Elective caesarean

[1sttimemum21]

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

@flashbac

I also think - and this will really throw the cat amongst the pigeons - that demanding a c section when there is no need is pretty inconsiderate given the strain the NHS is under at the minute. You need alot more staff to do a c section and that operating room that is being used is one less that can be used for emergencies.

Define "need", I don't NEED one for medical reasons but I need one for mental health reasons ... I don't think it's a decision women take lightly

@jillypill

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.

Why are you getting annoyed about something that you agree is true?

Of course a straightforward VB is hard to predict.

Sorry, yes, i phrases this wrong. What i meant was people often say a VB is easier to recover from, they don’t pause to consider they mean a straightforward VB. I don’t remember the odds of intervention being needed for a first birth but i remember thinking when i saw them after the fact that they were surprisingly high.

Just to add to the above discussion, dd2 was born at exactly 38 weeks by elcs and we had immediate skin to skin and she latched/BF no problems (still is 13 months later) but the retained placenta with dd1 meant i never produced milk at all and dh ended up doing an emergency dash to midnight tescos for formula as i sobbed in a heap about my failure as a mother. I know this isn’t any indication of how it would go for anyone else, but all the happy feels for me came after the elcs.

I just wanted to come back on and share a little more about my experience because I was in a rush earlier.

My first was an emergency due to failed induction (very long and traumatic labour and resulted in baby in distress). The emergency c-section was decided very suddenly and before I blinked I was wheeled into theatre. I lost a lot of blood- a dangerous amount and almost died. I remember when the fear in dh's eyes as my bp plummeted and the staff jumped into action. I was in hospital for a week after and had a couple of transfusions and was on iron tablets. They told me not to have a baby for a good few years as I had a lot of damage but I fell pregnant within the first year. Total accident but an elective was suggested. The elective was amazing because the only experience I had was a terrifying labour and emergency c-section. I wish I had been able to have a vaginal birth. After my first c-section, I had lots of stomach damage and my pelvic floor was bad (something people don't tell you about when you have a c-section). My stomach muscles never healed in time for my second so I had lots more damage. However, I healed much quicker after the elective and was out of hospital within 24 hours. A huge difference to the week long stay of my first. I was prepared for my elective, I wasn't for my first and the trauma of an emergency is much worse. Health care professionals can always tell by the scar and damage whether you have had an elective or an emergency.

So I guess the big question is why do you want an elective? Are you at a higher risk of having complications? I hope i don't scare you but want to make you aware of the reality. I hate it when people tell me I was lucky because I didn't have to push. It certainly wasn't 'an easy option' and i am still recovering from the damage now.

Thanks for all your responses!
I didn't mention my reasons in the original post, it was just so I could get a general response before going into it more.
We have a high chance of complications due to me being in the older pregnancy age category, confirmed high chance of Down's syndrome, and my low BMI. Other considerations are my long history of mental health issues & severe anxiety, as well as specific phobia of vaginal birth.
I've looked into all the risks & am terrified either way, but it's been explained to us how much of a danger my high anxiety can be on the baby in general, and also during delivery, so we have to figure out which is the greater risk.
The practicality of recovery would be covered as my partner will be with us full time for a few weeks after arrival, and we're really fortunate that he can take more time off after that if needed, albeit unpaid.
The only thing that matters is that baby stays safe, and trying to make the right decision to make sure that happens is sooo scary! Welcome to parenthood hey? haha

I have tokophobia too ! I have a found a lot of resources on it happy to share

They will likely refer you to perinatal mental health re this

I had an elective section for twins recently and although the decision was out of my hands because they were breach I would definitely choose an elective section again if I ever had anymore children (I don't plan to).

My first child was a long labour resulting in forceps and episiotomy and a long and painful recovery which although I have been fairly lucky I do feel I will suffer longer term consequences of probably in years to come. I couldn't sit down for over a week and was in pain for weeks and weeks after that.

