Elective section or induction?

[espressoontap]

Hi everyone,

So I am 37 weeks. Have had a terrible pregnancy with needing an appendicectomy, lots of episodes of reduced movement, anaemia and now pelvic girdle pain. Oh and not to mention baby is >95th centile for weight, length and abdominal circumference.

I already have a 3 year old, that was a vaginal birth but I was in labour 30+hrs, got to 9cm on nothing, then everything stopped, had the syntocin drip, when it came to pushing he got distressed so needed an episiotomy and forceps. Thankfully he was fine, but I ended up in theatre due to a retained placenta and lost 3L blood needing lots of blood products. Recovery was extremely painful and traumatic. He weighed 4kg.

I have been offered either a c-section at 39 weeks or induction. I am really stressing over the labour, I don't want to go over, I am so worried about baby being big and needing intervention, I am worried about needing intervention with induction, labouring then needing a section anyway. I like the idea of a planned section as it's a lot more controlled, if that makes sense but worried about recovery.

Sorry for such a long message. I'm so worried and uncomfortable.

Does anyone have and advice?

I would definitely do a cs tbh. It sounds safer and a lot nicer for you both! (I've had a Cs and would do it again).

NHS don't tend to offer sections unless it's necessary as they are costly.

as in they wouldn't offer if wasn't a good option.

I would also opt for an elective csection. I've had two, and honestly the recover wasn't horrendous. You do need to keep well rested while you heal, and keep the wound site extremely clean, but I can't imagine recover after forceps or an episiotomy is a walk in the park either! Do you have family/friends nearby to help you with your 3 year old? That was the toughest part I found, the week after the birth of my second, and having to entertain a toddler. Was very grateful for the help I got. There will always be pros and cons of each, but if the thought of "natural" labour is causing you such anxiety, I'd say the c section recovery is truly not that bad, and will be worth it to make you feel more at ease for the remainder of your pregnancy. Good luck op!

I’ve had an emcs and a VBAC (should have been an elcs but baby had other ideas). In your case I’d go cs. If the thought of labour is causing stress book a cs.
I really didn’t want to labour for my second booked a cs. Then right at the end for very stressed about the thought of the cs. Anyway baby came a few days early and had a normal delivery.
I do totally understand about the stress of making a decision.

Do you plan on having more? I had a similar first labour - induction, forceps, transfusion - second I opted for an ELCS. I don't think one was 'better' than the other - the first was scary in its uncertainty - the second - the recovery sucked - where I live not being able to drive was a really isolating issue. Both were essentially positive.

I had an episiotomy/forceps delivery after a 48hr labour with my 1st and then a PPH and developed sepsis was in hospital over a week and baby on special care as they damaged his facial nerves with the forceps and he needed resuscitated. Just had DC2 via elective section on the advice of consultant after discussing my previous delivery and it was great! Very controlled home next day and I was out for a walk with the pram on day 3 and back driving after 10 days. Personally I have found the recovery far more straight forward then a traumatic vaginal birth in terms of pain, mobility and energy. That said there are risks with sections but they wouldn’t offer if they didn’t feel it justified in your circumstances. Good luck with whatever you choose!

In your position I would elect for a c section

I would chose the ELCS, I had a failed induction resulting in Semi EMCS so for DS 2 the following year I snapped their hand off when they offered the ELCS, both were a great experience unlike the 3 day failed induction.

@Nubbin no, this is definitely the last. I've had two miscarriages between this pregnancy and my first, I can't go through TTC again, or pregnancy for that matter. I will ask them to sterilise at the same time if I go ahead with the section.

Thanks so much, everyone. I've heard recovery is a little easier if the section is elective as you haven't laboured then ended up needing one. I was in a lot of pain after the appendicectomy but couldn't take much due to being pregnant so at least I'll be able to have ibuprofen post-op.

I have family that live nearby and my husband will be WFH after paternity leave so will have support, he will also be able to take DS to preschool, which he starts next week 😬

I just remember being rushed to theatre after having DS and thinking 'this is it', I had to have a GA as my BP was far too low to tolerate a spinal block. They're not nice memories.

