Vaginal or planned C section? (due to previous complications)

[BoyMummy90]

Hi everyone, sorry for the long post, but any advice would be greatly appreciated. 😊
I have a dilemma on what birth option I should have, vaginal or planned C section. I'm nearly 34 years old, mum of 1 and currently 31 weeks pregnant with my 2nd baby boy, high risk and consultant led.

Here's a bit of a back story...

1st labour 3 years ago was natural but very stressful. I went into labour after my waters broke early hours in bed. 8 days over due, it was extremly quick and painful. Went from being barely dilated, being told I couldn't push to being 10 cm in such a short space of time. My active labour was 1 hour 30 mins. I didn't feel heard, and being my 1st baby I didn't know any better. The contractions were so intense and I felt no relief or break. I wasn't able to get an epidural in time and gas n air just didn't work down to how fast I progressed. (This is what current midwives have told me.) My little ones heart rate was dropping so I had had to try and change position. After pushing a few times I was relieved to have my little boy in my arms but my placenta was now stuck. I had to be taken into theatre to recieve an epidural to get it removed manually. I had a mild haemorrhage and a small tear. All seemed fine and I was so grateful. After a few days in hospital, I came home with my healthy baby. A few days in and things didn't feel right down there. It felt swollen and with a bulge. I was eventually diagnosed with a grade 2 uterine prolapse.

I am now met with a choice with this pregnancy to either have a natural/vaginal birth but with the possiblity of my placenta being stuck again and my prolapse potentially worsening. I was told an epidural might not be an option again if I have a quick delivery again, as it takes time. I could eventually fix my prolapse with surgery if I decide my family is 'complete' after this preganncy or choose a planned c section to help stop further prolapse and have the option for future pregnancies.

There are pros and cons to both options. Vaginal delivery could still be quick and easier on my body's heal time but I am absolutely terrified due to what happend before. The CS could enable me to feel more calm, and in control but having 2 little ones at home after major surgery is daunting.

Does anyone have any advice or been through a similar experience, going on to have another baby? Vaginal birth or by C section, I would love to hear your stories.

Thank you so much for reading x

I had a traumatic labour with my first, she was back to back and the pain was unreal I was in labour for 28 hours in total, it ended in me having a 3rd degree tear and being in surgery for two hours straight after her birth. Thankfully I have had no lasting effects from it.
I really struggled with the decision between natural and section for my second but the possibility of it happening again and worse this time swayed it for me so I opted for the section. Honestly it was the best decision, it was actually a lovely experience and helped me to make peace with my traumatic first birth. I recovered so much quicker and was pretty much back to normal daily activities in a couple of weeks minus lifting and driving.
Obviously discuss with your midwife and consultant so you know the risks of both but I'd recommend an elective section to anyone.

@faithtrustandpixiedust Thank you so much for your reply. It means the world! I'm so sorry to hear you had a really tough first delivery. Your second journey is definitely reassuring and I'm glad you had a much more positive experience with the C-section. The fear of the unknown is so daunting, but I will definitely discuss with my midwife and consultant next week ☺️

I have only had a ELCS so maybe of no use....

But it was a super calm and nice experience.
I made sure I had good help for first fortnight and kept on top of pain meds. I had a fairly textbook recovery...

Ultimately you have to make the right choice for you...
I was happy for ELCS as we knew we wanted 1 or 2 max...

Hi there - I'm sending you so many sympathies. I have prolapse since my first birth 3 years ago so I know what and utter sack of shit it is. I thought hard about whether to go for CS for the second but to be honest it wasn't that difficult a decision to go for it. I did speak to a pelvic physio before making the decision, just to get their professional perspective, so maybe try that. A one-off consultation privately shouldn't be too crazy expensive and will get you to see someone quickly.

It sounds like your main concern is what the recovery will entail with either option. I can say that for me, the CS was wildly easier in terms of recovery than the vaginal birth. I felt pretty much back to myself within maybe a week or two. That didn't happen for.... well it hasn't happened even yet regarding the fallout from the first birth! But the major, major symptoms were there for months and were severely limiting in a way that I just did not experience with the CS. The first few days are really painful and limiting, yes. But they are only a few days. Just have a plan in place for someone else to do all the lifting of your older child for 6 weeks - that's the main challenge but it's fine. Happy to try and answer any more specific questions you might have!