My section on the other hand- I was up and walking around pain free the next day and although I took paracetamol for a few days it has never caused me more than very slight discomfort around the wound. I was able to look after my twins myself on the ward from the start and have been able to resume normal life a lot quicker than I could after a troublesome "natural" birth. I know not everyone is as lucky as I have been with sections but I certainly wouldn't gamble with another vaginal birth.

The practicality of recovery would be covered as my partner will be with us full time for a few weeks after arrival, and we're really fortunate that he can take more time off after that if needed, albeit unpaid

that’ll be good for when you & the baby get home but no use to you on a busy postnatal ward with Covid visiting restrictions. Midwives don’t have time to assist you with things like nappy changing/ getting your bag/ plugging your charger in/ passing you something from the table etc in the same way your husband would

and of course you’ll be in hospital for longer with a CS than you would be with a straightforward vaginal birth

I had my 2 dc's when I was 37 and 39. The first was 40 hours of labor followed by an emergency cs and the second was a VBAC. My baby almost died during the first delivery (there seemed to be a mixture of staff shortage and incompetence) and I almost died during second (not clear if it was incompetence or bad luck). I checked myself out of the hospital after 3 days on the first (because everything was broken and there was no care (1 nurse for 40 people) and they kept trying to convince me to formula feed even though bfing was going fine and the blood on the floor from day 1 was still there on day 3; and with the second they checked me out after 1 day (and then called me 4 hours later asking where I was because they wanted to give me a transfusion). All of this was in well respected hospitals in London with ostensibly the best NHS care available.

If I had it to do all over again I would do an elective CS with both. I think it's dangerous for women in their late 30's + to have natural births when there is no support or research or knowledge about the added risks and all the hospitals are completely understaffed.

PS. My recovery from the emergency cs was only a few weeks and I was in pain and not really mobile for several months after the VBAC.

@Backbee

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.

I agree with that. There seem to be quite a few people requesting a C-section nowadays. Years ago women did all they could to avoid one. It seems strange to me to want one if there are no complications. I am not criticising, just seeking to understand.

I've had 3 straightforward vaginal births, an induction (which didn't work), an elective c-section and an emergency c-section. The elective c-section was the worst, closely followed by the emergency one. So I wouldn't recommend it. I haven't had a difficult vaginal birth to compare it to though.

I had an emergency section with my first and planned with my second. I recovered a lot quicker from my planned. You can mentally prepare for it. You can rest before it and you know exactly what's going to happen.
I also had a failed induction with my first and basically told the consultant when asked why I wanted a planned that under no circumstances would I allow another induction.
I can't offer any advice on a natural birth as mine obviously didn't go that way.
Good luck whatever you decide.

My emergency c section was lovely. Labour was horrific and I shall never put myself through it again.

@Ahorsecalledseptember

My emergency c section was lovely. Labour was horrific and I shall never put myself through it again.

Surely that depends on how long it lasts. It must be awful to be in labour for a long time but not everyone is. I was at home, walking around and doing things, for most of it and went into hospital when my waters broke, giving birth 2.5 hours later. That seemed straightforward to me. A lot of people panic and go into hospital too early which intensifies everything and you can't move around so much or think of anything else. Fair enough if there are complications, then you have to, but most of us don't have those.

@elliejjtiny Why was the elective the worst?

Physically two weeks after my emcs considering I had nearly died due to pph & hellp syndrome, had nearly 3 days in high dependency, I was very well, my scar had healed, I was in no pain, my energy levels were up & down but that may have been due to pnd. I was able to drive, my insurance company said I could when I felt well enough. My mum took me for my first walk with ds in the pram on week 3 & by week 5 we managed a morning at Meadowhall & lunch. I was signed off by the midwife at week 6, she had continued to visit due to me suffering severe pnd & my bp still being high from pre eclampsia. The emcs itself was the least of my problems & had I has a successful pregnancy again I would have chosen an elective Cs.

