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 have said, which is a fact, that a planned CS rules out a horrible VB plus nasty aftermath, which is what I want to avoid at all costs.

So you will have a CS then?

@KevinTheKoala

The c-section didn't have any influence on bonding for me, although I was able to hold my baby immediately after the vaginal birth whereas I had some complications after the c-section so didn't hold her myself for an hour afterwards (I did get to see her though). I did have PND after both deliveries however both were traumatic and so that is a consideration for ELCS, personally I think if I were to get pregnant again I would be considering it to avoid another traumatic experience - it's actually the pain that would put me off more. It really is such a personal choice though and so many pros and cons to both.

I see. That’s a really valuable point, I also worry about PND because of pain. Thanks for sharing, really sorry you had to have traumatic deliveries. It’s such a tough business isn’t it.

So I may not be the norm, had a horrific labour, back to back and stop start for 72 hours. I had a second degree test, was disappointed when I asked the midwife how many stitches and she said one long one, we don’t count them anymore. It was quite a long tear but healed nicely. The medicine dispenser couldn’t believe that I didn’t need any pain relief the morning after I gave birth after reading my chart. Had a poo fine the next day too.

I’m sure you’ve done your research but I’d definitely recommend reading the information from the RCOG.

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

Honestly it's part of the reason I'm having a elcs this time after an emergency with my 1st. I don't want any after pain in that area. I don't want a potential forceps or assisted delivery or increased risk of prolapse or etc

I didn’t really have any vaginal pain after my first birth, and I had an episiotomy/ventouse delivery. Just kept on top of the paracetamol/ibuprofen and it was fine.

I’ve had a vaginal delivery and an ELCS and the section was definitely better , I spent less time in hospital and less time recovering from the birth . I was driving 10 days after my section and out and about doing most things .

If you are choosing based on which method will be easiest to recover from, I wouldn't recommend a CS. At first I couldn't even walk to the loo, couldn't laugh or lift anything without extreme pain. Recovery was months and you're left with not just the scar but also a strange ridge which affects the look of your stomach. Obviously everyone is different, but CS is pretty brutal.

It does not bother me that you are considering to forego the pains and risks of a VB. It does bother me that you are not considering to forego the pains and risks of a CS.

"CS pain and a long recovery is a given."

No one told my body that...
Seriously, I was googling 'when do c sections start to hurt', when in hospital.

2 easy recoveries. In the end they weren't entirely pain free, but much more so than i could have anticipated.

The surgery itself was so pain free that I even videoed my husband's first cuddle on my phone. I had skin to skin cuddles within 3 minutes of birth, breastfeeding within the first 30 minutes, and bonding was great - I think made easier by me not being in pain or exhausted.

There was pain but it was limited to:

• trapped gas pain
• birth after pains, which you get regardless of the method of delivery
• some pain getting up and down for the first 48 hours. The first time I got up, it was quite bad, by the 20th barely noticeable.
• mild bruising with my second. This just felt like I'd overdone a workout, was only present occasionally and not bad enough for painkillers

With my second, i got a mild burning occasionally, for a few days, across my scar line, but it just felt like I'd hugged a bag of chips for too long rather than pain.

I was back to doing basic chores, shopping, sitting on the floor to do nappies, walks, meeting friends within 3 days.

I’m sure vaginal trauma alone would be different after birthing a term baby vaginally?

I don't actually know if this is true tbh. I think position helps.

3rd degree tear with I have no idea how many stitches. Mild discomfort eased by para and ibuprofen for 3 to 5 days. I was repaired by a surgeon though as I was theatre to have my baby so don't know if their skill helps. I was dreading it but it was no where near as bad in real life as my head had imagined

I breastfed straight after my CS so that was no bother.

Hmm. Curious. My baby weighed 600g when it was born, I didn’t feel any pain. I’m sure vaginal trauma alone would be different after birthing a term baby vaginally?

Not for her. She said in some ways the bigger babies were easier to birth as obviously gravity plays a part. She was ‘lucky’ in that she had easy labours and no tears/stitches though. As was I!

