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Childbirth

Share experiences and get support around labour, birth and recovery.

Honest CS v. vaginal birth thoughts?

276 replies

kallia · 17/12/2020 08:54

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!

OP posts:
emeraldcity2000 · 17/12/2020 12:35

Op, don't regret it. The birth is one tiny part of motherhood and is worth it in the end, I promise,
I've had a elective cs (not really as she was breach and I had severe pre-eclampsia but non emergency) and a vbac.
The cs was completely fine. Recovery was painful but I also had pelvic problems from the breach position. No infection etc.
The vbac was the one you dread. Failed epidural, instrumental with episiotomy and a bad tear. Slight infection in recovery.
I actually preferred the vbac (although I wouldn't have said that in the middle of it!) even though it sounds far worse. I loved being up and about afterwards and found the episiotomy and tear manageable with pain relief. It also meant I could lift my 4 year old and I found breast feeding easier. My tear has healed fine and no incontinence issues after some focus on pelvic floor exercise!
A friend of mine requested her csection both times because of fear of vaginal birth. Both very positive experiences and she was well supported in her choice.
Go with your instinct. Much more important you feel relaxed in your choice and not terrified than anything else.

And I am a total wimp and survived both so you have most definitely got this xxxxx

fastandthecurious · 17/12/2020 12:36

Had an emergency CS with DS. I was 9cm dilated but had pre eclampsia, DS was back to back and it was getting to dangerous to leave me in labour any longer as I'd been stuck at 9cm for 3 hours. The CS was fine, was given a spinal block so felt no pain during. Initial recovery was ok, pain was tough at first but by day 2 I was on painkillers only and could walk around but couldn't turn over in bed/ lift DS alone without pain. Long term my recovery was really rough, I got an infection when DS was about 4 weeks, then about 10 weeks in I noticed my stitching wasn't dissolving as it should be and all in all it took about 18 weeks to stop having little holes in my scar because my stitching was being weird. It also bled lots and I couldn't do much at all for weeks afterwards because it would bleed and itch like hell. Just wanted to give both sides, a c section is major surgery and it's often treated like it's not in the way you're expected to just get on with things later on x

BiBabbles · 17/12/2020 13:22

If you feel your antenatal midwife is dismissive or not giving you a fair weigh-in, you can talk to the hospital about seeing someone else. PALS can be helpful in this. Medical professionals should give you the benefits and risks properly and I think 100% that the supportiveness of professionals involved has far more an effect on whether you'll be content with what happens over whether it ends up a vaginal or surgical birth.

Reading the NICE guidelines may give you some information to discuss with them. I find it helpful to talk to medical professionals with those in hand/sent beforehand if it's something serious.

If you're concerned about recovery, look into a women's physiotherapist. This is normal in some places, but not in the UK yet, and they can help with many post-birth issues.

The issue with the options is that everything has risks and even for someone who has given birth before, it's hard to know what's going to happen. Like the rest of life, it's somewhat a roll of the dice and sometimes all the options are rough. There just isn't a pain-free, low risk way of dealing with this major of a process. Epidurals can be a great option with many benefits, but anything that much of a benefit has significant risks and - not to add to the terror - there are people whose epidurals fuck up, they feel things they shouldn't and/or they end up with chronic issues afterwards.

While the idea of a pain-free labour that you're just knocked out for and wake up with baby is many women's dream, the reality is that coming out of general isn't fun. Having done that after a manual placental extraction after a vaginal birth (I'm too high risk for an epidural) - yeah, I didn't feel the removal, but I woke up really disoriented, I had tubes the back of both hands that I had no idea about as they were put in during the procedure (and even later struggled to find details on), everything hurt that hadn't going so between that pain and the tubes I couldn't reach the cot that was right next to my bed or pick my newborn up or put her back in it once she was handed to me. Like already said by a pp, the issues is that the recovery period is kinda negated with needing to care for an infant. Being on a high dependency ward because I'd had a general was awful and if anything it seemed like the afterpains were worse, even compared to my next child.

Genuine question, I am always amazed that women go on to have a second or even third child after a horrible birth experience ... is the desire to have a baby so strong that you are willing to take the risk again?

I think it is for some. For me, I had one more after the terrible experience I described above. What caused the need for a manual placental extraction was a medical fuck-up (midwife yanked on the cord, and a chunk tore off), and because I had that 'excuse' for why things went wrong, I kinda went in with a 'that's not going to happen again' mindset. And it didn't, but the strain on my body that might have been contributing factor to why that fuck-up ended up getting worse than it might likely have been for someone else was something I underestimated and it wasn't until late in my next (last) pregnancy that I recognized that. I have had no desire for another after that point. It was a balance of the risks and benefits that worked out, but it was riskier than I'd really considered so full recovery from all the damage from my previous births took a lot longer than I thought. No regrets, but not really a recommendable course of action...