@rookgizzardpie

The practicality of recovery would be covered as my partner will be with us full time for a few weeks after arrival, and we're really fortunate that he can take more time off after that if needed, albeit unpaid

that’ll be good for when you & the baby get home but no use to you on a busy postnatal ward with Covid visiting restrictions. Midwives don’t have time to assist you with things like nappy changing/ getting your bag/ plugging your charger in/ passing you something from the table etc in the same way your husband would

Obviously I can't speak for all hospitals but this wasn't my experience at all. Staff were busy but made sure I had everything I needed the first night when I couldn't get up and there was plenty of help offered with feeding and changing the babies etc. I could do it all myself as long as the cot and everything I needed was close enough but there was plenty of help if I hadn't been able to and I had twins!

Let's not try scare and scare mums to be about things that simply aren't true

@BuffaloMozzerella it was a close thing between the emergency and the elective but with the emergency c-section they got on with it quickly so I didn't have time to be nervous. With the elective I had to sit around wearing a hospital gown and nil by mouth all day in the middle of a heatwave (I wasn't bothered about food as I felt sick with nervousness but I was so thirsty). I was so scared and just wanted it over. They kept telling me it wouldn't be long, only another hour etc until at 11:30pm they said it had been postponed until the next day so I could eat for half an hour, wear my normal pyjamas (bliss) and then nil by mouth again from midnight. Thankfully I was first on the list the next morning and there were no emergencies so my baby was born at 9:47am.

I found the emergency c-section and the elective c-section pretty much the same in terms of recovery and the actual operation. But with the emergency c-section there was no nervous waiting around. The Dr decided I was having a c-section at 1:35am and baby was born at 1:53am.

Let's not try scare and scare mums to be about things that simply aren't true

I’m speaking from experience

@flashbac

I'm so glad to read this thread as it appears balanced unlike the usual "c sections are great, make sure you demand one" rhetoric that can be the norm for Mumsnet. It was this that left me feeling very confused after my c section because it was definitely not a better experience than my VB. I'm still in the first few weeks following my c section and the disadvantages are numerous:

• No skin to skin after being is born, you have to wait ages to be patched up again. I'm very sad to miss out on this. It's one of the best bits of birth
• no feeling of euphoria after birth
• more swelling and more medication needed + plus side effects
• anxiety over the healing process. Numerous things I am worried about including reoccurrence of adhesions
• bowel issues
• can't get back to normal as quickly, I really miss exercise :(
• pain
• harder to be independent
• harder to bond/breastfeed baby

There are others but that's all I can recall in my exhausted state.

I’m sorry that you were denied the opportunity for skin to skin contact immediately following the birth. I had a c section 19 weeks ago and had skin to skin contact immediately.

The NICE guidelines compare the risks of vb vs elective cs. I've seen a few people say the risk is always higher with cs, that's not actually the case apparently. Its a really interesting read.

www.nice.org.uk/guidance/cg132/chapter/Appendix-Planned-CS-compared-with-planned-vaginal-birth

it's major surgery with a high risk of complications

I love how this fact is always whipped out as if VB aren't risky

I'm 37+3 and have wanted a home birth from the start but my bloods came back with low iron and platelet levels which I've been put on iron tablets for. I'm still not sure as to whether I'll get my homebirth but I'm beginning to lean towards an elective c-section as time is creeping closer and I have no birth plan in place and if I get my bloods redone on Wednesday I'll be 38 weeks or more before the results come back! Could I have your opinions please? Thanks x

For all those saying it's major surgery: yes, it is. However, I found the recovery from my ELCS a piece of piss. I was 10 years older and 4 stone heavier than when I last had major abdominal surgery, and recovered far more reading. There is a huge difference between an emergency section following labour and a planned section in terms of recovery I believe. Only you know why you want a section and the choice is yours and yours alone. Please, please do read up on the potential implications for future pregnancies though! There were concerns I had placenta accreta in my current pregnancy, for which a section is a risk factor. You really don't want accreta...