Recovery for ELCS vs EMCS?

[hanflan]

I am trying to decide whether to try for a VBAC this time round, as I had an emcs last time for "failure to progress" and DD was getting distressed.
I have heard from various people that the recovery from EMCS is a lot harder than for an ELCS, but my midwife says this is not the case and they are not much different.
Do any of you have any experience of this that you can share? I am no closer to making a VBAC decision!

I've not had an emergency one, but had an awful tear first time round and an elective this time round.
I would say that I was up and walking 12 hours after the op with the catheter out and home the next day. I was in a moderate amount of pain for 3 days after, then stopped all painkillers after 10 days of a small amount of pain (around 4 out of 10 I would say!!!) I'm now just past a month and I'm back to driving, lifting a toddler and baby and walking for around 20 mins at a time.
The pain totally went around 3 weeks and is only sore now when I pull the skin around the scar to get a better look at the scar.
Not sure how that compares with Emcs!

I haven't had either but it seems quite irrational of your midwife to equate the two. With an emergency section, you are also recovering from whatever length of time you spent in labour before the section and any issues or fatigue caused by that. There are hugely varying degrees of emergency, some of the less pressing ones may well lead to a nice, calm, controlled section equivalent to an elective. But at the other end is the smash-and-grab version where time is of the essence and the surgery will of necessity be performed in a much more hurried and possibly rough manner. And of course, various degrees in between.

I'd also consider that a planned section will be carried out by a fully-staffed, fully-briefed well-rested team who will have studied your file and can tailor any specific accommodations to your particular needs. An emergency could be middle-of-the-night with whichever staff are available and who may not have dealt with your case before

Anyone I know who has had both says recovery is easier with the planned one. You should ask your doctor or midwife what are the chances of reoccurrence of the factors leading to your first section. This will be a useful help to you in deciding.

I've had both - (and both were carried out by a 'fully-staffed, fully-briefed well-rested team!) - and recovered equally well each time.

I think the issue with some EMCSs is that the woman has been in labour for some time, and is already shattered by the time t EMCS is done - putting her at a disadvantage for recovery. I had 'only' been in labour for about 5 hours when I had mine, so it wasn too bad.

Nothing beats a planned sector through - it was calm and relaxed and all done during the day, so I got a good nights sleep before he was born.

Hope you find the right plan for you.

I have had both and it is easier overall after an elective because as the previous poster said, I hadn't gone through labour and therefore wasn't completely exhausted from that. The actual physical healing was no different though.

I've had both. First for same reasons as you and a second 20 months later. I recovered pretty easily from both. First I was generally more knackered as had been labouring for ages and was emotionally all over the place. Second was lovely and calm from start to finish. Both times I rested up completely and my husband did everything but feed the baby for a couple of weeks. After that I was pretty much back to normal.

Echo what pp have said. In terms of physical healing a second section wound won't heal as quickly as first because of previous scar tissue, however emotionally an elective procedure is a much more calm and predictable environment given a well and rested mum and baby.

In hindsight I wish I had tried for a VBAC but mostly because I hate by belly overhang which I didn't have after first section. The reality is you'll never really know which is the better option as you can't experience both. As others have said hours of labour followed by a section is clearly going to be harder to recover from and with one child already it is quite useful having a scheduled section as it makes sorting childcare easier. Either way sure you will do great and have a lovely little one join your family. If it makes a difference it's quite hard picking up a toddler to cuddle post section so make sure you gave help arranged.

I've had a cat 3 emcs which was almost an elective (planned 2 days before it happened, no labour but I did have leaking waters) and a cat 1 emcs which was a baby born 23 minutes after they decide to do a section thing.

The pain was awful both times, although it was worse with the cat 1 cs. The cat 3 was done in a calm manner by the consultant. The cat 1 was done in the middle of the night by the registrar in a mad rush and I ended up with a bigger scar than normal. The tiredness was a lot worse with the cat 1 as I'd been up most of the night in labour and in theatre. Then I was in HDU with drips and alarms that went off if I moved. By day 2 I was crying with tiredness and begging the midwives to turn everything off so I could sleep. With the cat 3 I started off with a fairly good night sleep which helped.

My elective was a lot easier than my emergency caesar. I'd laboured 30hrs before the EMCS, but had no contractions before the ELCS. I had a smaller haemorrhage with the EL which kept my iron levels up and meant my milk came in faster. And my wound healed perfectly after the EL - after the EM I had a haematoma in my wound and it took 7 weeks of nursing to close up.

