ELCS due to not wanting to have vaginal pain AFTER birth?

[Dexter77]

I’m currently deciding between an ELCS and a VB with epidural. I don’t believe in enduring pain that’s unnecessary and always assumed I’d have an ELCS as I think it’s a great and safe option, but now wonder whether the latter would be preferable. What’s holding me back from attempting VB is the prospect of weeks/months of pain in vaginal area after birth, as well as the fact that postnatal aftercare of birth injuries seems to be woefully inadequate in the UK with long waiting times and insufficient support.

I’d be fine with temporary pain during birth but find the prospect of having vaginal pain for so long totally unacceptable - not even to mention other potential complications such as prolapse and incontinence.
I suppose I’m asking whether it’ll be a given to have vaginal/perineal pain AFTER the birth with VB of normal sized babies (no reason to assume mine will be big).
Keen also to hear from women who had a pain free birth but pain afterwards and how they found it.

PS: And yes, I know there’ll be pain from having an ELCS after birth, but I just know I’ll cope better with having pain in abdomen than in genital area.

I've never had a VB so can't really help with that, however I did have an epidural with the intention of having a VB and ended up with an EMCS.

I was actually relieved when the CS became an inevitability, as for whatever stupid reason I didn't feel comfortable requesting an ELCS in upfront, but had similar concerns to yours around pain/birth injuries, etc.

My recover from the CS was absolutely fine, no pain at all after the first week and even that was more than manageable with pain relief and taking it steady. If I decide to have another DC I'll absolutely have another CS rather than attempting a VBAC.

Would also highly recommend the epidural if you do opt to try for a VB. They don't work for everybody, but in my case it was heaven and made my experience of labour so much more relaxed.

Good luck

Do you realise that a CS is major abdominal surgery?

In terms of pain, I had a VB and a second degree tear which required stitching. It was sore for about 7-10 days because of the stitches but I wouldn't say I had any vaginal pain beyond the first day or 2. I would imagine the abdominal pain from a CS would be worse based on my experience of recovering from a laparoscopic gallbladder removal and the healing of the internal stitches and muscle damage.

@EgonSpengler2020 A CS is a 10-20 minute routine surgery that happens every day in a calm controlled manner and perfectly safe. I’d prefer not to have a scar on my abdomen but would rather have abdominal surgery than major vaginal injury.

I had an emergency Cx and was in a huge amount of pain for several weeks despite pain killers.
I struggled to get in and out of bed, to sit in a chair and to hold baby.
I wouldn't assume an ELCS is relatively pain free for everyone because this wasn't my experience at all with an emergency Cx.

I had an emergency c section and I had an awful recovery, extremely painful, couldn't stand up or walk properly for weeks, I had nerve damage too so would get crawling sensation up my sides for around a year afterwards. I remember for the first few days after I got home, I couldn't sit myself down onto the sofa, I could only sit if I went straight down like onto a kitchen chair, if I had to go backwards at all I couldnt do it, too painful.

Also the average c section takes closer to 45 mins and mine was over an hour due to haemorrhage.
I'm not trying to over dramatise things, I just want to illustrate that there are pros and cons to both vaginal birth and Cx.

@HalfShrunkMoreToGo I see. Have to say being sore for 7-10 days would be about the maximum I’d find acceptable. I just feel very strongly about pain and discomfort in my genital area and feel violated and tortured very quickly in that regard - inserting a small tampon hurts me. In other areas of the body I’m not that pain sensitive but pain down there has a huge emotional impact on me for some reason.
I just fear that having pain or soreness in this area would affect my bonding experience with my child. Thanks for sharing your experience!

It's not a given to to have weeks or months of vaginal pain after giving birth, no. There are no guarantees whatever you choose of course.

I’ve had 2 vaginal and 1 CS and can say from my experience that the CS was the worst to recover from - weeks compared to days with the vaginal births. I took myself back to hospital as it was so painful I thought the internal stitches must have come undone! (They hadn’t!)
But obviously everyone’s experience is totally different so if you feel more comfortable with a CS then go with that, it was definitely a much more pleasant birth experience for me, just the aftermath was dire!

