I need to make a decision...

[CathyandHeathcliff]

Elective c section
OR
Vaginal delivery

It’s my first baby...I have the option of an elective caesarean due to my anxiety and pre existing mental health problems. However, I’m torn between that and a vaginal delivery. I have a huge fear of hospitals and anything medical, my partner pointed out that the c section would be more medicalised than the vaginal. I’ve been listening to hypnobirthing and feeling a bit calmer (at times) then others I feel really overwhelmed and terrified by it all, so I just think a c section would be better for me as it’s more controlled and less ‘not knowing’ what might go wrong.

I have a high BMI so I have growth scans, baby is head down, I have an uneventful pregnancy so far, no complications, Baby is measuring on the top line, but following his line so far.

Elective c sec all the way. It's a known quantity to a large extent. Anything could happen with a vaginal birth. I suffer with anxiety too and if you're terrified why the hell would you put yourself through a vaginal birth if you don't have to! You don't win any medals for a vaginal birth and c sec can still be a lovely " experience ". Do you worry other people will judge you if you "take the easy way out"? If so, screw them. It's your body and your choice.

@ThanksHunkyJesus it’s not really that so much. It’s more the medicalised environment of a c section. Not being able to move while being cut open...I’ve never had an op before. I’d fear it would send me into a panic attack. Also there is a risk of significant blood loss after a caesarean, even if it’s elective, I think it’s higher with an emergency. Plus I know some vaginal births go smoothly and without issue, which I know is the case for all the female members of my family and one of my best friends. Plus a colleague at work who has had three kids said she’d love to do labour again...I just can’t decide.

What sort of vaginal birth are you looking at? Home birth, midwife led unit or labour ward? Have they mentioned induction?

@ThanksHunkyJesus They’ve said I can have my vaginal birth at the MLU as long as everything goes to plan.
I’ll be refusing induction. I’d rather have a caesarean, I’ve heard some horror stories about induction
I quite like the idea of the pool too.

I was utterly terrified when I was pregnant with my first if they had offered to knock me out and hand me my baby when I woke up I’d have done it in a heartbeat. I am so glad that wasn’t an option in the end. I’m not saying labour is a walk in the park but overall I was lucky in all three of my births and felt well and reasonably normal almost straight away. None felt particularly medical and I have had lovely supportive midwives who encouraged me to labour how I wanted.
My friend has just had her third which ended up with a section after two normal births and she feels like a train has hit her compared to previous times. She needs more help than she did before as well and isn’t as back to normal as quickly.

Ultimately it’s uo to you to figure out where your anxiety lies and people are so quick to share their horror stories but there are many many good experiences out there too.

Hi op, I have had 2 emergency sections due to serious complications during delivery. The stress of it all has caused a great amount of stress and anxiety and I have suffered from post natal depression both times. A c section isn't without It's risks, but I wish now I had gone for an elective when offered the second time round so that the whole experience would have been a bit more "controlled" if you see what I mean. Good luck.

It sounds like you want to try a vaginal birth then? Have you ever had counselling or CBT to help you with your anxiety? It might help you reach a decision.

I think it's natural to be scared about birth, however they come out.

I'd suggest continuing with the hypnobirthing prep to allow you to calm your mind and body, and maintain control of your decisions and responses.

Once it's medicalised, even if it's your decision, you have ceded control and things are done to you. Obviously if and when this is necessary, you have to go with that, but if you can avoid it I would.

Practice how you will stay calm, cope and beleive you can.

Know what your red lines are and when you will agree to intervention, but know that it will be your decision at each step.

I don't mean to make it sound easy, it needs prep, belief and a determination to give it a go, but if you can do it, a vaginal birth can be amazing, and you'll be amazed at what you can do.

I had a very traumatic and medicalised first birth, I was very scared the second time around and prepped with hypnobirtjing, I didn't know if I could do it, but I wanted to try.

It was one of the best experiences f my life. I would never have believed I cuold stay so calm and cope so well (I'm not brave) but I did, and I hate to use the word , but it WAS Empowering.

I know this is just my experience, and if necessary you have to go with the C section, but I just wanted to say, I'm sure you are tougher than you believe right now,.

I have a high BMI so I have growth scans, baby is head down

How big is baby's head looking?

A friend sent me a study recently which suggested that head size over 35 cms was linked with an increased chance of c-section. I've had 2 emergency sections due to the fact that my dh's family seem to make giant headed babies which can't be pushed or pulled out of my pelvis (both over 35 cms at week 39).

Both my recoveries were really easy though requiring zero pain killers whatsoever.

