First baby - caesarean or natural delivery

[12Doves]

Hi,

I’m 39 weeks pregnant and so overwhelmed about giving birth.

I was hoping to go into labour naturally, and have a planned caesarean if that didn’t happen. But at a recent growth scan baby is measuring big (8lb 6oz at 38+3). The obstetrician said they would offer me induction or a planned caesarean at 40 weeks instead of 41 weeks due to baby’s size.

A caesarean is currently booked for 39+4 but I don’t know whether to try and postpone it until 40 or maybe even 41 weeks. I know growth scans can be unreliable but I was born weighing 9lb 5oz so it’s feasible this baby is on the bigger side too.

Other issues in mind, I have a health problem that means I tire easily, so stamina in labour will be difficult. Midwife has suggested an early epidural but if I have a natural labour I’d like to keep active and mobile to try and avoid interventions. I’m a survivor of assault and the thought of strangers rushing in with forceps is really difficult for me, as is lying on a bed unable to move while people do intimate procedures. I’d like to avoid VEs as much as possible.

I also have endometriosis so avoiding abdominal surgeries is better, where possible. I’ve read that c-sections reduce fertility and I needed IVF to conceive this baby so keen to avoid more issues there too.

Does anyone have any thoughts or advice? I just don’t know what to do for the best.

Thank you.

Hi OP. Do you mind if I ask how old you are and your BMI?

@Cuppasoupmonster Of course. I’m early 30s and BMI is now 28 as unfortunately have gained about 3 stone in pregnancy! BMI was 22 at booking in appt with midwife.

Honestly, I don’t give scans much credit when it comes to determining the weight. DC2 was predicted 5lbs at term and came overdue at 40+6 at 7lbs 6oz.

I did have a lovely home water birth with DC3 who weighed in at 9lbs 6oz, and I’m only petite. No tears or issues from the birth.

I fully understand not wanting to be on a bed and feel unable to move. That was sadly what happened with my DC4 when I got induced.

Have you asked/been offered a sweep to see if they can kick start things naturally first?

Please know that you absolutely don't have to accept an induction.

I've had an emergency section and I'd choose a section over induction. I'm 31 weeks with number 2 and have already told my consultant that I wouldn't be induced.

With induction, midwives tend to recommend having an epidural very early on due to the fact that it can go from 0-100 quite quickly, rather building up naturally as it would with spontaneous labour.

Growth scans are also notoriously unreliable and also, I believe it's 80% of first time mums that go overdue so whilst you may go into natural labour at any moment, the odds are never stacked in the favour of ladies on their first child!

If I were in your situation, I'd choose an elective section personally where things will be calm and organised. The more interventions you have (and a sweep is an intervention) the more likely you are to have birthing complications and there's nothing to say you may not need an emergency section regardless. Out of my NCT group, 3/5 of us had emergency sections!

Good luck with whatever you decide! Baby will be in your arms before you know it!!

Are you being offered a sweep first? I’d probably be pushing for a sweep and waiting a little longer. However I’d always opt for a natural birth rather than a C-section. C sections have always frightened me slightly.

whatever you decide your beautiful baby will be here soon ❤️

Hi OP I really think your best chance of a nice straightforward birth is to just go with the flow and listen to your body, baby will come when they are ready at the size that they are and your body will most likely do a great job of birthing baby naturally if you just let it get on with it.

Have you done any courses or reading about preparing for labour? I found understanding what my body was doing at each stage really useful and re-assuring.

I have a breathing condition and nerve damage to my upper body, I was a bit worried about what would happen in labour, mainly whether I would be able to breathe 😂 but no my body did a fab job, your body really does just do what it needs to do if you give yourself the time and space.

I didn’t have any vaginal examinations during labour, I birthed baby in a birthing pool and I scooped him out of the water myself. It was all very hands off. The pool was great for protecting my space.

