Honest CS v. vaginal birth thoughts?

[kallia]

I'm 13 weeks with #1 and absolutely TERRIFIED of giving birth and all that surrounds it. I have a low pain threshold and am very bad with pain (usually pass out on my period, even with painkillers) so had been thinking about having an ELCS as the thought of giving birth sends me into a daily panic. However when I was doing research/talking to midwife I found it really hard to find an honest and fair weigh-in on pros and cons - she gave me a leaflet with supposedly all the "pros and cons" of all the birth choices but it only had pros for vaginal birth and cons of ELCS.

To help me decide I wrote down my pros and cons here (might help someone, you never know) - if I've missed any, or you have any experiences you want to share which might help me make my decision, please do let me know!

Vaginal Birth
Pros

• If all goes well, quicker, easier, and less painful recovery
• Home sooner, and possibility of home birth which would be much less stressful
• Water birth option, which I know would help me relax
• Various pain relief options, including epidural, if and when I want them

Cons

• If I tear/need stitches, recovery could still be painful and long, with potential risks (e.g. scar tissue, incontinence)
• Unlikely to have home birth if I want pain relief
• Might get denied pain relief, which would terrify me
• May not get a water birth depending on Covid restrictions/if it's busy
• Trickier to plan, you're at the mercy of your body/hospital on the day
• Nudity (I know, I'm a massive prude, but it really does bother me, I don't want strangers seeing/measuring/examining areas I'd rather keep private)

ELCS
Pros

• Anaesthetic guaranteed :)
• Much quicker actual birth
• I will know in advance what day it's going to happen, and what will go on
• Much calmer as it will be planned
• No risk of tearing/cutting/stitches/permanent injury down there

Cons

• Slower, more painful recovery
• Small risk of serious complication, e.g. infection, which would make recovery even slower and more painful
• More days in hospital
• I think there's a limit on the number of CS you can have? Not that I'm even thinking about #2 now, but I had always wanted a larger family...

That's about all I've got. If anyone has anything they want to add in which might help make my decision, please do let me know!

My friend has just had her second CS so I don't think that would be a problem. I think it comes down to the hospital and if they will actually let you have a cs as I thought it was quite hard to get one unless you provide medical reasons etc. It sounds like your hospital are supportive though.

I had a vaginal birth and I had pain relief so it wasn't that bad, afterwards was but that's a different story!

I've never had a VB, I had CS. Like you I was terrified of a VB and didn't want it at all if I could avoid it. Which luckily I did. Failed induction.

The recovery for me was fine, my scar healed up quickly and without complications. I didn't have other children to worry about so no real lifting and carrying needed.

I preferred the control of the CS. The recovery was well worth it for me. I had a fear of tearing, episiotomy, back to back labour etc.

I suppose the element of relative predictability of the CS suited me and my circumstances as opposed to the dice roll of VB.

I haven't had a chance to talk it through with the hospital yet. I really do think I have a mental health reason for needing an ELCS though as the prospect of giving birth and the pain associated makes me break down in tears most days. But yes it's afterwards I'm particularly concerned about (for both types of birth) - and beforehand, as I understand you can't have any pain relief in early labour and that terrifies me...!

I had two births, the first I laboured for 15 hours then had emergency c section. I was in pain, exhausted and had a bad recovery and contacted MRSA from the hospital.

The second was a planned c session and it was a doddle. So calm and relaxing. I was well looked after. I only stayed one night in hospital and recovered quickly. I was pottering around in the hospital in the afternoon after I had her in the morning and almost back to normal by week 2.
There are some cons though
You are naked from your chest down for the cs. I didn't notice for dd1 but I did for dd2. They do put a screen up though and try to maintain your dignity.
Dd2 was very snuffly for weeks and also had bad reflux which I think may be linked to the c section.
I would still chose a c section if I did it again though.

You may find labour is not as bad as you think if you have very painful periods and there are lots of ways to manage pain.

If you do have a c section get up and moving as soon as you are allowed. It will hurt at first but it is the best way to speed up your recovery. (By move, I mean gentle pottering)

I’ve had 3 c sections, my cousins had 4. Yes the risk increases but we’ve both been fine.

I stayed in hospital over night all 3 times. First time mums with VB often stay in over at our hospital anyway to establish feeding etc

Recovery has been fine every time, make sure you are as healthy and fit as possible. Eat well throughout, walk & swim as often as you can; it will all help so much with recovery. My took the DC to Chester Zoo when DC3 was 12 days old, I walked the whole day absolutely fine.
Would advise as soon as your catheter is removed to get up and have a shower, the sooner the better to aid recovery.

