Page 5 | Is my logic correct in ELCS vs. vaginal birth?

EvelynSalt · 2023-01-04T19:38:20+00:00

I'm due to give birth this year and whereas I've just always assumed I'd go for a vaginal birth, I'm leaning towards ELCS. I'd love your opinions on whether my logic is sound or flawed, as I'm really struggling to know what the right decision is. With such chaos and backlogs in the NHS at the moment, staff shortages, increasing COVID rates etc. my thinking is that ELCS would be a safer option as it's more medicalised than natural birth. Normally I wouldn't necessarily feel that's a positive, but I'm really scared of having a complication through a vaginal birth which then isn't treated properly afterwards. I haven't had great experience with OBGYN here in that a lot seems to be brushed under the carpet as "just one of those things women have to deal with". If you've had good experiences with after care from tearing, incontinence etc please correct me...I'm so confused at the moment!

NameChange30 · 05/01/2023 12:51

RidingMyBike · 05/01/2023 10:32

Emily Oster's books are excellent re weighing up the evidence and how good the research is, as well as what it actually shows. She doesn't tell you what to do, just sets out what the research shows.

But bear in mind she's not in the U.K. so different hospital environments etc

I rate Milli Hill. The Positive Birth Book and Give Birth Like a Feminist.

Kennykenkencat · 05/01/2023 18:08

FoxtrotSkarloey · 05/01/2023 09:49

Also once the anaesthetic has worn off and catheter is out wouldn’t you be able to get everything you need.
All be it very very slowly.

Hahahahahahahahahahahahaha. If only it were so easy.

The catheter typically stays in for at least the first night. I spent 18 hours after my first section sitting in a pool of blood. After the surgery they had shoved a maternity towel between my legs but without pants to keep it in place, they might as well not have bothered. Even after the anaesthetic had worn off and I could move my legs, I was in so much abdominal pain I couldn't move apart from to reach my arms out to reach a water bottle. It took about a week before I could even turn over in bed or sit up without having to use both hands and arms to push myself up (no core strength as it had just been cut through of course). I had to position myself and someone else had to pass me the baby every time he needed a feed.

Second time around was slightly better because I knew what I was in for and I asked to get up and go to the bathroom once the anaesthetic had worn off (catheter in tow, but I wanted to freshen up) and it also gave them a chance to change the bed sheets.

Overall it was 'fine' and overall I don't have a prolapse, but I do have a tummy overhang. However, don't underestimate how bloody hard those first days are, and you can't even prioritise yourself and your recovery because you have a baby to deal with.

A c section is not to be chosen lightly.

Obviously different hospitals do things differently. My catheter was out later on the same day. I was able to manoeuvre myself with the help of the bed controls and arm strength
i certainly wasn’t in any pain. I didn’t have pain killers for either CS.
i know the nurses were a bit amazed about that but there again I have no feeling in that area even now.

After Ds was born I was wandering around the shops and we had a few friends over.

I was back driving both times in under 2 weeks.

Compared to one of my friends who tore so badly and had many years of issues from the birth injury I will take a CS over a VB any day.

Allsnotwell · 05/01/2023 18:19

I had a ELCS first and hated that I was in pain, couldn’t drive and my legs swelled up, that first pop was awful! TMI! I didn’t like watching them lift the baby out and felt ignored whilst they dealt with stitches and cleaning the baby who was removed straight away to be weighed and cleaned. They then took the baby to be bathed and put into clothes (DH was there, I could hear the baby screaming, and felt helpless! I could only wait til they returned her)
Then had VB with twins which I had to fight for! Luckily the midwives were supportive, there we two sets of staff for each baby, and midwife sat next to me all the way through and I was much more involved and encouraged during the birth. They were in and out to check on me all the time whilst awaiting. I get like she wasn’t mine - and had to really push myself to connect with her - not everyone’s experience I know.
I could bathe and dress both shortly after and we were well liked after. DH held the first one, whilst waiting for the second and cut both cords.
I was up showered and had breakfast on the ward and could get up to answer the phone (no mobiles)

Much nicer experience.

Allsnotwell · 05/01/2023 18:19

Another thing - when you get to 9 months you really don’t care how they come out, you’re so tired, huge, uncomfortable and just want them evicted by any means necessary!

Babyboomtastic · 05/01/2023 19:23

Allsnotwell · 05/01/2023 18:19

I had a ELCS first and hated that I was in pain, couldn’t drive and my legs swelled up, that first pop was awful! TMI! I didn’t like watching them lift the baby out and felt ignored whilst they dealt with stitches and cleaning the baby who was removed straight away to be weighed and cleaned. They then took the baby to be bathed and put into clothes (DH was there, I could hear the baby screaming, and felt helpless! I could only wait til they returned her)
Then had VB with twins which I had to fight for! Luckily the midwives were supportive, there we two sets of staff for each baby, and midwife sat next to me all the way through and I was much more involved and encouraged during the birth. They were in and out to check on me all the time whilst awaiting. I get like she wasn’t mine - and had to really push myself to connect with her - not everyone’s experience I know.
I could bathe and dress both shortly after and we were well liked after. DH held the first one, whilst waiting for the second and cut both cords.
I was up showered and had breakfast on the ward and could get up to answer the phone (no mobiles)

Much nicer experience.