I had a traumatic first birth vaginally and although I (eventually) recovered with no lasting issues I was told this was unusual for my degree of tear, so I opted for a section for my second baby.

Best decision ever. Much easier recovery and everything was calm, immediate skin to skin and no issues with anything.

I have only had an ELCS but can echo others that it was the most lovely, calm experience. I was very lucky that, although stiff and slow, I didn't actually feel "in pain" at all afterwards (in hindsight, I think I was so uncomfortable at the end of pregnancy, that comparatively, CS recovery didn't seem that bad!). I was back in jeans 2 weeks post section and felt totally normal by then.

I think your main considerations need to be the inability to drive for a few weeks, and having good help for the first few weeks, especially with another child to care for. If those aren't an issue, then go for it.

I've had two elective sections and can comment on the recovery with a toddler at home.

It is fine. You know when you are going for the section, it's in working hours, so that helps with childcare plans and explaining to your eldest. I'm guessing you already are stopping carrying/ lifting anyway with the bump, but you need to avoid this after the section. If DH is on pat leave for a few weeks then you'll be great. The recovery is hard for a few days and then the improvement is rapid. I found the pain was fine with over the counter pain killers but they also give codeine if needed. It's very straightforward surgery and will minimise unexpected vaginal birth effects. Nothing is risk free but it is quick and calm. From friends who have had both, many have said the recovery was easier with a section. It just depends what you think you can cope with best.

There's loads of advice on recovery and now to manage afterwards on here and from midwives. It's nothing to be scared about though.

I'm so so sorry last time was so tough for you all. Good luck!!

No traumatic births here, I had two elective c sections, only 18 months in between. I was able to be on my feet the next day after both c sections and carrying on as normal 2-3 days after. (With lots of help from the dihydrocodeine paracetamol and ibuprofen)

My second caesarean was easier recovery than my first. I do have the c section shelf on lower stomach but that can't be helped but is something to consider.

@GreatGateauxsby thank you for your reply and advice, it's really helpful. I'm so pleased to hear you had good experience having an ELCS.

You only get one body, you need to keep it in the best condition you can for the sake of your future quality of life. In your shoes, I'd take the CS option and prevent potentially more damage. I had an emergency CS for my first child and natural birth for the second. I'd have been quite happy if I'd needed a second CS.

Hi! It’s so hard isn’t it, oh to have a crystal ball! I had a traumatic delivery with my first and has an episiotomy, vontouse and manual placenta removal. I was so torn with what to do for my second, in the end the decision was taken from me as all went wrong and I had a crash section at 33 weeks. I won’t lie, the recovery was really really tough, much harder than my instrumental delivery. But I have heard that elective section recovery is much much better than emergency and I would go for one were I to have a third

@Jean24601Valjean thank you lovely. Having the prolapse has been horrid and like you say it's just an ongoing issue. Sorry you were dealt with the same cards as me. I really do feel for you too. I've felt very alone on it as none of my mum friends have had such issues.

Thats all great advice. It's definitely worth a visit to get an an opinion from the physio therapist. I'm glad you were happy choosing to have a CS, it does seem like it could make the world of difference. Just for my peace of mind too. I would be so grateful if I could come to you if I have any more questions. Thank you for sharing with me! 😊

@TheBeeb hey, thanks so much for taking your time to reply to me. I'm sorry to hear you had a traumatic first birth. Big hugs! That's brilliant that you were happier with your 2nd delivery. Its really reassuring when considering a CS. Thank you!

@Mmmmpavlova oh that's so good to hear! I'm glad you had a lovely experience and a smooth recovery! My parter would be able to book of 3 weeks from work so it would definitely be helpful. Including arrange childcare for my 3 year old. Thank you for the advice 😊

The other thing I really liked was I felt my ecls was a known quantity. I felt a lot more in control as I knew what would happen.

Obviously things can go awry but I knew I wouldn't be begging for an epidural or trying to negotiate with unreceptive midwives who thought I should be "breathing better".

I also spent a good amount of ££ on physio osteo post c section to prevent tight fascia and scarring. It was really worth it and I feel it helped ensure I healed properly. And I used silicone plasters on the scar - I totally rate these!

I had pretty much the same experiences as @faithtrustandpixiedust
After having a traumatic labour I just preferred the risks of the ELCS.

