish off' after the baby has been born, so I kept saying to the anaethetist 'is he nearly done yet?'. The first elective C-S was for a breech baby, the second just purely my choice. I was frightened of the spinal block first time, and was shaking so much that they had to give me morphine as soon as DS was out, but this time I was not at all scared, I chatted to everyone throughout the procedure. If you want an elective c-section, just demand it, and have it put in your notes that that is what you're demanding, after all, how likely are you to succeed at VBAC if you don't actually WANT to?

All very useful advice and I think by the sounds of it elective c-sec sounds more likely - my only worry is last time when I had an emergency I had to have a general as the epidural didn't work and I kept saying to the anetheatist that the epidural hadn't worked so why would it for a c-sec - he assured me with a top up it would be fine - it wasn't, I'm not sure what they put next to my skin, they asked if I could feel it I said yes (it felt like cold metal) and the next thing I was under and woke up an hour or so later not with it at all and not able to hold my baby for five hours ! So you can imagine my fear of having another c-sec (awake or asleep) or natural birth (with all the horror stories of 3rd tears)! I have under 4.5 months to plan... although my gyneacologist ( a man - of course who has never been in that situ personally) insists I have another c-sec...

Minxi - I would say go for a natual birth. You may not have the problems of pre-eclampsia again. Your labour would not be allowed to go on for a prolonged period. If you don't try you will never know. Once you have had a second section you are more or less committed to C/S section for subsequent pregnancies. I have seen women have vaginal deliveries with no probems in circumstances similar to yours. Good luck with whatever you decide.

Minxi, I am so sorry if my horrible 3rd-degree tear birth story has frightened you. In fact, 3rd-degree tears are relatively uncommon - I have seen statistics that suggest that only 2-4% of women suffer one, so you are VERY UNLIKELY to have one. So don't worry about that tiny possibility.

Could you have a spinal block instead of an epidural? I don't know whether it's a different kind of anaesthetic or just administered differently, but I'm sure they'd tell you if there were any other alternatives to the general anaesthetic.

Minxi

The link below is to the NCT website. There's a question about c-sections and general anaesthetics that might be interesting. Don't know how to do the proper link thing, I'm afraid.

www.nctpregnancyandbabycare.com/faq.asp?newsid=5827

Also, there is an NCT-affiliated website called www.caesarean.org.uk

You may find something that will put your mind at rest.

Good luck!

Hi just had baby no 1 seven months ago so not having second yet but I just wanted to know if anyone had any knowledge of the situation were I was overdue and induced, reached 9cm about 18 hours later and then whisked in for an emergency c-section if in my second pregnancy if i go overdue would they induce me or do I have no choice but to go through another c-section which I personally dont want but would I have no option

Thanks Anto - will take a look at those sites and thanks all advice - will let you know !

wog - it is best to avoid induction and wait to see if labour will start spontaneously, even going to 42 weeks. However, I have seen women successfully induced who have had previous C/S. The decision is not the doctor's alone - it is yours too.

wog, mears - I was told by my midwife at my booking appointment that they won't induce me due to my previous C/S.

I have just been at a seminar for doctors,midwives, nurses in the birthing field. They asked me to speak about my births. Anyway, the speaker before me was a epidemiologist (statistics) and he mentioned that there are several reputable studies linking induction particularly pre-term induction (ie a week before your due date) with autism. In fact he was quite angry that so much time has been wasted on the incorrect link to mmr instead of following up this link which he says has a lot of real evidence.
Also a very famous elderly midwife who spoke later also agreed that in her opinion, c-section was preferable over induction particularly in the case of breach babies. She felt that a vaginal birth should be tried for, but if labor isn't progressing, then there should be a c-section rather than induction. I am going to do some more research on this, but thought you might want to keep it in mind.

I had emergency cesarean after 14 hour labour. Got to fully dilated with the baby's head crowning (lots of ooh! look at all that hair from the midwives) but after an hour of pushing, he wasn't coming out and had actually turned to face down. Forceps were tried but didn't work so into theatre. I was so high off the gas and air and practically delerious that I cannot remember much - except that I declined the offer of music to accompany the op!! I

My son was born fine but I couldn't hold him because I was shaking and being violently sick (14 hours worth of lucozade, water and dextrose tablets - nice ) but as I say - don't really remember.

Anyway, after a week in hospital I went home. Scared and in pain with a baby who had not mastered breastfeeding properly (he had a very sore head and did not like the breastfeeding position . Apparently he was so engaged dureing the last 10 weeks or so that his head had been banging on my pubic bone. The midwife called the swelling on his head 'caput' anyone heard of it??)

My breasts had been pulled and tweaked and shoved and manhandled for 5 days in hospital and were sore, cracked and bleeding. I remember getting in the shower and removing my breast pad only to find the crusty top of my nipple came with it. However, I persevered with the feeding because I had always wanted to breastfeed and the few times it worked with no pain, it was wonderful.

Finally, 3 and a half weeks later and with 2 bouts of mastitis under my belt I came down with a high fever in the middle of the night accompanied by violent shaking. The doctor was called and I was rushed to hospital with septaceimia. Apart from the obvious agony of having to leave my young baby (thankfully with my brilliant husband) I was in a lot of pain.

Once in a room I was stripped and sat in front of a fan to cool me down (temp 40 degrees) and hooked up to IV antibiotics. There I stayed for 4 days, not much of which I can remember.

AFter a horrible internal scan it was suggested by one group of doctors that something may have been left inside me during the cesarean. Funny, I just thought one felt shit after having a baby! It explained why I had got mastitis so readliy as I had no reserves to fight it off as my body was already trying to deal with the underlying and more serious infection in my blood

Anyway, sorry to ramble. But it is good to pour my guts out to strangers! My husband and I area trying for our second and I am already worrying about how the baby will be delivered. I desperately want a natural birth because it took me so long to get over the cesarean and I hope that I will be awake and well enough to sort out breastfeeding early on.

Anyone had a natural delivery after a first cesarean?? How was it?? I am scared by stories of 'trial by scar' and rupturing uterus'

Gosh sounds horrendous.

I too had a first emergency c-section after a 34 hour labour, without epidural etc... Got to pushing in the birthing pool and the little blighter would not come out. Tried ventouse, forceps and finally c-section. As you, he was spine to my spine.

Totally exhausted and traumatised by my experience the first three months were a blur, breastfeeding a disaster.

Happy to report that on 30 May this year, I gave birth to a second son by natural birth. The labour was just as long and again he was the wrong way round, but with the help of a fantastic midwife and an epidural I succeeded. I was out of the hospital that day. Hurrah.

It was such a different experience, and I have never felt such joy as when they placed him on my chest.

However, I was very lucky - it so easily could have been another emergency c-section. I don't know if I could have handled a repeat experience.

I naievely assumed that the labour would be shorter and the baby would be the right way round. It wasn't and they weren't. without my fab midwife it would have been a different experience.

If you do decide to try for a VBAC ( which is worth the effort ) then give yourself the best chance - get a private midwife or a doula to be alongside you and do not rely on the vagaries of the NHS midwifery service.

This is meant to be a positive message, because for me it was definitely worth it HOWEVER, assume that everything will be as difficult as last time and give yourself the best chance. If it isn't then its a pleasant surprise.

Congrats on second son Kazz33 and 'natural' birth. What is a Doula?? Also, I had a wonderful midwife during the latter stages of delivery. He was strong and encouraging and gentle - not what I expected of a male midwife (what did I expect??). If I did want a private midwife, or a Doula, then how would they fit in in my local NHS hospital?? and how would they be different from the NHS midwives?

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