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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:
kallia · 17/12/2020 18:47

@AltJ I know painkillers could harm my baby, and I don't want to take anything stronger than I need. But the pain isn't just "mild cramping", it's very severe and I'm often doubled over. I've also had stabbing pains so bad the GP thought I might have appendicitis (didn't thank goodness). Not round ligament pain as it's too early for that, he was a bit baffled as to what it was, but ruled out anything serious.

Maybe the pain is psychological; I'm not a doctor, I don't know. I know I have a low pain threshold. I'm having counselling and hypnotherapy for the pain; I tried acupuncture but it didn't help. I really have tried everything non-medical I can.

OP posts:
Occitane · 17/12/2020 18:49

I can only talk about my own experience. I had a vaginal birth first. I was young and healthy with no pregnancy complications. It was horrendous, back to back baby, terrible pain, very long second stage - 6 hours pushing, episiotomy, forceps, horrible midwife who examined me internally while I was screaming at her to stop, post-natal depression, and very slow and painful recovery.

For my second birth, I had an elective caesarean. It was lovely, calm, painless, just a bit of aching and discomfort, and a quick and practically painless recovery.

I think the ideal would be to have a simple vaginal birth with no complications. I haven’t experienced that, but some of my friends have. Unfortunately we don’t know how our births will turn out.

Good luck with the birth. Flowers

mumsyandtiredzz · 17/12/2020 18:56

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!

Not in my case- my ‘ideal’ birth was actually either a straightforward home birth (or midwife-led birth centre) with no interventions, very calm and private OR a planned Caesarean section.

A big factor is knowing you’re not guaranteed the former so a planned section can also be a very appealing option to somebody who is also very interested in home birth.

For me it was all of the other things in between that I feared- vaginal birth getting complicated, interventions, tons of people and no privacy when in labour, forceps, emergency c-section, loss of control.

So whilst home birth and planned caesarean may seem like ‘opposites’ on a spectrum, many of us actually see them as choices that help reduce fear, loss of dignity, loss of control etc

Topseyt · 17/12/2020 18:58

[quote 110APiccadilly]@Topseyt I got that from my experience, which was less than four weeks ago, so it's pretty clear in my memory! I may have misunderstood and it may not be something everyone has to do, but it was presented to me as completely normal and just part of having had a C-section. I was told it was to reduce the chance of blood clots I think?[/quote]
It must be a relatively recent thing then.

I was given clot busting injections into my cannula by the anaesthetist just as they finished the surgery, but nothing afterwards. Certainly not that I had to inject myself, and I am rather thankful for that as I don't think I would have ended up doing it. I'd have had to have relied on visiting midwives as DH wouldn't have touched it with a ten foot bargepole. I'd have taken tablets had any been prescribed, but they weren't.

kallia · 17/12/2020 19:03

@mumsyandtiredzz

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!

Not in my case- my ‘ideal’ birth was actually either a straightforward home birth (or midwife-led birth centre) with no interventions, very calm and private OR a planned Caesarean section.

A big factor is knowing you’re not guaranteed the former so a planned section can also be a very appealing option to somebody who is also very interested in home birth.

For me it was all of the other things in between that I feared- vaginal birth getting complicated, interventions, tons of people and no privacy when in labour, forceps, emergency c-section, loss of control.

So whilst home birth and planned caesarean may seem like ‘opposites’ on a spectrum, many of us actually see them as choices that help reduce fear, loss of dignity, loss of control etc

I think you've hit the nail on the head and described it better than I could have done - thank you!

Generally speaking I'm bad with hospitals, strangers touching me, lack of control, no privacy, people hearing me scream etc. etc. I'm also terrified of being left on my own at any point.

If I could have a perfect, relaxed home birth and know that would be the case I would in a heartbeat. But failing that, I'd prefer a CS.

I think it's about control. You can control a lot with a CS or a home birth. The "in between" hospital/labour ward birth is much more left to chance, who's on duty on the day etc.

OP posts:
Screwcorona · 17/12/2020 19:05

I'm 100% for csection. My first was born emergency csection after a 48hour labour. He got stuck high, I refused high forceps which I stand by my decision. The labour was horrible, the pushing still caused me damage without baby even coming out, i was exhausted and traumatized. The csection was the positive bit of it all.

My second child will be due in may and I'm having an elective this time.

