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!

@UsedUpUsername

Have you asked for stronger painkillers? I wanted to walk to the recovery ward after my ELCS but they wouldn't let me and I was definitely up and about walking that night. If you're in that much pain, they should definitely be giving you something stronger

Have you considered that her recovery is not like yours?

I honestly get tired of hearing ‘my recovery was a breeze I was pottering around the shops within the week’.

I understand this is your experience but those of us who say, ‘hang on, it’s quite painful and I found it hard going’ basically get ignored or there is an implication that there was something wrong with us or the hospital

I was walking loops in the hallway the second day in tears from the pain (I know it helps recovery so powered through) but there weren’t enough painkillers in the world to make much of a difference.

My mum basically commented that I was a pansy because I’d never had surgery before (true ...) and maybe this is why I found it difficult.

Also, I’d always been fairly active, doing daily exercise during my pregnancy even the day before I went into labour and it killed me to have to wait months before getting back into the routine.

It’s a bit demoralising to hear people imply that csection is a doddle when for many of us it is not ...

I don't think anyone is implying people are weak or there's something wrong with them, rather that they may need to ask their medical staff about better pain relief and get checked for infection. Its not that we are saying they are being silly for saying it hurts.

I'm not trying to upset anyone when I say that my recoveries were fine. I also think age matters here. I was very young when I had my kids, so obviously I found it easier.

I think you've been treated really poorly by medical professionals and I'm not surprised you're fearful of birth. I'm angry that you've been told you've got a low pain threshold rather than being referred to gyne, sadly I'm sure you're not alone. I very much doubt that your pain has no significant cause, it needs investigation by actual specialists. I also am outraged at the dismissal of HG, although again not surprised.

I think that your fear means a ECS would be sensible - I wonder how possible endometriosis affects birth options? Might need to be considered.

I had an awful pregnancy and a brilliant birth experience, but some of that was luck, I felt prepared and confident about a VB and I had a really good experience of having pain relief when I requested it that was effective, I found pethidine really helpful and I'm aware that's luck.

I tore and had scaring which was stitched and did become infected, but it was all okay and helped by regular attentive midwife care, which certainly here in Hampshire is not the service it was 13 years ago when I gave birth. Healthcare assistants do most home visits here now and they don't look at stitches.

Good luck with it all, hope your care experience improves x

*Have you considered that her recovery is not like yours?

I honestly get tired of hearing ‘my recovery was a breeze I was pottering around the shops within the week’. *

Totally agree with this @UsedUpUsername

I have ha 3 c sections and my recovery was different each time, one c section I didn’t need any pain meds afterwards and I was honestly fine, with another I took weeks to recover from. People are so quick to make you feel like you are doing something wrong if you aren’t recovering well.

@Thesearmsofmine

*Have you considered that her recovery is not like yours?

I honestly get tired of hearing ‘my recovery was a breeze I was pottering around the shops within the week’. *

Totally agree with this @UsedUpUsername

I have ha 3 c sections and my recovery was different each time, one c section I didn’t need any pain meds afterwards and I was honestly fine, with another I took weeks to recover from. People are so quick to make you feel like you are doing something wrong if you aren’t recovering well.

No, like I said, I generally put poor recoveries / pain down to medical professionals who trivialise women and their pain (including those who suffer birth injuries during a vaginal birth).

Apologies if I wasn't being clear. I said I and other c sectioned ladies in the room were unable to walk, sleep or function properly. We can walk but very gingerly and slowly, same for other functions. Yes getting timely pain relief is an issue but the point is, any procedure that involves dosing yourself up to the eyeballs in drugs so you can at least walk slowly and gingerly to the toilet and have to stay in hospital longer for is nothing great in my opinion. I can't drive for a while and can't resume exercise as quickly as I'd hoped. The skin on the outside of my abdomen is numb and I will have to forever endure the horrid itch that you get from surgical scars. The surgery makes breastfeeding more of a struggle too. It was a necessary thing to have but I am a but traumatised by it and how much of an onslaught it has had on my body especially as I believed the Mumsnet opinion of them being so bloody great.

