Experiences of elective c sections (not interested in responses from the natural birth cult thanks! 😂)

[Lauratwelve]

Hiya ladies,

For those of you who have requested c-sections for your first. What are your experiences? I don't want to give birth vaginally so i'm just looking into requesting a c-section. I have nothing but respect for all woman and how they choose to give birth but vaginal delivery is just not for me. Ive had abdo surgery before so I know what to expect. Thanks guys 🌺🌸🌺

Cost shouldn't come into it but it sadly does. There is also a lot of pressure nationally to reduce the section rate as it has been proven many many times over to lead to worse outcomes for both the baby and the mother on a statistical level. People have horrendous vaginal births and people have horrendous ELCS but overall for a first baby where no medical conditions exist for either the evidence strongly supports vaginal birth.

Obviously some women need an ELCS for a recognised indication and an ELCS is safer than an EMCS,

That said maternal request for mental health is a valid reason. NICE guidance states that if a consultant is unwilling to perform a maternal request ELCS they should refer to someone else that will. Remember that NICE guidance is guidance not law and the hospital has no duty to follow it however.

If someone is armed with the facts and willing to accept the increased risks then they are far more likely to have the ELCS agreed than someone who falsely states it's safer, that's why I wanted to make sure the OP knew it wasn't. As her request won't be taken seriously if she isn't accepting what the evidence says. Women shouldn't have to jump through hoops to get what they need but sadly they often do.

Met with consultant. Explained my reasoning and she glossed over it and handed me a leaflet on natural births. Unfortunately I then had a panic attack in the corridor as we were leaving. Consultant freaked out a bit and hurriedly said to me “don’t worry, we’ll sort it.” Then head midwife came out to my house the next week and had a chat with me and was totally supportive. She wrote to consultant advising ELCS and it all went smoothly from there. And it was 100% the right thing for me. Had a good experience.

@VinIsGroot

Because sometimes it's a false economy. It certainly was for me. I asked about an elective when I first found out I was pregnant, the midwife poo poo'd my fears, told me she'd seen loads of women in similar circumstances who found normal birth "healing". I didn't pursue it. Instead I ended up in labour for 75 hours as Ds attempted to leave via my spine (some at home with a midwife popping around to check on me/some on the labour ward/some on the MLU), failed forceps and an emcs with around 30 people in the room. DS went to NICU and I massively triggered by everything I experienced had a total mental breakdown and attempted suicide. We were both in hospital for 3 and a half days. That's also two Psychiatrists, two referrals to Psychotherapy with 2 different Clinical Psychologists and a fairly useless CPN which has also had to be paid for. I suspect I'd made up the difference in cost between an elective and a normal birth before I even left the Labour ward. It is the opinion of my Consultant Psychiatrist that had I been granted an elective, none of this would have happened. It would also have been thousands of pounds cheaper to the NHS.

Sorry to break into a side conversation here but hoping @Catchingbabies can maybe sense check what I'm saying....

To the best of my knowledge you can also choose what NHS Provider you use. Say you live in SW London, in theory you have the choice of St George's Kingston or St Helier.

If you're dissatisfied with your antenatal care at one provider I think you can switch to another?

Obviously if you live somewhere like Kings Lynn this advice means fuck all x

Nobody can say vaginal birth is horrible or torture, for some women yes it may be but for many women it's fine, painful but fine. Equally some ELCS can be horrible with awful recovery, whereas many are fine!

Op, you need to really do your research so you are armed with all the knowledge you need when you request a ELCS. catchingbabies has posted some really useful research/guidelines for you to use.

Nice guidelines are great but they are guidelines, so not the absolute. Therefore some obstetricians may not always completely follow what the guidelines say. But they are a good starting point for you to base your request on.

It is very unlikely they will say yes straight away, it is likely you will have to really argue your case, have some antenatal counselling, and in some cases have to try different obstetricians in other hospitals.

Good luck.

My first birth was an ELCS - far from being too lazy/afraid/unnatural or whatever to give birth, both me and DS would have died if I'd been forced to give birth naturally. There simple was not enough time to induce me and for us to live. But hey, begrudge me the extra £200 or so it cost the NHS eh? Jesus.

I was undecided with DS2 for a while. I knew there wasn't a mechanical reason for my first section (ie failure to progress, placenta praevia) but the consultant had said after my first that I had large fibroids that may impede a natural birth in future. My midwife was very blase about risks, so I researched all the statistics. My nightmare scenario was going through labour then ending up with a section anyway, and when I realised a VBAC had a 30-50%+ chance of ending that way it made my mind up. I went into my consultant appointment prepared for a battle at armed with loads of stats. When I said I would like another section, he just said 'That's a perfectly reasonable request' and booked me in. My only gripe was they put off this appointment until I was 36.5 weeks, then every theatre slot was booked up until I would have been 43 weeks! I got shoved onto the end of a gynae theatre list in the end - why do they do that, leaving the decision until so late?

