What would you do, ELCS or try again

[Sausage1986]

Currently pregnant with my second child. First baby was a difficult birth, large baby, long labour which resulted in wrong positioned head, shoulder dystocia and Kielland forceps. Babies head was very bruised, cuts to head and ear and 2 large hematomas that took months to heal and some dents to her skull. I was also pretty beaten up, we had a week in hospital, large episiotomy and a catheter for 3 weeks. Unbelievably, neither of us have significant lasting damage

I’ve seen a consultant who has been less than helpful about my next birth, said it’s up to me if I want a ELCS. Risk of dystocia increases to 1:10 from 1:150 with a second child. I suppose I wanted them to make the decision.

I'm looking for some other opinions, wwyd?

I'd bite their hand off for an ELCS!

I was in a not dissimilar position to you and i went elective. Never regretted it either. I know it is major surgery but i was still in a much better way, physically and mentally after my section

How far along are you? I think you should ask for growth scans to monitor your baby's size and position. If you're having another big baby then maybe opt for an elcs (easier for delivery but a lot harder for recovery).

I would recommend elective LSCS (I'm a midwife). You shouldn't get much resistance if it's what you want.

@Babaquestions im 30 weeks. I’ve got another appointment /scan in 2 weeks to check where my placenta is as was a little low. I was thinking the same about asking for the babies expected size as I was measuring big at my 28 week midwife apt.. I know they’re not always accurate.

I am concerned about recovery and lasting complications of surgery, but my recovery from the first birth was pretty gruelling

@NomineCornelia the consultant is really leaving it up to me but framing it that I’m too ‘fearful’ to have a second spontaneous birth rather than it being a sensible decision. Could I ask a bit more if your opinion given your profession. I feel like the consultant has made me feel weak in some way or that’s just my ego!

I had an Emergency section with my first and went on to have two very successful vaginal births. Recovery was easier with a vaginal birth personally, and actually second time round they withdrew the offer of a section 5 weeks before I was due. I'm glad they did as I definitely struggled more after the first birth. As for measuring bigger I've met lots of mums who were told the same who ended up having relatively small/average sized babies. Good luck with whatever you choose

Measuring big as in your bump or a scan? I measured very small but then I had growth scans showing my baby was 50th centile. I've known others who measured big but their baby wasn't huge. If I was you I would ask for growth scans to predict baby's size. Would you feel more confident giving birth if the baby was smaller than your daughter was?

Are you really asking this question?!

Section all the way

My god, no way would I do anything other than a planned C section. It really doesn’t matter how you give birth as long as the baby and you are well and healthy.

I'd go for the section (Dr who has had both vaginally and section).

Just at the bump measurement, I know they are pretty inaccurate. I think I will ask for a growth scan at my next scan in 2 weeks. My first was born on the 99th, so would hope if the second is smaller maybe the risk of shoulder dystocia decrease, but maybe it’s just all to do with position and not size, but definitely something I have been ruminating on

100% a section.

You've had just about one of the most challenging births possible last time- I'm sorry you had to get through that. There's no way of telling how labour would go beforehand- lots of women do go on to have normal births after forceps. I know a lot of women find elective quite a healing experience after a traumatic time before. I just think in your shoes I would probably opt for LSCS.

Kiellands are hardly seen these days- I was born by Kiellands in the 80s! We don't even have them in our Trust.

I've had two sections, and I'd definitely recommend it. My planned one was a walk in the park and even the emergency one sounds less traumatic then the birth of your eldest. After the elective section, I was up and walking that afternoon, home the next day and more or less back to normal (apart from taking paracetamol) within 2 weeks.

Before my consultant appointment I was comfortable with a CS and just assumed that’s what they would recommend. I came away from the appointment feeling like I’d made a mountain out of a mole hill and it was my own fear preventing me from a second vaginal birth. Even when I asked about increased probability of shoulder dystocia again and further damage, she was pretty dismissive. I’ve booked a birth reflections appointment to see if that helps with some clarity and confidence in my decision making. I suppose this post is also part of that process for me, so thanks for the contributions

Thank you for this, really helpful. That’s what I thought about Kiellands, but the consultant didn’t want to discuss that. I think they might have made a bit of an error somewhere along my labour as I was stuck at 10cm for quite a long time (over 3 hours) with them know her head was in the wrong position.