Mumguilt19 · 17/12/2020 19:06

Speaking from my own experience, I had an EMCS after a failed induction and to be honest I was fine with it. Had a quick recovery which surprised me as I had read about long recovery times and the like. I want to have another baby and if that time does come, I would go ELCS, after having the emergency one and it being fine, I wouldn’t bat an eyelid at a planned one 😀

110APiccadilly · 17/12/2020 19:08

I didn't think I could make myself do the injections tbh, but, rather to my surprise, I managed it. I won't pretend I wasn't utterly relieved when I'd done the last one though!

sproutsnbacon · 17/12/2020 19:16

I’ve not rtft but in a nutshell it boils down to pain whilst it’s happening or pain after.
I’ve had an emcs and a VBAC ( chickened out of the elcs)
The episiotomy scar has given me exactly the same issues as the cs scar. You can feel them rummaging and pulling the baby out during a cs. The VBAC was bloody painful. I had a good recovery from both. Orgasms were really painful for a year after the cs.
Just go with your gut. Good luck.

HazeyJaneII · 17/12/2020 19:16

I did the clexane injections (thigh rather than stomach though)

The reality of my csection was far from predictable and calm!!

The pain as a result of the section was also leagues ahead of my vaginal births (episiotomy, ventouse, 3rd degree tear, surgery and 14 months later a 2nd degree tear, stitched 'wrong', surgery).

Wrt numbness - 10 years on the area around my scar still feels sort of numb, but the scar itself pulls and feels very uncomfortable often, and I can't bear anything on it. My vagina, however feels fine!!

mynameiscalypso · 17/12/2020 19:17

I think @mumsyandtiredzz has articulated it perfectly - that's certainly how I felt (I also have PTSD which meant that I would have found lots of parts of labour really tough and no, before anyone says anything, you don't just 'forget' about it when you're having a baby). Some people love the unpredictability of labour, others don't. Your body, your choice. Short of anything that's actually damaging to the baby, I tend to think that the best option for baby is whatever is best for the mum. Is it better to spend 9 months in a state of high anxiety and stress worrying about birth or risk that a baby might not have a very small increased chance of asthma later in life? Also be wary of stats that show that VB are 'safer' or have better outcomes - nearly all stats on c sections lump ELCS and EMCS together and obviously they are performed in very different circumstances.

HazeyJaneII · 17/12/2020 19:25

Just to add some of the risks to the baby are actually reduced in an emergency section - as the baby will be 'ready' and as Labour has started, the processes preparing the baby for birth have kicked in, even the contractions help the baby. This is the way the paed in NICU put it, when I had ds.
(Of course other risks can be increased...nothing's ever black and white!)

Jobsharenightmare · 17/12/2020 19:33

I agree you often get present with the pros of VB and the cons of CS.

Haven't RTFT but in case it hasn't been mentioned, find out what % FTMs and an EMCS at your hospital. If it's high that might make a difference to you.

beckyyl · 17/12/2020 19:43

@bluebluezoo

The impacts on the baby are definitely something to be considered, but the risks from a CS seem negligible especially when compared to a vaginal birth, which isn't risk-free either

the risks from a cs are much higher, which is why they are avoided unless necessary. Consequences are much more serious too, bowel damage, bladder damage, infection, sepsis. If you intend to have more than one child the risks increase with every surgery, and scar rupture is a known risk of subsequent pregnancies- ideally you'll need to space out pregnancies to allow healing, and preferably no more than 2 or 3 sections. Of course people do have more, but usual advice is that more than 3 sections are too much of a risk to mother and child.

Not trying to scare you, but don't underestimate the risks of a surgical birth. "negligible". they are not.

Completely agree!

I had a planned c section which everyone assumes will be 'calm and straightforward', and I ended up having a spinal that did not work and a major haemorrhage close to death so no one should ever assume that a planned c section will automatically be calm and easy.

Not trying to scare you OP but there are SO many risks with a c section.

Metallicalover · 17/12/2020 19:58

[quote olderthanyouthink]@Metallicalover you can have gas and air at home. Some trusts leave air at your home ready and some the midwives carry it. I had a BBA and the ambulances had it too. [/quote]
For the early stages of labour before you go into hospital you can't! For a home birth yes!

NameChange30 · 17/12/2020 20:21

I absolutely understand your point about control; with a straightforward home birth and an ELCS you are in control in different ways. A spontaneous vaginal birth in a birth centre or hospital can be more scary because you don't know what's going to happen and because you're in an environment where you feel that the health professionals are in charge, not you.

