Vaginal birth then elective c section

[Cbd333]

Accidentally posted this in pregnancy so trying again!

Please could I have some advice from anyone who has had a vaginal delivery followed by an elective c section? What did you find better / easier and quicker to recover from? Did you have any negative feelings towards the section?

I had a reasonably difficult birth with my firstborn ending up in theatre with episiotomy, forceps and sizeable haemorrhage. I am suffering some anxiety and mental health problems with this pregnancy, firstly because of the sudden loss of my beloved mum which has left me with a big fear of the unknown and also another issue which I won't go into on here as it could identify me, but basically I have a job that means I know all about everything that can go wrong in pregnancy in minute detail.

I am considering an elective section as I know this would give me the control I am craving and might make me more able to cope, especially without my mum being here, but I still have this niggling worry that I'm letting the baby down somehow by opting for this. I don't even know how or why I would be but I can't shake the feeling.

Please share your experiences as I'm really struggling without any maternal support or advice. I just need some help with this decision.

I haven’t given birth yet so can’t help you unfortunately but just wanted to say sorry for your loss. No wonder you’re feeling like that after such a hard first birth too. I’ve opted for a c-section for my first later this summer. I somehow lack that feeling of FOMO at not having a vaginal birth somehow (I think most people do have it). I’ve been the most anxious person ever all my life about giving birth and had basically decided I wasn’t having a child because of it but have managed to talk myself into it when I knew I could have a section! To me it’s much more planned, you get a date in advance (getting mine at 33 weeks), you arrive at the time they tell you and know exactly what’s going to happen when, as it starts you know it’s such a short wait til you meet your baby, yes the recovery might not be ideal but I have friends who’ve struggled to walk or sit down for months after a natural birth so it’s not guaranteed to be a ‘longer recovery’ as people always say. For my anxiety those factors make me feel better about it and I know what to expect on the day etc. I’m sure people have nice easy experiences of a natural birth a lot of the time but to me I can’t even cope with the fact you’re just at home then all of a sudden one day you’re in labour and you don’t know when it’s coming. I then imagine it all to be very chaotic, emergency buzzers being pressed, forceps, tearing, episiotomy, heavy bleeding.. all these awful things that I think would happen to me 🙈 You should discuss it with a consultant or ask if your hospital has a birth reflections service to speak to about it, they would be able to help you make your mind up. The only thing I would say is the consultant I have was a bit dramatic about the risks of a section and I felt she almost exaggerated them and said them as if they were definitely all going to happen to me to try and put me off, when in reality these are often the risks of an emergency section when someone’s already in a life threatening situation from labour rather than an elective one. Good luck, hope you get whatever birth you choose is best x

@sarah13xx thank you for taking the time to replay and I'm so glad you've made the decision that's right for you.

I have spoken to a consultant and they were overwhelmingly supportive. They said that what happened to mum was reason enough and that coupled with the job I do she would be happy to perform the section.

What I really wanted was to avoid forceps and she said that sometimes there can be an increased risk to baby if opting for elective section rather than instrumental birth and that the way to remove that risk would be to have a section. She also explained the risks but said that actually there are risks with a vaginal birth too, just in a different place (tears, incontinence etc) so I felt she was, if anything, gently saying that perhaps a section is the right option for me.

I think mum would have helped me one way or the other to decide and I'm so missing that. As supportive as dh and dad are they are very binary and less willing to discuss the merits and drawbacks of each option, which I understand as obviously they don't have vaginas!

Sorry, I mean there can be an increased risk if you opt to not have an instrumental birth but go straight to an emergency section if you need assistance. Just realised part of my last message doesn't make sense!

Hi OP.

First birth was like yours - episiotomy, forceps and haemorrhage as baby got stuck. It really traumatised me and I took a while to heal physically and mentally.

In Feb I had my second baby by ELCS and it was the complete opposite. The theatre staff were amazing and it was a very calm atmosphere and all round positive experience. The first couple of days afterwards I was sore but able to get myself out of bed and move around slowly. Within two weeks I felt reasonably back to normal.

I probably won’t have a third but if I did I wouldn’t hesitate to have an ELCS again.

I had my first baby 7 weeks ago today by c section after going into labour 4 weeks early and not getting past 2cm after 48 hours (so it was like an unplanned elective if that makes sense!)

I was allowed to take in my own pillow and playlist and the threatre staff were incredible. They kept me calm and were very reassuring when I had a little wobble in the middle. The whole experience was extremely positive for me and my partner.

I did briefly feel that I had somehow "cheated" or missed out by not giving birth vaginally but a friend gave birth 11 days after me and had a horrible experience so I have no regrets now. The first few days after were quite tough because my stomach was tight, I had bad trapped wind in my chest which gave me back pain and I found showering and going to the toilet a bit scary! After about a week I felt a lot better and by the time my baby was 2 weeks old I felt about 90% recovered and had keep reminding myself I'd had major abdominal surgery to stop myself from overdoing it.