Growth scans are notoriously incorrect. And even if yours was correct, your baby isn't big, just slightly above average. I've birthed a few 8.5-9.6lb babies in a pool, and it was such a straightforward experience. Painful, but quick, and excellent recovery.

There seems to be a lot of intervention which is often unnecessary. Inductions for a FTM can be longer and more painful, and lead to a section. A c-section in your case shouldn't be necessary unless the baby is breech. You can of course request one.

But really ask yourself why you wouldn't wait until the standard 10/12 days post due date for an induction. Your body knows the right time.

Thank you for all of your replies.

I don’t think induction would be the right choice for me, the need for examinations and an epidural for the pain isn’t going to put me in a good place mentally.

I was feeling confident about the birth until the baby’s weight was brought up as an issue. The consultant recommended not going far beyond 4kg estimated weight for the best chance of a ‘successful’ vaginal delivery. Until then, I was hoping to wait until at least 41 weeks before intervening. Maybe I still should be. Argh.

Finding this such a difficult choice.

@PinkPlantCase Did you come up against much pressure when refusing VEs? The pool sounds like a good way to keep personal space.

Thank you @Chanel05 and @Nancy155 for the reminder that come what may, baby will be here soon. I’ve sort of lost sight of that with the worry about birth.

Hi OP, I wasn’t under any pressure to have VE’s, but I did birth at home in an area with a designated home birth team where the midwives were used to people no wanting them so it was quite normal for the midwives who cared for me.

But there’s no reason why you can’t decline them in a hospital or birth centre if you go into labour spontaneously.

I found in hospital where the midwives are used to being allowed to do VEs I was all very impressed and happy initially as they would ask permission for every one, but as I started to get further into labour and more irritable/wanted to be left alone I found they would come up to me, ask "Is it OK if I examine you?" and if I said no they would just stand there expectantly until another couple of contractions had passed and then say "Is it OK now?" until I just agreed out of annoyance.

They do leave you alone when in the pool, it's a weird thing.

I had an appointment yesterday. We’d been told that the date of the caesarean could be altered but actually when we got there, the hospital said they were fully booked and couldn’t postpone. I’d like to have pushed it back to somewhere between 40-41 weeks.

I said I’d like to avoid a caesarean but had been warned about baby’s size. They offered a sweep which I’d always been dead set against having, but with the caesarean date looming, felt like I needed to do something to get labour going naturally. I’m 39 weeks and cervix is 2-3cms dilated. Posterior but soft. Bishop score of 4-5. Midwife couldn’t do the sweep itself due to position of cervix.

Just really want to go in to labour before Tuesday now! Don’t feel excited about meeting baby, just dread about how the birth is going to pan out.

Thank you @PinkPlantCase and @BertieBotts that’s really good to know. Forewarned is good - I’ll reiterate to my DP to not let them pester me if I’m beyond talking for myself.

Sounds like labour is imminent! Let us know how you get on!

My second DC arrived via an ELCS due to predicted size. Most people I talked to said growth scans were always off. As it was my DC’s growth scan was accurate and they arrived at 39+4 weighing in 10lbs! I’m very glad I went for the ELCS over induction. However it is very important you do what feels right for you. I was adamant I wasn’t going to be induced and this was very much respected. My first DC was also on the larger side at 9lb but this was at 41 weeks and I needed an episiotomy and forceps. I don’t have any lasting damage from it though.
In your position I would be inclined to go for an ELCS based on the info you’ve given. I think you will feel a lot more in control and whilst it is major abdominal surgery and you very much need to allow time to recover I will admit it felt a lot less invasive than a vaginal birth.

Thank you @MummyJ36 I think my scans could be accurate too, I was 9lb 5oz. Feeling a bit calmer about the ELCS now, the way you describe it as being less invasive is probably going to be the option that leaves me feeling well mentally.

I think I’ve started to lose the plug this morning so will see if anything progresses, but the ELCS on Tuesday seems less scary if there’s no change before then.