If that was before mobiles, then I can assure you that things have very much changed now, to make a c section 'experience' better and more nurturing.

My husband was able to cut the cord shorter (surgeon did the initial cut I guess), and I had skin to skin contact in theatre within a minute or two. Baby stayed on me whilst they stitched, amd I bf in recovery. Only after about an hour after birth, and after that first feed, was it suggested they weigh her. She was on me and covered with a blanket, but no nappy even for most of that, and then not clothes for a little while.

Isthisexpected · 05/01/2023 19:41

Another thing - when you get to 9 months you really don’t care how they come out, you’re so tired, huge, uncomfortable and just want them evicted by any means necessary!

^ not my experience. I very much cared. I was also someone who didn't feel my dignity going out the window was a necessary part of delivery.

RidingMyBike · 05/01/2023 21:08

Whereas I found a 'standard vaginal delivery' really didn't help with bonding at all! - DD was born and put straight onto my chest, then BF immediately and we did skin to skin for about an hour before she was cleaned up a bit and weighed. I hated it and just wanted a break. I wanted someone else to hold her and she was also rather gross as covered in my blood which I could smell!

Skinnermarink · 06/01/2023 09:48

Allsnotwell · 05/01/2023 18:19

Another thing - when you get to 9 months you really don’t care how they come out, you’re so tired, huge, uncomfortable and just want them evicted by any means necessary!

Nope. Definitely still very much cared about the exit strategy!

Nannyfannybanny · 25/02/2023 16:03

First booked for elective CS...left lateral breach. Went into labour while I'm hospital with high BP. Ended up with an emergency CS, it was horrible,I aspirated, catheter, IV,. 10 days in hospital. Didn't see my DD for 48 hours. When they brought her along, she could have been anyone's. Post op recovery was awful. This was 1970. I had to fight tooth and nail for a VB. My youngest DD, a tiny 7st,size 4. popped her 3 out,no sutures,no tears,3 hours and home. So in our cases,age and size had no bearing. I've had to have various abdominal surgery since,and the GA makes me vomit dreadfully.

iloveburmese3 · 25/02/2023 20:45

OP, an elected C section with the right doctor in the right hospital is the dream. Recovery doesn't have to be hard. If the surgeon is an expert you won't have nicks to the bladder or infections on your scar. It's the safest way to give birth and in some countries natural birth is now the weaker link. I totally admire anyone who has a baby naturally - I really am in awe of it. I'm a very nervous patient who needed to know when the baby was born and exactly what will happen. A top doctor can more or less tell you step by step. I've had one C section and my next one is in 4 weeks. After my first I was walking 3 hours after my baby was laid on my chest and hiking up a mountain 5 weeks later. Don't stress it they're wonderful!

WTF475878237NC · 25/02/2023 22:52

OP, an elected C section with the right doctor in the right hospital is the dream.

^ a physiological birth where baby releases prostaglandins when he or she is ready for birth is the baby's dream, not being yanked out on your random timeline because you need to feel in control.

RidingMyBike · 27/02/2023 09:41

WTF475878237NC · 25/02/2023 22:52

OP, an elected C section with the right doctor in the right hospital is the dream.

^ a physiological birth where baby releases prostaglandins when he or she is ready for birth is the baby's dream, not being yanked out on your random timeline because you need to feel in control.

Considering the risks of vaginal birth and the numbers that died during birth before CS became safe I don't imagine this would really be the baby's dream at all. What an odd thing to say.

I imagine my baby would have much preferred to be 'yanked out' via a CS than end up with shoulder dystocia and an E-coli infection thanks to a vaginal birth.

DeoForty · 27/02/2023 09:59

WTF475878237NC · 25/02/2023 22:52

OP, an elected C section with the right doctor in the right hospital is the dream.

^ a physiological birth where baby releases prostaglandins when he or she is ready for birth is the baby's dream, not being yanked out on your random timeline because you need to feel in control.

Compares to a vaginal delivery, a C section is statistically safer for babies. Less safe for mothers during the procedure, but has better long term outcomes for complications. Or so my midwifery text book tells me...

DeoForty · 27/02/2023 10:05

And as someone who 'gave it a go' for three days, before requesting a CS, I honestly felt I'd won the lottery when I climbed onto the operating table.

I also had to have GAs with both my births, which are known to mean a tougher recovery (no residual pain relief), and I'd take it every time over an augmented labour.

