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 gave birth in a pool and healed in a week or so. I was cycling after three weeks without a second though.
I do acknowledge I was very fortunate. I didn’t need heavy duty drugs or a catheter and never felt “injured” just a bit swollen.

Yes my EMCS was easier than my ELCS - my baby was in an awkward position so they had to do an extra incision in my uterus, then DD needed some help to get breathing properly (all fine but scary compared to DD1 who was screaming before she was fully born) and i had a hemorhage. I had a minor scar infection after my first which was easily treated with antiobiotics (although I was bfing and DD was very unsettled that week which I think was related), but a friend ended up needing a skin graft her infection got so bad, the saga went on for months. Then a friend of a friend got sepsis and ended up in ICU.

Look, I'm not trying to scaremonger here OP, search my name and you'll find umteen posts extolling the virtues of the c section, I'm absolutely a convert. But you do seem a little bit in denial as to what it involves, the risks and the recovery.

@MIndyStClaire glad to hear you had such a good experience, but just for the record I have watched 2 ELCSs family members had, looking over the curtain the entire time, I think I know quite well what they entail and a skilled surgeon will indeed just make a very small cut under 10cm, then stretch the rest.

As said previously I don’t believe an ELCS doesn’t entail any pain, ofc it does, but pain that, according to the testimony of many, appears often much easier to endure than vaginal birth trauma.

I have permanent nerve pain and numbness in my tummy after CS. Just something to be aware of.

@museumum that obviously sounds like a dream :)

2 x VB's and no pain after birth to speak of other than slight stinging when going to the toilet. Second birth had a second degree tear with stitches and some grazing and that didn't hurt either.

I'm 100% with you, OP. I wanted to avoid the long term birth injuries that are unfortunately so common and accepted in the general population. I did a lot of research of pros and cons, statistics etc, and in the end chose the ELCS.
It was a fantastic experience with a very smooth recovery. I would hands down choose another for subsequent pregnancies.
Also, I did not tell anyone that it was an ELCS, because people can be judgemental about them and it's really irrelevant whether they agreed with my decision or not.

You can't compare emergency CS with planned.

All my children have been planned CS. I would have another like it tomorrow. My scar is virtually invisible, and if I'm going to have stitches, I know where I'd rather have them.

Recommended to my bf whose just had her first DC and she can't believe how straight forward it was either.

Day 2 when you stand up for the first time, you panic that you've been cut in half (the dressing they put on is huge) and shuffle about like the hunchback of Notre dame. Day 3, you're upright, but still shuffly. Day 4 you're confidently upright and little steps, and it then rapidly improves. Day 10 after DTwins I walked into town and back. Probably shouldn't have, but I did.

I know people have different experiences, that was mine. Hope it all goes well, whatever you decide.

I had a VB with an episiotomy, forceps and a second degree tear with an epidural from about 6cm.

I felt nothing after I had my epidural in, even when pushing I had to be told by my midwife as I couldn't feel the contraction (you judge whether this is a good or bad thing). All I felt was pressure.

My tear was stitched by a consultant due to being in theatre for my forceps delivery and was only a slight discomfort. I didn't even have the awful poo that everyone moans about, it was no problem for me at all! The discomfort completely fell off the radar in about 5-6 days and was easily managed with mild painkillers beforehand.

The only ongoing issue I have from having my daughter is actually the piles that arrived while I was pregnant! No longlasting effects from childbirth at all (and I had the dreaded drip- which I also didn't think was that bad).

I think you're underestimating CS's a little..

It's not a 10 minute surgery. Closer to 45 minutes to an hour without complications. Yes the actual birth is relatively painless, but recovery was pretty tough. Can't lift / drive for 6 weeks, and I totally agree with PP who said sex was painful after CS. Trying to lift a baby with a big wound hurts like hell. I'm not for a second saying you're assuming this, buts it's not an easy way out.

I found going to the loo, mostly peeing really painful and my vagina was sore for weeks and weeks. The catheter wrecked havoc with my bladder and everything was so sore 'down there.'

I also found the after pains / contractions absolutely awful, I had pethidine to help me, but I do have lots of abdo issues anyway so I guess you don't need to count that.

The birth itself was a breeze, but its major surgery. If I had a choice to do it again, I would attempt a VBAC for the recovery. But CS for the birth itself was amazing.

Tough one.

@mummyh2016 haha no I’m not treating an ELCS “like a spa treatment”, what a ludicrous thing to say.
I just know it comes with much more certainty than a VB and I’m simply not prepared to be fobbed off after sustaining vaginal birth trauma and potentially having pain for ages in my body’s most sensitive area.

And btw yes I am going private, for exactly the same reasons, not willing to accept that “I’m not guaranteed an epidural” and similar misogynist nonsense.

