Elective caesarean

[1sttimemum21]

I'm having my first baby & considering elective caesarean, does anyone have any thoughts/advice please?

NHS or private?

Nhs

I'm in the same boat and have an appointment with a perinatal midwife and possibly a consultant on Monday - my thoughts are that ELCS are easier to recover from emergency C sections but are still very hard, recovery is a lot lot harder than VB - is there any particular reason you're thinking of an ELCS?

I guess the important thing to consider is why you want one, and to make a balanced and informed decision. You can talk it over with your midwife, you need a consultant as well to sign it off, bur you could ask them any questions you have which might help make your mind up. Personally I think it's important to remember that it is major surgery, and recovery can be tough.

Read the Birthrights website , arm yourself with facts and also read how to give birth like a feminist .

They will push back and try talk you out of it . Even though it may be the right choice for you ( as it is for me too)

19 years ago towards the end of my second pregnancy, I had to endure 60 minutes of a young male registrar trying to 'talk me out of it' (I'm sure he could have made better use of his valuable time)....to then be booked in a week later to 'discuss further' with the main female Consultant. She capitulated immediately, agreed with me it was a very safe procedure for baby and Mother; and booked me in there and then for my future date. She introduced me to the female Registrar who would likely be doing the op and made a point of saying she absolutely supported a woman's right to choose. Interesting that despite her support, I had had to survive the initial 60 minute grilling. For me it was the best decision and recovery was straightforward.

It's major surgery. I feel this is glossed over too much. And no way is it easier than a straightforward VB.
A straightforward VB is far less risky than a surgical procedure to remove a baby. Do your research yes but don't be fooled into thinking it's an easy ride.

What is your reasoning for thinking about it?
It is major surgery, and not an 'easy option' by any means, however it can be necessary.
(I have had 1 Emcs and the next had to be ELCS)

I believe that's it's your right to decide. I had emc for my first and only. I wished I'd had a straightforward vaginal birth but what can you do. One thing that worries me is a vaginal birth after a c section is more risky. And there's more risk in every c section which is scary for me as I originally wanted 3 or 4 children. Have you read any books or attended any birth classes (presumably via zoom)? I found these really helpful. I liked hypnobirthing and I enjoyed the positive birth book. Good luck

Why? That would be my only question. Mine was horrific and I thought I was going to die - my whole body shook uncontrollably for hours as a reaction to the anaesthesia (I was awake). I threw up with the fundal pressure (when they are exert pressure trying to pop the baby out through the incision). And not having any feeling in my legs made me really nauseous. The suppositories and catheter weren’t a barrel of laughs and as others have said, it is major abdominal surgery and recovery time is weeks longer than VB. Not being able to drive or lift a newborn in a car seat is a real pain.
But if you have good on tap support at home for a month and have other reasons to avoid VB, then of course, insist. I had 2 VB after the ELCS. The VBs were no picnic and my arrangement with the consultant was that should I ever be off my head and get pg again then I would have ELCS, however bloody awful.
It does depend though. It isn’t the easy out that lots assume (although I know a good few German doctors whose wives have CS to keep everything nice and tight and less likely to leak in old age. Which is nice.)

I’ve an emcs (I recovered very quickly, driving and two weeks, did a kit day on week 3) and an unassisted VBAC (it was supposed to be an elcs, baby arrived before due date and I decided to try for a VBAC)
It boils down to pain during labour (VBAC) or pain after (cs).
The cs scar was numb over a large area for 6 months and then by 2 years all the numbness had gone, I was incontinent for a few weeks after my cs, I got twinges from the scar for about a year they decreased over time and sex was fine but orgasms agony for a year.
The VBAC I had an episiotomy healed really quickly but is numb and gives me regular twinges. Orgasms are fine this but I am a bit tighter due to episiotomy no pain just need a bit of lube. Not been incontinent this time which was a relief. Definitely easier to recover from the VBAC. Episiotomy healed quicker than cs scar had healed. Needed fewer pain killers afterwards with the VBAC.
VBAC very hard when I was in labour. CS could feel them rummaging around and definitely feel ds being pulled out as they really had to pull but no pain.
I was desperate to have an elcs early in pregnancy with my second. Changed my mind at 38 weeks and was in a panic about having a cs without being out of it on drugs and exhaustion ( you know half way through labour).
It’s personal decision and you don’t know how either a cs will go or labour. My mother had two cs, she suffers the same issues now as her sister who had vb. She had an infection after her second cs that took weeks to heal she is very pro cs still as she wouldn’t have go either of us out without them.

I couldn’t hold ds after the cs as I was shaking so much, it didn’t bother me as I was so tired I went to sleep. I didn’t want to hold my second which worried the midwives a bit!

If it's for mental health reasons then I can understand but don't do it if you think it is easier. It isn't.

It's major surgery. I feel this is glossed over too much

I agree, I've had a straightforward ish VB & an elective CS. would chose VB.

I'm pregnant with second baby and trying to decide between ELCS and having another vaginal birth. The thing is, I have no experience of recovery from CS but I hate it when people say recovery from vaginal is easier- in most cases I'm sure it is but mine was horrendous last time. At least with a CS I'm hoping I can at least plan the recovery and expect it to be tough?

A straightforward VB will be an easier recovery from major surgery though. That doesn't mean a CS recovery won't be better than a bad VB.