@BoyMummy90
Being in control was one of the major things that swayed my decision, i knew exactly what I was going into and the midwife's explained every step, the whole team in theatre were amazing and put you so at ease through the whole thing. we got our time slot went in and were back on the ward with baby an hour later.
One thing my consultant asked was were we planning to have any more children after this one. she said that as we were not then she would recommend a section where as if we had been planning more then she would probably have recommended more towards a natural birth, the risk of complications with future pregnancies after a section is greater I can't remember what she called it but it's where the placenta gets stuck to the previous scar tissue. So that's something to discuss/think about with your consultant.

Thank you so much to everyone one of you who has reached out to me! ☺️❤️

Your stories and advice has been absolutely wonderful. I felt very stressed in my own head (possibly sleep deprived too 😅) and it's nice to know many of you have gone on to have more positive 2nd birth experiences. All nothing short of amazing 👏 Thank you for given me an insight on what to expect during and after delivery. I feel much better about seeing my consultant on Wednesday and making a decision. I will also have a growth scan the same day so fingers crossed all is well with little one.

I hope you all have a lovely Sunday x

@BoyMummy90 Absolutely drop me a message with anything. I also found it to be an extremely isolating condition, as nobody I know has it apart from a couple of my friends' mums. There are some really good accounts and groups on social media though that I've found to be helpful and supportive. Happy to try and break some of the isolation!

@Jean24601Valjean Ah that's lovely, thank you so much for your support. I shall have a look for some support groups online for sure. I've not long got over covid which was awful. Especially while pregnant as you can only take paracetamol. The coughing really hit hard on my pelvic floor, and my bladder 🫣

Hi,

just jumping on this post in solidarity with your decision making, but don’t have anything to add currently in terms of experience though.

my little one is 6 weeks, had a vaginal birth and unfortunately had to do a lot of quick pushing at the end due to heart rate concerns, and I’m sure it’s this that caused the issues, I’ve been diagnosed with both an anterior and posterior prolapse.

i know 6 weeks is early days, but it’s upset me that it’s affecting what I can do with my little one now - lifting him makes it bulge more, darent babywear/carry etc. and also that is will affect my decision of whether to have a second, and birthing options.

I know that doesn’t help your question, but just wanted to let you know there are other people out there feeling the same xx

@cat234 hi lovely, sorry to hear you had a hard birth, I had the exact same situation with my little boy. I can sympathise and like you after birth my prolapsed really got me down. It scared the life out of me when I noticed something wasn't right. Definitely get referred to a physio therapist through your gp if you havent already. I was wrongly diagnosed in my doctors at first, mistaking it for my bladder and not my cervix. They could atleast tell me what grade of prolapse I had and options to help manage it. I am terrible doing pelvic exercises but 3 years have past and I can tell you that it does get better over time. Just try your best not to bear down on the toilet, be conscious when coughing, heavy lifting ect.

Physio said I should get help with things like rubbish bags and when walking; to sit down after 15/20 mins. I could pretty much feel and see my prolapse at the opening in a few months hopefully you will see some improvement.

My consultant did say they they wouldn't consider surgery to fix my prolapse until I had a good 6 months of therapy after birth and had done having all my children. Hope that helps xx

Hi there I can't really comment on the risk of another vaginal delivery on making the prolapse worse, it's beyond my area of expertise. However as a midwife I know plenty of women who found the recovery after an elective CS after a previous vaginal delivery more unpleasant that they had anticipated. A CS is a big abdominal surgery with extra risks of excessive bleeding, infection and blood clots. Additionally if you get pregnant again your next pregnancy will be high risk. I appreciate you felt out of control last time. Have you looked into home birth? For the 2nd baby with straightforward pregnancy the risks of home birth to mother and baby are the same as birthing in hospital. Most home birthing mums meet their midwife in advance which could make a massive difference. I hope it helps

I had a severe shoulder dystocia with my first, 3rd degree tears and retained placenta. I had planned c-sections for the next two recovery obviously isn't pain free but it was a lot easier than my 'natural' even with a double stitches abcess.

I heard lots of awful horror stories about c-section and this was not my experience at all.

Apologies, further to the earlier message, not sure how to edit. Retained placenta is not a common event and almost always happens after the 1st labour. Virtually unheard of after subsequent labours (not to be confused with placenta accreta)