natural or c section?

[witchywoo]

Hi all, need some help and advice! Im 14 weeks pregnant and really worried about childbirth. I already have a 15 month old daughter and had a terrible labour with her. Waters broke early sunday morning, didnt go into active labour so induced. Took 26 hours to dilate but could only make it to 9 cm. Prepared for c section but not needed. Tore twice and ended up having 4th degree episiotomy, daughter born ventouse. To be honest i know many people have their own horror stories and half of the labour i cant really remember. Either drugged up or being sick!!! I found after the birth the hardest. Severe back trouble for two weeks from the epirdural, still cant talk about the pain downstairs. It took seven months for the episiotomy to finally heal. Couldnt walk more than 10 mins without pain, couldnt sit on the floor and as for sex.... it still hurts like hell now!!!!!!!! Im so scared of going through the pain again, would a c section be easier in the long run?

Firstly, I'm bias, so will always say plump for a vaginal birth!
Secondly, you may not be able to get a CS on the NHS, even if you had had a CS they could push for a VBAC, but having had a vaginal birth previously they'#ll probably expect you to go for another one this time.
Don't be too disheartened though, if you really cannot go through it again you may be able to persuade them.
Did you do anything to prepare for the birth last time? Often with intervention in births once it starts it can continue on like a waterfall effect so the reason you had such terrible tears etc could be to do with your induction.
Have you thought about maybe trying a doula for a vaginal birth?

Not the expert, but first I think you need to really work through your first birth. You need to emotionally get around it before you can focus on the second birth.

If you want to try for a vaginal birth you may want to hire a doula, or take a course like hypnobirthing (after two hypnobirthing babies I recommend it highly)

It sounds like the epidural may have done you in. If you don't want to use more natural methods of pain relief, you should look into a spinal. A friend was recently told that since she had bad after affects of the epidural than it was more likely to happen again and a spinal was a better alternative. She had two c-section but either way, you should ask about it.

Congratulations on your pregnancy!

whats a doula? Can you give more info about the hypnobirthing? thanks

A doula is someone who will be with you during labor (and of course you've established some form of relationship prior). Her role is to support you and your birth choices, but has no role in making medical decisions regarding your birth. Lulumama, Marslady, and Klaw and clarify more as they are all doulas.

I did Marie Mongan's hypnobirthing (Her book is "Hypnobirthing: the Mongan Method"). In a nutshell hypnobirthing is about getting yourself into a state or total relaxation. You really go into yourself. It's about relaxing and let your body do what it already knows how to do. I've had to babies and the first I don't really remember because I slept through it, and second for fast and furious so didn't go in as deep, but picked a spot on the ceiling and didn't let it out of my sight.

I hope this helps.

I'm with VictorianSqualor - I'm a big fan of VB, and managed a VBAC too. But I also agree that this is about talking through the first birth and finding some answers as to why you had such a bad experience. 26 hours to dilate isnt that unusual for a first birth, and if the labour is well managed then it needn't be horrendous. Did the epidural contribute to the episiotomy and ventouse? IME more of the mums I know who've ended up with instrumental births have had an epidural than not.
Hopefully Lulumama will be along soon - she gives excellent advice for people who've had traumatic births.

There are a few doulas on MN, lulumama is one, as is marslady. They support you throughout the birth and help you get what you want from your experience, often birth is a traumatic time for people because they lose the control, everything seems to end up buzzing around you without you having much say or input even though it's your body!

Lulumama actually deals with birth trauma in her life outside of MN so she would definitely be best to advise in that respect.
Sorry if it seems I'm pushing vaginal birth but there are risks with CS's and you may be refused one or go into labour before booked in anyway in which case you'll need to be emotionally prepared for a vaginal birth anyway, so I do think you need to get some closure on your first birth and along with that find out why the problems you had happened.

Thankfully you have plenty of time and are in the right place for advice so hopefully whichever method of birth you end up with it will be a satisfying experience.

I agree that it would be really helpful for you to talk through your first birth with a sympathetic midwife or doctor. Have you enquired about getting back your notes and having a 'debrief'? You are entitled to do this, and it might help you to decide what your course of action should be.

