C-section vs Vaginal birth - Advice needed

[Bisquick]

I'm currently 25 weeks pregnant and expect to discuss birth options with my consultant in a couple of weeks.

If there is any medical reason he suggests a c-section I'd just go for it immediately.

Absent any medical reason I'm torn between both options. Any advice welcome particularly regarding recovery etc (Detailed circumstances below which will be relevant).

We had a stillbirth at 37 weeks in January. I went into labour naturally then - waters broke went to hospital, was told to labour at home, came back at around 5cm dilation. They couldn't find a heartbeat. Dilated from 5cm to 10cm and gave birth to our stillborn son vaginally all within a space of about 30 mins.

Extensive investigations haven't found a cause for the stillbirth or why my labour was so sudden and quick.

I didn't have an epidural despite begging for one (long story) and had some first degree tears which healed up quickly.

On c-sec I'm worried about needing GA (I'm so freaked out and anxious about birth I would like to be awake and have my DH in with me), worried about being groggy and nauseous during first days, establishing breastfeeding etc.

But obviously main priority is just getting this LO out safe and sound.

On vaginal birth I'm worried about my pelvic floor, but mostly worried about my ability to deal with labour. Obviously when I am calm I can handle it and am grieving but it is manageable. I wonder if I'll just freak out mid labour if it reminds me too much of last time. I worry about baby undergoing stress (perhaps that's what went wrong with our son?) and so on.

FWIW we've gone private this time so hopefully a much lower chance of all the endless fuckups with pain relief and monitoring that we had on the NHS. I'm not specifically blaming anyone but if we had been monitored better this wouldn't have happened, and the emotional pain of delivering my dead baby was only compounded by their continuous fuckups with regards to the epidural.

I've tried to make this as unemotional as possible following multiple rewrites, but you know what I mean? I want help making a decision and right now I'm struggling to do so.

I also felt some pain during my section. The tugging was quite painful and the spinal was wearing off as they were stitching me up. And something made me throw up repeatedly in recovery - which was the most painful experience of my life. I got through it is the best that can be said.

I also know others who have experienced the spinal wearing off early and so on. It's not that unusual.

I felt no pain during the procedure. I could feel... tugging? I suppose is the best word but no pain. It was like someone was having a rummage around in a bag.

I've had different types of birth and virginal was the best for me. However you should do what ever you feel drawn to

Wow Gooseberry, that's impressive. But not sure how much use that comparison will be to the OP when you're the first one in over 2000 years (allegedly).

Ah that typo made me smile Gooseberry! My due date is actually Christmas Day though so perhaps we're all due a virginal birth after 2,017 years 😂

Thanks for sharing all your c-section experiences ladies! I was surprised some people reported feeling pain - thought it was meant to be just feeling some tugging and pulling etc that you feel. Another thing to check with the consultant as well! I don't have a particularly high pain threshold - although I did manage without an epidural - but so do lots of other women so that's neither here nor there I suppose.

I did also throw up a lot after my second c-section. My baby was in NICU and no one had time to take me to him, although I was so groggy and sick I was in no fit state to be moved anyway. I assumed it was all the gas and air - I had to ask the anthestist to turn it down it was so strong!

With my first though I had my baby in bed with me feeding away as soon as I went to recovery. Then stayed like that for 3 days.

Spinals usually work really well but occasionally you get one that doesn't work at all or is just inadequate. Lots of possible reasons, often we just don't know why. You shouldn't be left in pain though, sometimes the anaesthetist can try another spinal or epidural if the surgery hasn't started yet. If the pain occurs during surgery, you can try things like gas and air or morphine-type drugs but ultimately you should be offered a general anaesthetic. (Obstetric anaesthetist)

I really hope everything goes well for you OP. I've had an emergency c-section and am booked for an elective with my current pregnancy.

My main reason for choosing a c-section this time is to avoid an emergency situation like last time. I wasn't worried about labour during my first experience, but knowing firsthand how it doesn't always go to plan, I know I'd be anxious about it this time, worrying about a repeat performance. Medically I was offered either option (VBAC or ELCS) but for me it's a case of better the devil you know.

Furthermore, the risks of a c-section tend to lie mainly with the mother, which I can handle, rather than the baby, which I couldn't.