You say that you're considering hiring a doula. I hired one myself and I wholeheartedly recommend it. My first birth was in hospital, no doula, and I didn't get good care from the first midwife (later the shift changed and the second one was better). I found the experience traumatic because of the combination of being in pain and being unsupported. So for my second birth I hired a doula to support me and advocate for me if I wasn't able to do it myself. She was an excellent source of support through my whole pregnancy. We did some hypnobirthing and a session to put my feelings about the first birth behind me so I could feel more confident and positive about giving birth again. I wonder if a doula could do something like that for you, as it seems like a similar experience in a way - trauma due to being in pain and not being taken seriously or supported by HCPs. (Incidentally, did they refer you to a gynae or has it always been managed by a GP? Have they ruled out endometriosis?)

I wanted to respond to a couple of points you made:
"I didn't know that stress could make labour slow down or stop, which is definitely something to consider."
"I hope my fear can subside a bit and I have have a "good" vaginal birth"

It's true that stress and fear can hinder the process, so it helps to stay as calm as possible. But please don't feel that you've failed or that you can't have a "good", straightforward vaginal birth if you're stressed or afraid. Trust that your body knows what to do, and even if your mind isn't in a perfect zen state, you can still give birth. The medical professionals are there in case something goes wrong, and they worry about that so you don't have to.

I did hypnobirthing both times and felt reasonably positive (albeit apprehensive) before the birth. Unfortunately I didn't really achieve a zen state Grin Both experiences were very intense and I did have moments of stress and fear. I still managed to give birth, first time with a minor complication (no lasting effects) and second time no complications. It wasn't exactly enjoyable but it was empowering, I'd say, and I'm pleased I did it.

A friend of mine had both her babies by ELCS, the first one was uncomplicated and she recovered quickly, the second one was more difficult and I can't remember exactly what the complication was - I think possibly she haemorrhaged? And the recovery was longer. She has no regrets though as in both cases it was her choice (tokophobia and wanted to be in control).

There is no perfect solution, as you will have worked out by now! But my advice is not just to focus on the risks of each option - it's important to be aware of these, but also focus on the best case scenario and what that might look like and feel like for each option. It is possible, even if it might not feel like it!

Also, I'm sure I've read posts from mumsnetters with endo, and other problems causing very painful periods, saying that childbirth was actually LESS painful than their periods. So you never know!

FWIW if I were you I'd plan for a vaginal birth with an immediate epidural, make sure it's all over your notes and your birth plan, talk to the consultant midwife about it in advance, and hire a doula to help you insist on having one. You can get a "mobile epidural" which is a lower dose and helps you retain some sensation and movement. You can also ask to get into a more upright birthing position - eg kneeling forwards on bed supported by cushions etc - before they put the epidural in, so you're not lying on your back. Anyway those are just some suggestions to consider and discuss with your doula, midwife etc.

NameChange30 · 17/12/2020 20:22

@mumsyandtiredzz

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!

Not in my case- my ‘ideal’ birth was actually either a straightforward home birth (or midwife-led birth centre) with no interventions, very calm and private OR a planned Caesarean section.

A big factor is knowing you’re not guaranteed the former so a planned section can also be a very appealing option to somebody who is also very interested in home birth.

For me it was all of the other things in between that I feared- vaginal birth getting complicated, interventions, tons of people and no privacy when in labour, forceps, emergency c-section, loss of control.

So whilst home birth and planned caesarean may seem like ‘opposites’ on a spectrum, many of us actually see them as choices that help reduce fear, loss of dignity, loss of control etc

Oops hadn't read this when I wrote my post. I agree!
Nymeriastark1 · 17/12/2020 20:22

@chillichoclove

I find it strange that you don't mention the baby
@chillichoclove

"Obviously I'm glad the baby is healthy but I'd quite like someone to consider my concerns for once!"

"The impacts on the baby are definitely something to be considered"

"I don't think the risks to the baby are particularly more severe with a CS?"

"But as far as I'm concerned as long as me and the baby get through it alive and without permanent physical or mental injury, I'm happy."

I find it odd you'd say that when she clearly has . Hmm Read the thread properly.

kallia · 17/12/2020 21:20

@NameChange30 that's really detailed and helpful, thank you.
No, never got referred to a gynae (are there NHS gynaes? Sorry stupid question - but I thought you had to go private?). The GP did think it could be endo but said there was no point confirming because there wasn't any cure anyway. I did get painkillers in the end.

