Planned c-section therapeutic after previous bad EMCS?

[Ennirem]

Hi ladies, I'm just pondering birth options for hoped for second child (not pregnant or ttc yet, just mulling!) as I saw a thread on AIBU about VBAC.

My first birth was horrible - went postdates so induced, didn;t work, took ages to get going and then after two days of increasingly agonising labour and all the meds (my plan had been a natural waterbirth in the MLU!) I had dilated only 5 cm with no sign of it budging after 10 hours on syntocinon, I'd had an epidural and felt like a slab of meat, I was exhausted and demoralised and agreed to a c-section.

My epidural wore off while I was waiting for the section as I got bumped a couple of times for more emergent cases, so was in agony again as I went in, then they overdid my anaesthetic so I couldn't move my arms or head and had trouble breathing. I couldn't hold my baby, I couldn't lift my head to see her being born, I was terrified I was dying and no-one was listening to me. I was very depressed about the whole thing for many months afterwards.

SO I want a VBAC next time - or I did. But as I was reconsidering the stats, and considering anxiously the likelihood of having to have another section, I suddenly had this image of an elective section - of going into it refreshed and alert and pain free, of being lightly anaesthetised and it not interacting with previous pain relief, of having no curtain so I could see my baby being born, of immediately being able to hold them and attempt to breastfeed, of everything being very calm and relaxed and under control... And I was quite tempted by the idea!

Also appealing is the idea of knowing what would happen - I have worried that 'trying a VBAC' would feel like a big gamble, and the anxiety of it 'failing' and 'ending up' having a c-section would make it more likely to fail if you know what I mean... And is it just bonkers to set myself up for a situation that I could 'fail' in given how betrayed I felt by my body the first time around and how badly it affected me?

Any thoughts? Did anyone here have a horrible unplanned c-section and find later c-sections therapeutic for that trauma? Or has anyone experienced the opposite? Or VBAC experiences? Just after a general range of views on these options! xx

It sounds as though you had the worst of all worlds with your first experience and I can see why you wouldn't be keen to go back.

My first delivery was a horrible failed induction - my body just couldn't labour - but an excellent EMCS at the end of it. It was five nights between beginning the induction and finally having the CS. I knew when in recovery that if we ever had another child I would be requesting an ELCS because I couldn't bear the thought of attempting VB again.

Two years later I had an ELCS and it really was calm and controlled. I was so relieved not to be at the mercy of my body or a busy ward and my memories of DC2s arrival are completely untainted by any of the issues which came before DC1s birth.

The consultant kept asking if I wouldn't just try a VBAC so I didn't feel like I'd missed out, but I didn't feel like I was missing out. It was just a different method of delivery and I preferred the risk/benefit stats and experience of it over the VBAC.

Thanks for your thoughts DuggeeHugs - that does sound lovely actually. I just have this idea in my head of a natural birth, I guess - I want to know what it feels like to actually bring my child into the world rather than have them removed, if you know what I mean. I am beginning to wonder if this is just another bullshit misogynist headfuck laid on women and I'm susceptible to it... but equally I will never know unless I try... but certainly I know the absolute worst thing for me would be to try for a VBAC and then find myself in that 'cascade of interventions' hell again where I stop having options or agency and become more and more tired as the situation gets worse and worse. If I could be confident that I'd have the sense at a certain point just to say enough, c-section please, and not feel shit about it, I would be more confident to 'give it a try'... maybe I should think about getting some counselling around how my concepts of childbirth and my feelings of 'failure' aren't actually very relevant or helpful.

I had a horrendous birth with my first, ending in an EMCS. At that point I was in a wheelchair and barely knew my own name. I was in such a terrible state that I went into shock shortly after the birth and had to be knocked out and pumped full of drugs. I was so traumatised (and so was DH after being told to call family to the hospital as I was touch and go) that we decided we couldn't go through it ever again.

We finally decided after many years that if I was guaranteed a planned c-section from the start, that we would try again. We had our second DC last year with a planned c-section and the experience could not be more different. I was fresh and alert and knew exactly what was going on (rather than having to have help signing my name in the state I was in after 4 days of labour and multiple blood transfusions the first time!) It was an amazing experience and much faster recovery. I was able to see the birth, hold my baby immediately afterwards and it was another world to the complete shit show the first time round. If we ever decided to have another I would have a planned c-section again in a heartbeat.

I'm so sorry you had such a horrific birth first time round but if you decide to go for it a planned c-section would definitely be what I would advice based on my experience. The second time round was enough to kill any doubt that I had done the right thing for not only me and my baby, but also my DD and DH who needed me to be ok and not risk it just because I was fixated on giving birth 'properly' as I had been previously.