I didn't find the c-section at all painful during the procedure, just deeply weird! I did find recovery painful, even though mine was straight forward. But then again, vaginal recovery can be hard too. I puked a lot pre and post surgery (due to the medication I had during labour) which probably didn't help with all the bruising. I'm doing it again soon, I'm just very aware of not pushing myself, having help organised, etc. I'm told it's generally easier recovering from a planned section as you don't have all the physical work of labour to contend with on top of recovering from major surgery. Here's hoping that's true!

@cheerios I also found my EMCS painful/uncomfortable but I think it was mostly the pulling and the fact it felt like someone was leaning their body weight just under my ribs ... it was very unpleasant. In saying that my baby was awkward and apparently flipped around in the womb mid c-section so that might be why the pulling felt worse!!.

I got the shakes from the epidural (as it was EMCS they just keep topping up the epidural unless it's not working when they would switch to a spinal block, but I just had lots of epidural). My body was shaking and my jaw was clattering and it also made me vomit which was horrible as I hadn't eaten in 24hrs because I was in labour.

My recovery was also painful because I don't tolerate anti-inflamatories well so couldn't take any...

ALL that being said I would opt for an ELCS next time around as I wouldn't want to go through the whole labour and still end up with a section when you're knackered and maybe baby is in distress.

Friends who had ELCS report much more pleasant experiences than mine.

I also think there's a lot to be said for knowing what's coming when you are anxious.

Best of luck with it!

Thanks everyone for the very useful advice! Have a bunch of question written down for my next meeting with my consultant.

As of now I think I'd like to book in for an ELCS at 38 weeks, and then check what he suggests is the best course of action if I go into labour naturally before then (which I just have a feeling will happen).

Based on a recommendation on FB I also got this book which is chock full of statistics, which I find comforting when making a decision.

Sorry for your loss op.

Just to correct an earlier claim,there isn't growing scientific evidence that vb is important and beneficial for the baby. There is a lot of hot air talked about it, but all we do definitely know is that the microbiome of vb and Cs babies is different. We don't know whether that's important and, if it is, which is more advantageous.

Good luck with whatever you decide.

Sorry for your loss, its no wonder you are anxious.
Have you thought about using a doula to support you with the birth, whatever options you choose, a consistent presence of someone who is there just to support you, knows your wishes and will speak up on your behalf can be really valuable. Have a look at doula.org.uk/

Sad to hear about your loss.I think was not due to normal/vaginal delivery. There might be some other reasons. I had c-section for my first baby. I am very clear about vaginal delivery and c-section. I advised you for vaginal/normal delivery. Although you have to go through unbearable pain but it is safe for you. If you chose the c-section, you will find it comfortable. You will face the pain only first week after c-section. Once stitches open, you almost have no considerable pain. But c-section has long term side effects or you can say it has its side effects for the whole life. You can never spend a normal life as before. c-section caused back pain which remains for your whole life. Whenever you will get burden, more exercise, more work at home or office, you will get back pain, fatigue and sometimes nausea. You can't pick up your baby for long time, not more than 1 or 2 hours continuously. Vaginal delivery is only tuff until baby comes out. After that all thing are normal as before. C-section is like tear up some thing and sew it again. It is not same as before.

Don't go for c-section until you are in critical situation or your doctor advised so.

Wow Suzi has some strong views on c sections it seems!

That's a whole heap of scare mongering and no actual facts in there. Vaginal birth also carries risks to both mother and baby... ahhh actually I'm not even going to bother

@bisquick You seem to have your head screwed on and are doing your research so just ignore those types of scare mongering and blanket statements.

Best of luck

Don't be an arse suzi. You're talking to someone who had a stillbirth earlier this year.

I loved my elective CS. Very calm and recovery was easy. Was only in hospital for one night. Completely trauma-free.

I had planned c-sections for both births. The second one was not a good experience, but I still felt it was the right decision as I had looked at the risks and felt more comfortable, in my circumstances, with the risks (mostly to me) of a planned c-section versus vaginal birth or emergency c-section. I was less comfortable with the risks (primarily to my children) of vaginal birth in our circumstances. Look into vaginal seeding but you might want to consider having a strep B test, etc if you are thinking about doing it. The current thinking (I believe) is that there is more of a risk than benefit.

I'm sorry for your loss OP and wish you a happy birth, whichever option you eventually decide on.

