Assisted Delivery Vs C-section

[EdithGrantham]

Hi,
Expectant FTM here.

I've been reading up a bit about birth options and in one book I'm reading it suggests that there you can request on your birth plan that you have a C-section rather than forceps/ventuouse delivery if it gets to this point.
Is this a realistic assertion? I had thought that by this point the baby was too far down for a C-section to be suitable?
Thanks

I can only comment from my own experience, but I had a forceps delivery as baby was back to back and head up, stuck with no way to push her any further. Before starting they also prepped me for an emergency C-section (got a spinal, and all the necessary medical personnel ready) just in case the forceps wouldn’t work. So I’m pretty sure I could have requested for just a C-section at that point. However, forceps worked fine and so there was no need for the section. It might depend on how far down the baby is at that point?

You can request it.

I got to this point and was absolutely refused a c-section. I begged and begged and they told me I "110% would give birth vaginally".

I had a horrific emergency c-section.

I inisisted on a c section when they advised forceps. When we got to theatre and they examined me the baby had moved down a lot.
The doctor was great, reassured me that she wouldn't do anything I didn't want and would do a section. But advised of the risks of now doing a section, and if they did forceps the baby would be out in 1 or 2 pushes. I consented to forceps and it was absolutely fine.
Baby was out in two pushes (couldn't feel anything due to spinal but they told me when I was contracting and to push). Had episiotomy but no extra tearing, very quick recovery and no long term problems. Baby wasn't breathing when came out though so slightly scares me that if I had section, which would have taken longer, she may have been very poorly.
As it was they gave her a touch of oxygen and she starting breathing.
I think you need to trust the experts in these situations. I know doctors can be a bit quick to induction etc but in the scary scenarios of 'we need to get this baby out', they know what they're doing.

Just wanted to add a ventouse experience - I had ventouse (and episiotomy) with my first and it was absolutely fine, definitely not worth arguing a c section over. I think induced be much more reluctant to have forceps knowing the recovery from that can be pretty rough, but then so is recovery from a c section. But if they suggest that ventouse will be enough, I’d definitely not opt for a c section instead. In my head it’s like opting for an amputation over a cast for a broken leg (I realise this is an overly dramatic comparison but couldn’t think of anything else lol)

Thanks all that's really helpful.
I've been diagnosed with tokophobia and had some counselling for it which went really well and I was feeling pretty ok about the prospect of giving birth then I read that and it was like an additional weight was lifted from my shoulders knowing that I could avoid instrumental delivery altogether. I think in part because I have a version of it in my head where I'm very much a passive participant in my baby basically being forcibly pulled from my body.
I know C-sections can be awful to recover from as well but it's worth knowing that in theory I have that choice (sorry you weren't allowed to make that choice @Chanel05, that is what really worries me, having that choice taken away)

Hi, there isn't always a choice. Once the baby has passed the ischial spines, instruments are safer for the baby. A c-section at that point (full dilation) carries a risk of fractured skull for the baby as they have to be pushed back up. That can lead to brain damage or death. There is also a risk of serious bladder damage (because baby is low) for the mother.
When people are prepped for instruments and c-section just in case means it's pretty serious stuff.
RCOG are starting to be a bit more transparent about instruments and I've seen on their website that if you'd like to avoid instruments all together, you should look at a planned caesarean section (a much safer procedure than when in labour and fully dilated).
"If you are certain you would not want an assisted vaginal birth, one option is to choose a planned caesarean birth before you go into labour."
www.rcog.org.uk/en/patients/patient-leaflets/assisted-vaginal-birth-ventouse-or-forceps/

I hope this is useful. Wishing you all the best.

I agreed to be induced on the basis they’d give me a section rather than forceps - I ended up with forceps! My understanding is that while they can’t give you forceps without your consent, and would have to give a section in those circs, if the baby is sufficiently far down then they would be advising you that to do a section they’d need to push baby back up, which is not only risky for the baby, but also risky for your pelvic floor and therefore presumably risking a big part of the damage you’re hoping to avoid! So technically you could ask for a section, realistically you’d probably opt for the forceps rather than jeopardise a sage delivery. It’s a choice but it’s not really a choice if that makes sense.