My EMCS left me pretty bruised, in a lot of pain for a week or two and exhausted, but I was already extremely ill. My ELCS amazed me, hurt the next day or two but then I recovered so quickly. My friend who was on the same ward, at the same time, and had a natural birth, is still suffering with pain and incontinence over five years later.

I know I made the right choice second time, as the consultant told me afterwards that the scar on my uterus from the first time was so thin it was starting to separate - I'd been at serious risk of it rupturing at any time, let alone once labour started.

I had a planned c-section with my first child. Induction didn't work (I didn't dilate at all after having the maximum dose of pessaries, so couldn't have the drip or ARM) and I was two weeks overdue, so I as given the choice and I took it.

I found the theatre cry overwhelming and scary, but the actual op was fine. No real issues with recovery in terms of the wound healing, pain or getting up and about, but I did feel like I'd been hit by a bus in terms of having to recover from major surgery and care for a newborn.

Elective section second time around and it was a breeze. Mainly because I knew what to expect, so the fear element wasn't there so much, and because I planned really good care afterwards - DH took 2 weeks off work, I had relatives helping out etc. That really helped, as I was able to rest and properly recover. I also didn't have the whole exhausting, frustrating 4 days in hospital being induced beforehand, so I was in and out of hospital in 48 hours on the nose, which was nice.

If I'm 100% honest (and I know its not a popular opinion), I can't imagine a nicer, more serene, pain-free and wonderful birth than my second c-section. It was a doddle.

I think you need to be really informed about your choice and clear about the reasons you want a section, OP. And remember that if one consultant sys 'no', you can request to see another consultant.

Best wishes

I had an elective c section a month ago and recovery has been brutal. It was my second c section after an emergency one with my middle son. I got an infection and the wound has reopened both ends, I’m on week two of strong antibiotics, and at the nurse every other day for it to be cleaned and dressed. It could take weeks. I cant do much, it’s painful. I suspect my huge tummy overhang isn’t helping, and during surgery it was tricky as I had placenta praevia and scar adhesions from the emcs. Everyone’s experience is different, but I would certainly caution going into it thinking it’ll be a breeze. By comparison, I have also had a mid cavity forceps delivery and whilst the first week post delivery was very hard, I was soon fine.

I can't really help with requesting one for first baby. But I'll tell my story from first pregnancy and this one so far.

With my first I was in hospital being induced and it didn't work, I didn't dilate or labour at all so asked what's next and they suggested doing it all again or a section. I said section. So it wasn't an emergency, more elective, didn't have it til the next day.

So I had Ds 15days overdue and the section was amazing. Calm, controlled, lovely. I was scared, was I making right decision? But Ds was fine, undiagnosed breech and 11lb7oz so section WAS definitely the right option.
I lost a litre of blood- they had to keep an eye on me but all was fine.

The first few days were tough, not gonna lie. First night in hospital I couldn't get up (had him at 8pm) so they did all the feeds and nappy changes and if he wouldn't settle they'd take him off for a walk or have him at their nurses station. Next day I first got out of bed early afternoon and it was tough. It was a lot of effort to sit up, stand up, walk to toilet etc. By that night I had to do all night time feeds and nappies with Ds on my own. That I found hard because I was still in pain and it took me ages to get up, bend over etc. But next day we got to come home and it all got so much better as I had DH's help (he wasn't allowed to stay over at hospital).

Recovery was absolutely fine from then on. DH went back to work 2 weeks after we got home and I coped fine.

I'm pregnant with number 2 and want another section. Saw consultant at 14 weeks, he wasn't sure about agreeing but I had done lots of research, printed off lots of info, highlighted lots and wrote two pages about how I felt and what my reasons were.
He didn't even need to see it all to understand I wasn't there just on a whim and I really did know about the risks and what I was letting myself in for. He explained ultimately it's my choice, because I've had a section already (he did say if it was my first there wouldn't have even been a discussion because the hospital doesn't allow maternal requests for first baby or electives for first baby or something - It wasn't relevant to me to don't remember exactly what he said). He said we would sort date and sign papers at 36 weeks. I did question if he was making me wait til then to then say no so I had no time to request another consultant as nice guidelines say I'm entitled to. He said no. If I still felt I want one then it would all be signed off at 36weeks. He wrote in my notes keen for a section, confirm at 36 weeks so I felt reassured that it's in writing in my notes incase I don't see him again or go into labour beforehand. I'm still still a tiny bit anxious that he'll say no or something but I have to trust what he said and hope he says the same at 36 weeks!

He referred me to a birth choices clinic to go through first birth with someone, talk about what happened, what went wrong, what's likely to happen again or if it was a one off.
I found this appointment useful but still feel the same. He did say some people have this appointment and totally change their mind though.

