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.

@ThePoisonousMushroom

Yes going home quickly was a massive benefit to me. 3 children and the longest I was in hospital after giving birth with any of them was 6 hours. That’s also one of the reasons I didn’t want an epidural… I didn’t want to have to go to the postnatal ward if I could help it.

Understand a longer hospital stay is undesirable for some. I’m actually looking forward to staying overnight and have the option to request help from a lactation consultant for instance, which is offered at my hospital. I think I’d want to stay overnight regardless of delivery method.

@MyGrassIsBrowner

I've had both a vaginal birth and 10 days ago I had an ELCS. My section was the most incredible experience, I would do it all again in a heartbeat! My vaginal was a different story and have been left with a rectocele prolapse. Wasn't prepared to potentially make it worse with another vaginal delivery so opted for an ELCS and I'm so glad I did! The theatre staff took some amazing pics that I'll treasure forever. Good luck with whatever you choose to do! X

Really sorry to hear about your birth trauma. This is precisely my fear. Glad you had such positive c sections. I know it would drive me insane if I opted for a VB then sustained a major injury if I could have avoided this via an ELCS.

I will explain this to my consultant who has already said she’ll happily do an ELCS if that’s my wish. Do you know whether anything could have been done differently in your VB to avoid the rectocele by any chance or was it just chalked up as bad luck?

@danidandan

OP, you say you're fine with a CS because your genitals will be intact.

I along with a couple of others on this thread had massive problems 'down there,' after my section, but it seems like you don't want to hear it.

And you'd resent your child if you had those problems? That's not right and you need some help in addressing that. You cannot predict mental health and who's to say you will or won't resent your child if you have CS complications.

(Please don't come back with a rude reply like you have done with others,) and I mean this kindly. You're really underestimating CS's.

Umm, I have responded to the two people above who said they had pain in vaginal area after section and enquired for more detail. Why are you making the baseless claim that I don’t want to hear it?

I have not been rude in the slightest, just won’t be patronised by ideologues who have no interest in maternal choice and honest education.

And no, I’m not underestimating C sections. Please, do let me know what makes you think that? The fact that I’m considering electing one? Another ideologue, getting boring.

And as for your tasteless comment regarding my expectation that I would resent my child if I had horrific injuries: to dismiss that as”not right” and somehow a character flaw of mine is such a callous, unqualified thing to say. You don’t understand anything about mental health, evidently.

Thankfully, I do.

others have started convulsing because I’ve expressed that I don’t see why I should have vaginal birth trauma. Guess that was to be expected
People have tried to be helpful. Nobody has been "convulsing". Nobody has said you should have vaginal birth trauma.

You say you are aware of the risks of CS but you don't want to talk about them even though you are happy to talk about the risks of VB.

Here is a summary from an article in the Lancet called "Short-term and long-term effects of caesarean section on the health of women and children" that might be helpful.

A caesarean section (CS) can be a life-saving intervention when medically indicated, but this procedure can also lead to short-term and long-term health effects for women and children. Given the increasing use of CS, particularly without medical indication, an increased understanding of its health effects on women and children has become crucial, which we discuss in this Series paper. The prevalence of maternal mortality and maternal morbidity is higher after CS than after vaginal birth. CS is associated with an increased risk of uterine rupture, abnormal placentation, ectopic pregnancy, stillbirth, and preterm birth, and these risks increase in a dose–response manner. There is emerging evidence that babies born by CS have different hormonal, physical, bacterial, and medical exposures, and that these exposures can subtly alter neonatal physiology. Short-term risks of CS include altered immune development, an increased likelihood of allergy, atopy, and asthma, and reduced intestinal gut microbiome diversity. The persistence of these risks into later life is less well investigated, although an association between CS use and greater incidence of late childhood obesity and asthma are frequently reported. There are few studies that focus on the effects of CS on cognitive and educational outcomes. Understanding potential mechanisms that link CS with childhood outcomes, such as the role of the developing neonatal microbiome, has potential to inform novel strategies and research for optimising CS use and promote optimal physiological processes and development.

[quote mummyh2016]@Dexter77 I have read it and a lot of posters are questioning why are you are minimising the effects of a CS and dramatising the effects of a vaginal birth, this is why the majority of your posts are either biting peoples heads off or arguing with people.
I couldn't give a fuck how you give birth but I do care about you scaremongering other people who may not do their own research. So come on, you've listed the possible bad outcomes of a VB, let's hear them for a CS shall we?
Have you heck read the risks. [/quote]
You can libel and bully me all you want. I have absolutely no intentions to let you command me around, why don’t you list the CS risks yourself?