If your fear of another vaginal birth is extreme, you may well be able to argue for an elective c-section. However, I think it is almost always worth giving a vaginal birth a shot (I'm biased too, although have only had a c-section myself thus far!). Having the support of a doula may well help, not necessarily just at the birth, but also as someone to debrief with beforehand to help formulate a birth plan (which I think is very important for mothers who have had a traumatic first birth) and to generally act as a support and advocate for you.

Good luck x

sorry for lack of punctuation!

Having had my baby by C-section in December, I would definately say if at all possible go for vaginal birth.
It's a major operation which is subject to complications like any other op.
I am still seeing the nurse 3 times a week to have my wound dressed as I contracted MRSA in the hospital and wound isn't healing. Still can't pick up baby, drive, push pushchair etc. It wasn't until I had experienced all this that I found out that it is relatively common (especially the MRSA worryingly enough!)
I was induced and it ended up in C-section after 43 hours.
My thought process is that I will try for vaginal birth next time (if I'm allowed) and focus on having a getting good support etc. Unless I go overdue at which point I'll have an elective as the statistics for vaginal birth after inductions aren't brilliant.

Hope this helps. xx

Starwberrymum, just have to say quickly, they cannot not 'allow' you to have a VBAC. I was told with DS(DC2) that I couldnt have a VBAC, so had an elective, my cons this time round is not too happy with me refusing a CS because of other added complications but has said herself they cannot stop me.
Just something to bear in mind for next time.

witchy, if you want to email me either CAT me or drop me a line on mail @ mothering instincts.com

no gaps !

really importnat you debrief your birth experience, you will then be in a better place to make choices about your birth preferences this time

or you can have a look at www.doula.org.uk

www.nurturingbirth.co.uk

www.birthtraumaassociation.org.uk

www.sheilakitzinger.com/BirthCrisis.htm

for more info re doulas and birth trauma if you want to be more 'anonymous' x

As everyone else seems to be saying to go for VB can I be a lone voice for C.section?

C.section won't necessarily be easier than a VB for you, I had one and had complications too, but at least it won't be a rehash of your past experiences. In general C.section is probably more predictable than VB and this in it's self may be better for you.

I do think that you need to speak to someone about your previous birth experience and also discuss with an obstetrician your risks of further pelvic floor trauma and damage after another VB.

Gosh, I'm very sorry to hear about your awful first-time birth. You are very brave having another baby and very best wishes for the pregnancy. I had a brilliant C-section last year, it doesn't have to be horrid at all if you explain your fears and are insistent about your wishes. Good luck with it all

Witchywoo - I am sorry to hear you had such a terrible time, but it does sound like you were poorly managed by people who should have been helping you. Did you feel in control of the labour, or did you feel at the 'mercy' of the hosp staff?
I'm a first timer preparing for birth in June and I feel there is not enough info out there for women about how to minimise their pain naturally and give birth with a minimum of necessary intervention.
My SIL is a case in point - first time around she was on her back for most of the dilation stage - so no help from gravity meant it took forever.
Her contractions slowed during transition (going from almost fully dilated to body prepared to start pushing) so, rather than allow this natural part of the process (which can take a couple of minutes to three hours...) she ended up with intervention - episiotomy and ventouse, and wasn't treated with respect (eg - said she didn't want to see the placenta - it was placed in a dish by her head!).
The second time around she'd read this book and felt better informed and more in control. She stayed active and upright throughout the first stage, and thanks to all that extra gravity (and it being her second no doubt) had a mega speedy transition. Her son was literally minutes away from being born by the time she went into hospital and they were reluctant to admit her because she seemed too calm!
It sounds to me like you weren't given enough time to dilate and all the subsequent intervention did indeed 'cascade/ waterfall' (ie, where one thing leads to another).
You do sound like you need some counseling after the trauma of your last experience, but, rather than 'surrendering' to the will of the hosp and handing yourself over to a surgeon, you could consider trying to take more control of what happens to you this time. I hope that doesn't sound patronising - esp as I haven't even given birth to my first yet (!) but maybe if you feel better informed it will make you feel stronger and more in control of what happens.
If you want to read more about why a doula's a great idea, have a look here.