My next appointment is in December at 36 weeks with consultant. Hopefully to sign it all off!

Good luck!

Morning all,
We have received a great number of reports about this thread, and have been through it and deleted the posts that we consider were goady or attacking or broke our guidelines in other manners.
There can be few subjects more fractious and anxiety-provoking than childbirth, (although it's not long until breast and bottle feeding so brace yourselves) but if anyone is feeling stressed out by the thread it might be a good idea just to hide it for a while.
Fwiw, I've had both ECS and VB. Both fine, in the grand scheme . All we can really hope is that everyone gets the result they wish for.
Peace and love and all that shiz.

I had an elective almost a year ago. My first daughter was lost at 20 weeks and the subsequent issues I had following her birth (I had to have a D&C due to retained placenta, this was unsuccessful and I suffered two major post partum haemorrhages as a result) left me terrified. So when I found out I was expecting number 2 I was pretty set on a c section from day one.

My advice to you is to be persistent, bring it up and keep bringing it up. I won't say I had to fight for mine, I didn't, had amazing support from my midwife, my bereavement midwife and anaesthetist who all agreed that given my history a c section was the best option for my mental health. The consultant did try to talk me out of it but I stood firm and made it clear I knew the risks and on balance I felt the c section was the safer option for my baby and myself. From the moment it was booked I felt like I could breathe again. I had it at 38 weeks and it was great, very calm, very relaxed, my recovery was excellent, I was up the next day, I took all the pain killers I was offered and felt completely back to normal in under a fortnight. I can't drive anyway so that was never an issue. I also had something called a PICO dressing, which I highly recommend you ask for, it's a vacuum dressing with a battery powered pump attached, it stays on for a week and does wonders for your healing time. Good luck too you!

So very sorry to hear about your wee daughter, DbutD.

Thank you Helen.

Good births aren't all that common IME. Out of my antenatal group of 12, we all hoped for the water birth, g&a only natural delivery in the local birthing centre.

2 girls (second baby) managed this.
8 girls were induced.
2 had forceps
4 had episiotomy
Most had some form of a tear
4 had EMCS, with varying degrees of labour beforehand.

I had EMCS. I will be pushing for ELCS for my next, because it's all I know.

Maternal anxiety is totally understandable. C section recovery was very tough and definitely not a walk in the park, it's major surgery. Vaginal birth is also (although natural) not risk-free and not a walk in the park.

We'd all love to have a calm natural labour where we breathe the baby out on minimal pain relief. It's just unfortunately undeniable that giving birth is not easy whichever way you do it and you should be entitled to undergo a major medical procedure (vaginal or caesarean) in the manner you would want. Neither are easy. Good luck.

@lauratwelve sorry to be late answering your question about what complications I had. I had to be readmitted at 3 weeks postpartum as I was in early stage sepsis amongst other things. Three days on IV antibiotics. The recovery was slow and I have internal adhesions which are painful and have a (very mild) impact on my mobility. I'd still do it again - I think - as it was a risk I was willing to take against the risks of VB to my children (in my circumstances). But please be aware of the risks. There is also some evidence that VB has a beneficial impact on the baby's immune system, but I guess that has to be balanced against the risk of Strep B etc.

I wanted a VB desperately. It’s not safer for the mother when you look at the rates of pelvic trauma etc. but it certainly is safer for the baby. I didn’t get one, and when you factor in the induction, long labour then EMCS in the middle of the night and subsequent illness, I think we cost the NHS far mor than an ELCS would have. Don’t think costs come into it with such an uncertain process.

There is also a lot of pressure nationally to reduce the section rate as it has been proven many many times over to lead to worse outcomes for both the baby and the mother on a statistical level.

No it hasn't.

Hi Lauratwelve, I also requested a C section for my first baby. This was a maternal request on grounds of family and close friends' childbirth related and post natal depression and trauma (including one suicide) and my own anxiety related condition dating many years back. This was granted and was not as difficult to get agreed as I had imagined.

Had my request been rejected I planned to either go abroad or pay in the UK (not cheap!) to have the birth that I wanted and believed was safer for my baby and to some extent myself, on balance of acceptable risk(s) and injury.

As others have already pointed out, you need to be determined in all ante-natal appointments, give them good reasons (you noted some already- no surprise you are impacted) and show that you understand the medical risks and physical impact. Explain this calmly and don't be put off by lecturing and attempts to dissuade you but search for an understanding professional in your hospital, or even a different hospital if possible and needed. If you encounter push back in meetings don't wait too long but ask to be referred asap and follow up by calls and emails.

In the end my ELC turned out to be medically necessary as I had come complications but despite that I had a good experience- operation was relatively calm, baby was safe and brought to me quickly, most HCP were kind and I recovered faster than anticipated. Thanks to this I had a good start which allowed me to be reasonably calm and collected with the new baby around and all the challenges and demands that inevitably throws at you.