Who is scaremongering? Is it me, who simply has listed which - pretty common - VB complications I want to avoid, or the small handful of people in this thread treating an ELCS like putting on a suicide vest?

It’s you and a small handful of others who have picked an argument. You didn’t comment to help me make a decision, you commented solely to belittle and pillory me for my concerns and preferences. Embarrassing.

@Bitofachinwag

others have started convulsing because I’ve expressed that I don’t see why I should have vaginal birth trauma. Guess that was to be expected People have tried to be helpful. Nobody has been "convulsing". Nobody has said you should have vaginal birth trauma.

You say you are aware of the risks of CS but you don't want to talk about them even though you are happy to talk about the risks of VB.

Here is a summary from an article in the Lancet called "Short-term and long-term effects of caesarean section on the health of women and children" that might be helpful.

A caesarean section (CS) can be a life-saving intervention when medically indicated, but this procedure can also lead to short-term and long-term health effects for women and children. Given the increasing use of CS, particularly without medical indication, an increased understanding of its health effects on women and children has become crucial, which we discuss in this Series paper. The prevalence of maternal mortality and maternal morbidity is higher after CS than after vaginal birth. CS is associated with an increased risk of uterine rupture, abnormal placentation, ectopic pregnancy, stillbirth, and preterm birth, and these risks increase in a dose–response manner. There is emerging evidence that babies born by CS have different hormonal, physical, bacterial, and medical exposures, and that these exposures can subtly alter neonatal physiology. Short-term risks of CS include altered immune development, an increased likelihood of allergy, atopy, and asthma, and reduced intestinal gut microbiome diversity. The persistence of these risks into later life is less well investigated, although an association between CS use and greater incidence of late childhood obesity and asthma are frequently reported. There are few studies that focus on the effects of CS on cognitive and educational outcomes. Understanding potential mechanisms that link CS with childhood outcomes, such as the role of the developing neonatal microbiome, has potential to inform novel strategies and research for optimising CS use and promote optimal physiological processes and development.

You have posted this list before. Why, I’m not sure. I don’t NEED to talk about these risks on this thread because I’m not concerned about them. I have noted and accepted them ages ago.

Shall I post a corresponding list of VB risks now for good measure? Suppose I should, but I shan’t, I’m not 7 years old.

Hi OP, it does sound like you have made your decision and that the c section feels like an easier option for you but just wanted to share my experience. I'm not trying to sway you either way!
I had an emergency c section 5 years ago and a planned c section 17 months ago. The emergency one was a horrible traumatic experience and I was left with PTSD.
I requested a planned c section second time around purely because I did not want to risk an emergency c section which might trigger my PTSD which I have worked so hard to recover from.
I hear a lot of women say their planned c section was a wonderful experience. Sadly I don't agree. Ok, it was calmer, I wasn't worried if my baby was still breathing, and the staff were amazing BUT it is still surgery and I feel VERY out of control during c sections. Both times my blood pressure has gone very low (which is common) and it's made me shake and shake so badly I couldn't even hold my baby when she was brought towards me. The shaking goes on for a couple of hours afterwards. I've got quite a few friends who had the same. I did not like the sensation of the surgeons in my numb stomach, in fact just the thought of it now makes me feel quite anxious.
I found recovery from the planned c section much harder but I accept that might be as it was my second one and that I was probably slightly more active this time as I had a 4 year old too.
I'd love to meet all these women who say they felt no pain after a few days.....because I was in a lot of pain. Ive got a few friends who had c sections and all of them were in a lot of pain. Both times I have been left with a numb stomach and the first time I had nerve sensations down my legs for over a year.
My friend's womb was accidentally torn during her first c section and she could then only have c sections. They say she is still a higher risk of needing a hysterectomy as a result. She also had to have a lot of scar tissue removed from the side of her bladder - all due to having had a c section.
I have found it frustrating both times that I can't easily get down on the floor and change nappies etc and I do think this affects your initial bonding. The first time around I struggled to even breastfeed due to the pain. I obviously can't talk for vaginal births but I wish I had had the opportunity to try one, I guess that's just life but if the circumstances had been different I would have taken the chance to have a quicker recovery, no matter how small.

You have posted this list before. Why, I’m not sure
It's not a list, it's a research summary. I have not posted it before. I did post a link to Tommy's with lists of risks of VBs and CSs.