The endo thing is really something I'm considering. Periods are awful - but maybe if that's the case labour will be "easier"?! All the endo stories I've heard have been completely anecdotal - most of the research about endo is about people trying to get pregnant, and there doesn't seem much info on what pregnancy/labour is like.

OP posts:
NameChange30 · 17/12/2020 21:26

"No, never got referred to a gynae (are there NHS gynaes? Sorry stupid question - but I thought you had to go private?). The GP did think it could be endo but said there was no point confirming because there wasn't any cure anyway. I did get painkillers in the end."

Of course there are NHS gynaecologists! I'm appalled that your GP said that. Obviously you are focused on the pregnancy and birth atm. But when your periods come back, if they're still as painful you should insist on a gynae referral. Flowers

www.endometriosis-uk.org/getting-diagnosed-endometriosis

NeurologicallySpeaking · 17/12/2020 21:38

@bluebluezoo

I don't get the big drama some people make about the evils of c sections. If you want one just get one

It’s not about the “evils” of sections. It’s about the balance of risk. Vaginal births are statistically safer with fewer complications, and quicker recovery.

O/p is doing the right thing asking for as much information as possible so she can make an informed decision. She has every right to ask for one if she chooses, but any dr will make sure she has the full facts about the risks before allowing her to make that choice. “If you want one just get one” -it doesn’t work like that. You need to make informed consent before it can go ahead.

That is not true. There are different risks with both and you have to decide which you are willing to accept and consent to. When you read the NICE statistics 1) they lump ELCS and EMCS together for most which is clearly not useful and 2) many of the risks are nearly identical or are listed as having insufficient evidence to be able to tell either way.

Of course you don't consent to a VB- that's just the outcome of getting pregnant for most.

By the way OP I also had to have the Clexane injections for 10 days. I was a wimp so got DH to inject me. Not pleasant for either of us!

boymum88 · 17/12/2020 21:39

@kallia completely agree that if u still have probs after baby then request to be referred to a gyne consultant. Endo is chronic but treatable and can be managed so what ur gp said is not true. I have endo and have had a couple of surgery's to 'burn' away / treat the endo. A gyne dr will be able to help, their are also plenty of specialist in the area that take a special interest in treating it.
Endo dose not mean you can't get pregnant and carry a health baby, ( some do have trouble ttc) I found in my first pregnancy the endo caused me to have bad round lig pain and growing pains but haven't really had any this time xx
Really hope you can get sorted

drumst1ck · 17/12/2020 21:51

@kallia my friend has bad endo and found pregnancy and labour both very easy going. She ended up with an positive VB from an induction and very quick recovery

ChickenDipper28 · 17/12/2020 23:32

I had my baby a couple of months ago. I was the exact same as you, absolutely petrified of childbirth and the pain. I have an extremely low pain threshold and because of my anxiety, any sort of pain I'd go dizzy, be sick and nearly pass out. The same with period pain!

I spoke to the midwife who referred me to discuss an elective c section because of my fears and I had researched every single thing you could possibly research about birth. The midwife referred me straight away to a consultant who granted the c section with no questions asked. She said it was my choice and went through all of the risks with me which I happily accepted. Even though I didn't like the sound of the recovery, when I received the section date I felt so much more at ease!

I started getting slight pains two days before my section date (but so slight that it didn't make me sick or dizzy, just felt like trapped wind) the next day the pains stayed the same but got closer together and it wasn't until the afternoon I thought that I could be in labour as they came every 5 minutes. I got admitted to hospital at 7:30pm and they tried to accommodate my wishes of a c section still, but the hospital was very busy. Turns out I laboured pretty quickly and I had my baby 1:06am the day of my planned c section. I wasn't sick, I didn't pass out. I had zero self confidence before labour, I always made myself ill with anxiety and the thought of pain, but I did it. All I had was gas and air! Honestly? It was the best moment of my entire life, I am so thankful that she came early because it's changed my life. I've never been so confident. I've never believed in myself but now I do! If I can do it, anyone can.

The recover time was amazing! Yeah I had stitches and yeah they were really uncomfortable for a few days because of swelling, but within a few days the swelling had gone and after a week I felt hardly anything. By two weeks felt nothing at all! Just do what they say, take painkillers every 4 hours whether you're in pain or not and you'll be amazed with how little you feel it! I would have really regretted it if I had a c section!

allycat4 · 17/12/2020 23:38

"I find it strange that you don't mention the baby" ....except for throughout all OP's posts. Women are permitted to consider their own needs!