I would choose the elective. I've had an EMCS and a vaginal birth with forceps. The EMCS was much easier to recover from. I was walking into town pushing the pram after just a few days and driving after ten days. It was a breeze compared to the VB.

I’d go for an elective CS. It sounds safer given the complications in this pregnancy and the complications in your birth last time around.

You could be induced and end up needing a CS anyway. I was very close. I wouldn’t wish induction on anyone and if I had to go through it again, I would definitely have an epidural.

Good luck with whatever you choose.

@Enteringthejamshed

I had an episiotomy/forceps delivery after a 48hr labour with my 1st and then a PPH and developed sepsis was in hospital over a week and baby on special care as they damaged his facial nerves with the forceps and he needed resuscitated. Just had DC2 via elective section on the advice of consultant after discussing my previous delivery and it was great! Very controlled home next day and I was out for a walk with the pram on day 3 and back driving after 10 days. Personally I have found the recovery far more straight forward then a traumatic vaginal birth in terms of pain, mobility and energy. That said there are risks with sections but they wouldn’t offer if they didn’t feel it justified in your circumstances. Good luck with whatever you choose!

This is it. People think vaginal births with intervention are easier but it's really not is it. Very reassuring to hear your experience, thank you. The reg I saw yesterday didn't even entertain a section but I had a call from the consultant and she is happy for me to have one having seen my history and the size of baby.

If you aren't going to have another - I'd take the ELCS - you can prepare for the recovery where there is no real preparing for the uncertainty of the other.

My insurance wouldn't sign me off to drive without a gp ok - they wouldn't give it until at least 4 weeks post section - worth checking. We live pretty remotely so not being able to drive was a big issue for me.

I had an extremely similar first birth experience to you, I didn't lose as much blood and had a massive tear.

This time round I opted for a C-section as I knew myself I didn't care what anyone said, recovery from a section could In no way be harder than the last time.

I'm so glad i stuck to my guns as I was totally right. Yes it's painful but at least I could go to the toilet for the weeks after it without wanting to pass out.

Plus I had a 9 pounder the 1st time and the one I've just had was 10lbs4oz at 37 weeks so no way I could have birthed her without tearing.

Best decision I ever made.

The fact that this will be your last has swung it for me in saying I would have an ELCS if I was you. Your first labour sounds traumatic.
Recovery from ELCS can be very smooth if you keep on top of pain meds and really rest for the first week or so.

Elective section all the way. I had a similar birth experience to your first (induction, episiotomy, failed forceps, surgery for yet more forceps). The recovery was awful and I'm left with birth injuries (prolapses). My baby also has permanent facial scarring.

Having spoken to women who've experienced both, the consensus seems to be that C-section recovery is a walk in the park compared to a traumatic forceps delivery. I wish I could go back in time and refuse forceps - but noone ever mentions the potential aftermath do they?

I chose induction over an elective last time and it was hideous. I ended up with an emergency c section anyway. This time I'll be having an elective. So in your shoes, I'd definitely opt for the c section

Gosh I didn't expect this many responses, thank you so much. I'm sorry so many have had similar experiences, forceps are used so regularly here, I remember after DS reading that in Holland, Sweden and a couple of other countries I can't quite remember, forceps accounted for quite a low number of their births.

My DH has said I seem a lot calmer since having the conversation and it now looking likely. It feels like a massive weight has been lifted. I know recovery will be hard but I can get my head round that and prepare. I just don't think I could forgive myself if I had an induction and it ended up in instrumental delivery or losing a lot of blood again, or even an emergency section, I'm at an increased risk of another retained placenta so there is that, too.

Absolutely no more children, I am done!

Just an update... I had an elective caesarean last month and it was a fantastic experience. Recovery has been great, think I may just be lucky, but have recovered so well compared to my appendicectomy I had at 22 weeks. Our little girl is perfect and we are smitten.

Definitely no more children!

Oh and she was just over 9lb!

Aw that's lovely, so glad everything worked out well, congratulations xx

@Mumof3almost4

Aw that's lovely, so glad everything worked out well, congratulations xx

Thank you x

Ah congratulations!
I was going to vote C section! enjoy your babe!