Elective C-section or VBAC - don 't know what to do

[S18z]

I am due to give birth this summer to my second child. My first experience of childbirth (8 years ago) was extremely traumatic, involving 36 hours of labour, attempted forceps which failed and eventually an emergency c-section.

I now have to decide whether I want to try for a VBAC or opt for elective c-section and I don't know what to do.

I feel extremely anxious and emotional about the prospect of labour and have not yet had an ante-natal appointment where I have not burst out in tears. The anxiety is so bad that I feel no excitement at all around pregnancy or birth, just fear. The consultant I have seen has been very unhelpful and is pushing for a VBAC because "it is unlikely that the same thing would happen to me again"

I know this topic is much discussed but I see that most women considering a VBAC feel strongly about wanting to experience a natural birth, I don't at all. I experience contractions the first time and hated them. I did not deal well with the pain at all, progressed slowly and found the whole experience traumatising. (which is in contrast to how I went into that labour - I wanted a natural birth, I felt confident that my body would know what to do. I didn't prepare much or read lots, I just felt like I would 'go with the flow').
The reason I am considering VBAC is because of the recovery of a c-section. I am worried about how long it will take to recover, I have another child to think of and my partner will have to go abroad 2 weeks after my due date so I will be on my own probably.
I am also worried about the overhang that lots of women get after a c-section. I did not have that the first time but I know there's no guarantee that you won't get that the second time. I really don't want that. I know that sounds superficial but I think we should be allowed to care about these things.
The reason I am considering elective c-section is because that would take all my anxiety about birth away, I would feel more in control and know what to expect. But I also know how awful you feel after one and how long it takes to recover.
I would love to hear from people who have had an elective c-section after an emergency one, was recovery quicker? could you leave the hospital quicker.
The other issue I have is that I do not feel safe in the healthcare system here at all. There was so much malpractice that lead to the disaster of my first birth experience and so little care and support. I felt neglected and like my life didn't mean anything to the healthcare professionals around me. I know that if I go for VBAC there is a chance I will need less medical support and care and if things go well that I could just manage it on my own with a midwife.... but then I think based on my last experience, that's a very unrealistic perspective.

Any advice much appreciated.

[Vsirbdo]

I had an elective after an emergency one and the experience was worlds away; my elective one was a very positive experience and the recovery was certainly easier. In part because I knew what to expect so I prepared things at home as well as myself mentally. Plus because you aren’t going into it exhausted after starting a natural labour the recovery feels very different.
i do understand your worries about an overhang; its your body and there’s nothing wrong with worrying about something that has an impact on it. I don’t have an overhang but my scar now (2 years later) is slightly more visible than it was 2 years after my first DD which I think is unsurprising and not to an extent that bothers me and is hidden by a bikini

[rhubarbcrumbl]

Same emergency was scary then elective recovery from the section was easy I went home the next day

[LegoLady95]

I have had an emergency section, followed by a VBAC less than 2 years later, then an elective section 4 years after that.

For me, the VBAC healed a lot of psychological wounds after an awful first birth. I was under a consultant, went to a different hospital and the experience was great. Needed ventouse but otherwise no complications.

However if your anxiety is so bad then I think you should go for the elective section. Having had an emergency and an elective section, the elective was a much better experience despite a few complications. I had two children aged 5 and 4 to look after while recovering, my husband didn't take any time off work and it was fine. Your older child is 8 so presumably you won't be lifting and carrying?

[TheGlitterati]

I had a similar birth to you and the same anxieties. I chose an elective and it was the most incredible experience.

[LegoLady95]

Also should add that when I had my elective section, my old C section scar was removed completely by the consultant, and he did a very neat job. Might have been lucky but it certainly wasn't worse after 2 sections, if anything it looked better after the second.

[allfurcoatnoknickers]

I've only had an ELCS since I had a breech baby, but the recovery was embarrassingly easy. I was up and walking within 24 hours and up and down stairs no problem once I got home. I was pottering around the neighborhood as normal within a week. I just made sure to keep on top of my pain killers and follow all the advice to the letter. If your older child is 8, the presumably you won't have to lift and carry them and they might be able to bring you the odd drink or snack?

I don't have an overhang/shelf and you can barely see the c-section scar - my stomach looks exactly like it did pre-baby, although it took a lot of Pilates to get there 😁.

[Inthesky42]

Sorry to hear about the trauma of your first birth.
I had an emergency c section followed by an elective c section only 19 months later.
The birth itself was much more relaxed and pain free. I actually loved knowing the date I was going to have my baby so I could arrange childcare for my first child and be fully prepared for the birth. The experience in theatre whilst still nerve wracking was very calm and straightforward and over very quickly!
Unfortunately for me I had a few complications with my c section which I think is worth highlighting as they are with considering.