Elective section definitely, I've had both and would choose section every time

It’s a decision only you can take. Having a CS isn’t necessarily the easier option. Being prepped for surgery, having an epidural and being awake for the procedure will be a challenge too. It’s great that you’re doing hypnobirthing though as, whatever you decide, that will help you to stay calm.

Are you planning on having more children? If so having a CS now may well tie you down to future CSs. Obviously you could try for a VBAC in the future but you need to be confident going down that route and if you’re not sure now you probably won’t be next time. I had a CS with my first and found the recovery fine but it would be more difficult recovering from a CS when you have another child to care for. Having a CS also means you shouldn’t get pregnant again within a year. These could all be non-issues, or equally relevant factors for you. If you have a high BMI that could also make recovering from a CS more difficult - perhaps it’s worth asking about that?

FWIW I’ve had an unplanned CS and a VBAC and would take a vaginal delivery any day. I recovered really quickly from my CS but it’s still major surgery and not something I’d want to go through voluntarily.

@dinosauratemydaffodils

And here is the growth scan chart

@snop can I ask why?

Two great vaginal births in labour suite after inductions here. Would do it again in a heartbeat if I didn't have to look after a newborn again afterwards! Both very straightforward and six hours both times. You can always start with induction, in which case you're having one to one support once you get to labour suite. If it's not going well, CS before forceps and episiotomy? I had two good recoveries, despite catching every bug going and crippling PND after first baby. Diamorphine is a wonderful drug.

@Helpmemyhairisterrible yes I’d choose a c section over forceps and an episiotomy. The idea of instruments being inserted into me makes me feel quite ill.

If it helps you feel any better, the part I was most afraid of was tearing and being stitched down there. First birth was a second degree tear with a lot of stitches. You know, it really isn't the worst place to be stitched. Consultant had to do it because it was through muscle, but all I felt was like having my bum flossed. Had has and air throughout and super effective diclofenac suppositories. No pain, no complications other than constipation three weeks after.

Second birth 18 months later was six stitches from a student midwife. Don't even know where they were.

Yes, I've been very fortunate, but I'd take the vaginal birth over an unnecessary CS recovery any day. You'll have a good birth whatever you decide.

If you go for a vaginal birth you may not have much option to refuse instruments, if in the event it is necessary to by the baby out ASAP. Sometimes there is no time to go to theatre for CS. If you go for VB you are taking the risk of needing forceps.

ELC with my first. The fact that you are open to natural I would continue with your hypno birthing and give it a go. I was delighted with my section but you are awake the whole time in the operating room which if you have a hospital phobia could be hard.

Having said that I went into theatre at the exact time I was booked for, had DD with no complications and recovered ok. I wouldn't change anything.

@puppymouse Thank you, that’s positive. Can I ask why you went for an ELCS with your first?

I had an emergency section. I had a panic attack while they were doing it. I'm not trying to scare you just to prepare you.

It wasn't the actual section, it was because I had a bit of a cold and I couldn't cough (they had warned me about this it was because of the spinal). But because I couldn't cough I kept thinking I couldn't breath. It wasn't very nice.

The actual getting the baby out is very fast, only a few mins and then obvs you have your baby to look at and concentrate on.

@CathyandHeathcliff anxiety and previous sexual abuse. I have to be sedated for smear tests etc and despite an initially rocky consultant meeting, they decided it was too risky to try naturally.

@puppymouse and @lemonsorbetinthesun both really helpful responses.
Can I ask what happens if your blood pressure goes too high or low on the operating table?

It’s just so difficult for me to make a decision, as a PP mentioned above, being on an operating table in a theatre wide awake is what my nightmares are made of. Versus the Midwife led unit which could potentially be relaxing to an extent with birthing balls, the pool, dim lighting etc. But obviously I don’t know if I’ll end up in the main hospital as something could go wrong or I could end up with a c section anyway.
I’m having another growth scan next week and if he’s showing very large then I’ll be more inclined to go down the c section route I think.

I'm due my second shortly and have elected for a c section this time after a difficult birth last time with spinal, foreceps and episiotomy. I found the fear of the unknown last time the worst thing for my anxiety, I was a first time mum, in labour ehich was scary enough, and then things went tits up and I didn't know what was or would happen.

This time I've suffered anxiety from the moment I found out I was pregnant and have undergone a lot of counselling to try and get past my previous fears but I can't. So I've decided an elective is best for me. I know what to expect, I know the potential risks, you can watch c section videos online to get an idea of what will actually happen in theatre, I feel calm and prepared, something I never felt first time round.

If you are open to a vaginal birth and the potential of anything beyond a straightforward delivery, go for it. However you need to be prepared that it may not go exactly as you planned, which is what I failed to prepare for.