Deciding between elective c section vs vaginal birth with epidural

[Hann376]

i have quite bad anxiety and terrified of giving birth (first baby). I would definitely want pain relief (probably an epidural) but I’m terrified of having a traumatic birth due to induction (which is probably likely as it’s my first baby) and the consequences of having an epidural (e.g., episiotomy or forceps leading to third or fourth degree tear with long term problems).

I am thinking of requesting an elective c section as most of my friends have had really positive experiences with c section (and recovery seems to be way better than having a complicated or traumatic birth) - can anyone share experiences of either?

If I was prepared to give birth without pain relief I would go for a vaginal birth but because I’m determined on having an epidural I understand the likelihood of more interventions and a complicated labour/delivery is more likely so is it better to have a c section ?

Also my mum had to have forceps with delivering me despite only having gas and air as pain relief so I feel like forceps are quite likely for me!

I had an induction 4 months ago, I did need interventions so I had an episiotomy and forceps to get her out safely. It wasn’t nice (obviously) but that evening I was on a ward with 3 other women, I was actually the only one who hadn’t had a c section all of them had and that night was incredibly difficult for them. While I was in some pain and discomfort I could get up and pick my baby up, I could walk to the toilet or for some water, I could bend over to change my baby, I could get in & out of bed etc. I then saw 2 of the women again at a weighing clinic 3 weeks later and both were saying how rubbish they still felt, hadn’t been able to cope getting out for a walk yet, still in pain, struggling to do things etc- I was absolutely back to normal by then. I was back doing all my usual things even dog walks etc within days of being out of hospital. Everyone is different obviously but for me although my birth was the opposite of what I wanted and was my worst nightmare really, I was back on my feet much much quicker than if I had a section x

If you have an epidural and need a c-section, they can top it up. You can also ask for a c-section during an induction, you don’t need to wait for them to say it’s an emergency c-section. It sounds like you want the c-section due to fears of pain? A c-section, elective or emergency, is going to hurt and you’ll need pain relief for weeks after.

It doesn’t always go to plan, so if you want an epidural but have a spontaneous labour you might not be allowed one as you’re too close to the end. I had an induction, which was absolutely fine. I did request further pain relief in the form of an epidural but I was 8cm and so they didn’t give me one. I gave birth with gas and air and no further interventions.

Elective c-section is the most predictable birth but still not 100% predictable. You will have pain after though because it is major surgery.

I had an epidural but my twins came before it had taken effect. It was fine - in fact I think it was better than being completely numbed as you have a bit of control. Also I was encouraged to have a cut to my perineum as much easier to stitch up afterwards than a tear. Have you visited the place where you'll give birth? Go for a visit when you get the chance so it feels familiar when the time comes. If you go to an established maternity unit (large or small) then they will now what they're doing and you just have to take their advice and trust them.

I had an epidural for my first, it was the start of a chain of events with lead to c section. I had a VBAC with my second and like most women I needed an episiotomy.

My second recovery was so much easier, even though I had a new born and a toddler. With my first I couldn’t get the buggy in and out of the car, drive for at least 6 weeks, I literally couldn’t get out of bed by myself for the first week and then I could but it was agony. After my second I was lifting my toddler onto the toilet less than 48 hours later, I could drive, lift the buggy so could go to baby and toddler groups and meet friends but I could just get of bed and go for a wee without waking my husband.

I get what you’re saying but look carefully into the recovery advice after a c section. It’s the only time some one has major surgery and then isn’t told to rest.

I had an induction using the drip, I had paracetamol and gas and air initially but I was struggling so had an epidural, but I was still able to push as I felt a huge pressure and I do think I got lucky as it was a quick pushing stage with no interventions. I had minor internal grazes and tears which they did stitch as they were bleeding a lot, but recovery was very smooth, I didn't feel any need for any further pain relief or the witch hazel pads, spritz for bits etc I'd bought
I do think it was mostly down to luck but it is possible to have an intervention free vaginal birth with an epidural, however I did have in my plan if it was possible to have a c section over forceps due to the recoveries I'd heard so I understand your worry over interventions.

