Please help me decide

[OverdueFirstTimeMama]

Hi everyone I am looking for some advice please as feels as though every medical professional just tells me to seriously consider my options. Apologies that this is a long post.

my DS is 3 and was born vaginally at 42 weeks after being induced. I had to have internal and external stitches, my labia re-tore so that is now split in 2 on one side and my placenta would not deliver so I had to go to surgery to have it manually removed.

although the above written down actually sounds a lot, I don’t think of my birth as traumatic.

fast forward to now I am 34 weeks with DS2 and I have a grade 2 bladder prolapse likely caused by weakened pelvic walls when tearing etc etc.
the pain some days of the prolapse when pregnant is awful. It just looks disgusting down there - huge, swollen, lumpy, can see the prolapse etc 😢 don’t get me started on the pain after sex.

I have been given the choice to decide if I want an elective section or have him vaginally. Please can anyone at all help me decide? The idea of a c section recovery is scary for me when I have a 3 year old but the idea of delivering vaginally and causing my prolapse to go to a stage 3 is equally as terrifying.

it seems as though no one medically can ‘force me’, it has to be my decision. Anyone been through anything similar or can anyone share their experience of ELCS after vaginal delivery?

thank you!

i’ve only ever had sections so can’t give a comparison (sorry!) but just to say sections aren’t as bad (in my experience) as you build yourself up to think. one was emergency and one was elective - the emergency one i found harder as i was nervous, but the elective was honestly so calm and overall a lovely birth experience. i recovered from one with a 2 year old and whilst it was obviously easier recovering from the first one, it was still fine (as long as you have support around you!)

I don't have experience of a difficult vaginal delivery, as my DS came via emergency c-section. What I would say though is, when I compare my experience to that of others who had a vaginal birth with stitches/use of intervention around the same time as my c-section, recovery time wasn't hugely different. I would say I was sore and walked funny for a week, then couldn't manage long distances (or carrying anything bigger than the baby) for another week. After that I felt pretty OK, though I didn't drive until 6 weeks. So with support, you might be similar in that I was "normal" after 2 weeks. I think the main difference for me (compared to them) was that they got discharged home quicker than I did- I was in for a week (not necessarily c-section related, mostly baby related) and that big was very hard as there wasn't anyone to hand me the baby etc (well, could buzz for a nurse but if the baby is crying you can't really wait till they get a moment) so I did get quite sore in that week from the overnights alone.

I only have experience of induction, episiotomy and forceps, not CS. I have worked in surgery for many years and assisted with around 50 C-Sections when on placement in obstetrics over 15yrs years ago.

I've always been put off CS knowing it's such a major abdominal surgery and having seen so many of them, however I'm even considering it now to avoid another induction, for fear of the pain of induction and potentially tearing or another episiotomy. Despite the fact my episiotomy healed well and went about as well as one could hope to be honest.

If I was in your position, I think I would probably go for the ELCS. It is major surgery, but I wouldn't want to make the prolapse worse and makes things worse in the long run. Someone I know feels they recovered quicker from their ELCS than they did from their vaginal delivery.

I'm sorry if you aren't getting appropriate support or guidance from the medical professionals. I know they can't 'force' you but have they advised you at all of which they think would be better medically?

I had a section and it was lovely so I’d go for that all the way!! Also recovery with an elective is much quicker than what it sounds like you went through. Since you’ve already ‘done’ vaginal I wouldn’t feel I was missing out if I were you either.

I was only in one night for my section

Thank you all for your replies, it means a lot.

@Cakeorchocolate no, not really. I have been seeing a physio and at the last appointment I felt as though she was trying to tell me to opt for ELCS because she said unless I can breathe him out and guarantee I won’t tear again then the prolapse won’t get worse. Midwife I feel is more pushing me to vaginal birth. But again, neither of them have openly said it. I am seeing a birthing options consultant next week so I am hoping they give me a genuine opinion.

In your case I’d have a c section. I had a minor prolapse after DC2 and had DC3 vaginally but… my prolapse didn’t worsen during that third pregnancy and I made it clear that if I needed to be induced I wanted a c section instead.

I’ve had a vaginal delivery and a planned section second time around due to 3rd degree tear first time, very fast labour, and being warned that although I recovered really well from the tear first time, I may not be so lucky next time.

I was sad to choose a section second time around and found it really scary. I found the recovery harder and feel like she was kind of taken from my body rather than ‘birthed’. I do realise this is totally ridiculous and is very emotional, not remotely rational. Of course I would never think it about anyone else, and I am above all else glad she arrived in my arms safely and that I am healthy so I can be a present and happy mum for my DC. I’m just sharing this to illustrate how conflicted I felt about the c section.

With all that said, given the consequences of vaginal birth you’ve described, if I were you I wouldn’t even consider a vaginal birth.

I hope whatever you choose you are both safe and healthy on the other side of it.

I think you are very brave to be even considering a vaginal birth!

Thank you everyone for all of your help xx

I thought it may be useful to update incase there are any other women in a similar situation in the future.

I saw a consultant towards the end of my pregnancy who recommended a vaginal birth. She said that the pressure of carrying the baby for 9 months means the prolapse damage is already done and pushing baby out would cause minimal additional damage. She described it as the weight of carrying the baby made the prolapse 85% and pushing would make it 87%.

she also said why put myself through two surgeries (c section and prolapse surgery) in such a short space of time when I will need the prolapse surgery anyway.

This really calmed my nerves and helped me to look at things in a different way. I had my little boy via vaginal birth last Monday and didn’t tear.
I am now 8 days PP and feeling well and doing my pelvic floor exercises throughout the day.

I will see a pelvic physio in a couple of weeks to assess next steps.

hope this can be helpful for anyone in the future :)

Amazing news. Well done and congratulations on your baby and your positive birth.