Thanks for all your help and advice. Im def going to request looking at my previous notes from first labour and asked to be debriefed on them. I never knew i could see them. You are right, i do need to talk about my last labour. I wasnt in control and felt i was always told what was going to happen instead of being asked. Things were never explained to me at the time which is why im so scared now. Lulumama, thanks for all the links. Will let you know how i get on. x x

I had an emergenc cs due to failed induction. My cs was a very positive experience at the time and TBH my recovery was very good. However, my cs left me with adhesions (Ashermans Syndrome) leaving me infertile - have had two ops recently to remove them, 5 years on and treatment just finishing, didn't know outcome yet) which is something I hadn't planed on. And the recovery is, I think, longer and more slow after a CS.

a 4th degree tear can mean your future faecal and/or urinary continence may be imperiled by future vaginal delivery.

really you need to speak with a consultant and discuss what your particular risks are.

many who suffer 4th degree tears are offered elective CS second time round in order to avoid this possibility, but you really need to speak with a consultant about it.

Have only read OP.

But if I was in the position to have to seriously consider this, I think I would opt for a C-section.

I would think I'd done my bit in the way of vaginal delivery!

Best of luck with whatever you decide

Talk to someone. I had a horrible first delivery and was left absolutely terrified of a repeat performance. Fortunately I had a fantastic midwife and doctor who took lots of time talking everything through with me. I was told an elective CS was possible, which actually lifted a huge weight off, and I was able to make a more reasoned judgement (for me). In the end I had a vaginal delivery with no complications beyond a small tear. But as expat says, a 4th degree tear is a big issue. Speak to someone now. Don't let it fester.

I had a similar experience with my first labour, bad tear and episiotomy, crooked stitches, heavy blood loss, infected stitches, could still feel the effects a year later, if not two.

The second time round I didn't ask for a caesarian (didn't know you could tbh) but ended up having an emergency section due to ds's heartrate dropping- and it was a breeze. I know you're supposed to feel deprived if you haven't done a vaginal labour, but I didn't miss it one little bit.

IME you get more help and sympathy at the hospital if the damage has been done by men in green coats, the scar is easier to keep clean, and you can go to the toilet without agony. And the surgeon is unlikely to make such a mess stitching you as a sleepy midwife after a long delivery.

Of course it is a major operation and you have to be careful about lifting etc afterwards - but if you've already survived a bad tear, that's hardly going to come as a big shock.

I would first ask to be debriefed, and then ask to discuss a selective caesarian.

witchywoo - your experience is so familiar to me! I had a very bad experience last time and I am still suffering the effects of a large episiotomy (pain during sex, aching scar during period etc). I am now pregnant again and am very worried about labour and delivery.

I have decided that I'm going to get as many opinions and as much help as possible. Have you seen a consultant about your painful scarring? I have already arranged with the GP that as soon as I'm "safely" pregnant that I will go back for the consultant to examine my scar to see if it will cope with vaginal delivery. I also had my GP refer me for (free) counselling for post-traumatic stress disorder when DD was about 6 months old. I think I need to go back to the counsellor to talk through my feelings again. Then I'll have practical and emotional support to make the right decision for me.

Good luck with whatever you decide. Just wanted to let you know that you're not alone in going through a rough time being pregnant after a traumatic delivery.

Hi, I felt like I had to post a comment as I have gone through a similar experience. I too had a 4th degree tear (they just let me tear rather than an episiotomy) and it took a very long time to heal. As a result of it my muscles have been damaged and I now have bladder and bowel problems. Like you I was induced but I don't feel that that was the problem with me, it was having a large baby and pushing to fast and hard. I am now pregnant again and will probably be offered a C-Section when I see the consultant (as hinted at by the Midwife). I do feel that I cannot risk further tearing to make my bowel even worse and become incontenent, but at the same time I would love to have a natural delivery again. I just wanted to say you are not alone and you still have plenty of time to think about it - talk to as many people as possible but just do what feel right for you.

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yes, with 4th degree tears there is the added potential for bowel problems later, so it's best to speak with a consultant but i've not heard of a woman who's had a 4th degree treat not being offered an elective csection.