Planned c-sections can be very good experiences. Some obstetricians enable 'natural ' sections so that women are able to feel very much the key player in the birth of their baby - which of course they are. And delayed cord clamping, skin to skin straight away if you want it, are all pretty standard now in planned sections.

And it really isn't usual to suffer the ill effects a PP has mentioned.

So sorry for your loss. Birth of DC1 resulted in an emergency. If we hadn't been on continuous monitor it would have been a serious injury or stillbirth. Im gutted when I hear stories like yours as you are right monitoring may well have given your little one a chance.

I went for vaginal birth with DC2. It was awful as DC2 went into distress immediately. Given what had happened first time i found this terrifying and required counselling afterwards. They refused to perform a cs when baby was in distress but dr was visibly very concerned and panicked which increased my fear for my baby. If you choose vaginal birth you do need to consider that things may not go to plan and how you would feel about that.

My understanding is that cs is safer for the baby and the common injuries are less likely to be long-term (initial breathing difficulties which can be managed at the hospital, whereas in a vaginal birth oxygen deprivation is a risk and would have much longer term consequences). Repeat Cs can be slightly more dangerous for mother but I believe that's compared to a very straight forward vaginal delivery (rather than one with interventions) and also the risk is only higher for cs after several previous cs. Also they don't advise having any more than 4 cs. So if you want a really big family vaginal delivery is better.

Personally based on my experience and what you've said, I'd go for cs at 39 weeks. You may well be relieved to get baby out at that stage rather than the emotional 'when will I go into labour' waiting game.

Some doulas specialise in loss. Might be worth checking in your area as they would be really good at supporting you through this!

Also I don't know anyone whose had any issues post cs. So not sure what PPs are on about. It's definitely not common! I do know quite a lot of people who have stress incontinence or pelvic floor issues from Vaginal births tho!

Summer! My thoughts entirely. Perhaps MN moderator could remove the Suzy scaremongering gobbly-gook?

OP I am so sorry for what you've been through and wish you the best experience and a healthy LO this time.

My DDs had a crash CS under GA which saved the life of her baby and herself. Not too much finesse was used (understandably) yet she is fine, I can't think of a more extreme C section experience and yet she and baby are A1 and she will probably have an elective with a future baby at 38 weeks like you are considering. You will be very carefully monitored indeed whichever you choose. You sound very rational and intelligent and I'm sure you will make the right decision.

Don't know why this thread disappeared from my watchlist. Thanks again for the helpful comments.

Not sure what the needless scaremongering was by @Suzi763.. But clearly just an outlier amid all the good advice!

And @SummerSun1234 and @holdthewine that's exactly my concern. (And yes, I do think the baby would have been fine if we had been monitored more closely.. there were a series of tiny mistakes made by different overworked people that just led to a massive tragedy.) Obviously I would be offered continuous monitoring this time but what if it fails or highlights problems at a stage when there isn't time to do a CS etc etc. I discussed this in detail with our bereavement counsellor who is also offering antenatal counselling and one thing she said struck a chord with me: I need to make a decision I can live with, whatever the outcome.

Going to speak to our consultant tomorrow but I think my tentative preference is to schedule a CS for 38 weeks assuming baby continues growing well, and then just keep an open mind on how everything goes.

This thread has been super useful in terms of helping me weigh up the pros and cons of c sections without a lot of the emotional baggage, so thank you for sharing your experiences!

Bisquick: If you're being monitored carefully (as you will be after your tragedy) and things go wrong and you're in hospital it's amazing how fast they get you into theatre. I think it's was half an hour from the first sign (my DD developed maternal sepsis) to delivery and the staff were literally running with alarms going off. As soon as they hear "category 1" the procedure kicks in. It was pretty impressive - though I hope never to go through it again. They actually stop other operations - it does really go to the top of the queue. Being a bit of an old hippy I rather wished I'd had one at home but have to say that experience changed my mind!

The chances are you will have a perfectly normal, healthy, delivery this time, by whichever means you choose. Also choices made now are not fixed in stone. You can always change your mind.

Please keep us posted. I shall leave this thread in my watch list in hope and expectation of happy news!

Suzi isn't communicating in perhaps the best way, but damage to abdominal muscles and painful adhesions are relatively common side effects of c-sections. I'm very pro c-section by choice (I think it should be offered for every birth) but it can and does have risks.