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!

I was like you @kallia and strongly considered asking for ELCS. But after my NCT classes and talking to DH I went for vaginal birth.

I was high risk (age and GD) and was in to be induced as couldn’t go overdue. Induction failed (I reacted to the pessary and they couldn’t get the catheter in) but I had spontaneous labour before they went for ELCS.

It was fine, really hard and painful but actually nowhere near as bad as I feared and I felt like superwoman afterwards. Active labour was 6hrs, I had no tearing and no pain once DD was out. I didn’t need so much as a paracetamol after birth and was bouncing around within hours. Several friends had babies at sane time, 1 ELCS and 1 EMCS and seeing their recovery I can’t believe I almost voluntarily did that to myself. No regrets at all.

I was clear in my birth plan though that if I didn’t progress and instrumental delivery was thought necessary I wanted to go for CS. I stand by that still.

@kallia. Talk it through with your m/w. I believe it is possible to site an epidural, and you can remain mobile and able to feel the contractions, but top it up when you need more pain relief. This helps you keep control and work with your body.

There are lots of options before you go straight to CS. :)

Please also include the pros and cons for the baby.

That's ultimately what made me face my fear of a natural birth.

Sure it was painful but it was also amazing and I've never felt so proud of myself.

Whatever you end up with - the most important thing is a healthy baby.

This is such a demoralising phrase. I am incredibly grateful that I had a healthy baby, but I'm also hugely traumatised and ten years on I have PTSD that impacts a lot of my life. Yes doing the best for your baby is important, but so is the mum.

Think this is a tricky one to call.
My first was emergency csection. The anaesthetic failed during procedure. They nicked a blood vessel during procedure. Recovery was long and hard.
Second birth - I wanted vbac. My uterus ruptured so I had second emergency csection.
I have had constant infections since. I'm right month on now.
I hated the daily fragmin injections.
Sorry. Not saying all this as a horror story but just so you know things can happen. It's not an easy decision to make.

@LastChristmas20 all births are amazing.

OP please don’t let anyone make you feel less of a mother for choosing a different option!

Have you done any reading and research, OP? My friend was like you. Fainted at moderate pain, absolutely terrified. Spent so much time worrying about the pain it took over her life. So she decided to learn about birth properly. She read every book she could and watched LOADS of videos of births. She managed just fine in the end and felt so much better knowing what to expect and what was going on xx

I will talk it through with the midwife. I just wish I could talk it through with a medical professional whose job isn't to push me one way or the other but to actually help me make an informed decision.

[quote SendHelp30]@LastChristmas20 all births are amazing.

OP please don’t let anyone make you feel less of a mother for choosing a different option![/quote]
I said nothing about anyone being less of a mother.

But I was also petrified of birth. But seeing the benefits for baby was enough to convince me to have a natural birth.

Was just stating my experience.

I have had a ELCS and a VBAC and there are plusses and minuses certainly to both and I think goes down to what is the right individual choice.

For you the panic and anxiety comes across and I think the uncertainity around the VB and the potential outcomes are not good for you or the baby.

In your shoes if they go for it an ELCS sounds like it would suit you best

(although nudity is pretty much for both the incision line is far lower down than they ever show on tv series well within the hairline!)

I’ve had a VB and a ‘semi-elective’ CS, so-called because I refused induction as it looked like medieval torture. VB was my first birth - 30+ hours, all the pain relief including epidural ending in episiotomy and forceps delivery. Took me months to feel normal and it was pretty traumatic. CS was 4 months ago. Birth was amazing - calm and pain free. Recovery was painful but I would choose it over VB any day. Scar is minimal. I have a big tummy and a hernia but not CS related - I had one after my first baby too and will have surgery to fix it in the future. No more babies for me. Happy with my son and daughter. Push for a CS if you want one OP. You don’t get a medal for these things. Take care xx

@User415373 I've done a lot of research, reading medical journals etc. (I'd rather go to source than read blogs/personal accounts so I know what the actual stats are). It has been incredibly hard to research as I tend to break down in floods of tears as I'm so terrified, but I'm trying to push through. Lots of people saying "yes it was painful, but it was fine" - that's exactly what I'm afraid of. That it will be painful.

If it's anything like my period, I'll spend 6 hours lying on a bed drifting in and out of consciousness.

Wish they could do a chloroform job on me like Queen Victoria!

I can't face doing NCT/antenatal classes, I think I'd pass out very quickly!!!

Honestly if it's pain you're afraid of I'm not sure how you could be contemplating a CS (major surgery and painful recovery) over a vaginal birth.

Hi OP, sorry you are struggling with pregnancy and anxiety about the birth

I have two children and had vaginal births for both of them (home birth for the second), I would have had a c-section if necessary but it was not my preference. However, I am passionately "pro choice" when it comes to childbirth - or perhaps I should say pro informed choice because it can be very difficult to make decisions if you don't have objective, balanced information. Please do your own research and don't let people bully you either way.