@flashbac

Apologies if I wasn't being clear. I said I and other c sectioned ladies in the room were unable to walk, sleep or function properly. We can walk but very gingerly and slowly, same for other functions. Yes getting timely pain relief is an issue but the point is, any procedure that involves dosing yourself up to the eyeballs in drugs so you can at least walk slowly and gingerly to the toilet and have to stay in hospital longer for is nothing great in my opinion. I can't drive for a while and can't resume exercise as quickly as I'd hoped. The skin on the outside of my abdomen is numb and I will have to forever endure the horrid itch that you get from surgical scars. The surgery makes breastfeeding more of a struggle too. It was a necessary thing to have but I am a but traumatised by it and how much of an onslaught it has had on my body especially as I believed the Mumsnet opinion of them being so bloody great.

That still doesn't sound right to me. I was on no painkillers by that stage 1st time and just paracetamol 2nd time. Can I ask if it was a particularly traumatic emergency? My first was an ELCS and second EMCS and the emergency was noticeably more painful and difficult (hence still being on paracetamol) than the first. I am really sorry the experience wasn't a good one for you and hope you feel better soon.

@flashbac still doesn’t sound right, I’m really sorry you’ve had this experience. As I said, I’ve had 3 with the last 2 being elective due to how amazing my experience was; low music, slightly dimmed lights.
The numbness does go- I don’t have any numb skin. Youngest is 15 months.
By day 5 I could stand up straight etc I’m not saying this is how all women are but what I am saying is please make sure there isn’t an issue. Why are you still in hospital on day 5?? What issues are you having with breastfeeding? Try laying on your side and laying baby on their side next to you to see if that helps and the midwifes can help baby latch if that’s an issue.

Sorry meant to say the itching isn’t forever either. It goes after a few weeks.

My recovery from ELCS involved heart monitors, vomiting (not great after being cut open), a lot of pain (see vomiting), breast pumps with a photo of ds, a shit load of morphine and an infection in my veins that caused my legs to swell up meaning I had to be wheeled down to NICU to see ds, who was whisked away at birth due to breathing difficulties ...sometimes shit happens, and recoveries can be difficult. The same can be said of some vaginal births - I really don't think it is always down to mismanagement.

I had elective C section as baby was breach. I also petrified of giving birth. The procedure was calm and all over in about 20 minutes but the recovery is tough. Get up and get moving as soon as you can as it definitely aids recovery. Good luck!

I didn't get any pain relief after my c-section due to a mix up and whilst it hurt, it wasn't as bad as some other operations I have had. (In the end I only got paracetamol anyway and it was manageable). I am not boasting but just pointing out that experiences can vary wildly. My vaginal birth was very painful, scarily so (and again - no pain relief - I don't know why I went back to that hospital for c-section to tbh as they were not very hot on pain relief!) and I found it a lot harder to cope with. I also broke my coccyx giving birth vaginally which was not fun.

Nobody tells you about the bastard blood thinning injections you have to have in the belly area for ten days afterwards. Sting like hell in an already sore area!

Hi @kallia I would definitely encourage you to find a good doula to support you even now in trying to get the right info and make plans.

Regarding birth, I have had 3 good vaginal births. The first was textbook, the second was a great birth but they had to break my waters just before I started pushing. 3rd was 30 mins from start to finish (thank goodness I was already at hospital for a checkup). I had gas for the first and nothing for the second or third. It is difficult to describe the feeling. It is by far the worst pain I have experienced but there was only one moment where I thought "I can't do this" and that was when I was transitioning. The rest of the time, I was able to cope using basic hypnobirthing strategies.

However, extreme anxiety will make your experience harder. If you are panicked or can't relax and take control of your breathing, if you can't adequately express what help and support you need, you will have a harder time. If you can't listen to and trust your body, you will have a harder time. If you fight against the process, you can do damage to yourself. I would strongly encourage you to speak to your OBGYN or midwife about a planned CS but to cover all bases I would also be looking into a hypnobirthing course and maybe even counselling to manage the anxiety. From everything I have heard, a planned CS can be a very calm and positive experience.

Good luck whichever way you go.

I had 2 female friends who were doctors (one a paediatrician one a gynaecologist). Neither had had kids lyet, but both were more 'in the know' than me and neither had an agenda. Before I was even pregnant, i asked them both what they would do re pain relief.

They both said 'have an epidural at 4cm dilated' I didn't even understand properly what they meant, but I knew that's what I would do. That's what I did for DC1 and it turned out to have been the best option of all available. I would have done it for DC2, but I was 10cm on arrival at the hospital so had no chance.

@TorchesTorches

I had 2 female friends who were doctors (one a paediatrician one a gynaecologist). Neither had had kids lyet, but both were more 'in the know' than me and neither had an agenda. Before I was even pregnant, i asked them both what they would do re pain relief.