I had an 8lb4oz baby via VB. I had 2nd degree internal and external tears, and had a surgical removal of the placenta which had retained. No vaginal pain that I can particularly recall; ‘tender’ is the word I’d use, but not for long at all.

If I had another it’d 100% be via ELCS, but that was because I had a precipitate labour and no time for pain relief. Likely to happen again (ditto the placenta issue), not willing to do either again!

Good luck x

I almost didn't reply to this because it seems like you've made up your mind and aren't really listening to anybody... but here goes anyway...

A few months ago I was equally as arrogant as you in regards to having an ELCS. Having already had my first naturally I wanted a "calm" and planned section, I had read all the stats and the anecdotal reports of women who had easy peasy operations and perfect recoveries.

Search my name for my thread on what actually happened to me if you want the details, but frankly it was an utter disaster. Over three weeks for anything close to what could be classed as a recovery, the pain was horrific and I have a very high pin threshold. My first vaginal birth I was out and about the next day on cloud 9, this time I felt borderline suicidal with the shock of what happened to me and the pain I was in.

Everyone has the right to choose, but I can say from experience you NEED to be prepared for it to go wrong and be horrible and to be at peace with that way before your surgery. I didn't listen to anything negative as I thought it was so rare and would never happen to me, and frankly it made the whole thing so much worse, I just wasn't prepared.

@EgonSpengler2020

Do you realise that a CS is major abdominal surgery?

Really?! Who knew?!

It's also very routine and a complete lifesaver for some women. I hate it when people pull these stupid scare tactics.

@ThunderSocks

I recently had to make the decision between vb or elcs having previously had 1 emcs and 1 vbac. Despite having experience of both (neither of which were especially bad pain wise), I found it incredibly difficult to weigh up the pros and cons given all the unknowns, particularly in the outcomes of vaginal birth. Similar to you op, I was more worried about the consequences of birth injury from a vb than pain in labour. While the vbac I had was practically textbook in how straightforward it was (only gas and air, discharged home after a few hours), I felt quite disturbed by it. I found being stitched up afterwards particularly horrific as the local anaesthetic was insufficient (was only a 2nd degree tear), and it was definitely made worse by the fact I was being stitched in such an intimate area. It also didn't heal well and I've been left with a small extra flap of skin. Having said that, I don't know of anyone else who's had such a bad experience with stitching and I was offered the option to go to theatre which I turned down (I'm scared of hospitals and wanted to be able to go home asap).

I don't remember having a lot of pain during the recovery from vb, but I do remember being very aware of the damage that had been done, which I was quite upset about. After the emcs I needed to take a lot of painkillers and found walking/getting out of bed etc difficult, but was surprised at how quick my recovery was - I'd been expecting a lot worse.

In the end for my most recent delivery - after much agonising - I opted for an elcs. I definitely made the right choice, as it couldn't have been more straightforward. Even though I felt I'd had a good recovery from the emcs, it was nowhere near as good as the recovery from elcs. I was discharged within 24 hours and managed to walk up the 3 flights of stairs when I got home without too much bother. I took painkillers for the first week or so, nothing after that. 5 weeks on I have a bit of numbness, but otherwise I'm absolutely fine.

Obviously this is only my experience of emcs/elcs/vb, and unfortunately no one can predict how things will go for you. I just wanted to post as I can relate to the idea of experiencing pain in my stomach vs vagina differently (if that makes sense!). As a previous poster mentioned, it's worth talking your concerns over with your midwife. Hope all goes well whatever you decide.

Thanks so much for sharing @ThunderSocks, that is very helpful. Ofc everybody’s experience is different in the end but as you said it looks as if our concerns are/were very similar.

My midwife isn’t really the person to discuss this all with tbh as there’s no continuity of care, but I’ll be switching to a private consultant at 30 weeks and will discuss these concerns and the pros and cons through this lens.

