Birth options

[cafedesreves]

I have asked for a meeting with a consultant following my 36 week scan next week to discuss birth choices. I feel incredibly ill-informed about the risks of different types of birth and nervous about the pain involved although I have done a lot of reading.
I am considering asking for an elective c-section, as I feel like this could be the calmest way to give birth. What I really want to avoid is last minute emergency surgery/forceps/episiotomy as I know this would make me very worried!
I would love to hear the choices you made for your child's birth/whether you would recommend a section or natural delivery, and if anyone has any literature on the likelihood of needing intervention with a first birth.

Thanks so much!

Is there any health reason you would have an elective c section?

Not to scare you, but really you have very little choice when it comes to birth - they will do what needs to be done in the moment. Aside from choosing an elective c-section, what happens is pretty much out of anyone's control.

I was induced & had a forceps delivery. It sounds bad on paper but it was fine. Nobody was running about or pushing emergency buttons, all decisions were taken calmly and there was never a sense of panic. In fact we were laughing and joking with the staff as the baby was born.

My best advice would be dont look into it too much and scare yourself, just see what happens on the day.

I had an ELCS - no medical need (at time of request and acceptance, although as DD was very happily transverse it would have been necessary anyway). Happy with decision and would do again.

Thanks everyone. At the moment I'm strongly considering an ELCS but wondering if this is mad! No health reasons other than lots of anxiety. @FluffMagnet great to hear you had a positive experience. How was your recovery?

What exactly are you anxious about OP?
A different view but I wanted to avoid a c section on the grounds that it was major surgery and I was concerned about recovery.
Are you in the U.K.? Hasn’t your MW spoken to you about pain relief and choices? Haven’t you discussed a birth plan?

I’ve had two sections - one emergency and one due to a medical need. Mine were fine but I wouldn’t recommend if a natural birth is possible; it’s a massive surgery and the recovery is hard. It’s a major operation and I think people underestimate that. It being calm is not guaranteed; complications can happen which mean you’re suddenly put to sleep or have more blood loss than expected and the whole environment is completely clinical compared to what you can have with a natural birth. I also found the whole experience very anxiety provoking so I’m not sure it’s the answer to anxiety around the birth.
I also think you need to be prepared for the fact that you might not have much choice; even if you’re booked in for an elective section if you go into labour beforehand you might have to just go with it particularly as they’re unlikely to rush into a section if there isn’t the medical need.

@Wolfiefan I suppose the things I'm anxious about are:

• the pain in labour - I'm very frightened about this
• being incontinent after it - a midwife told me that after the age of 50, half of women suffer from stress incontinence due to childbirth which sounds dreadful
• needing an instrumental delivery - if you have an epidural this risk is 1/3
• having a terrible tear
• baby's heart rate suddenly dipping and emergency help being needed
• being utterly exhausted afterwards and struggling to bond with the baby.

I am in the UK but haven't seen a midwife since 28 weeks and haven't found it easy to discuss over the phone. They booked me in for a chat with the consultant when I tried to discuss.

Hi OP,

In my opinion, the best person to discuss this with would be your midwife. Can you ring her and have a chat? Midwives see births of every type on a daily basis, doctors only see the births that have gone badly and need extra assistance. Their perspectives on childbirth are very different.

I understand that you are worried about the pain, and when you discuss your birth options think about pain both before and after birth, in terms of support and pain relief. C sections can take considerable recovery, but occasionally so can natural births. I had a 4th degree tear with my first. Recovery was fairly difficult and took a few weeks, about the same time as friends who had C Sections. I do however have no lasting problems, I've been fine since DC was about 4 weeks old. Serious tears are rare - they occur in less than 1% of births.

Good luck with whatever you choose.

Also pelvic floor muscles are weakened by pregnancy, not labour. But stress incontinence is often easily fixed with pelvic floor exercises!

If you're worried about incontinence, I'd suggest seeing a women's health physio in the months after birth and getting bloods checked for deficiencies, if possible, though there are some online physios that give postnatal core exercises that could be worth a google.

As pp said, it comes from the additional weight/pressure on the pelvic floor and on our systems during pregnancy rather than vaginal birth. I started having issue a year after my youngest was born and the exercises helped, and even more so for me was correcting deficiencies. I haven't had any issues in years now. Getting my sinusitis dealt with also helped.

It is scary and there are risks for every option in pregnancy and birth, including elective c-section (I'm not sure how abdominal surgery is more calm, at least for recovery). But many people get through it fine - I've had 4 non-induced natural births (epidurals & spinal medicine isn't an option for me anyways so my favourite labour pain relief was heating pads and being on all fours & pushing the top of my head into the mattress. Biting but not actually breathing the gas and air helped too). The most vaginal damage I had was labia grazes with my first. I had placental issues and reacted badly to the third stage injection when I had it, but that's very rare and connected to my previous health (I don't get on with a lot of medications).