I have a photo that the anaesthetist took of the three of us just after she was born as my phone wallpaper 💕 it really was the best experience of my life.

Wishing you all the best with your pregnancy and birth x

My first was vaginal -third degree tear, pph (3.5 litres), sepsis. Numerous complications. Bloody awful and took months to recover.
Second was an ELCS. Absolutely no way was I risking going through that hell again and the consultant confirmed I'd be at risk of tearing again, probably worse. The c section was marvellous, so calm and straightforward. Recovery was much easier. No complications. First couple of days you need to stay on top of pain relief but within two weeks I felt fine. I'd go for a c section any day of the week!

I haven’t had a vaginal birth - one EMCS, one ELCS - but just wanted to say sorry for your loss. I think if you feel an ELCS would be the right option for you, it probably is. Mine was a very positive experience overall, though I was in more pain afterwards than after the EMCS (suspect I was running on adrenaline first time round).

It also sounds as though you have a balanced consultant - mine was keen to emphasise the risks of a section (I get it, it’s her job) and the benefits of a vaginal birth but not the other way round. Your consultant will be better placed to talk about the risks of tearing again vs the risks of a section, and if I were truly on the fence about what to choose, that would be a factor in my decision, ie the likelihood of tearing badly and ending up with damage vs the known factor of having an abdominal scar.

I would also, in your position, consider whether this was likely to be my last baby. Not that you can’t have multiple ELCS, or an ELCS and then a VBAC, but I think if you have one section, you’re perhaps more likely to have sections in future and there would be additional risks for any future vaginal births (albeit small risks). If you want a larger family, you might be more inclined to try for a vaginal delivery, whereas if you’re confident it’s your last child, that might sway you more towards a section.

I’m sure you know this but statistically an ELCS is low risk for the baby - it’s considered lower risk than a more complicated vaginal delivery or EMCS - so please try to put aside any thoughts of letting your baby down.

Hi OP.

I am in a fairly similar position. I had an induction with my first baby, delivery was "OK" but it has been agreed that the care I received during my induction was well below the standard it should have been and, without going into detail, it has left me petrified of labouring and giving birth at hospital. It was recommended I discuss an ELCS and this has been booked for 39 weeks.

I am still unsure. I thought it was 100% what I wanted but now it's booked I'm also scared of the section too.

It's very difficult but I do agree with some previous posters that if you've been thinking about it seriously, it's likely that it's the best option for you. The stats just scare me abit.

All the best and congratulations on your pregnancy XX

Thank you so much for your replies.

@SomeCatsLikeCheese this is almost definitely my last pregnancy - I'm 37 and it has taken us nearly two years with both this pregnancy and my first to get to this point with miscarriages and an ectopic inbetween.

Friends who have had vaginal births followed by sections all recommend I go for the caesarean as they also know how traumatic the last year has been for me, but one friend who had essentially the same first birth as me had a vaginal delivery with her second and said it was more more manageable and was really satisfying.

As you say @hitchin89 there is a sense of cheating a vaginal birth and that I'd somehow be letting down my baby, especially if there is a cut to him/her during the incision or any breathing difficulties. My midwife, who is much much of the vaginal birth school of thought, also talked about the benefit of microbiomes in a vaginal birth, but I am probably overthinking all of this! I do think there is this sense of pressure put on us women that 'natural' is always best and that the pain / tears / incontinence are just part of the package. I'm sure if it was men who gave birth all babies would be born by elective section

While we were agreeing I would have a c section the consultant midwife ran through the risks of a section and the benefits of a vaginal birth, but not the other way round so it wasn't a balanced assessment! Only you can make the decision on what is right for you and your baby

@Cbd333 hi I just wanted to say I am very sorry you have lost your mum. I lost mine very suddenly last year 6 weeks before I had my first baby and it turned my world Upside down I miss her desperately.
I had an emergency section and am 20 weeks pregnant again and my consultant has basically told me to have a section because the risk is too high for scar rupture with the gap being so close.
Unmumsnetty hug x

OP, I wouldn’t worry too much about the risk of the baby being nicked during the incision. It is a really small risk. Ironically, it did happen to DS2 - he had a tiny 1cm scratch near his eye (which made me shudder to think about it afterwards). The surgeon was mortified. But the odds are really low and any nick is likely to be very minor - his healed within a day or two.

My first birth was a traumatic natural delivery, second planned c section.

My second birth was a much better experience, I felt in control, I knew the plan. The recovery was much less painful.

I had a vaginal birth with epistiotomy and ventouse followed by an elcs because of a breech baby. I sound the ELCS pretty tough - I reacted badly to the drugs and found recovery difficult. But my Dad died very suddenly 2 days after ELCS so I think that probably affected a lot of what I thought about it and recovery. I went on to have a VBAC after that and found it generally enjoyable and felt pretty healed mentally by it.