It's a bit weird to be going on and on about how "acceptable" you find the pain? 🤷🏻‍♀️

Anyway I was left infertile after my c section that's pretty "unacceptable" - I'd have rather have a reputed the pain of a vaginal birth

@PaddleBoardingMomma

I almost didn't reply to this because it seems like you've made up your mind and aren't really listening to anybody... but here goes anyway...

A few months ago I was equally as arrogant as you in regards to having an ELCS. Having already had my first naturally I wanted a "calm" and planned section, I had read all the stats and the anecdotal reports of women who had easy peasy operations and perfect recoveries.

Search my name for my thread on what actually happened to me if you want the details, but frankly it was an utter disaster. Over three weeks for anything close to what could be classed as a recovery, the pain was horrific and I have a very high pin threshold. My first vaginal birth I was out and about the next day on cloud 9, this time I felt borderline suicidal with the shock of what happened to me and the pain I was in.

Everyone has the right to choose, but I can say from experience you NEED to be prepared for it to go wrong and be horrible and to be at peace with that way before your surgery. I didn't listen to anything negative as I thought it was so rare and would never happen to me, and frankly it made the whole thing so much worse, I just wasn't prepared.

Excuse me? What makes you think I’m “not listening to anybody”? There’s literally NOTHING “arrogant” about my pondering an ELCS, you sound like a really unpleasant person.

Sorry you had a shit time, but what exactly are you trying to tell me? You had a bad time and therefore all other people thinking about an ELCS are “arrogant” for wanting to entertain the idea?

If you had actually read my posts, I am prepared for the risks of a c section, but I’m not prepared to accept certain risks of a VB. This is a perfectly valid stance. Have a good day.

I had my first baby by elective c-section 5 weeks ago as I had vasa praevia and my consultant considered it to be too risky to give birth vaginally. Honestly, I was petrified about the surgery but it was fine. One of the doctors I spoke to said it is generally the safest option to give birth but it’s not routinely offered due to lack of funds in the NHS. I was quite fit before going in to surgery and was “up and about” technically a couple of days after but very much in a shuffling kind of way. Normal 5 minute walks would involved multiple sit downs even a couple of weeks after surgery due to burning pain around my scar. Other thing I didn’t realise was how painful it would be to go for a wee. Bought me to tears a few times, again probably for at least 2 weeks. Having said that I now feel completely fine and normal. I’ve not done anything more strenuous than walking the dog and picking up the baby mind but I feel great. Interesting to hear about the 10cm scar up thread. Measured mine today and it’s 17cm long but in a sort of smiley face shape so it may end up being a little bigger than you were expecting.
My baby ended up in NICU for a little while and he was also my first so I didn’t have to look after other kids while I recovered but I can imagine the recovery would have been a lot tougher if I had other children to look after as well.

@ThePoisonousMushroom

Hmm. Curious. My baby weighed 600g when it was born, I didn’t feel any pain. I’m sure vaginal trauma alone would be different after birthing a term baby vaginally?

Not for her. She said in some ways the bigger babies were easier to birth as obviously gravity plays a part. She was ‘lucky’ in that she had easy labours and no tears/stitches though. As was I!

Very interesting! I birthed my tiny baby in an upright sitting position and gravity seemed to help there too.

I’ve heard from one mother who had a VB with a very preterm baby who found it excruciating too, but apparently they told her later it was because she had a full bladder the baby was pushing against because they didn’t have time to put in a catheter and she couldn’t relieve herself due to retention.

I am prepared for the risks of a c section, but I’m not prepared to accept certain risks of a VB.

What are the certain risks of a VB?

[quote Dexter77]**@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![/quote]
I know lots of people say this but with my ELSC I still lost nearly two litres of blood, I had to have a balloon inserted to stop the blood and I was in hospital for 5 days on iron transfusions and my milk didn't come in. I was in a lot of pain after personally.

Exactly the same here! Vbac with epidural much quicker and less painful recovery than emcs, in every part of my body!

@Dexter77 I don’t think she found her preemie birth excruciating, more that she was lucky that her full term babies were easy to birth too!