You might find this helpful:
www.birthrights.org.uk/factsheets/right-to-a-c-section/

It sounds as if you are leaning towards an ELCS, but if you do decide to aim for a vaginal birth, I just wanted to respond to this point:
"I don't want strangers seeing/ measuring/ examining areas I'd rather keep private"
If you're talking about vaginal examinations, you do not have to have them. It's questionable as to how necessary / important they are in most situations (it might be necessary sometimes). When I gave birth to my second baby at home, the midwife only touched me to check baby's heartbeat, and it would have been the same if I'd been at the birth centre (except that I felt much more "in control" at home and might have felt more pressure to do as I was told in hospital! I certainly did first time around). Anyway there is some info on VEs here:
www.aims.org.uk/information/item/vaginal-examinations-in-labour

@LastChristmas20 I know you didn’t use those words but to a women already struggling with the choice- comments like best for baby- have that exact effect.

I had all sorts of reasons for wanting an ELCS and it was 100% the right decision for me (and therefore baby). As someone said, ELCS are marginally safer than vaginal births for babies.

My choice was to have an ELCS, I was 'persuaded' not to and felt too belittled to complain (this was many years ago - am sure it would be different now) ... in the event I ended up with an EMCS which I was delighted with . But what a waste of money and resources - I should have been allowed the ELCS in the first place!

No problems at all recovering - I know everyone is different but have heard so many horror stories of VBs going wrong .... and few people talk about it until after you've had your baby.

I made sure never to have a second child though .

I really feel for you, OP. I'm like you and rely on science and data, however personal accounts are useful (which is why you're here!)
The positive birth book is great and has lots of great advice for a positive v birth or c birth. It explains your choice at every stage and is based on science and evidence. Some really positive c birth stories in there too, if that's what you go for.

@kallia

I will talk it through with the midwife. I just wish I could talk it through with a medical professional whose job isn't to push me one way or the other but to actually help me make an informed decision.

A doula can do this. They are not a medical professional, but they obviously have experience of supporting women giving birth, and a good one should be able to help you find reliable information about your options.

You can also ask the community midwife to refer you to the consultant midwife at the hospital to talk through your options.

If you don’t like pain I wouldn’t pick a CS, I had an elective due to a breech baby, they hit a nerve in my back which gave me excruciating back spasms for weeks, I was nearly sick in the middle of surgery and it took ages for me to see and hold baby properly. I couldn’t stand up straight for weeks or sleep comfortably, i then felt I was expected to get on with it even though it is major surgery, it’s bloody painful. Now pg with number 2 and I’m desperate for a VBAC. I’ve got a really high pain threshold as well and I found the CS tough going.

OP your original list doesn’t seem to include impacts on the baby? There are a lot of benefits to the baby of a vaginal birth - main ones are that babies born vaginally have less respiratory issues at birth as the squeezing through the vagina forces mucus out of their lungs, and, most importantly, babies born vaginally are exposed to a range of bacteria from the mother’s gut that helps form the basis of their microbiome and can have lifelong health implications (reduced risk of obesity, asthma and diabetes among others).

If you don’t give birth vaginally there are other ways to help develop the microbiome (eg breastfeeding), but it’s just something to add into your pros and cons when weighing up the choice as a whole.

@kallia
Exactly, I didn't even bother discussing my choice with anyone from real life because I knew it would just add the stress. It's much harder to disagree with people you know and they also know how to press your buttons to convince you. Though fortunately my mum fully supported me because she had a traumatic birth with me, and always said that it should be been an emergency c-section but she was forced to do it naturally.

The argument "it's major surgery" also scared me and gets packed out with every debate about CS. But in the end it doesn't even make much sense. The risks of surgery are obviously factors to take into consideration, but those are obvious to anyone and could happen with emergency sections as well (infection, anaesthesia complications etc). Not having a CS just for the peace of mind that you avoided a "major surgery" seems quite bizarre. It's like telling people I chose not to have a boob job because I didn't want major surgery.

Fwiw I found the experience of having "major surgery" no different to getting a lengthy treatment at the dentist. You are awake, you have no pain, people faff around you doing stuff all the time, you might be a bit anxious but on the whole it wasn't unbearable or unpleasant in any way. You basically just lie there and let things happen to you. If you feel odd or unwell at any time you can tell someone and they will fix it. This is also underscored by the fact it's one of the happiest days of your life...you hear your baby cry for the first time, get to hold her, get to take pictures and have incredible memories.

@kallia NCT and similar so important for making friends. My NCT whatsapp was a savior in those early months, day and all night.
So important, don’t skip it!!

[quote SendHelp30]@LastChristmas20 I know you didn’t use those words but to a women already struggling with the choice- comments like best for baby- have that exact effect.[/quote]
I think you might be projecting a bit? The OP specifically asked for factors she might have missed out from her pros and cons list. That poster suggested she considered impact on baby as part of the list. I don’t see how that’s offensive - the birth happens to the baby as much to the mother and it’s a different experience for them (with different pros and cons) so worth thinking about.

I had my second child by ELCS. The birth itself was fine but the wound was extremely painful for a couple of days and I got minimal pain relief (this was a 'good' hospital; Queen Charlotte's). Recovery was quicker than VB.

My first, the VB was awful. I was induced as the waters broke and no contractions. After induction I was left in agony on a pre natal ward (with a lot of interested spectators). They refused to believe I was in labour. It was a brow presentation so agony. When my husband arrived he went to get the doctor and the nurse tried to physically block him seeing me. I was found to be 7cm dilated. But in so much pain had epidural and later a forceps delivery - ok just one stitch.

DD1 was traumatised, jaundiced and screamed for the first few months of her life until I took her to an osteopath. DD2 (CS baby) was fine.

Go for the ELCS.