• I didn't get to leave the hospital for 2 days as I had an issue passing urine after the surgery (fairly common due to them shoving your bladder out of the way to deliver the baby). I had to be re - catheterised which wasn't pleasant.
• on day 5 post surgery I had to be readmitted to hospital as I had bad swelling and extreme pain behind my scar. It turned out to be an infected haematoma. It was infected with a hospital acquired superbug which I picked up during the surgery. I was kept in hospital for 2 weeks whilst they tried to identify the bug and fight it with an antibiotic that worked. I was very sick and in lots of pain. I had my baby with me (EBF) but had to leave my toddler at home with dad. Who had to take unpaid time off work to care for him. It really was a very unpleasant experience but thankfully I am here to tell the tale.
• I now have the delightful c section overhang (didn't have one with my first) Which at 9 months pp is now getting a little better but my scar is hard and lumpy most probably due to the infection I had.

In your situation and based on what you've described though I think I'd still go for the ELCS, with an older child you won't need to do lifting and carrying and actually they can help fetch you things for baby etc. You should be fully mobile etc by the time your DH returns to work. The chance of you experiencing what I did are very low.

[tuliplover]

I had two sections, both were planned due to medical reasons though the first happened much sooner as my waters broke week 37.
Both times I stayed in hospital a few days, second one I lost a lot of blood and my child had to go to NICU, but that didn't really affect recovery time, and I was up and about on the second day and as soon as I got home was fine - visitors and out to a restaurant the next day.
In your shoes I'd opt for a section. Initially they wanted me to try for VBAC but changed their minds after 30 weeks. I was not at all keen and couldn't care two hoots about experiencing a 'natural' birth. A healthy baby and less trauma for me was the priority.

[SunThroughTheCloudsAt6am]

I went for VBAC, and ended up with another EMCS - which, had I actually had someone to talk through honestly (instead of the VBAC midwife who wanted to meet targets), I think I could have predicted.

They persuaded me that 'every birth is different' and it would probably be fine this time, when actually it went exactly the same way, albeit without being induced this time. I should have known that if you're on full whack with the drip, and you're still not dilating, and the baby still isn't descending, and the surgeon after says that the baby was wedged in, that it was likely something to do with my anatomy, and I should just skip to c-section. But I didn't. sigh.

[AnuSTart]

Elective CS! Goodness based on the above I would never consider a VBAC.
I've had 2 emergency sections and 3 electives. Apart from the first, all were fantastic. Sure the physical recovery is harder, but well worth the absence of emotional and potential physical trauma.

[onetiredmumma33]

I have recently had an elective section following an emergency one about 8 years ago so very similar. This time i did want a VBAC. I think got the 'experience' and to prove something to myself. Silly really.

The choice was taken out of my hands due to baby being transverse and other health conditions. An elective is so much different to an emergency. You can plan and prepare, they take more time, it's a lot calmer and obviously painless. My recovery has also been great, I was up the next day and pain was manageable with only paracetamol and ibuprofen. A week on I was out and about again.

So yes ELCS definitely has its advantages. This was my last baby and I do feel a bit sad that I never got to have a natural birth but that's my issue. What really matters is getting your baby here in a way that's safe for you both. There are no prizes for childbirth so just do what you think would be easier for you.

[tothemoonandbackbuses]

I booked an elcs for my second. I was adamant I was having another cs. I went into labour early and changed my mind and had a VBAC. Which was great. I have no regrets booking the cs

[WilliowGreen]

If I were you I would choose an elective caesarean. That way you would have some certainty of what is going to happen.

[MacaroniCheeseCat]

I have a similar history to you, in that I had an emergency section first time round after wanting a low-intervention vaginal delivery. That experience left me with birth trauma and flashbacks.

I was incredibly anxious second time round (pretty anxious first time round but it wasn’t picked up). Really couldn’t decide what to do. I was terrified of giving birth either way - didn’t want another section but couldn’t handle all the variables of a VBAC. Like you, I didn’t feel I got a balanced view from the hospital as to the likelihood of an uncomplicated VBAC - I got all the pros of a VBAC and all the downsides of a section.

In the end, I booked an ELCS for a week after my due date, with a view to seeing what happened if I went into labour. I didn’t (which in itself laid some ghosts to rest as I never went into labour first time round either) so I had the section.

It is hugely personal but what I will say is that I think it was easier to get the support I needed on the day in relation to my anxiety by having the section. If the staff are aware (and I made sure mine were, I also cried at every appointment), in my experience they will do what they can to make it a smooth and positive experience. I question how much of that would have been in their control if I’d turned up in labour.