My VBAC choice was taken away as DC2 was breech. And I'm really glad TBH because the ELCS was such a relaxed and wonderful way to meet her.

I've had 3 children - DD born by ELSCS after 24 hrs labour and DD was stuck back to back. I was overnight in high dependency but home after 2 nights.

2 years 4 months later I had DS via VBAC. He also was stuck back to back and a normal rubber ventouse failed but he was delivered after a metal rotational ventouse (& a wonderful epidural!). He was a little stressed but fine. It was amazing being able to experience him being delivered on to my tummy. I had quite a few internal sutures and while these and my episiotomy healed I was pretty uncomfortable for 2-3 weeks. Recovery was better than first time round by far but I didn't expect the sutures to be limiting me for so long with mobility. I could pick my 2 year old up though.

4 years later and after falling pregnant again we opted (after a lot of discussion) for an elective LSCS. I am now 6 weeks post section and have to say I totally disagree with your midwife. The 2 experiences of emergency vs elective could not be more different. As others have said you are well rested before an elective section and the theatre environment is so much calmer - radio playing and lots of jokes,! I even had DS2 delivered onto my chest. I apparently had some scar tissue to resect which took a while but was fine and very little blood loss.my milk came in quicker than my emergency section by far which I was worried about as it was about a week after my emergency section. I was pretty sore for 3 days using painkillers regularly for a week but I was mobile and in the shower after 6 hrs and only stayed 1 night. I was driving after 4 weeks and after 5 weeks managed a 5K walk with DS2 in his sling!

As you can see from my story there are pros and cons of each delivery method. I don't regret my elective section but remember it's still major surgery and with that comes risk. I would recommend discussing with an obstetrician who will individualise your success of VBAC and help you decide. Best of luck!

I had an EMCS and my best friend had an ELCS a week apart.

I'd been labouring for 24hrs beforehand and was bloody knackered, best friend is breezing about having a good recovery etc..

I think if you have an ELCS there is some kind of mental preparation whereas I found it very hard to deal with the fact I got rushed into theatre all of a sudden for what is major surgery you're not expecting (DS was well and truly stuck / distressed so they needed to yank him out)

Having said that, recovery has been smooth so far (touch wood) I think it's more the shock that you weren't expecting a CS than anything else.

I'm so thankful for this post!
OP I am in a similar situation to yourself.. I had an emergency section after 36 hours of labour, an attempt at pushing and a few too many worried looks from the staff and was whisked off to the theatre for my DD to come out of the sunroof.
However, this was 6 and a half years ago and now, at 15 weeks pregnant, I am trying to also decide which route to go down.
I'd love to experience a natural birth but don't think I could take another experience like before. I struggled a lot after the birth of DD with postnatal depression and a lot of it was trying to come to terms with all that had happened and not being able to give birth naturally.
I quite fancy the thought of a pre-arranged babysitter for DD and good nights kip the night before but I'm being made to feel by certain family members like I'm being 'lazy' and taking the 'easy way out' (which I know, and probably all other csection Mummy's know, is a pile of compete crap )

ELCS is so much better! My first I was in induced labour for 28 hours, only dilated 5 cm, got an infection and heart rate dropped. Felt horrendous for about 8 weeks after.

This time round I felt pretty good straight away. Went for a walk to the park a week after (15 min walk each way) and just had more energy and felt generally better. I did have a slight reaction to the spinal which saw me throwing up for the rest of the day but bar that was fab!

It's so hard to choose but I looked at the worse case which was feeling how I did with DD1 and having a 18 month old to look after with a newborn! Good luck

I've had one non-urgent EMCS (for failure to progress), one crash EMCS, and one ELCS, and I noticed very little difference in the recovery, in terms of getting up and about and the wound healing. I wasn't in established labour for either of the two EMCSs which may have made a difference though. Good luck with making the right decision for you.

I had EMCS after 25 hours of labour, failure to progress and a baby in distress. They jogged down the corridor with me down to get me into a theatre. It felt really rushed and panicked.

Then I had ELCS 3 years later. The ELCS made me realise how rushed the EMCS was. It was so calm in comparison. I remember lying in the side room and hearing a baby cry and being told that would be me very shortly. It felt really chilled.

