ELCS or vaginal birth after traumatic first labour?

[feliznavidad2]

Hi all,

Pregnant with no. 2 and was adamant until now that I would have an ELCS if we ever had anymore children.

Now the time has come to think about it, it doesn't feel such a clear cut decision. I know I'll have a consultant with an obstetrician at some point but just wondered if any others had similar experiences and what they'd chosen to do for consequent births?

Trigger warning

DS who was born five years ago was following induction (for obstetric cholestasis) and took days to go into labour. I ended up having my waters broken after 3 days of no real progress with the pessaries/gel. The labour went ok, albeit was v heightened v quickly due to drip and I had an epidural around 4cm. DS was born at 8pm after waters broken around 10am, his heart rate started dropping at the end and his head wasn't in an ideal position so we went to theatre where they used forceps and ventouse to try and get him out, I had an episiotomy and he came out with the cord around his neck and wasn't breathing properly, he recovered quickly though. I lost around 1.5L of blood and needed two blood transfusions. Subsequently DS struggled to feed, and my milk supply was poor, he was also found to be anaemic.

The midwife suggested that an ELCS would be fine if that's what I wanted this time given our experiences before but having had a read around, it appears there is a slightly increased risk of PPH with c-section. I'll obviously be guided by the professionals but just wondered if any others had experienced similar and what they'd chosen to do?

No pph for me 2nd time with c section.
Very very good, calm, controlled and safe experience for me.

I had a traumatic first birth - I won’t go into all the details but I was left with a complex third degree tear which didn’t heal properly and needed follow up surgery.

My gynaecologist advised after my first birth that I have a section for any subsequent babies. When it came to it, like you, I found it a more difficult decision than I anticipated. I kept reading about the risks of a c-section (including PPH, and the risk of needing a hysterectomy) and freaking myself out.

Long story short, I had an ELCS on Monday and it has been, by comparison, blissful. I lost a fraction of the amount of blood that I lost during and after my vaginal birth. The recovery has been straightforward so far - the first couple of nights were tricky but it’s now day 6 and I’m very mobile - went for a gentle walk for an hour this morning. Last time I was struggling to get from my bed to the toilet on day 6. The trauma led to major MH problems as well.

There are risks either way and I think you have to try and weigh up the relative risks, and also try to work out from your consultant whether you are at greater risk because of your history. In my case a second VB carried serious risks to me - I could be facing long term double incontinence if I tore again in that way. And the chances of that happening were not low. In your case I would want to understand from the consultant whether a) a previous PPH after a VB puts you at greater risk of excessive bleeding during/after a c section and b) if you attempt another VB, what’s the risk of another PPH.

Best of luck