A CS is more 'guaranteed'. You aren't going to have an easy breezy birth in a pool, but you aren't also going to be forced through the seven stages of hell. It's a measured decision. You sacrifice one outcome but you do also gain a bit more certainty.

Mum1976Mum · 27/02/2023 10:14

Whichever option you choose it will be shit unless you can afford a private birth. I had an epidural as labour was 2 days and baby was well and truly stuck. I was left longer than I should have been and, to be honest, it’s a wonder we both survived - it was at Shrewsbury Hospital and we all now know what happened to lots of mothers and babies there!

After I had given birth I was left in a side room with no help for hours. My epidural didn’t wear off very well so I couldn’t move to get my baby who was vomiting up black gunk. When someone did come after about 8 hours they basically told me I was lying about not being able to feel my one leg and wrote in my notes that ‘mother doesn’t want to look after baby’. I was very vulnerable as a first time mum who had already lost 10 babies. There was no care and compassion. I left as soon as I could. What I went through traumatised me for life and I imagine it’s worse now as this was 11 years ago.

Babyboomtastic · 27/02/2023 10:44

Mum1976Mum · 27/02/2023 10:14

Whichever option you choose it will be shit unless you can afford a private birth. I had an epidural as labour was 2 days and baby was well and truly stuck. I was left longer than I should have been and, to be honest, it’s a wonder we both survived - it was at Shrewsbury Hospital and we all now know what happened to lots of mothers and babies there!

After I had given birth I was left in a side room with no help for hours. My epidural didn’t wear off very well so I couldn’t move to get my baby who was vomiting up black gunk. When someone did come after about 8 hours they basically told me I was lying about not being able to feel my one leg and wrote in my notes that ‘mother doesn’t want to look after baby’. I was very vulnerable as a first time mum who had already lost 10 babies. There was no care and compassion. I left as soon as I could. What I went through traumatised me for life and I imagine it’s worse now as this was 11 years ago.

I'm sorry you had such an awful experience. It sounds horrific :-(

That being said, it's not an inevitably that birth is shit. Things do sometimes go to plan and postnatal wards arent always hell.

I had two very very good birth experiences (ELCS's) with great after care. It's certainly possible.

Mum1976Mum · 27/02/2023 10:51

Possible maybe. Usual….nope!

WoolyMammoth55 · 27/02/2023 11:18

"Whichever option you choose it will be shit unless you can afford a private birth."

I just had to disagree strongly with this. My 2 births were NHS, one natural/vaginal birth and one ELCS. ELCS was a dream, including all staff and aftercare. Vaginal birth was in water at a MW-led unit attached to hospital, it wasn't perfect and I felt unsupported but I was never left alone, nor was I or baby ever in danger.

Since the London private maternity hospitals all rush their complex/escalating cases to the NHS emergency unit at UCLH, I doubt that private has loads going for it over NHS care.

WoolyMammoth55 · 27/02/2023 11:21

@Mum1976Mum if you're struggling with PTSD please do check if you can self-refer for EMDR therapy on the NHS. It's clinically proven and you can where I am.

I know quite a few friends and family who it has really helped, no flashbacks now and much better quality of life. Wish you all the best, and sorry for what you've been through.

Kennykenkencat · 27/02/2023 12:45

WTF475878237NC · 25/02/2023 22:52

OP, an elected C section with the right doctor in the right hospital is the dream.

^ a physiological birth where baby releases prostaglandins when he or she is ready for birth is the baby's dream, not being yanked out on your random timeline because you need to feel in control.

Dd needed to be “yanked out” as she was already weeks overdue and despite my waters breaking which I think was more to do with her dancing around in me I think she would still be in there to this day.

Ds was also “yanked out” at my convenience which turned out did save his life.
Another 24 hours and they said it would have been a different outcome.

So being yanked out was better than waiting round.

Also it was found I had a tilted pelvis so would never be able to give birth without intervention.

I am all for elcs. Myself and my children wouldn’t be here without them

Kennykenkencat · 27/02/2023 12:51

Allsnotwell
I had a ELCS first and hated that I was in pain, couldn’t drive and my legs swelled up, that first pop was awful! TMI! I didn’t like watching them lift the baby out

How did you see anything. Didn’t you have the big blue sheet up so you couldn’t see.

I can’t compare a CS to a vaginal birth but I was out of hospital after 48 hours and I was driving 10 days later.

LaurelGrove · 27/02/2023 12:58

C section - issues afterwards with my ureter as it got slightly damaged during surgery, infection in my c-section wound requiring antibiotics and three GP consultations, enormous problems walking, picking up DD and doing anything useful for several weeks.

VBAC - walked out that afternoon, felt fine a day or two later.

Anecdata but I'd be looking for as little medical intervention as possible given the state of the NHS. I was lucky that my c-section predated these issues and my GP was willing to come to the house (incredible, looking back in it). If it was an option and I was pregnant now I'd seriously be considering a homebirth if it was a low risk pregnancy.