I had an elective cesarean for my first and I loved it. I never wanted a vaginal birth and never had one.

You don’t need a reason in the UK for requesting a c section. It’s maternal choice and your hospital has no legal basis to refuse it. Refer them to NICE guidelines if they refuse. You shouldn’t have to fight for it.

Hi OP, I have had both. My first was straightforward, second was straightforward at first, but baby wouldn't come out without assistance. Forceps etc. Third was elective c-section.

If you're scared, ask for c section, because you mustn't be all anxious to the point of absolute panic.

If you do have a c section, then remember to take paracetamol in with you. Then top up with their mediation. I was very worried about having my c section, but it was a very good experience for me. I was the next morning, and showered etc.

However, one thing that helped me to recover was that even though I was asked if I wanted to go home the NEXT BLOODY DAY..I said I was in pain and wanted to stay another day. Please don't be rushed out of the door....stay for another day rather than be rushed home, into a car journey...xx

You can have pain relief in early labour, I had to stay in hospital as my blood pressure spiked and my waters had broken so had to be monitored and they gave me dihydrocodeine for 2 days, then I had just gas and air for active labour in the delivery suite.

I had an episeotomy and a 2nd degree tear so a good few stitches and a couple of other things happened in hospital (dont want to go scaring anyone) and I was able to walk to see my son in NICU without my husband 9 hours later.
Whereas a poor lady who had a planned section on my baby had to wait two hours for an assistant to wheel her up there to see her baby as it was that busy and outside visiting hours so that is a potential con in covid times.

I had VB first and ELCS second. To be honest, both were incredibly hard to recover from but if I had to choose, the ELCS was the better option. That said, I really do think it depends on how your VB goes. Mine was hard, 29 hours, ended up with forceps delivery that gave my son issues with his arm/shoulder afterwards and possibly his jaw (as yet unproven). If it had been much smoother and straight forward I may well have put the VB first. You just don't know.

Also in a VB the risk to the baby is slightly higher, and in a CS the risk to mum is slightly higher. These are very slight increases, but having been through a traumatic loss in VB I opted for CS second time around.

A planned CS is very different to EMCS and i found it very peaceful.

There is some evidence that passing through the birth canal has some benefits for baby, but otoh I bf her for 2.5 years so I think I’ve made up for my guilt over her not going through the birth canal.

Also don’t worry about it so early - just find out the policies at your trust and how best to word your request so you can have the birth you want.

*bay not baby

Reading MN convinced me to have am ELCS and it was the best decision ever. All the stories of ELCS were overwhelmingly calm and positive, whereas VB more of a mixed bag. If it goes well then VB is the best experience of course but nobody can guarantee you that. For most women the chance of having a good VB is worth the risks of something going wrong. However I was never that keen on the idea of VB and I mostly wanted the security of having baby safely and NOT having any injuries that will last after the birth or “change me for life“. MN posters also revealed the statistic that up to 40% of women suffer a birth injury during VB which seemed too high to me for comfort.

Of course recovery from ELCS was drawn out and more painful but once it‘s over you literally don‘t remember any of it. I have a tiny scar very low down in the pubic hair area so it gets hidden even by low rise bikinis. My body is 100% back to the way it was before pregnancy, both physically and functionally. My greatest fear was some kind of pelvic injury that would lead to incontinence issues after the pregnancy but no trace of that. (Yes it is possible to have that after a CS due to internal stretching caused during pregnancy but far rarer.)

In the end it‘s your decision but please go with your gut instinct. I find real life friends/family are overwhelmingly VB (I don‘t know a single person who had an ELCS). So I was glad that MN posters were so open on the topic of ELCS and I‘m adding my own story here!

You've got quite a wide range of factors there, I would say someone who was in favour of a home birth is quite a long way from someone who wants a CS!

For me, the cs is more predictable and the pain afterwards is fine as long as you stay on top of your painkillers. But if the thought of a lovely home water birth with candles is floating around in your head then is there a chance you're going to beat yourself up for not trying etc? (I wouldn't because I have absolutely no desire to give birth naturally but I think I'm in the minority)

Thanks ladies. This is all super helpful.

From what I've heard it does seem like most of the difficult recoveries from CS tends to me from EMCS rather than planned (makes sense as you'll be a lot more tired, possibly seriously ill etc.)