[quote Dexter77]@HalfShrunkMoreToGo I see. Have to say being sore for 7-10 days would be about the maximum I’d find acceptable. I just feel very strongly about pain and discomfort in my genital area and feel violated and tortured very quickly in that regard - inserting a small tampon hurts me. In other areas of the body I’m not that pain sensitive but pain down there has a huge emotional impact on me for some reason.
I just fear that having pain or soreness in this area would affect my bonding experience with my child. Thanks for sharing your experience![/quote]
If this is trauma related you probably are better off choosing an elcs.

A csection is about 45-60 minutes in total, not 10-20 unless it's a crash section. I've had 3 csections not by choice, but the healing was fine, especially my second two. I would recommend going into it as fit as possible, I did strength training and cardio up until a week before my last cs and the difference in my recovery has been huge. 3 weeks post cs now and I feel like it never happened, have been pain/discomfort free for probably 2 weeks and minimal after day 1 anyway.

Yabu to underestimate a Cs... I had 10 vb and 1 Cs.
Choose the 10 again any day..
No stitches and 6 hour discharge in most dc... Others at non appropriate times for early release!

@BrownEyedSquirrel and @lochmaree I think one can’t compare an EMCS with a ELCS though, the former are almost always more brutal and recovery slower as it’s an emergency, whereas an ELCS is a calm, precise little cut that’s being gently stretched and recovery is often said to be miles easier than after an EMCS.
I’d also like to avoid a EMCS as lots of people seem to have had slow painful recoveries afterwards like you guys, but the only sure way to avoid an EMCS is indeed an ELCS!

I had 2 VB one with an epidural (due to forceps) and one with a 3rd degree tear. No major lasting damage save a bad scar from the first but I suspect longer term increased risk of incontinence, had good after care though and I def wouldn't have preferred ECS simply because I have friends who had bad experiences and I feel.lucky to have had an option. Def had pain for around a week to 10 days after but manageable with paracetamol and I was up and running around as normal in 3 to 4 days I would say, slightly longer for the first where recovery was harder.

I’ve had two vaginal deliveries. One with forceps and episiotomy and the other with two minor tears. Recovery took longer for forceps delivery but swelling and pain probably eased around day 5 and I was active with baby by end of the first week. Stitches did take a few weeks to heal though.

With the minor tears, I felt fine, soreness gone after second day and I could walk further and do more within a couple of days.

I had a 2nd degree tear needing stitches, it was sore for a few days and healed within 2 weeks. That area heals well and will only tear as much as it needs to when in labour.

Might be worth bearing in mind that having an epidural can increase the risk of needing delivery assistance which may result in vaginal damage.

Speak to your midwife, see what option may be best for you.

I had a forceps delivery with 4 degree tear and then an ELCs. I was very lucky with my tear - it healed very well. I had a catheter for a day or so. I was pretty much incontinent for a few days - wasn't in a lot of pain but would struggle to make it to the toilet. I had average /moderate pain for a week or so and couldn't walk properly for months. I couldn't get up from the sofa or walk up or down the stairs while carrying DC for a few weeks

The ELCs was a walk in the park compared to that - yes it's surgery but it was recognised by the hospital staff and they would offer you painkillers etc. I was bed bound for a few hours and my abdomen was painful for a couple of days. And that was that. Other than not being able to hoover for a month or so I had no other issues.

Only you can decide OP but my impression is that women's pelvic floor, genitalia etc are seen as cannon folder by some health professionals. There is no need.

I have had both a planned CS and a VBAC. I think my vagina took longer to recover after my CS! Sex was painful for a long time.

There are pros and cons to both, but having a CS does not guarantee you a pain-free recovery, and a VB might be entirely trouble-free!