Have you done any kind of antenatal course? Obviously there has been nothing F2F, but there are online courses. It's so helpful for considering your options and feeling more informed and calmer about birth. I've heard that the Positive Birth Company course is good, but there will be loads of options - have a google. Personally I really recommend hypnobirthing, which is for any kind of birth and not just a hippy "natural" birth!

My friend had an ELCS for anxiety, you are completely within your rights to request one if you feel unable to overcome your fears of a vaginal birth. You can find info and advice on requesting a c-section here: www.birthrights.org.uk/factsheets/right-to-a-c-section/

If it helps, OP, there was a women on here the other day having dreadful incontinence problems- leaking all night. She'd never given birth. And I did once see a post from someone who'd had an elective section go very wrong and ended up with a hysterectomy to control the bleeding.

Unfortunately, childbirth- however you do it- carries inherent risks. You've got to look at the risks and likelihoods of both and make your mind up which sound least bad.

I found the birth choices website quite helpful if considering a vaginal birth: www.which.co.uk/reviews/birthing-options/article/where-to-give-birth

Risks of C-section:
www.nhs.uk/conditions/caesarean-section/risks/

PS You can also ask to talk to the consultant midwife at the maternity hospital (that's what I've done, for various reasons I won't go into here).

Sorry OP. I got distracted by RL stuff!!
I think what you need is information. If you need to get that over the phone then do.
Know your options. I wanted to avoid an epidural for the reasons you’ve said you were concerned.
But I’m no hero! I was open to every pain relief method available. I saw it as a sliding scale. TENS. (Godsend!) Water (not with tens!) Gas and air.
Etc.
I never got past gas and air. But that’s because my first was born two and a half hours after I walked into the hospital!
Find out your options and then choose what’s best for you. Your birth. Your choice.
Good luck OP. (Wishing a swift and simple delivery like mine!)

I was asking petrified as you OP. It is down to everyone's own choices. I ended up having 2 natural births. Both very different but wouldn't change either. I had to be induced and forceps with my 1st. Hardly any pain when the epidural hit and took less than a week to recover. I have no incontinence issues as i was constantly doing pelvic floor exercises. I was slightly put off by the recovery from an elcs but i know there are people who recover quicker than others. It is best talking this through with a professional. Go with your instinct, neither choices are right or wrong.

I had a c section with DC2 as I felt it was the option I had most control over and that was really important to me. I also found the pain much more manageable and more inline with my expectations. My recovery was very good. 6 weeks after birth I honestly couldn't tell I had given birth.

If I could have guaranteed a 'good' vaginal delivery I would have gone for that, but it is really hard to predict - much harder than c section as their are more variables.

Research also says that anxiety in birth increases the risk of interventions.

Thanks very much everyone, this is all very helpful.

There’s a similar thread on this and while I 100% support a woman’s right to choose etc I always think if there’s no medical reason it’s a good idea to aim for a natural delivery. I’ve had two- one with an episiotomy one with a slight graze needing one stitch. Both births were hard but so empowering and positive and I look back on them very fondly. It’s better for mum and baby to have a vaginal delivery (assuming it goes smoothly which of course you can’t). I’m a nurse and wouldn’t choose an operation unless I 100% needed one.

This may not sound very reassuring given your anxiety, but bear with me!

When I was expecting DS, a very good friend told me this: 'There is no easy way to get that baby out of you. Every method has its advantages and disadvantages and none of them are going to be completely pain free, so sadly you need to get used to that idea.'

Harsh but in my case, it honestly did me the world of good to hear it!

Thanks all. I suppose I just want to reduce the risk of my birth being traumatic. Research shows 1/3 births are and I'd like to know I've done all I can to minimise that risk,

Like a pp said, I would really recommend doing a course such as the Positive Birth Company's online one - it might help with your anxiety and also is really informative about all your options

Another recommendation for the positive birth company digital pack! It’s really good.

I opted for a VBAC and my little girl is now 4 months old. I wouldn’t change my decision even after experiencing some of your concerns. My little girl was born at home so I had no option of any pain relief other than gas and air but it is doable. Labour is painful but it is what it is..... it’s hard work but totally worth it in the end. You will be tired but you have a huge surge of hormones and it’s quite amazing. I had deep second degree tears and labial lacerations. But she was born with a hand by her head and her elbow caused most of the damage also she was crowning sideways so that didn’t help. But I didn’t feel it and when we got transferred for stitches it was also okay, the recovery was fine. I found it easier than my section. It’s a very personal thing but I’d definitely recommend doing the PBC course and go from there x

I'll definitely look at it - thanks!

I think the definition of 'traumatic' is not helpful!

I had an episiotomy and ventouse delivery. I think technically that is 'traumatic'. But I was absolutely fine - it was the bitch of a midwife who upset me and you're at risk of that whatever you do.

I personally wouldn't volunteer to have major surgery unless I needed it