The recovery was slightly harder because I had a 3 year old to deal with as well as a newborn. But I felt more prepared. I had slept the night before the elective whereas with the emergency I had been awake for 25 hours.

Mine was booked when I was 20 weeks pregnant. They were not going to change my mind. I have absolutely no regrets.

I had a VB first time, 3 days labour all fine though exhausting, then a 3rd degree tear and nearly catastrophic haemorrhage. Took me months to recover even with multiple transfusions. The tear pain was awful too - maybe 6 months.

Second time a ELCS (though it wasn't 'elective' entirely - had no choice due to complications, but it was planned). Quicker recovery. Hurt like hell the following day, then bad wind pain in shoulder for a week then achey but fine.

Also had both, EMCS after nearly 3 days in labour, ELCS next time.

I apparently was making a good recovery after the EMCS according to the midwife - but I felt so so so much better after the ELCS. So so so much less tired and so so so much better in myself.

Also, I would have gone with a VB if that had been an easy/ likely option, but had induced labour for medical reasons at 39 and 38 weeks. In the end, all that mattered was that I and the baby were fine.

Congratulations and hope all goes well.

Have had EMCS and ELCS and for me recovery time was the same. Went home a day earlier with the elective.
3 days in hospital. Then painful to lift/move etc for about 2 weeks. Maybe I was back to moving around, driving etc after 3 weeks.

If you are able to have a CS, I would not waste time doing anything else. NCT and other groups push for VB but it's not that great, really. The first time around, I had an EMCS after progressing to nearly 10cms. Only in consultation for second child's birth did I learn that DD 1 was in the wrong position and the CS was a blessing for both of us: sparing me a likely tear and her neck/shoulder problems or even paralysis.
Second time around I was encouraged to go for VBAC. Terrible idea. I did manage that but had placental adhesion so nearly bled out immediately following DD2's birth. I nearly died right there on the birthing bed!! I then spent 2 hrs in theatre and had a massive transfusion. DD2 is lovely but her 90th percentile head over stretched me and I needed reconstructive surgery which came about just as I was returning to work. So instead of having a civilised CS and 6-9 mos mat leave for recovery, I had to take another 6 weeks out of work for surgery.

I've had 2 ELCS, my wound recovered better the second even though it was precisely over the scar (and very neat). I knew what to expect and was much better prepared. I did want to do VBAC, but I was late and we'd scheduled ELCS for when you would have done induction. However, I'd not had an EMCS/bad labour with first birth - if I had I'd factor that in.

Not read the full thread but IMO, what makes the recovery harder from an EMCS is that a) you're likely to have laboured for a long time prior so will be exhausted before they even get you into theatre, b) you're unlikely to be mentally prepared for an EMCS, which personally I think can make a big difference, and c) in my case, the EMCS op itself was much more panicked than my ELCS, and therefore less time to plan and execute the perfect incision, as it were!

I've had both but wasn't in labour before the EMCS (lack of movement from DD prompted it) but as it was so emergency it was under GA - my ELCS was far calmer (aside from my anxiety, but that's another story) and I was able to see DD2 straightaway (although she had to go to NNU immediately, again, not relevant here) but I was much more aware of everything with the ELCS.

Only have an ELCS experience and had one due to placenta previa (no idea why it was classed as elective as there wasn't any choice for VB).

Some pains on the first day, got up and walking as soon as I could.
Would say it was a slight discomfort after the first day but I know I have a high pain threshold. Not much pain at all after day 3.
Bruising on lower stomach was tender; much more than the incision. I wasn't expecting the bruising
I think the way the body is 'prepped' for a ELCS goes a way towards a quicker recovery. No exhaustion from labour and no gassy intestinal cramps (for me anyway) post-op as I was nil by mouth from the evening before.
All in all a fantastic experience - aware of everything throughout (not the pain) and bonded with DD straight away. Would have done it all over again.

If anything the pain after birth that sticks in my mind was the unbelievable back pain from sleeping on my back in a hospital bed (bed was comfortable but I'm not a back-sleeper). Never had back pain like it before, or since.
The incision itself hardly gave me any pain or trouble.
Good luck with what you decide.

I have had both and found recovery to be more or less the same with all of them.

um - isn't half the point how it affects the baby? An EMCS where a baby is pushed to the edge versus an ELCS?