Induction, epidural, episiotomy and forceps. I lost quite a bit of blood but I was up and about in a day or two and able to care for baby straight away. Went out shopping on day 6. Healing was fine, I wasn't too sore and probably felt back to normal within a few weeks really. A year later I can cough and sneeze all I like, my pelvic floor is great. Episiotomy scar is pretty much non existent. No lasting effects other than I will definitely opt for epidural again! :)

Also you aren’t your mum, her story isn’t yours, so no guarantee your birth won’t be absolutely textbook and smooth!

On paper my births were nearly identical, similar length, similar pushing stage, second degree tear on both. One was PROM and other suspected PROM so on drip for both. Epidural for both, one was magic and the other failed. I suffered PPH for one but was fine for the other. Didn't have regular contractions for either and for my second I went from 8cm to delivered in 14 minutes. They honestly felt very different but both fairly positive and I wouldn't have chosen a c section. I had a catheter in after both (one for 2 days and another for 10 due to my bladder being knocked by my babies massive heads) so my recovery wasn't smooth and after the second I felt like someone had hit me in the groin with a cricket bat (39cm head circumference will do that, I suppose). Anyway, my point is that even though if you read my birth notes they'd appear identical they were very different experiences and no ones delivery will be like another. After my first I was walking at 3 days and hiking (3-4 miles) at 3 weeks. After my second I felt I could hardly do anything for 10 days due to the catheter. That said, I did have a toddler trying to climb on me. All the best!

I've given birth 4 times in different ways.
With pethidine, with nothing but gas and air, induction without any pain relief and a c section.

All had good and bad points but if you're truly anxious about birth say c section and don't let them bully you about it, be firm in your choice.
Mine was emergency c section but I imagine a planned one is very relaxed.

It is painful afterwards but so is a vaginal birth, go with whatever causes you less anxiety x

'Enhanced recovery after surgery' protocols now mean that after many major surgeries patients are encouraged to sit out in the chair, stand walk etc very soon after surgery

Move around yes, but not encourage to stay up all night breast feeding and survive on a few 2 hour naps now and then.

I've had 2 emc the recoveries were hard and long

I had a vaginal birth with epidural and had to have an episiotomy. It was so painful and recovery was awful, my stitches got infected and I had to sit on a cushion with a hole in for about a month. I have never felt the same down there and will be opting for a c section next time

I would book in a c-section. You can always change nearer the time.

Things can change rapidly, but at least if it's organised you know you have the slot.

I ended up induced when I was after a c-section. My baby was prem and I was very poorly with pre-eclampsia..apparently the epidural lowers blood pressure, so oddly enough in my circumstances it kept me well 😅 they said on my babies situation vaginally birth would help push out the fluid from lungs as they were not sure how developed they would be.

But also from also planning for c-section they are harder to book slots for, whereas induction can be next day. So book c-section, any changes you can sort as it comes about :)

I was booked for an elective c section but my waters broke early and ended up having an emergency c section. Happy to answer any questions

I declined a forceps delivery, and had an emergency c-section on the Thursday, went home on the Saturday, was up and about walking outside/pushing the pram on the Tuesday. I honestly don't remember being in any pain? No issues with pelvic floor. I was quite bloated, still looked pregnant, for about four weeks, but otherwise happy & healthy.

@annahay I've had 2 emc and booked for elective this time. How quick did they get you into theatre / how fast and furious were your contractions? This is my main concern if I go into spontaneous labour my second labour was very fast however Tbh if it happened I'd just go with it and trial a vba2c

There are obviously no guarantees either way, but I can give me experience of both as I've had a severe degree tear and an elective c section.

I actually am not at all phased by labour, but hadn't fully recovered from the tear before getting pregnant again. I would go through labour with just gas and air again in a heartbeat, but I'd never accept induction. I was in the water, lots of massage, aromatherapy oils, positive affirmations, the works, but sadly my body needed help (I've since found out I have damave to my pelvis that was probably the issue) and forceps led to the tear. A bad tear is rare though at only 4-8% of births, I think I around 30-40% get prolapse, but I could be wrong.