Kakapop · 17/12/2020 13:43

Hi @kallia, hypnobirthing might be a good option for you, even if you decide to have a CS. Part of this is understanding what's actually going on with your body during birth - I found this made me way more relaxed about the idea of vaginal childbirth (though this was always my preference - CS is the last thing I want and more scary to me!). Of all the books I've looked at, the only one that went into the level of detail I found useful was a hypnobirthing book I borrowed from a friend.

Even if you don't go for hypnobirthing (which is different than just hypnotherapy), I recommend looking at the positive birth stories on the Positive Birth Company website. They have stories about every type of birth, from home births to induction to CS.

You might also want to look into "natural" or "gentle" CS. You can get this on the NHS, but I'm not sure if it's available everyway, so you might have to switch hospitals.

I hope you start feeling better, emotionally and physically, soon!

Hardbackwriter · 17/12/2020 13:46

@unmarkedbythat

In practice that can make it very hard to get one, though. Where I had DS had a 'refuse and refer to another hospital' policy for non-medically indicated C-sections (they were upfront about this and had a leaflet about it) but it was the case across the trust so if you lived where I did they'd have referred you to a hospital over an hour away
unmarkedbythat · 17/12/2020 13:47

Oh definitely, guidance and reality sometimes differ enormously!

UsedUpUsername · 17/12/2020 13:50

Just wanted to give both sides, a c section is major surgery and it's often treated like it's not in the way you're expected to just get on with things later on

Yep. And then you have posters that claim they left the hospital the next day and were back to normal within the week. I certainly wish my post-CS experience was as easy.

It’s such an individual thing ...

ivfbeenbusy · 17/12/2020 13:54

Your pros and cons haven't actually covered any of the risks associated with either option

I had an ELCS due to breech baby and was left infertile within 2 years after adhesions/scar tissue destroyed my tubes and I nearly died twice from ectopic pregnancies. We had to spend £35k and do 5 rounds of IVF to have another baby

I know this is totally worst case but I really don't recall these sort of risk being discussed at the time when I signed the consent forms for the c section

User1990232 · 17/12/2020 13:55

Another C section risk for second babies is that the placenta can attach to the c section scar. It’s called placenta accreta. My friend has this with her second baby and is going to have to have a hysterectomy as soon as the baby is delivered as the risk of haemorrhage is so high. She had wanted more than 2 kids and is devastated. Not sure how common this is but it’s worth considering if you want more than 2.

Willow4987 · 17/12/2020 13:59

I’ve done both. DS1 was a vaginal birth that resulted in forceps and 5 hours of pushing. The long term effects of that and the pain afterwards has been no walk in the park

Had an ELCS for DS2 - absolute breeze in comparison. I’m fully recovered from that 10 month PP but still not fully recovered from DS1 over 2 years later

kallia · 17/12/2020 14:01

@ivfbeenbusy thank you for sharing, and I'm so sorry this was your experience. This is exactly why I started the thread - so I can learn more about the risks associated with each. Scar tissue is definitely a concern of mine, and I know how it can cause serious complications.

I think I've summarised a few - at least the ones that are most concerning to me - but I definitely want to hear more about the risks/benefits from each side to help me make my decision.

OP posts:
NeurologicallySpeaking · 17/12/2020 14:06

My own anecdata- had one terrible vaginal birth. Epidural was the absolute high point (and didn't cause problems) but induction before epidural was horrific. Truly horrific. And then issues with placenta after regular delivery meant I nearly bled out on the hospital bed and ended up in high dependency unit. Was in hospital for 5 days beginning to end.

Second baby I was terrified so asked for ELCS. The senior midwife completely understood why. The consultant was bullying and unprofessional. Birth was a much more positive experience although I did go into labour naturally before my CS date so had to labour for a few hours before a theatre slot became available. Was in hospital for 24 hours.

I did get an incision infection and dehiscence afterwards- it was v worrying (to me) but not painful.

There is a huge amount of misinformation about C section out there. I mean it's good enough for farm animals when there is a need but apparently human women should suffer out of principle.

I used the NICE guidelines- they do a good comparator table showing risks for VB and CS. Little difference, particularly when you consider not all but the majority of data lumps EMCS and ELCS together.

Also there is a Facebook group called Caesarean by choice awareness group which is useful.