Is LO here yet @12Doves?

How are you OP?

She’s here!

Lost my waters on Sunday night, then ended up with a PROM situation when labour didn’t really kick off. Into MLBU on Monday night, swiftly moved to delivery suite. In so much pain that I ended up with an epidural which I had major worries about beforehand, but in the moment was just desperate for the pain to stop.

Had 3 hours of pushing before going to theatre. Failed suction cup to turn baby who was facing to the side, finally ending in an EMCS. There is some irony that she was born by EMCS on the date of the booked ELCS! I could have taken the planned section in the morning, but I guess I always would have wondered if I could have had a natural delivery. A little sad that I had a long labour and got to 10cm but didn’t manage to get her out by myself in the end.

We had to stay in due to infection and temp worries but home now. She’s perfect - have never felt anything like it and am just in awe of her. We waited a long time for her and she is more than I could ever have dreamt for.

Congratulations OP, sorry you had a rough do, but great that you're both doing well!

Fantastic OP! Sorry you had a rough labour , did they do an episiotomy for the suction cup? If so, I found adding a chamomile teabag and few drops of lavender oil to a bath to make a huge difference in speeding up healing. Congratulations 🎉

Oh OP well done. It sounds like you had a bit of a rough ride but you’re out the other side now and you have a gorgeous little girl! How are you feeling? Remember to look after yourself and give yourself a huge credit for getting through such a challenging labour. You’re a warrior! Treat yourself super kindly, take all the help, have a glass of wine (if you want!) and breathe a sigh of relief that it’s over. And enjoy the baby snuggles!!

After my two births I reasoned that if my DD ever had a baby herself I’d be able to give her lots of good advice now that I’d been through it and experienced all the contractions, interventions and also a c-section. In years and years to come you may be able to support your DD in a similar way if she finds herself in a similar position and that is totally invaluable.

Congratulations! What a tough labour you had, but wonderful news on your healthy baby girl. Well done!

Was she as big as they predicted?

Congratulations!!!

So glad that she's her and more wonderful than you'd hoped.

Sounds like you've had a bit of a tough birth but done brilliantly. Now just remember to accept every single offer of help

Thank you all for the lovely messages.

That’s a really helpful perspective @MummyJ36 so thank you for posting, it’s a more positive way of reflecting on what happened than feeling the labour was all in vain. Hopefully the experience can be put to good use, even if it’s just supporting others close to me.

Hey! I fell pregnant at 18. Gave birth at 18 on the 21.06.22, was due 14.06.22. I had 2 sweeps, the first i had on the 16.06.22 I was only about 1cm dialAted, she stretched me to two. I had another sweep scheduled for the following Monday, 20.06.22. The on the 19th june I started to feel slight cramps, on & off but nothing too drastic. Monday can, I had my second sweep and she said I hadn't dialAted much at all and that as the baby moved further into my pelvis, he pushed my cervix back up so she had to pull it back down and stretch me again. I had this done around 12pm. I fell asleep around 2ish and woke up around 4pm & that was when I really started to feel stronger, more regular cramps. I breathed through my Labour at home until the contractions were getting lasting 50 secs etc. got down hospital at 11.30pm/12.30am. They examined me and to mine & my partners surprise, I was already 7cm dialAted! I managed to have a water birth, completely natural vaginal birth with no pain relief (but that just what I wanted to do) I'd been practicing hypnobirthing meditation & breathing techniques and I promise you, it helps. The more calmer your body is, the more your birth will progress. My son was born at 3.26am. I did tear & had stitches but I honestly had the best first birth experience ever. The water birth was amazing, my midwife's were great! I had to stay overnight though because he wouldn't latch on but it was sorted & I was discharged the next day. I live in Wales, Swansea and my friends told me that their experience on Labour ward was awful, so I opted for birth centre and it was amazing! Congratulations by the way!