A c section also isn't easy though, and I didn't get the same 'buzz' of birth from the hormones, but I know my body will likely heal well (albeit with the scar, stomach shelf, and nerve damage around my scar). I still struggle with prolapse from the vaginal birth but know I can manage it with strengthening exercises and lifestyle changes (e.g. what I eat and how I lift). Future births I'd go for a section to avoid damage to existing scar tissue.

In your position I'd personally still attempt a vaginal birth (but refuse an induction!) and embrace hypnobirthing. I'd ask your hospital about consent for interventions so you are in control if it doesn't go to plan. I had to sign to say I was happy for an episiotomy and forceps over an emergency section, you should be able to opt for an emergency section instead.

I'm 8 weeks post c section after a failed induction and honestly the recovery isn't easy. I was quite fit and healthy before, had a straightforward pregnancy until the end. I still haven't recovered fully, my wound hasn't healed, I have had an infection in it and mastitis and 3 lots of antibiotics. I was on clexane injections for 6 weeks. Couldn't walk the dog myself until about a week ago. Still can't walk for longer than 20 mins at a time due to pelvic girdle pain which hasn't resolved itself. I can lift the pram out the car if I do it slowly but I don't feel 100% comfortable. It still hurts to get out of bed in the morning. I haven't had a vaginal birth so can't compare the two but I think if I get pregnant again I'd want a vaginal birth. I honestly don't know how single mums do it because in the first few days I struggled to even bend over to pick up my baby. Even just walking to the bathroom was painful. Also nobody warned me about the horrendously swollen legs you'll get. None of my shoes fit and my partner had to go out and get me sandals before I left hospital. They were swollen for the first 2 weeks and were so heavy. They didn't look like my feet it was weird.

Have you considered other pain relief? I was very against an epidural with both of mine but there are other options

@Thriving30 I'm sorry you are having such a tough time but it's comforting to hear I wasn't the only one who struggled after both my emc I wasn't anywhere near 'better' til 4 months PP endless infections obviously was doing too much but with no family support and my hushed works away it was really tough. I'm due an elective in Oct and I'm praying it will be better than emc I really wanted to try for another vbac but the consultant scared me however if I go spontaneously earlier I'll trial one

Why do you think you are likely to be induced with a first baby? Plenty of people have first babies without being induced, some even come a few days early.

You also don't know if you will need an epidural; it's nice to know it's available if necessary but you could have a very straightforward labour and birth.

C-sections are not nice.

I would say, wait and see. There's no point in planning for procedures - especially fairly major abdominal surgery - if they are not required.

I had a planned c section and it was a very positive experience. I was up and around the next day, no problems and no pain and I healed really quickly. You can hardly see the scar. But it is a very personal decision.

I could have written your op!!

I went for elective c section- it was harder recovery than I expected but it brought me peace and certainty as I had just been dumped a month before baby was born and couldn't handle any more stress. I couldn't handle the idea of being incontinence either.

1.5 years later I'm totally back to normal and the scar is faded and inconsequential- I just look at it fondly as that's where my little boy came from.

I am single and late 30s so who knows if I'll have another. Weirdly I think now I feel so empowered in my body after working out more and I know how resilient I am as a single mum I feel now like I could manage a v bac if I ever was pregnant again with a nice man but that might be just because I am
Not pregnant that I can tell myself that!!

Do what feels right for you and don't over think explaining it to others either - they all have opinions but a couple of weeks after baby is born no one cares at all you'll be being judged about something else by then like if you use formula or a dummy or if you have a routine etc etc. mum life!

I had a planned CA as my baby was breech and unstable lie.
The section itself was fine but the recovery was definitely harder than my contemporaries who had VB. I feel great now 7 months down the line.

Breastfeeding was affected, I think. Baby was drowsy due to the drugs.
How much help will there be at home? Partner?