I've had a c section and a vb. section was classed as unplanned, which is what most are, in that it wasn't an elective section but also wasn't a rushed emergency either. I would choose a vb any day. I was in hospital for 5 days after my section in an immense amount of pain. I was given morphine when on the recovery ward and then was only allowed paracetamol and ibuprofen which didn't touch the pain. It took a good 3-4 weeks before I was able to properly get up and about. I also experienced vaginal pain after. Those early days and weeks with my DD were severely impacted by my recovery and what should have been a lovely bonding time with my new baby was just spent exhausted and in pain. My vb recovery was a breeze in comparison, even with an episiotomy. I was straight up and about and within 3 days the discomfort had almost gone. I opted not to have an epidural as they can slow labour and have an increased risk of needed an assisted delivery. If you decide to have a vb then check out all your options with pain relief as there are plenty of options which carry less risk of needing interventions, which means less pain after birth

https://www.rcog.org.uk/en/patients/patient-leaflets/choosing-to-have-a-caesarean-section/

This is a great link, you may have come across it already, apologies if you have. It outlines the risks for both you and baby if you're considering an elcs without medical need for it. There are some major risks to consider, such as baby having a higher chance of needing assistance to breath and needing to be on the neonatal unit.

Good luck with whatever you decide

I've had 2 c sections. The first was a preterm emcs and apart from permanent nerve damage meaning I have no feeling in my stomach, I recovered very well.
My second was born via preterm elcs. That was rough, 2 hours in theater due to low uterine tone (not known till surgery) lots of chest pain and shakes. After I had an infection and 14 months on I still have pain in my scar and back.

C sections were the safest option for me but they aren't easy and even with really good pain relief I was still in a lot of pain for weeks

@Marelle sorry to hear that, yes am aware having nerve damage and loss of feeling in abdomen is a risk of sections, may I ask whether you had an ELCS or EMCS?

You might not want to hear this, but here goes.
I had a vb and a 3rd degree tear (luckily no forceps). Going to the toilet and sitting down very painful for the first week but then recovered pretty quickly, no lasting damage. Sex painful first few times only.
However, had I had any issues there would have been no support, I feel. I was meant to have a consultant review how things were healing, but despite me calling the hospital and chasing up none was ever scheduled. I just left it as I was feeling fine.
Had a ELcs two months ago on consultants rec as tears are worse second time round apprently. Baby ended up in intensive care due to respiratory distress as a direct result of CS. He's fine now but I don't think I'll ever get over the guilt of having made that choice, my well-being over his. Due to me running back and forth between home and hospital for those two weeks and not resting, my stitches opened up and are still not fully closed now.
It sounds like you have a psychological issue with vb, so that will be a factor, but CS is not without its risks.

@Alfxn oh great to hear your ELCS went so well, I totally agree, the fact that birth injuries seem to be “accepted” as fact by so many in the population is a major reason why I’m so turned off by this route. I find it unbelievable when people shrug before saying it took them 6 months to recover from a VB and that this was “completely fine” etc. It’s not fine!

And re judgmental comments fir having an ELCS - I don’t care what people think about that. It’s a right to choose as per NICE guidance and I’m going private anyway so couldn’t care less what ppl think about ELCS :)

Being physically fit is important for any birth and recovery, or any surgery for that matter. Sitting up without the use of my abdominal muscles was much easier this time with strong glutes, thighs and a strong core. I was able to move myself to a wheelchair 5 hours after birth to go see the baby in NICU, and was in the shower and up and down the stairs to see her by 9am the following morning, much faster recovery than my previous ones. 3 weeks out now I've been walking 3-6km several times a week and feel great.

A CS is not a 10-20 minute surgery. It’s around 1 - 1.5 hours.

After my CS I could barely walk. The nerve damage afterwards resulted in burning pain if anything touched my skin. I wouldn’t take it lightly.

CS pain and a long recovery is a given. Vagina injury is not.

From your posts, it sounds like you will opt for a ELCS and I do think it's the right decision for you.

I hope you realise that most things child related can't be controlled into what you do and don't find acceptable. If that's how you cope it will be sorely tested.

My ELCS was fine. A painful morning after the morphine wore off but no difficulty otherwise. Yes, you are more tender than someone who has been lucky enough to have an easy VBAC but I agree that it's a lot more known and controllable than indiscriminate tearing.

I had a straightforward VB & a ECLS, would always choose a straightforward VB over it personally.

I had a few stitches with my VB but zero discomfort. My CS was good but I was still quite surprised to be discharged the next day & only given paracetamol. I was sore for a good few days & the first few were awful. Very vain but I don't like having a scar although no numbness.

My pelvic floor is weaker after dc2 despite CS so pregnancy alone does do damage.

i also hated the feeling of the epidural & the catheter as I didn't have for my VB.

My point??? That c/s is major surgery!!!

@ThedaBara thanks for sharing your experience, I’m sorry you baby ended up needed special care after the birth, that must have been very frightening.

But you never know about these things - statistically VB is more dangerous for babies than ELCS. My youngest brother nearly died in VB due to oxygen deprivation, my mother to this day regrets not having requested a section…

What I would say is ignore the "I did 5 miles 2 days after my CS". Even if you feel fine & can manage it, take the time to heal & let your body heal on the inside, long term that's better for you.

Hmm ... I had second degree with my first (needed stitches) and third degree with my second (needed surgery the day after0. All healed up fine. Recovering much quicker than a CX wound would have been.

I know some women do have terrible birth injuries and that care can e very poor - but I am not sure that it is the norm.

I would never choose an CS over VB if I had a choice. I realise some women don't have the choice and that a CS is the right option in some cases.