Personally I would never choose a C sec as it's major surgery with a higher risk of complications than a vaginal delivery, plus the recovery is long.

However, it is entirely your choice. I would make sure you do a lot of research and speak with one of the surgical team at the hospital to discuss the risks.

A friend of mine had an elective c sec for her third because she needed to know exactly when the baby was coming to sort out child care. It worked out great for her. Everyone is different.

The problem with anecdotal personal experience is that people compare a straightforward VB with CS recovery, or less commonly, as above, a straightforward VB with a problematic CS. Neither are predictable or the majority experience.

My personal experience was a very problematic VB for dc1 compared to a very straightforward elcs for dc2, so i find it risible when people say “ooh, it’s major surgery don’t forget” but i know that this is true for many. For me the “major surgery” was a week of paracetamol, driving the school run at 2 weeks. only actual problems were slight difficulty in picking up baby from next-to-me cot for feeding for a few days, and remaining numbness around the scar (i have had this with other surgeries though so was expecting it). As the baby was very large and there was a high chance it would get stuck leading to possible shoulder displasia and/or oxygen deprivation, it was absolutely the right call for us.

My first VB however had induction, massive pain as a result, failure to progress, ventouse delivery with an episiotomy that left my fanjo a completely different shape to previously, post partum haemorrhage, retained placenta, secondary post-partum harmorrhage 3 weeks later, emergency surgery to prevent bleeding out, MRI, ecoli blood poisoning from retained placenta, and a two week hospital stay with antibiotics on a central line. You can see why i get annoyed when people repeat the “oh but a CS is much harder to recover from than a straightforward VB” line - yes, true, but it’s a roll of the dice whether you get a “straightforward” VB or not.

ooh, it’s major surgery don’t forget”

But it is major abdominal surgery, that's a fact and not an opinion. I'm not anti C section by any means, they're incredible, but I'm pro informed choice, and part of that is understanding the risks, potential recovery and potential long term implications of both. Some people don't realise it's major surgery, and it's important that they do, just as it's important to be aware of the likelihood of vaginal delivery complications when making a choice.

I had an emcs after 60 hours in induced labour. If I had my time again I would have chosen an elective Cs. I didn't know that being induced & having an epidural could increase the risk of further interventions. I was offered a Cs before my induction was started & stupidly refused because I thought it would keep me in hospital longer, instead I endured 60 hours of a back to back labour before an emcs where everything that could go wrong did go wrong, massive pph, hellp syndrome, my major organs failing, several days in high dependency & ending up with ptsd. I was told after my emcs that I would never have delivered ds naturally due to his position, if they had told me this at the beginning, I would have had an elective Cs or a lower category emcs instead of them pushing my bed in to theatre running down the corridor, practically throwing me on the table & ds being born within 5 minutes of arriving & then nearly 2 hours of them trying to stem the blood loss & narrowly avoiding a hysterectomy.

@Nat6999 are the risks of a EMCS really that much greater than of a ELCS? Not doubting you, but trying to make my own birth choices and hadn't heard that before!

It's almost impossible to conclude whether the risks of an emergency C section are greater just because, or whether they are greater because there's already distress from baby or mum hence the need for an emergency one. Logically though having a well planned op and the resources allocated such as all of the medical staff beforehand rather than scrambling to get them in one place and the sense of urgency due to things not going as well as they could be does suggest it's more risky.

@Nat6999 sorry you went through that, absolutely agree that the heightened chance of intervention following induction should have been explained so that you could have made an informed decision.

I had two planned caesarians for medical reasons. They were very calm experiences. Appreciate that everyone has different experiences, I found the recovery fairly easy and was driving by the time my husband went back to work (with the permission of my GP and insurance company).

Only downsides for me, I was vomiting for the first day after the first one (not sure why the treatment they gave me for this wasn't until the evening), I had to have a blood patch for an epidural that went too far in and it was sore trying to lean over in the hospital to reach my baby. Other than that, it was fine and the scar healed pretty quickly.

@ths1 did you have an epidural or spinal which ended in you needing the blood patch? One of the reasons my vaginal birth recovery was so hard was because the epidural gave me a dural tap and I needed two blood patches. My understanding was that these are much less likely to be needed with spinals because the needle is much thinner than an epidural needle and therefore if anything is punctured then less fluid is likely to leak out?

33 hours of labour here - pushed for almost two hours when they knew baby was transverse as they didn't want to give me a section (hospital currently being investigated for having a 45% section rate!!). I had a cat 1 emcs due to haemorrhaging and losing 2.5L of blood and like a PP, being on the brink of a hysterectomy.

I appreciate that this was an emergency, not elective, but the surgery in itself is still extremely serious and I for one would not have chosen this over a vb. Should I choose to have any more children, I am not allowed a vbac due to the damage caused by my section, and blood will have to be on hand, in the room, in case I have another transfusion as there is a greater risk of this after you've had a pph in a previous birth.

I couldn't drive for 7 weeks, push my pram for 3, was bed bound for 5 days with a drain attached to my womb, so unable to care for my baby independently, all during COVID times when my husband was not allowed in to give me support.

An elective is not without the same risks. As most other posters have said, it is major abdominal surgery and unlike other major surgeries when you are given the opportunity to rest and recover, this does not happen with a section, you start your sleepless nights and have to get on with it, which makes the whole situation even more challenging.

Congratulations on your pregnancy and good luck with whatever you decide!