ZenNudist · 17/12/2020 14:24

It sounds like you really are very anxious about VB. Thing is it really is the lesser of two evils sorry.

I have 2 dc, both VB. I have many friends who had CS and the fact is you are then in pain for 6 weeks and can't drive at a time you need to get out the house to baby appointments. You also wont be able to lift baby or do as much round the house. So you will still be taking pain meds and wincing and expecting help from family weeks in. Now if you end up with EMCS this can't be helped but I wouldn't voluntarily opt for it.

The reasons the docs talk you out of CS is they aren't nice. I dont get why, scared of tearing, you'd opt for being cut open.

Tears dont really hurt. The contractions hurt (which can request pain relief for) but IF you tear by that time you really don't care.

It's one day of your life, worst case a bit longer, better that than weeks of painful recovery from CS.

I get you are scared. It's really not as bad as you think it will be. You recover really quickly. There's such a wide variety of birth experiences. Most people find it hurts but not enough to stop them having more dc. Trust your body.

If you want a second child you will want a VB to avoid having to deal with older dc and a baby whilst healing from CS. So you're going to end up having a VB at some point. My second VB was way way easier than my first.

kallia · 17/12/2020 14:36

@ZenNudist out of interest how long was the recovery from your VB? The long recovery time is definitely one of the drawbacks for a CS (for me). But somehow I can't imagine myself up and running a few days after a VB, especially if I've had stitches. Are they much easier because they're in your vagina rather than your abdomen?

I had always wanted a large family but this pregnancy has been so stressful on me physically and mentally (I'm still a stone lighter than my pre-pregnancy weight due to HG) that I don't think I can have another one.

OP posts:
riotlady · 17/12/2020 14:37

@ZenNudist

It sounds like you really are very anxious about VB. Thing is it really is the lesser of two evils sorry.

I have 2 dc, both VB. I have many friends who had CS and the fact is you are then in pain for 6 weeks and can't drive at a time you need to get out the house to baby appointments. You also wont be able to lift baby or do as much round the house. So you will still be taking pain meds and wincing and expecting help from family weeks in. Now if you end up with EMCS this can't be helped but I wouldn't voluntarily opt for it.

The reasons the docs talk you out of CS is they aren't nice. I dont get why, scared of tearing, you'd opt for being cut open.

Tears dont really hurt. The contractions hurt (which can request pain relief for) but IF you tear by that time you really don't care.

It's one day of your life, worst case a bit longer, better that than weeks of painful recovery from CS.

I get you are scared. It's really not as bad as you think it will be. You recover really quickly. There's such a wide variety of birth experiences. Most people find it hurts but not enough to stop them having more dc. Trust your body.

If you want a second child you will want a VB to avoid having to deal with older dc and a baby whilst healing from CS. So you're going to end up having a VB at some point. My second VB was way way easier than my first.

That’s a lot of scaremongering about a c section from someone who hasn’t had one!

I was able to lift my baby just fine after my c section, even in the hospital. The main thing that I struggled with was bending down and getting stuff off the floor, but I just changed her on a changing table and kept things next to me on the sofa.

I wasn’t wincing in pain for 6 weeks either. I would say I was properly sore for the first 2 weeks (sneezing and pooping were both v unpleasant) but after that it was only very mild. I was pottering round the shops with my mum the same week I gave birth.

Wolfff · 17/12/2020 14:43

Apart from the first few days, the CS wound was fine. I was able to do stuff normally after returning from hospital.

In contrast I was basically doubly incontinent for about a month after the VB and forceps (I would get like a minutes warning of having to go). I had one stitch - so not the vagina as such, more the whole area. Also awful piles for months.

It does vary from person to person and some people do struggle to recover.

PodgeBod · 17/12/2020 15:09

I've had 1 CS for breech baby, followed by a VBAC and then chose an ELCS but the baby ended up being breech again anyway. I much prefer c section, I won't go into details but my vaginal birth was horrid and I still feel very effected by it. I wasnt in horrible pain after my c sections, getting up in the middle of the night wasn't nice, but I was up and about and out of the hospital the next day. I didnt need family help and I felt fully recovered by week 3 (although you have to be mindful not to overdo it). I prefer the lesser pain of c section spread out over a couple of weeks to the intense pain of childbirth.

PodgeBod · 17/12/2020 15:13

@ZenNudist

It sounds like you really are very anxious about VB. Thing is it really is the lesser of two evils sorry.

I have 2 dc, both VB. I have many friends who had CS and the fact is you are then in pain for 6 weeks and can't drive at a time you need to get out the house to baby appointments. You also wont be able to lift baby or do as much round the house. So you will still be taking pain meds and wincing and expecting help from family weeks in. Now if you end up with EMCS this can't be helped but I wouldn't voluntarily opt for it.

