Petrified for second birth after traumatic first birth

[rosiebutterfly]

Hi all,
looking for some advice or words of truth, my first birth was an absolute disaster I was induced, 5 day labour, hormone drip, forceps? Severe PPH (2.5litres) 3 blood transfusions and a week hospital stay, after this birth I had various discussions with the midwives and even colon surgeon and they suggested that people with these sorts of traumatic births usually go c section next time.
Ive had this in my head until my consultant meeting today, I felt like I was being persuaded not to go c section.
I was told that the risks are a lot higher and mortality is 1 in4200 which seems really high to me.
i was also told that if going c section or vaginal birth I’ll need to be put on the hormone drip regardless of delivery after I give birth to control my placenta and help my uterus contract as it failed to last time which is why I had such a huge hemmorhage.
I’m just really feeling confused and low now as that death rate has really freaked me out and the thought of going through all the vaginal risks again with what happened last time to have to be placed on a drip afterwards anyway really makes me feel uneasy.
just wondering if anyone else experienced a similar scenario and what would you do?

Sorry you had such a horrible first labour.

That death rate sounds scary but is actually not high at all. Planned C-sections are really safe. Did they tell you what the equivalent rate for vaginal delivery is as that's not zero either.

I had a very traumatic first labour and if I did have a second I'd 100% choose a C-section so if that's what you want, make your decision clear to them.

Second vaginal births are generally more straightforward than first births, so you could have quite a straightforward birth this time. However, all my friends who have had planned c-sections have said it was an absolute dream so that could be an option. Do you have any risk factors?

Yes vaginal is 1 in 25,000 so a lot lower that is basically the only fact that’s scaring me right now x

I’m high risk because of the fact they said my uterus doesn’t contract properly, I’m older aswell 36 for this pregnancy. The fact I’ll need to be placed on a hormone drip after delivery if I decided to proceed with vaginal is really off putting aswell, I definitely am more considering c section just the mortality rate really shocked me

Have you had a birth debrief and if so do you have any indications as to why the first birth went like that? If you can have some ideas of the why that could help inform of the risks of some of it happening again?

i think it was just the worst case scenario for induction to be honest but I’ll have to be placed on the hormone drip regardless for this second delivery, so won’t be able to be the straight forward VBAC others have even if I take the risk

I was in this position.

Had a planned c section and it was the best choice I could've made.

Thank you so much this has made me feel a bit better

My first birth sounds like yours, it was traumatic and took me a long time to want to have a 2nd baby. I opted for c section for my 2nd and it was the best decision. It was calm, I felt safe, baby was fine, recovery was fine. Don't let people put you off, it's your choice.

I had a planned section 7 months ago. I had a great experience.

The risks of sections are known, so they will be prepared. Ask them what measures they can put in place to reduce the risk of another pph.

Honestly though OP, you'll be fine. I expect the vast majority of deaths from sections are for emergency ones.

I had a stressful and lengthy failed first labour (i.e. I needed a crash section) and knew instantly I'd have a planned section for my second. I explained that to a consultant, who said I needed to speak to the supervisor of midwives (it was implied she'd have to "approve" it). I did that, and politely but forcefully put forward my argument, which wasn't that coherent tbh (and I did cry!!) but she effectively immediately said it was fine and she could completely understand why. And that was that! I would really encourage you to try and advocate for whatever you think will have the best outcome for you and your baby.

Thank you so much this was my mindset before going into the meeting then all the risks I heard really freaked me out, I need to try and remember they have to outline risk of fatality but still so scary

Difficult first labour which ended in emergency section, opted for c section for second and best choice I made. Team were calm, relaxed, highly professional and kept me at ease throughout. Very glad I picked that option.