@Somuchgoo

You asked about bonding after my great sections: it was great. I had an overwhelming bond both times instantly. No hint of even baby blues, and a sense of euphoria.

Re fitness: I'm unfit, quite fat and normally take ages to heal from things. My recovery was days rather then weeks.

That sounds really reassuring @Somuchgoo :) There’s no reason to expect major medical complications during an ELCS in my case, but the bonding is a big concern.

Great to hear that you’ve had such a positive experience. Can I ask - how long did it take until you were allowed to hold your baby? Experiences here vary greatly it seems and I want to ask my consultant specifically what this would likely be like if things went smoothly.

Thereeeee it was. Can't you reply to anybody who doesn't give you the answer you're looking for, without being rude, can you?

You clearly haven't done any research really, as you said in an earlier post a CS is 10-20 minutes! Maybe you should take note of the people trying to help you!

I'm not watching this thread now, I think you're really, really rude.

@Dexter77 my recovery from my emc was totally grim for about 4 months. A smooth vaginal birth is much better for baby and if you do pelvic flaw exercises and perineal massage religiously hopefully that should stop any major issues for afterwards

I had an emergency CS followed by a planned CS with major complications. After the first my recovery was about 2 weeks, the second four weeks, both with severe pain (and some scar tearing) for about ten days. Complications to the scar both times led to long hospital stays. I have my two healthy DCs so think both were successful births, but both also taught me that you never know which is the best way forward.

@Dexter77 you've not really responded to any of us who told you about straight forward vaginal births with no injuries or complications.

I'm really sorry about your first baby and what happened. It must have been a horrible experience to go through.

As others have mentioned though, your body has now done birth once. It knows what to do and there's no indication that a second birth would cause any lasting damage.

If it helps, my second baby was heavier than my first and she was an easy water birth. Both mine were over 9lbs as well

A cs is major surgery, you will be in pai for days, probably weeks. A vb varies, some women have stitches that take a while to heal, others like me are at the shops 24 hours - tooth ache is far worse. No one here can tell you which is best for you because there's unknowns but only one option has the possibility of no pain afterwards because you definitely will with a cs

I would class myself as a fit and healthy individual (marathon runner, no health concerns) and had an ELCS 8 months ago.

I'm sorry, but I did struggle with initial bonding. Like poster above I was shaking and vomiting for hours after due to drugs given during, and couldn't hold my babies during all this time. I was admitted for 2 nights, and having to ring a buzzer every time I wanted help to lift my babies was awful. Not being able to do anything for myself with them did really hinder me in the early days, and I too had round the clock help when I got home.

I started running again 8 weeks post section, and it was a long and painful road to get there.

I still have nerve damage between my belly button and my scar. my scar is still sensitive, itchy, and generally bothersome. I also had a hematoma that took over a month to go away. I would never enter into an ELCS lightly.

@HappyGirl86

Hi OP, it does sound like you have made your decision and that the c section feels like an easier option for you but just wanted to share my experience. I'm not trying to sway you either way! I had an emergency c section 5 years ago and a planned c section 17 months ago. The emergency one was a horrible traumatic experience and I was left with PTSD. I requested a planned c section second time around purely because I did not want to risk an emergency c section which might trigger my PTSD which I have worked so hard to recover from. I hear a lot of women say their planned c section was a wonderful experience. Sadly I don't agree. Ok, it was calmer, I wasn't worried if my baby was still breathing, and the staff were amazing BUT it is still surgery and I feel VERY out of control during c sections. Both times my blood pressure has gone very low (which is common) and it's made me shake and shake so badly I couldn't even hold my baby when she was brought towards me. The shaking goes on for a couple of hours afterwards. I've got quite a few friends who had the same. I did not like the sensation of the surgeons in my numb stomach, in fact just the thought of it now makes me feel quite anxious. I found recovery from the planned c section much harder but I accept that might be as it was my second one and that I was probably slightly more active this time as I had a 4 year old too. I'd love to meet all these women who say they felt no pain after a few days.....because I was in a lot of pain. Ive got a few friends who had c sections and all of them were in a lot of pain. Both times I have been left with a numb stomach and the first time I had nerve sensations down my legs for over a year. My friend's womb was accidentally torn during her first c section and she could then only have c sections. They say she is still a higher risk of needing a hysterectomy as a result. She also had to have a lot of scar tissue removed from the side of her bladder - all due to having had a c section. I have found it frustrating both times that I can't easily get down on the floor and change nappies etc and I do think this affects your initial bonding. The first time around I struggled to even breastfeed due to the pain. I obviously can't talk for vaginal births but I wish I had had the opportunity to try one, I guess that's just life but if the circumstances had been different I would have taken the chance to have a quicker recovery, no matter how small.