They both said 'have an epidural at 4cm dilated' I didn't even understand properly what they meant, but I knew that's what I would do. That's what I did for DC1 and it turned out to have been the best option of all available. I would have done it for DC2, but I was 10cm on arrival at the hospital so had no chance.

Just because they're doctors doesn't mean their way is the best or only way. They'd never even given birth before! Doctors are only present at the medicalised births and the ones that go wrong, there are plenty of straightforward births that are managed by midwives. I'd be more interested in how midwives choose to give birth.

Not saying your choice was wrong, obviously it was right for you, but it might not be right for everyone.

They both said 'have an epidural at 4cm dilated' I didn't even understand properly what they meant, but I knew that's what I would do

I totally agree with this. Epidurals are amazing and I have no idea why they aren’t more widely used in the UK (although actually, maybe due to cost?).

Being denied an epidural is a thing Ive only heard about in the UK.

@TorchesTorches

I had 2 female friends who were doctors (one a paediatrician one a gynaecologist). Neither had had kids lyet, but both were more 'in the know' than me and neither had an agenda. Before I was even pregnant, i asked them both what they would do re pain relief.

They both said 'have an epidural at 4cm dilated' I didn't even understand properly what they meant, but I knew that's what I would do. That's what I did for DC1 and it turned out to have been the best option of all available. I would have done it for DC2, but I was 10cm on arrival at the hospital so had no chance.

I glad it worked out well for you but my own doctor friend had two home births, so I'm not sure we can draw universal conclusions on what is best on what individual doctors choose to do!

@TorchesTorches as pp said Drs only assist in medicalised births and when things go wrong. I'm glad it was the right choice for you, but it's not right for everyone.
For me the thought of an epidural terrified me because of the risks and problems it could cause.

@Metallicalover would you mind letting me know what are your concerns re the risks/problems of an epidural?

If I were to have a vaginal birth I think I'd have to have an epidural (no idea how anyone manages without, kudos to everyone who has) - but I'm a little nervous that my midwife spent ages explaining the risks of a C-section and said nothing about the risks of an epidural.

I totally agree with this. Epidurals are amazing and I have no idea why they aren’t more widely used in the UK (although actually, maybe due to cost?)

Staffing. Anaesthetists cover the whole hospital. At weekends and night you’ll have one in the hospital, more senior on call, if there’s a crash section or a road traffic accident then the labouring lady wanting an epidural has to wait until those are dealt with.

That and often the idea is to escalate pain relief, and many include it in birth plans. Paracetamol, gas and air, opioids, then epidural. By the time the woman isn’t coping and requests an epidural it’s usually too far on in the labour.

It isn’t the norm to have the epidural at the start of labour. Not so much it’s “denied” or refused.

evidencebasedbirth.com/epidural-during-labor-pain-management/

Above link is US-based, here is a UK one
www.nct.org.uk/labour-birth/your-pain-relief-options/labour-pain-relief-epidurals-and-combined-spinal-epidurals

@kallia nothing is without risk. There's risks to everything you do. Prior to birth I had to get in the mindset that if I did end up with an emergency c section that it's best for baby if I have an epidural as general anaesthetic can make them sleepy etc. Thankfully I was able to give birth naturally.

The thought of someone injecting my spine makes me 🤢🤢 There's an increased risk of assisted birth with an epidural.
My main concern is permanent nerve damage, which can lead to the loss of feeling or movement of one or both of your legs it's rare but it scares the bejeebers out of me.
I have saw a lot of spinal blocks in theatres during my time as a health care assistant when I was doing my nurse training.
I know lots of women who have had uncomplicated epidurals and people who have had spinal blocks for hip and knee operations and all been fine. However I know one girl who has lost the movement in one of her legs and is currently having rehabilitation (this happened after I'd given birth).

Thanks both - that Evidence Based Childbirth one is really useful.

Yikes though. Childbirth is a seriously risky thing. I know most women and babies get through it just fine (sometimes time and time again). Still. Yikes.

I was terrified DC1 I ended up having an emergency c-section. During which they advised against having another one as I had bad bowel adhesions from a previous ruptured ectopic pregnancy. I recovered rapidly and shovelled a tonne of gravel a week after having him.

DC2, I knew a c-section was off limits. I had a VBAC it wasn't too bad but I felt like I had little control as I was sure DC2 would arrive early, she did and it was all over in three hours. However, the whole experience was marred mainly because there was a very incompetent midwife who wouldn't let me hold her.