I know it's maternal choice but I think some hospitals make it easier/harder than others and I'm not very good at standing up for myself! I will definitely ask.

I wouldn't have a CS unless necessary. It's major surgery. Have an epidural. It's your decision though. Everyone is different,

@kallia

Thanks ladies. This is all super helpful.

From what I've heard it does seem like most of the difficult recoveries from CS tends to me from EMCS rather than planned (makes sense as you'll be a lot more tired, possibly seriously ill etc.)

I know it's maternal choice but I think some hospitals make it easier/harder than others and I'm not very good at standing up for myself! I will definitely ask.

Honestly recovery from my elective was fine. I had an emergency after my elective (would have had another one, but I went into premature labour that quickly escalated and had to be a crash section) and even that recovery wasn't that bad.

@GalaxyCake I completely know what you mean about friends/family being anti-CS! I mentioned it in passing to my mother as an option and she responded by writing me a 6 page letter about why I shouldn't have one!!! (Needless to say she got a 6 page letter back telling her to mind her own business.)

I had four vaginal births and if I could go back in time I would have had elective C sections. I had to have surgery to correct the damage done during birth and it's still not great, I may even need more surgery.

Hi,

I have had both - an ECS and 2 VBACs. I can understand a lot of what is being said. The think you don't have on your list is what are the benefits to the baby of a Virginal Birth. (There is a lot about the pros and cons to you....but don't forget baby).

Whatever you end up with - the most important thing is a healthy baby. But please don't dismiss anything out of hand. Tell your midwife you are really nervous. Ask what support would be available to you and how that might help. (I'm thinking hypnosis, one on one midwife care etc).

Good luck.

I pushed for an ELCS with DC1 simply because I had this odd idea I wanted to remain ‘neat’ downstairs . Honest to god I don’t know what I was thinking. I dragged myself through copious consultant appointments, argued, cried and eventually they ended up agreeing.

Then I can clearly remember being at work halfway through my pregnancy and feeling such a strong connection with the baby and pregnancy that I knew I wanted a vagina birth. It had been such a text book pregnancy and I felt the baby deserved to come out as nature intended. So of course everything then changed again and I ended up giving birth ‘naturally’.

Was it painful? YES. Do I regret my decision for one moment. NO. I’d do it again tomorrow.

So the moral of my tale is you can make a decision in the early stages but completely change your mind as the pregnancy progresses and that’s okay.

I’ve had two c sections and (one emergency and one planned); I’m not bothered that I missed out on a vaginal birth but the pain during recovery is tough and if you have a low pain threshold I’d think carefully about whether you’d cope better with pain for a short period of time plus epidural or pain over several weeks. I cried due to the pain after both my sections and it was hard going.

If it’s the pain you’re worried about wouldn’t an epidural be the best of both worlds?

Best advice I ever got was from a consultant anaesthetist- Don’t wait, and request sooner rather than later. Bear in mind the pain gets worse, so when you’re at 5 cm think it will be at least twice as bad by 10cm.

Not trying to scare you, but apparently why most don’t get their epidural is they tough it out until they feel they can’t cope. By the time the anaesthetist gets there they’re usually very advanced and it’s too late. Ask for it as soon as you can.

I asked at 1cm as the pain was quite severe and I thought if this gets worse I am going to struggle. I got a raised eyebrow from the m/w but the anaesthetist was duly summoned. Luckily as it turned out as the pain was due to placental abruption so he was there already for the emergency CS.

Talk to the m/w about getting the epidural early. It may be a better option than using a CS to get pain relief.

I'm 100% prepared to keep an open mind. That's why I want to think through all the pros & cons with someone who's prepared to consider any option - not an NHS consultant who has to keep their CS stats down.

I never particularly wanted a CS until I got pregnant, but even though I'm hardly out of the first trimester this has been extremely tough on my body (HG, extreme pain every day). I just want this over with as soon as possible. Midwives have just said that baby is healthy so everything's fine. Obviously I'm glad the baby is healthy but I'd quite like someone to consider my concerns for once!

@Mumdiva99 I'm having sessions with a hypnotherapist every week and listening to their recordings every day to try and calm my fears, but it's not really helping for me :-/

@bluebluezoo My concern with an epidural is that doesn't it make assisted delivery and tearing more likely, and therefore recovery longer and more difficult?

Also, I'm told it only works fully for 7 out of 8 women... knowing me I'd be #8 and it doesn't work...