As to your concerns: I have a very slight overhang. It’s more obvious at the moment as I’m carrying more weight. If you’re a healthy weight, it may not be as obvious and not everyone gets one.

If you know your partner has to travel two weeks after birth, can you plan ahead to pay for some support if you don’t have family who can help?

It’s a really personal decision but I felt safer having a planned section (I also did not feel safe when DC1 was born) and I felt it would be easier to recover from a planned section than from a complicated vaginal delivery (and the thing about vaginal deliveries is that you never know how straightforward they’re going to be in advance).

[Maxiedog123]

Like you I had a traumatic first birth with emergency Caesar , though for me due to my own I'll health, baby had to come out and I was too unwell for labour. Both of us had to go to ICU after, didn't hold my baby for days,all very traumatic.
With my second, consultant left it up to me, offered a VBAC , but all I wanted was a healthy baby and no ICU, didn't give a damn about any "birth experience". Elective Ceasar went very smoothly, I didn't have any difficulty looking after my older child when I got home. No regrets.

[dollface22]

I had an elective C-section first time & TTC right now so I when I do have my next one I will defo be going for a section again. It helped my anxiety massively. Yes recovery is hard but you know what to expect now.

[eternalopt]

If you're anxious and emotional about it, I'd ask for a c section. You can always change your mind, but it's harder to change your mind the other way.

I had an emergency section and and infection with first child. Second time around, I wasn't sure either, so was booked on for a section at 40+5 and decided to let Mother Nature decide before then. Went into Labour naturally at 38weeks. Decided to go for it (but still offered a section when I got to hospital if I wanted it as it was in my notes, so still had that option). Ended up with a bad tear, spinal anaesthetic for the repair and a 3 day stay in hospital anyway 🤦🏻‍♀️. Recovery from tear and emergency c section were about the same. Every other woman on my ward after second baby was there for an elective section - breezed in and out really calmly!!

[Amz6219]

6 months ago I had the exact same concerns and it took me a long time to decide, but like you I had no burning desire to have a ‘natural’ delivery, I just wanted the baby here healthily.

Eventually opted for ELCS and I would do it again tomorrow! Absolutely loved the experience and it healed a lot of the trauma from my emergency section. It was calm, relaxed and happy with an element of control.

Good luck whatever you decide! X

[DogsAndGin]

I don’t know why doctors say ‘it is unlikely’ that vaginal births go wrong in some way. It is so misleading

Only c.70% of ladies have a vaginal birth and of them 90% tear! 25% require forceps/episiotomy (so not natural at all) and c.30% have a c sec.

ELCS has only a 6% complication rate. Massively reduces risk of incontinence (22% for vaginal and 5% for ELCS). The risk of stillbirth is also reduced by ELCS.

I am not even contemplating a vaginal birth for my little one later this year, ELCS seems the more sensible choice to me.

Stats from:

www.ncbi.nlm.nih.gov/pmc/articles/PMC343856/

and

digital.nhs.uk/data-and-information/publications/statistical/maternity-services-monthly-statistics/may-2020

and

www.ouh.nhs.uk/patient-guide/leaflets/files/12101Ptear.pdf

[Pac35]

Why don't you book a caesarean for 40 weeks and try a VBAC if you labour spontaneously?

[18e6281o62]

Hi OP. Any chance of an update? I'm in the same predicament now and experiencing lots of anxiety deciding. Thanks.

[S18z]

Hi @18e6281o62 I had my baby by elective c-section 3 months ago. It was a very difficult decision and I kept going back and forth. In the end I decided that I would struggle emotionally if it turned out to be another emergency c-section and I couldn't distance myself from the trauma of my first labour experience. The elective c-section was calm and I felt in control which I think was what I needed. I struggled a bit with how clinical it all felt and that there wasn't the 'magic' of a natural birth that I hear other people talk about. But, both baby and I were well, I was able to have skin to skin and feed him shortly after and all in all I think it was the right decision for me. I really understand the anxiety of making this decision and wish you all the best Sending love

[18e6281o62]

Thank you for replying. Really grateful to hear how it went. I know I would also struggle emotionally if it ended with another EMCS. All the best with your baby Xx

[eternalopt]

It's a very personal decision, so I won't wade in with my full decision process - I had emergency c section and then a vbac. However, I made it clearly that I was a very cautious vbaccer !! I had an elective booked in for a week after my due date as I was dead against being induced. I went early and was given several chances in early labour to switch to a section if I wanted to. I discussed at length with the midwife that what I wanted was for her to err on the side of section if it looked like any intervention was needed. Worked quite well for me knowing it was still an option so might be something to discuss depending on what worries you

[eternalopt]

Sorry - just realised I'm replying to an old thread and you've already had the baby!! Congratulations- sounds like it went really well for you -