Ditto. It was almost civilised in comparison with my EMCS and my recovery was quick and straight forward. Was a blessed relief.

Similar situation here, currently pregnant with number 2 and I intend to have a CS and have made it very clear to anyone who will listen. Whilst I don’t fear another vaginal birth, I would be devastated if it went the same way as the first time. Mentally I could not handle it.

I am in a similar situation. SD with first child but resolved very easily.
Like many posts here, I know the best thing to do is an elective c section but I am grieving never giving birth vaginally again. I know if I go for the vaginal, it won't be the calm exciting time it was first time, it will be full of fear of "will it happen again".
Its nice to hear from you because I feel like people I know don't understand - they think just because a section is safest for baby that I should be all on board. But I can't change how I feel.

I had a large baby and SD with my first birth. Bled a bit but didn't quite meet PPH volume. I had gestational diabetes the second time so asked for induction at 38 weeks after a growth scan. Had a very straightforward birth with a normal size baby. Great recovery. In your position I would ask for a growth scan and make a decision. Could you ask for a scan to assess position of baby when you go into labour and have it written in your notes for an early bail out at any hint of malposition. I think to do this you'd have to place a lot of trust in your midwife and team or know your birth partner can say the right thing and advocate for you and your baby well. You can also say that you don't want rotational forceps or only forceps by a consultant experienced with their use. Good luck, it's a tough decision.

CS definitely, just because of the increased shoulder dystocia risk. Forceps and episiotomy aren't nice but shoulder dystocia is dangerous for the baby so, personally, I wouldn't risk it.

I can understand what someone else said about grieving the vaginal birth you imagined though. It's not an easy choice to make.

I had emergency section with firstborn for failed induction/fetal distress of "big" baby and it wasn't too bad! Also had a PPH so was actually glad to have been in theatre for that and I'm at higher risk of that again this time so although they've said I can try a VBAC, I'm pushing for elective section. As others said, it could be quite healing for you to feel that things are a bit more under control this time and it's the same for me, I don't want to take any chances with a VBAC with the number of problems I had the first time. Elective section logically seems the most straightforward. All the best with everything!

Fuck! No idea how you wrote that down and are still questioning the c section. You’re a tough cookie! It will be like a walk in the park for you comparatively.

I can't comment on your exact situation, but wanted to let you know I had a very similar experience with the consultant when discussing plans for this pregnancy after a third degree tear last time.

I really want vaginal birth with no interventions but am ultimately nervous about a repeat injury. I've seen a women's physio and gynecologist who have both said a c section is a good idea to avoid risk of long term health issues. The gynecologist said he sees the after effects all the time, whereas the maternity dept don't and for that reason consultants sometimes miss the bigger picture when making these decisions. He said I may be OK and have no repeat injury, but then also I may not... Whether it is worth the risk is my call and not up to the consultant.

Just thought I'd share as a reminder to follow your own instincts on what's right for you, as only you can know what the impact to you will really be. Hope you get a decision you're comfortable with!

I’d be interested to know what you decide OP. Our first births sound almost identical. Did you also have pph and tear? We must also be much the same gestation now - I’m almost 32 weeks.

Similarly I had a consultant appointment where they said about increased risks re shoulder dystocia second time around, and also harder to repair. But they didn’t push me either way because I (miraculously) healed pretty well. I wanted them to make the decision!

I thought immediately after the birth that any future ones would need to be ELCS, but I guess my memory has faded with time and I constantly doubt that choice. It took me at least a year to recover.

I have been having growth scans and baby was measuring over the 90th at 28 weeks. Have another later this week.

At the moment, my inclination is to get the c section booked but if I go into labour naturally beforehand then perhaps I’ll run with it…