Is an ELCS the wrong choice for me?

[Jvx01]

I am a 30 year old FTM who has opted for an ELCS. The baby was conceived via IVF (ICSI) and I’ve chosen ELCS to try and minimise the risk of things going wrong, ending up with interventions, an EMCS etc. I’ve had a previous ectopic pregnancy which resulted in emergency surgery which was scary and not a good experience. On the mental side of things I seriously doubt my body’s ability to do things ‘naturally’ and am also terrified about all the perineal damage you hear about.

BUT as d day approaches I am starting to have second thoughts. Do people think I’m silly not to try vaginal given I have no risk factors, am young (ish!), baby is in correct position, not overly large etc?

I cannot tell you the amount of hours I have spent (wasted!) researching the topic so I’m aware of the pros and cons of both. So what I want to know is what would you do if you were me? Am I overestimating the likelihood of something going wrong with VB? Are there ways to minimise risk of things going wrong with VB that I haven’t considered?

Any thoughts greatly, greatly appreciated!!

I can't be you b/c I never had infertility & then a huge lack of faith in my body on back of that. Surgery freaks me out, so I'd have to feel pretty extremely pressed to accept that without very compelling circumstances. I bet you don't feel that way, though.

I thought that statistically more "goes wrong" with ELCS than spontaneous vagB. Or at worst, there is no statistical advantage either way. So then it comes down to which one seems like the nicer experience, I suppose. Babies get better micro-flora when born by vag, iirc.

No one else can say right or wrong choice for you, sorry.

I’m having an elective c section. It’s absolutely the right decision for me because I have an anxiety disorder. There are too many variables that can go wrong in a vaginal birth...in my opinion anyway.
I can’t be in an emergency situation, either with forceps or an emcs, as it would send me over the edge.

I’ve heard elective c sections are very calming experiences, no panic, no pain and the staff reassure you, allow you to have music/radio on etc. I just think it’s the absolute best way I can think of to welcome my baby into the world. You can even ask to have the screen lowered when he or she is born and take a photo if it’s permitted!

Also I’m having a bigger baby, so much more chance of shoulder dystocia, getting stuck etc.

I've had elcs and vbac. Initially, I definitely did not want a c section. I didn't want a spinal or epidural. Baby was breech so elcs book, spinal and voila there was the baby minutes later. Very calm, peaceful. Easy. Yes there was pain, but not as bad as I expected.

Second was vbac. I had agonized over what to do and opted for vbac at the last minute. Narrowly (Very narrowly) voided EMCS under GA. The Labour was ok. It just all went a bit wrong at the end. Episiotomy, forcep. But BUT it was fine, for me. I was well looked after, we were both fine.

I think I'd go elcs if I were you. Less variables as you say, you know what is happening and when..

I havent had a CS but just wanted to let you know that even an emergency procedure can be calm and relaxed.

I had to be rushed to theatre for ventouse and episiotomy with my LO and it could have not have been a better experience. The team let me play my music and I was happilt chatting to the nurses and aneathetist throughout. It was so laid back even though it was an emergency.

I was also really against thr idea of intervention but I certainly wouldnt worry about it next time around

Hypnobirthing! Restores your faith/trust in your body and your baby. Natural birth is very empowering.

I had an elective c section because of tokophobia and vaginismus (which is so bad I have to have smears under general anaesthetic). There was a really small part of me before that thought actually, maybe I can have a natural birth and maybe I should, especially when friends and colleagues would scare me with c section stories. Anyway, thankfully, for me it was practically pain free and was such a pleasant and easy birth experience. Even recovery wasn't that bad. When I hear from my friends their natural birth stories or emergency c section stories I am even more convinced it was the right thing for me. You know your body.

Talk to your midwives OP. I had an ELCS as my baby was breach, it wasn’t what I wanted but it was for the most part calm and trauma free... though I was the last on the list that day, dehydrated, scared through the operation because it was very surreal. But ultimately it was fine.

Labour can be so many things...and it’s hard to know how yours would go. You need a professional to talk you through this.

I think the risk of complications is higher with CS, costs the NHS more and there is a longer recovery time because you’ve had abdominal surgery.

Good luck whatever you decide

ELCS all the way Op

I'd say you've made an excellent choice.

Thanks all. I have the section booked in for 15th October so not much longer to decide now! I think the overriding factor seems to be that with an ELCS you can effectively eliminate a lot of the risks and uncertainties associated with a VB and just limit your risk to the possible (though unlikely) complications associated with an ELCS.

I feel like there's something about VB that we must be doing wrong, I'm not sure if it's just me but barely anyone I know seems to have had an uncomplicated birth and the thought of all the possible complications after everything I've been through just terrifies me!

One last question, does anyone have any experience of c sections causing complications for future pregnancies? That is my only other concern, as I need IVF to get pregnant anyway I don't like the idea of it impacting future pregnancies!