Honestly OP, if your priority is to avoid instruments (as it was with me), have an elective section. I wish I had.

I had an elective section for my second baby and it was incomparably easier to recover from than the forceps and episiotomy. Sections aren’t necessarily awful recoveries.

Good luck!

@EdithGrantham

As some previous posters have suggested, go with a elective section.

I had one 6 weeks ago due to tokophobia and have been posting about my experience just today on another thread.
www.mumsnet.com/Talk/childbirth/4221711-C-section-due-to-severe-phobia-of-birth-when-did-you-get-yours-approved

I had a forceps delivery as baby needed to come out fast and it was put to me that they would have a quick try with the forceps and if it didn’t work it was an emergency section for me. I guess at that point the section was a last resort. Baby did however come out and only had a short stay in nicu. I did find recovery difficult enough but in saying that, so far I am hoping to try vaginal again this time around, as I was induced last time and I think this amongst other reasons led to the assisted delivery. As my due date approaches my head is being turned towards an elective section simply because many have said the recovery is generally smoother! My gp also has recommended one as I am quite fearful and she said they tend to be a lovely experience and not stressful the way my last one was. In saying that so many people have lovely births with no assistance needed. If it’s going to ruin the build up to the birth for you, I second the suggestion of an elective as for sure it is generally a lot more controlled and planned!

I had an emergency c section prior to which they attempted forceps in theatre. But I don’t know how they made that attempt as having had my second I’m sure my son was nowhere near the exit! I was 10cm but didn’t have the urge to push (not that I knew at the time only since having felt it with my daughter!) The c section was absolutely fine and recovered really well.

With my daughter I had a VBAC and it felt SO different she was clearly coming and in a hurry. I did have ventouse but I think it was just to help her rotate a touch as the notes said kiwi cap applied 9:30 - baby out 9:30 so there really wasn’t anything to the kiwi cap and did cause my daughter or me any issues (didn’t make her head pointy).

To be fair with my daughter they did say I could have a c section (I was booked in for one that day and she decided to change the plan!) At the time I just knew if I said I wanted a section they would have had to give me a general anaesthetic as I know I couldn’t have sat for a spinal (whereas when I had my son it was super calm - sat and had it no problems.

I did at at home hypnobirthing book with recordings which I absolutely believe helped me so much to stay calm and in the zone and adjust as my birth plans didn’t necessarily go the way I would have had as first choice. Both births were good.

I think the best thing you can do for yourself is be well informed of all the possibilities, have a plan with your wishes but an open mind. It is to some extent pot luck but the thing you can control is your breathing and how you will keep yourself calm and in the zone. That way you know you will have the best birth that you can have on the day.

Should say didn’t cause any issues!

I've had two ventouse deliveries and an EMCS c-section. I clearly said in my birth notes for all three that I did NOT want forceps, so the first two births it didn't even come up. The third one, despite me saying that they still insisted on taking me to the theatre to see if forceps could be used and had said if not it would be a c-section. I didn't cause a fuss, the mw knew the baby was nowhere near low enough for instrumental delivery and she was right.

Having had both I would 100% take ventouse over a c-section. My c-section wasn't horrific, but it's major abdominal surgery. I wouldn't choose it if I didn't have to. Ventouse was straightforward, and over quickly. No marks on the baby aside from a little bit of a conehead for a few hours. I didn't need an episiotomy for either although I did tear during both but it was minor. I absolutely would not have consented to forceps.

Thanks for all the extra info there's a lot to think about there. I have a midwife appointment coming up soon so I'll discuss it with her then.

Also, to mention one of your thoughts, you're not completely passive - with ventouse anyway. They waited until my contractions and I pushed while they gently pulled.

And also, my recovery from c-section was quick. I was out of bed ASAP and stayed as mobile as possible. I had minimal pain and managed on just Ibuprofen and Paracetemol but really didn't find it that painful or uncomfortable (even though I get an infection 🙄). It was fine. I do hoever HATE how it looks now, my scar is not pretty and I've got that overhang that I was not prepared for!!