The reasons the docs talk you out of CS is they aren't nice. I dont get why, scared of tearing, you'd opt for being cut open.

Tears dont really hurt. The contractions hurt (which can request pain relief for) but IF you tear by that time you really don't care.

It's one day of your life, worst case a bit longer, better that than weeks of painful recovery from CS.

I get you are scared. It's really not as bad as you think it will be. You recover really quickly. There's such a wide variety of birth experiences. Most people find it hurts but not enough to stop them having more dc. Trust your body.

If you want a second child you will want a VB to avoid having to deal with older dc and a baby whilst healing from CS. So you're going to end up having a VB at some point. My second VB was way way easier than my first.

As someone who has actually had 2 c sections, I disagree with pretty much all of this
UsedUpUsername · 17/12/2020 15:17

[quote kallia]@ZenNudist out of interest how long was the recovery from your VB? The long recovery time is definitely one of the drawbacks for a CS (for me). But somehow I can't imagine myself up and running a few days after a VB, especially if I've had stitches. Are they much easier because they're in your vagina rather than your abdomen?

I had always wanted a large family but this pregnancy has been so stressful on me physically and mentally (I'm still a stone lighter than my pre-pregnancy weight due to HG) that I don't think I can have another one.[/quote]
Having had both CS and VB, the recovery is generally so much easier with VB.

Sitting is more of an issue than walking around the first week after VB but after about a week, no big deal. Could look after my children just fine, which is one reason I opted for a VBAC.

After CS, I wore a compression belt because I felt sore and like my stitches were going to pop every time I coughed, sneezed or laughed. Definitely needed help in all aspects of childcare as couldn’t lift anything (luckily I had help) and was in quite a bit of pain.

A lot of the more extreme VB injuries come from the use of forceps. I would be hesitant to consent to forceps and would insist to go straight to CS in those cases, just too many horror stories with them. Jmho.

I also noticed that digestion issues were more severe after CS, not sure why. Maybe that was just me though ...

UsedUpUsername · 17/12/2020 15:20

I should add that I had a second-degree tear from VB which is the most common afaik. It really wasn’t nearly as bad as CS stitches.

You also should consider massage or postnatal physiotherapy after CS to get rid of adhesions as much as possible, no one really talks about those and it is something hard to fix later on

unmarkedbythat · 17/12/2020 15:20

@ZenNudist but every person is different and every birth is different. If I compare the births of my second and third children, one of them is like an advert for natural birth and one is like an advert for hard drugs.

HazeyJaneII · 17/12/2020 15:20

Wrt recovery I found the elective section a really hard (and long) recovery compared to two difficult vaginal births

mynameiscalypso · 17/12/2020 15:22

I also disagree with a lot of what @ZenNudist says - anecdotally, my recovery (and those of my friends who had ELCS) was much better than those who had vaginal births. DS is 16 months and a lot of my fellow mums who had vagina births are still dealing with the after effects - maybe not pain but definite issues. The worst of all were those who were induced, laboured for a few days and then ended up with EMCS after a lot of intervention. That was the main thing that I wanted to avoid.

Metallicalover · 17/12/2020 15:24

I agree with PP, look at pros and cons for baby as well. CS babies are more prone to having breathing problems at first due to fluid on the lungs. Most of the fluid is pushed out their lungs on a vaginal birth.
Also if it's pain your scared of, a c section is major abdominal surgery and the recovery is longer and can be painful!
The thought of an epidural terrified me more than the thought of giving birth. The fact I could end up paralysed etc. I was so thankful I could give birth vaginally as I hadn't really dealt with how I would react to having an epidural.
At the end of the day there's pros and cons for both vaginal and CS births.

boymum88 · 17/12/2020 15:27

Child birth will be completely different for each women if it a vb or cs.
I had my 1st baby Premature at 28 weeks ( and just coz small does not mean easier as ur body had not prepared to give birth) and had no pain relief and recovery was quick was down to the nicu within hours.
This baby I plan on having a vb again and will have what Eva pain relief I need, no health care professional will refuse u pain relief. I personally wouldn't have a cs if I could help it. It is major surgery ( I work as a scrub nurse so have seen enough to know that I wouldn't want one if I don't have to) it is also not completely pain free, and a quick uncompleted surgery is not a given.
You are doing the right thing and looking at all the options and have to make an informed decision that is right for u
Maybe see if you can speak to an anaesthetist in clinic for a pain management plan as think you will need it either way x