Thanks again all for your replies xx

My elcs was due to anxiety but when baby card out he was struggling to breathe due to the fluid that isn't squeezed out during a natural birth, he was then taken away to neonatal and was there most of the day meaning no first feed, no skin to skin which was horrible. He hates me holding him and doesn't like cuddles now 7 weeks on and part of me wonders if the initial experience during the elcs is the reason... just something to consider. Not all elcs will have a lovely outcome but I would probably opt for it again due to the birth anxiety and how calm and ordered it was. Recovery was hard for me tho especially as a first time mum who didn't have a clue x

No one can tell you the right decision for you.

I always thought I might go for an ELCS to 100% guarantee no perineal trauma & a good outcome for the baby.

ELCS is the 2nd best mode of birth after uncomplicated vaginal delivery...but of course no one can guarantee you will be uncomplicated!

I'm 36+5 now and I actually would quite like a "natural" birth, but with a low threshold for a caesarean.

What do you want? Are you attracted by the idea of experiencing a vaginal delivery?

Hi OP

I had an ectopic pregnancy (they operated and removed my left tube).

I then had an EMCS for DC1(long labour, baby in wrong position).

I then has ELCS for DC2. So, normal CS usually takes around 1 hour, but my second c section took 3½ hours as I had so much scar tissue and adhesions (my bladder was stuck to my uterus) from my two previous surgeries. It was so stressful for me and unexpected. My baby was born but cried for hours in theatre as it took so long for me to be sewn up. (Couldnt breastfeed a baby while I was on the operating table)

They told me the scar tissue and adhesions won't stop me from conceiving in future. However they don't really recommend it, as having another c section will result in further scar tissue.

Overall, it was calm in the theatre room (just not for me!) and planned and low risk to the baby, but in hindsight, in some ways, I wish I had tried a VBAC
I think I am a bit of an anomaly though. But thought I would share my story.

@Alyosha I know, but don't I wish that they could!

Your situation/thought process actually seems really similar to mine. It's the not being able to guarantee the uncomplicated VB that I'm struggling with. I feel like I'm trying to approach this logically, so my thought has been that the likelihood of achieving the second best scenario (an ELCS with no complications) is far greater than the best possible scenario (VB with no complications) so I'm best off going with the ELCS. A vb followed by an emcs would be the worst of all worlds!

I'm not quite sure why I am having second thoughts at this stage. I'm just starting to think, in spite of all the risks and trauma stories, babies ARE designed to come out vaginally and wondering if I am letting my fears of something going wrong rule my decision.

Perhaps a natural birth with a low threshold for section is something to consider.....have you discussed this with your midwife or doctor?

Thanks for sharing your story @namechanger55555 it's helpful to hear about the other side and potential problems. 95% of what people say about ELCS is positive but I think it's important for me to be aware of possible complications like those you experienced.

The scar tissue is something to take into consideration. I also had surgery prior to the ectopic to remove a benign tumour, though the scar tissue from keyhole surgery is not extensive in comparison to open surgery such as a section.

I feel bad about how much time I am spending thinking about this and for having these feelings at all. I'm normally more of a 'just get on with it' kind of person!

I had a forceps delivery with my first and had an elcs booked for my second because I didn't want a repeat of the forceps. However, I discussed a vaginal birth plan with the midwifes and they were happy for me to labour and if anything went wrong, go straight to section rather than try forceps if at all possible. That's what we did, as I went into labour before the elcs date, and my baby was born vaginally. It was great - I was expecting a long recovery as had prepared for cs, so was pleased to be better relatively quickly. Perhaps something you could think about? All the best.

Hi Op! I too had ICSI and tried the natural birth route. From my own experience, when things didn’t go to plan and could have left me with life long damage, I will 100% be requesting and ELCS if we are lucky enough to have a second child.

It’s compleltely the individuals choice on what’s right for them but from personal experience I want a more controlled environment that won’t put further pressure and damage on me

Natural birth is very empowering.

Don't universalise your experience.

If you're aware of the risks of both OP and simply find one set of risks more acceptable than the other then no, it's not the wrong choice. Same would be true if you'd decided to attempt a VB.

I have had 5 vaginal births and one ELCS (two weeks ago). The natural births were more unpredictable- with DC1 I needed ventouse and DV5 forceps - But, recovery from VB was definitely quicker and felt less traumatic to my body (apart from the forceps one).

Since my ELCS I've had an infection, my baby isn't putting on weight, just don't think it's the "easy " route as you'll be disappointed (I have been lol!) I think I went into it rather naive.

I preferred the fact that after VB you can move so much more easily to pick up and feed your baby, have a shower etc. Rather than being pinned to the bed by a catheter until the next day!

But I Totally understand you wanting to minimise any risks to your precious IVF baby . I'm sure most obs & gynae doctors choose CS for themselves so that says something doesn't it....