@Garman oh that’s interesting re the cardio, I’ve never heard this before, why is being physically fit important before a c section?

I’m due my second soon and will be having an elcs. I had a traumatic VB which ended up with epidural/forceps/episiotomy. I wasn’t worried about pain after birth but further damage as I still cannot feel when my bladder is full due to nerve damage years later and the episiotomy scar ‘pulls’ for lack of a better term. Aftercare for birth trauma is inadequate, I agree. You will no doubt get judged whenever you say you want a section but screw those people. It’s your body and your birth.

If you're trying to avoid pain, a csection isn't really your best option. The actual op is technically easier and more controlled, but recovery is much longer. There is no bouncing back from a csection. For every woman who tells you she ran a marathon a week after her csection, there are ten who will tell you that recovery was longer and harder.

I've had an elective and emergency. I was still in hospital after four days on the tramadol after the elective. I was still worried about bursting my stitches when I took a poo for about three weeks. I was anemic for 12 months after my emergency section. I still have no sensation in my lower abdomen and my youngest child (the elective) is 6YO. It's not all sunshine and rainbows.

I'm not trying to discourage you BTW. I would definitely recommend an elective csection over a difficult labour (I had that with DS1 resulting in emergency csection). But go into it with fully informed with your eyes wide open. You will be on that table cut open for longer than 20 minutes for a start.

I had a vaginal delivery on my first, and will be having a planned section this time.

My first was basically textbook everything I didn't want - was induced, induction failed initially, then baby was distressed and had to come out quickly. I had a ventuose delivery, an episiotomy but tore through it so a third degree tear. I did have an epidural, so thankfully didn't feel any of that at the time.

Recovery, however, was miraculous. I can genuinely say I felt no pain from the tear: I think the doctor who stitched me up felt really bad about how the delivery had gone, she certainly was incredibly thorough (was about 40 minutes in theatre having the stitches) and basically from the second the epidural wore off I had no pain at all. I was also quite lucky in that, I was checked by the postnatal physics purely because of the 3rd degree tear and they found some issues with my pelvic floor so I was seen afterwards for ages: they basically said while I didn't have continence issues now, they were worried I'd develop them later on if I didn't work on it. Again though, they actually thought most of that was to do with pregnancy, not the delivery. So I had a very fast physical recovery, better than usual postnatal follow up and no real continence issues except some urgency which I was supported to deal with and which I suspect would have happened anyway.

For me, my recovery was way way better and faster than everyone I know who had c-sections. And I was very squeamish about any kind of genital injury in advance. The only reason for a c section this time, which I'm quite worried about, is the increased risk of another 3rd degree tear: I feel like it might be tempting fate, and its been a harder pregnancy all round this time. However what I am concerned about is the recovery period, and being in pain for weeks. I definitely view it as vaginal = pain in labour, c-section = pain afterwards.

In terms of vaginal pain... I know people who felt generally swollen and a bit sore after a vaginal delivery for a week or so, like sitting on a haemorrhoid cushion type thing, but not to the extent they needed painkillers. Most pain people have talked about is that 'first poo' which I think is also an issue with a section. I don't know anyone who had ongoing vaginal pain like I think you're describing. The issue is, we're all different.

I will say, if you're very fit and healthy, I would say you'll do best with a vaginal delivery. My friends who were sporty before getting pregnant, and kept their fitness up - swimming, yoga, walking - had fast and easy deliveries and were up on their feet almost immediately regardless of size of baby.

I’ve had an emcs and a VBAC. I’d take the VBAC any day. Pain during rather than pain after and I had an episiotomy.
I was sore after my vbac and swollen so took painkillers on and off for a week or so. The stitches healed fine
I took painkillers exactly on time for 3 weeks for my section if I didn’t I knew it. In the first week I got stuck in bed and stuck in a chair.
My emcs was not done in a rush it was calm one as ds wasn’t in distress he just wasn’t coming out

Of course C/S IS major surgery!!