planned cs or natural vb at age 46 years ?

[Gerri40]

hi all, I'm 46 years old and 23 weeks pregnant with my first child. My consultant has recommended I have elective cs at 38 weeks as 'there may be complications with labour due to my age'. I'm a fit healthy person, slim and a non-smoker with no health issues and no issues with my pregnancy. I really don't want a cs as want to be totally hands-on with my baby from the moment they are born, obviously the surgery and recovery would limit what I could do physically and practically and hold me back so to speak in the first 6 weeks or so (assuming it's only a 6 week recovery period and not longer!) I want to breast feed and don't want anything to impact on my ability to do so. Has anyone around my age experienced a normal vb or had difficulties with labour due to their age? Also, what have been your experiences with planned cs ? Obviously I realise that if I do encounter problems with labour I could end up needing an emergency cs which would be far more traumatic than a planned one. I've never had any kind of surgery before and would obviously prefer to keep it that way. My hubby is off work for 4 weeks once baby is born so he'll be there to help with practical/heavy stuff but even so I'd rather not be hindered in what I can do. Would appreciate comments from Mams of my age :-) thank you.

Honestly I would go with your consultant's recommendation. They have seen so many pregnancies and births! Fwiw I had 2 elcs, one at 37 and one at 40. Recovery was a breeze after the first one, bit harder after the second but I was walking to the shops with the pram by day 4 and driving (with approval) from 3 weeks. Could have done it earlier but we didn't need to as DH was home and driving.
I didn't want the first CS but my consultant was quite clear what his opinion was. I did feel a bit disappointed but I wasn't pushed into it. And I was delighted with the outcome so chose the same again with DC2.
I was fit slim and healthy as well, but that doesn't always mitigate the age thing.
Good luck with your baby

Oh yes and BF was unaffected by the CS, I had tons of milk that came in really quickly.

I had a c-section after a failed induction with my first at 35 and an elective c-section with my 2nd at 40. The elective c-section was a very positive experience - I was well rested and looking forward to meeting my baby. My milk came in just fine and I only breast fed for a few weeks but that was nothing to do with the c-section. Some pain in the early days but I healed well both times.

I’ve never had a vaginal birth so I can’t compare. But I dreaded trying for vaginal and ending up with an emergency c-section when I was already exhausted. No regrets with my decision.

ECS was great for me at 45. Really swift recovery and absolutely no problem with breast feeding (who told you there might be a problem?).

OP, I mean this in the kindest way but I would stop focusing/obsessing on the birth. You're 46 - I mean, do you really care how this child (who is a bit of a miracle) comes into the world? Just get the kid popped as safely as you can and enjoy your baby!

Yes listen to your consultant. The risks of other complications from vaginal birth do increase with age (regardless of fitness) as your muscles don't stretch as easily. You could end up with an emcs or worse (forceps, tearing and long term problems with incontinence) . I had an emcs after an induction and 24hr labour but baby got stuck (I'm 37). My friends tell me about how they are still wetting themselves 1 year after birth :( I've had no issues like this and felt fully recovered within a few weeks.

Next time I'm going to go straight for an ELCS

OP, has the consultant laid out for you exactly what the potential complications are and what the statistical percentage of those happening are?

If not, then how can you make an informed choice? Being vague and saying there are possible complications doesn't allow you to make such an important decision. If you don't have specific details about the potential risks, I suggest going back to your consultant to ask for figures. Your "increased risk" could well be as little a 0.5%, which most people wouldn't consider a risk at all in everyday life. So go back to cons or look at RCOG guidelines for more information and please don't base your decision on vague possibles.

OP I'm 41, after a couple of losses I'm finally 24vweeks pregnant.
My consultant has advised me they wouldn't want me to go past 39-40 weeks as in older mums the placenta breaks down and is less effective toward the end which can lead to losses plus there is a greater risk of complications.

They'd be willing to induce me at 39 weeks but are very pro me having an elective Cs which is the way I'm leaning . This way I have a degree of control, I've seen several friends induced where things have dragged on for days sometimes ending with forceps , or other interventions or a baby in distress or they've been rushed for an emergency Cs to save baby.

I want the Cs offered, I believe it's safer for baby and me, even though I recognise thete will be discomfort afterward, but I've friends who had a vbac with tears or intervention that couldn't sit properly for a week afterward.

Listen to your consultant OP, get them to explain why they recommend Cs, it's not because it's easier for them.

thank you so much for all your comments, decision made, I'm going for elective c section at 38 weeks as recommended by my consultant and you lovely ladies. I'm thrilled to be expecting our first baby and as someone said it's not important how they come into the world, safety for both of us is the priority. My hubby says thanks too :-) we feel a lot better about things now.

Northernlurker - yes I'm getting extra growth scans :-)

Zaalitje - congratulations on your pregnancy and good luck with the birth :-)

My first was a vaginal birth. Episiotomy, tear, very painful to sit/feed afterwards and continence issues.

Second a planned cs (breech). Far less pain overall and more able to look after baby. No feeding issues. I'd do the second birth again in a flash!

Gerri40 - that's a good decision! I've had 1 normal delivery and 1 elective section. Breastfed after both. I would have no doubts in your situation.

You being fit and in good shape will speed your section recovery so definitely not wasted!!

Gerri that's the right decision, well done, and enjoy the little one when s/he arrives xx

Thanks for the update. Glad it all helped. Beat of luck with it @gerri40

Also one tip for you is to buy some special c section undies. Amazon have them or I've seen them in Tesco once. They have a special silicone panel that sits over the scar and they make you feel nice and secure. I wouldn't wear them immediately but once you're up and about.

You've made the decision I would, tbh. I know the thought of having surgery that may not be necessary isn't great, but if a consultant is pushing for it I'd be inclined to listen given how averse they often are to doing sections.

I had an ELCS and felt very rough afterwards, but had no issues at all breastfeeding and bonding. I was very unsure what to do second time round, but in the end I decided my worst case scenario was going through an exhausting labour and still needing another section. I couldn't risk that, so went for an ELCS. Best decision ever, I recovered so quickly in comparison to the EMCS and was driving after 2.5 weeks. Again, no probs breastfeeding (other than getting him to stop at age 4!).

Birth is a small thing in comparison to everything else you have to think about and do for your children over the years. And I have several friends who have had awful post birth issues in their 40s, including one who ended up with such awful bladder issues she now has to self catheterise every few hours and has had lots of failed operations. Not worth the risk.

All the best op, good choice I think.

Sensible OP- bigger picture is your goal, not which steps get you there

thanks very much all :-)
@Thisonetimething thank you, I'll get some :-)
xx