Thanks Regina - God that sounds like you had a shocking time first time around, mine pales in comparison So glad you had the birth you wanted afterwards.

I think I need to really drill down into what upset me so much about birth 1 - I've been focused on the fact it became so medicalised, but the more I think about it I feel like it was the total loss of agency more than anything else... I was so powerless by the end, I literally couldn't even lift my head much less birth my daughter. That above all else is what I desperately want to avoid next time.

And on the plus side, recovery from c-section was much less awful than I had been led to expect and I still have my foof in working order - worth considering also!!!

Yours definitely doesn't pale into comparison! And you are definitely justified in your feelings about it. I wasn't expecting a walk in the park... I just felt slightly robbed of that experience that so many people tell you when you're pregnant with your first. That despite the pain etc, once you have your baby in your arms it's all worth it. I didn't have my DD in my arms for days after as I was starting to go into shock while they were stitching me up on the table and they knocked me out not long after.

The feeling of being helpless and paralysed and no one listening to you while you are hoping and praying your baby makes it is not something you forget. Nor are throw away comments like 'Oh too posh to push are we' or 'You cheated! I didn't even have gas and air!' I felt so guilty for so long afterwards as it was me wanting to give a VB a go and not give up that contributed to what happened. I also felt the same feelings as you about about being powerless- I felt like my baby was finally here and I couldn't look after her or protect her as I couldn't even move. Like I'd fallen at the first hurdle of motherhood.

The second birth kind of dulled all the horrible memories of the first. I rarely think about it unless the topic of childbirth comes up and now it's just a factual list of events rather than being something I could barely bring myself to talk about, like it had been before.

If you feel like counselling would help you should go for it!

Haha my cousin has a beautiful phrase as she has decided that if she does have children she will only have ELCS... Save the beaver, have a ceasar!

I don't think there's anything inherently wrong with wanting a VB - it is still the most common delivery method and certainly the one most women expect to have initially. There's definitely some paternalistic ideas about maternal choice and informed consent which have a lot to answer for when it comes to the VBAC/ELCS debate though!

Your idea of counselling is a good one though - talking it through and feeling comfortable in your decisions would (in my view anyway) help you feel more relaxed when the time comes to deliver again. Could you also request a birth debrief with the head midwife to give you an idea of why things happened the way they did and what could be done differently in future?

Another useful tool is the Which? website: www.which.co.uk/birth-choice/units

It gives your chosen units averages for successful VBAC and interventions compared to the national average and other units you may be able to choose from. My unit had a success rate below 50% when I was researching and so that confirmed for me what I'd already decided. Other units have much better success rates which could provide you with a lot of reassurance.

I had a very traumatic emcs under GA and due to position of my baby I’ve been told I’ll need a c section next time which I find a bit of a relief to be honest.
I was really traumatised by the birth and it’s made me much calmer and confident about the whole thing to know it’ll be planned and organised

My first was a 75 hour back to back labour with mostly no to minimal pain relief, pushing, failed forceps, hallucinations on the operating table during my emcs, losing consciousness, thought ds was a doll, tried to leave him in NICU, massive mental breakdown, took me ages to bond with him because I thought he wasn't mine and that every knock on the door was his "real" mum come to take him away.

When I got pregnant again, I thought I wanted a repeat under general anesthetic so I could pretend I wasn't having a baby and whilst no one was particular enthusiastic, both the consultant obstetrician and consultant anesthetist signed off on it as a plan. They did however keep dropping hints about the difference between electives and emergencies and pointing out that I could ask for whatever I wanted.

Then I went into labour before my planned date and got an amazing Obstetrician, Anesthetist and Midwife combination who managed to persuade me to try a spinal on the understanding they would knock me out if I couldn't cope. Dd's birth was a million miles from my first experience even though technically both are classed as emergency sections. I watched her coming out slowly and despite having delayed cord clamping, she was on my naked chest in just a hat in about 4 minutes. We were out of the hospital in just over 36 hours from start to finish and that was mostly because we had to wait for a postnatal bed and I fell completely and utterly in love with her the second I saw her, all sticky up hair and grumpy expression as her head came out. It did also help me realise just how badly I was hallucinating with ds which helped a lot with my issues around his birth.

Part of me wishes I had tried for a vbac but no one could tell me why ds got stuck and I couldn't have coped with a repeat of his arrival especially when I could avoid it.

It was amazing experience, so calm and blissful. Dh was encouraged to take a lot of photos in theatre (so I couldn't claim this one wasn't mine and try and leave them behind) and I just look serene, a million miles away from the haunted half dead mess the first time around.

Ive never had an emergency cesarean or VBAC, but I have had an elective cesarean. I liked it. It was calm, I was in control, and I found it fairly pain free. I was listened to and respected.

If you have any questions feel free to ask :)