Really sorry you had such a hard time, especially after your EMCS. I agree with various points you raise - I also want to avoid an EMCS and given that the thing I want least is an instrumental VB an EMCS would be the only other option if a VB went pear shaped.

You mention not being in control during a c section and this is my primary concern. I felt horribly out of control during and after my last birth, mainly because my baby was so premature and needed immediate resuscitation that didn’t leave time even for a brief touch. The main selling point for a VB is that if things go well you get to have your child when it’s born without much interference. I do wonder whether a section will make me feel angry and upset about not being able to hold my baby for a while.

I’m aware of section side effects such as violent shaking - which sadly is also not uncommon after VB - and the tugging and pulling and loss of feeling. I think these are all more preferable to me than vaginal injury though.

My consultant has an excellent reputation for both VB and ELCS, but you just don’t know in advance how things will play out - and even less so, I feel, with a VB.

@danidandan

Thereeeee it was. Can't you reply to anybody who doesn't give you the answer you're looking for, without being rude, can you?

You clearly haven't done any research really, as you said in an earlier post a CS is 10-20 minutes! Maybe you should take note of the people trying to help you!

I'm not watching this thread now, I think you're really, really rude.

So no response to any of my questions then. Just baseless accusation that I’m rude. I wonder what you’re doing in this thread? You’re rude and your contributions are pointless.

I really really wanted to avoid an instrumental birth too, which is why I opted for no epidural.

I'm no expert, but i would say that during labour my pain was in my lower abdomen and back, rather than genital area. Also afterwards, things felt swollen and uncomfortable rather than acutely painful, only really painful going to the toilet for a week or so until the tears had healed. But my tears were only minor, so perhaps I'm not best placed to comment!

Just wanted to highlight that actually of everything that ached and hurt after labour, the genital area wasn't too bad

You do you OP but it is a totally valid choice.

I had a CS because I did not want the risk of anal incontinence from birth. I have multiple risk factors for this, and IBD so it really would be a problem if any damage there. I'm glad I did it.

[quote Twizbe]@Dexter77 you've not really responded to any of us who told you about straight forward vaginal births with no injuries or complications.

I'm really sorry about your first baby and what happened. It must have been a horrible experience to go through.

As others have mentioned though, your body has now done birth once. It knows what to do and there's no indication that a second birth would cause any lasting damage.

If it helps, my second baby was heavier than my first and she was an easy water birth. Both mine were over 9lbs as well [/quote]
Sorry I can’t respond to everyone, there are nearly 300 posts on this thread now, but I have responded to several people above who said they had straight forward VBs without significant pain or injury afterwards.

It’s always encouraging to read this is possible, though I have to say I’m increasingly inclined not to believe such stories entirely, as much as I would like to.
This thread alone has shown once more how many VB evangelists there are, who are prepared to say anything to convince you not to opt for a section.

I’m sure some women are lucky and breathe their babies out with barely a scratch, but statistically 90% or so of first time VBs end in injury and while some people claim their tears didn’t hurt, I’m also taking that with a pinch of salt these days. I suspect I would indeed be in pain if I had a tear and/or cut and/or various grazes, or worse.

Good to hear you had a good water birth, sounds great.

Ah ok… I’m not going to bother replying again now you’ve accused me of lying about my straightforward vagina births with quick recoveries.
Good luck with whatever you decide OP.

@Oodlesofdoodlescockapoodles

I'm no expert, but i would say that during labour my pain was in my lower abdomen and back, rather than genital area. Also afterwards, things felt swollen and uncomfortable rather than acutely painful, only really painful going to the toilet for a week or so until the tears had healed. But my tears were only minor, so perhaps I'm not best placed to comment!

Just wanted to highlight that actually of everything that ached and hurt after labour, the genital area wasn't too bad

Thanks for sharing, I’m aware some women experience labour and the aftermath in this way. I find it painful to have an internal scan and haven’t been able to have speculum examinations for years as I find them too painful, so I don’t think I’d find childbirth nor painful in the genital area, although you never know I guess!

@ThePoisonousMushroom

Ah ok… I’m not going to bother replying again now you’ve accused me of lying about my straightforward vagina births with quick recoveries. Good luck with whatever you decide OP.

Umm, I haven’t?

but statistically 90% or so of first time VBs end in injury
Well, 100% of CS births end in injury.