Thank you so much I was thinking maybe fatality is more associated to emergency or multiple c sections etc but still so scary hearing it, they already have measures put in place so I will have to be placed on the hormone drip with extra medication to help my uterus contract back to size which it failed to do first birth, if proceeding with c section I will have this too but at least I will already have anaesthetic so will not be painful

Thank you so much this has really helped me, I’m so sorry you went through a traumatic birth but glad you had a positive one second time around

Sorry you had a difficult birth also, thank you for your message I think I’m going to proceed and push clearly for c section, I’ll have to go on the horrible drip regardless so would rather it be controlled

Hi there it's a labour ward midwife. You had a number of risk factors to end up losing 2.5 litres of blood- first baby, induced labour, long labour, forceps delivery. I wouldn't be surprised if you also developed an infection and were on IV antibiotics in labour - this is an additional risk factor for PPH. The medical team will put extra precautions in place to try to control the risk of you bleeding excessively in your 2nd delivery. All things equal, you are more likely to bleed heavily from an elective Caesarean compared to a 2nd vaginal delivery. The risk of death is very small but higher with an elective. Even if you are induced you are very likely to go into labour after having the waters broken. Second labours are usually very straightforward as the woman's body has already done it once. The recovery will be a lot easier too. It sounds to me you would benefit from a proper debrief appointment. They are usually provided by either a consultant midwife or a consultant obstetrician. They usually last 1 hour and it's an opportunity not only to go through your notes but also to put a personalised plan in place. For example, in the event you needing an induction of labour, you can request to go for a Caesarean rather than on the drip. Everything is pretty much negotiable these days. I hope it helps and good luck

I had a very similar birth with PPH, transfusions, and a 3b tear. I am now sixth months pregnant and literally every health professional has recommended I have a c-section. I agonised early on but realised there's no way I want to go through the trauma of vaginal again and anxiety that I would make my tear worse. My postpartum period was rough because of the trauma both me, my husband, and my baby went through early on. It wasn't the best of starts to motherhood.

On the statistics, can I check if the c-section stats are for PLANNED sections, EMERGENCY sections or both. If the latter, its likely the emergency stats are skewing the probability as by definition, these were more high-risk situations.

Thank you I do appreciate your stand point, I tried to have a debrief but I already suffered from complex ptsd, after the harrowing birth I also suffered more ptsd and I couldn’t even bring myself to go to the meeting. I’ve been told the drip is necessary today by the consultant and it’s what they’re going to do to stop the same haemorrhage happening, so after if I have a vaginal birth I’ll be placed straight on the hormone drip to control afterbirth and most likely will not be with the pain relief I even had the first time around as second labours are a lot quicker, definitely edging towards c section as I can’t go through that again

The risks are always scary, but with my vaginal birth my daughters heart rate was dropping and they urgently needed to get her out, I had forceps with no spinal and on the labour ward just with gas and air, I honestly thought I was going to die. There are risks with both, but during my c section I felt so looked after and well monitored, I lost 700ml of blood and had 250ml but back in using that blood. I was back home within 24 hours, my 1st labour they wouldn't let me home for 3 days as my heart rate was high.

I’m so sorry sounds like exactly my birth, I remember crying in my wheel chair after saying I will never be able to have another baby again and here we are lol!
Weirdly this is exactly what happened to me everyone I spoke to medically suggested c section when this happened and the consultant was just a bit stand offish about it so I was left mind f**ked to be honest, I’m going to go with my gut and proceed with c section I think, I also had stitches front to back and couldn’t walk properly for over a month, c section can’t be worse than that surely?!

A doctor once told me that the risks of a planned CS are very low. Where things get riskier are in a subsequent pregnancy (because of the higher risk post CS labour and repeat CS) and also in emergency CS, where sometimes the mother is already in a bad way by the time she gets to theatre or the section should have been performed earlier. I don't know if that helps, OP, but I wonder if the person you spoke to was conflating the risks and just giving you the headline figures.

As @Okayornot mentions it must be borne in mind that the risk of c sections includes ALL c sections, emergency and planned, so the statistics relate to those who were in difficulty already from an attempted vaginal birth. This skews the mortality rate upwards.

Planned c section mortality rates and complications are exceptionally low and I believe I read somewhere ( don't take as gospel) less likely to result in physical after effects for the woman.

Do what you feel is best for you OP and never be afraid to question and ask why.

I had a planned c section. I ended up with an emergency one first time anyway.

Recovery from my c section was very quick. I only remember being in high pain for a few days.