My first baby was born after a very fast labour and I had a 3rd degree tear.
My twins were delivered by elcs as baby 1 was breach and baby 2 transverse. I wasn't given the option of vaginal delivery.
I've hated the whole c section experience. Babies are 8 weeks old and I'm not recovered. My wound still weeps and also bleeds if I do more than an hours walking. I had an infection and struggled with the pain. I also hated the blood thinning injections I had to give myself for 10 days.

Onion - Yes it has. I've posted the peer reviewed evidence if you would like to take a look at it before making statements as though they are factual.

And to the poster that asked. Yes you have a right to choose your NHS provider and don't have to go to the closest hospital to you if you don't want to.

You've posted a few pieces of peer reviewed research catchingbabies, but the problem is that you've done so selectively. So for example we have seen nothing from you about the risks to both mother and baby that are higher with attempted VBs than with ELCS.

Nobody is disputing that there are some risks that are higher with ELCS than attempted VB. The problem comes when a person presents, as you have, only those. We've seen nothing from you specifically addressing eg the risks of shoulder dystocia, or 4th degree tears. Without that, there is no informed consent.

The reality is that the risks and benefits are not the same for every dyad either. The birthing population is sufficiently varied that you cannot possibly make a sweeping generalisation like that. It depends on a woman's age, obstetric history, specific risk factors. It is not for you or indeed any clinician to decide whether eg the increased risk of stillbirth in potential future pregnancy is more or less important than removal of the risk of perineal damage with an ELCS this time round. The birthing woman decides that, not you.

With that in mind, such broad generalisations as you made are in no way conducive to informed choice. Unfortunately, the NHS is rather better at telling us about the risks of CS than of attempted VB.

another thread with a decent request for information and assistance descends into a bunfight.

Third thread today. This fucking place.

To expand further on that point, let's look at the NICE guidance catchingbabies linked to.

www.nice.org.uk/guidance/cg132/chapter/Appendix-C-Planned-CS-compared-with-planned-vaginal-birth

Notice that it lists side effects that may be reduced after planned CS, those that may be reduced after planned VB, and those where there was no difference or conflicting evidence. Naturally, some women are more at risk of and/or more concerned about some of the risk factors than others.

NICE also mention a pressing need for further documentation about the impact of both planned VB and planned CS across a number of years- see 4.5:

www.nice.org.uk/guidance/cg132/chapter/4-Research-recommendations#risks-and-benefits-of-cs

I quite agree. We know there is an unfortunate tendency to look at short term outcomes at the expense of long term.

Onion I never said I presented ALL the research. I would be here all month if I did that.

I also did not make a sweeping generalisation I specifically said that for women having their first baby with no pre-existing medical conditions.

I have also REPEATEDLY stated that I believe the choice is the woman's and the woman's alone and merely shared the research that the consultant is likely to use to persuade her away from her choice so that she can be pre-warned and pre-armed as a stated.

I have never once said the OP or anyone else for that matter should not have an ELCS. My opinion, like yours, is irrelevant. The OP did not ask for opinions she asked how to get an ELCS agreed and I gave advice based on that request.

I also posted the NICE guidelines to show that maternal request is a valid reason for an ELCS and for a previous poster who had posted an article that misquoted them.

Make this into a bunfight all you wish but I've not come on here in support of natural birth at all. You have no clue of my personal peference.

I suspect if you've managed to read my posts advising the OP how to get an ELCS agreed as being pro-vaginal birth and influencing her choice that you are also likely to interpret published research to your own liking also. But hey ho none of this matters.

CatchingBabies

My main interest when I was looking at this myself was always in long term consequences for my baby, i.e. death and permanent disability really. The fact that there is a slightly increased risk of respiratory distress having a C-section is obviously of less concern than there being an increased risk of my child's death for a vaginal birth.

It is impossible to make out an argument that an elective C-section of the type the OP is discussing - where neither mother nor baby have any medical issue - is not less likely to lead to the death or permanent disability of the child.

You've linked to a single research report to argue that a c-section is more likely to lead to the death of the child. It is absolutely bonkers to do this or generally to suggest that someone reads research reports to try to assess for themselves the various risks associated with different methods of birth. In producing the NICE guidelines / RCOG guidelines the relevant bodies have involved experts to assess countless studies to produce the guidelines for the figures on risk that they contain.

So this is a much a better source of information: the RCOG guidelines list say:

4 per 10,000 (0.04%) risk of delivery-related perinatal death for planned VBAC and similar for nulliparous women

versus:

Less than 1 per 10,000 (less than 0.01%) risk of delivery-related perinatal death or HIE for an elective repeat C-section

I would also point out the 10 per 10,000 (0.1%) prospective risk of antepartum stillbirth beyond 39 weeks while awaiting spontaneous labour.