Caesarean or vaginal birth

[SRH]

Advice Please!

We are expecting our first baby and up until now (20 weeks) I’ve very much been leaning towards having a caesarean section. I don’t have a full blown phobia about giving birth vaginally but I do have some fear. I fear it not going to plan, going past my due date, needing intervention such as forceps or worse, an emergency c section. The consultant told me that 30% of first vaginal births do require some sort of intervention.

By contrast, a planned c section feels very organised and calm. The recovery from a section doesn’t worry me as there’s no guarantee you won’t have an equally difficult recovery after a traumatic first birth.

I am 31 years old and know of at least two others my age who are refusing to have any further children due to how traumatic they found labour. I’ve also known two others who both required interventions and one who needed an emergency section.

Of course, vaginal birth is widely advocated as it’s the natural course. I would still prefer a c section but my main concerns are:

1. If it will negatively impact on future pregnancies. Could a traumatic vaginal birth also do this?
2. I read some horror stories regarding excessive bleeding and needing a hysterectomy. Of course I wouldn’t want this to happen at my first birth, we want multiple children. When I raised this with the consultant she didn’t really reply or seem to understand what I was talking about.

Has anyone here had multiple sections?

Has anyone done both and can give a direct comparison between vaginal and section?

Thank you xx

I had forceps, a third degree tare and a haemorrhage with my first. Still recovered quicker than a section. Had 4 more vaginal births. Being able to care for my other children was a priority for me and being able to drive. I'd hate not being able to do so for 6 weeks.

I know myself very well, and I never even contemplated a vaginally birth for a moment. I am sure would have had the c section even if I didn't work in the birth injury field (I do, on the legal side of things). But that certainly clinched it for me. I was very happy with my decision. I would strongly advocate for the woman's right to choose if possible though.

I have had a ventouse, vaginal delivery and a caesarean section. They were all hard, but absolutely fine - if that makes sense? For me, birth is tough but recovery is OK. It's the tiredness and looking after the baby that was more painful. Gosh, I don't miss that. With my vaginal delivery I was up and about in soft play the next day (don't advise that) but still felt pretty wrecked as I had a toddler to look after as well. The c section was really painful for a week, then got better very quickly. I had lots of family support which helped.

I have had on paper traumatic births but I can't say I feel traumatised by them. Bits were scary and unedifying but nothing that has really stayed with me. I must be lucky as I know this is not everyone's experience.

All deliveries can have poor outcomes, it's always a bit of a roll of the dice. Can you make a list of pros and cons but separate them into long term and short term? That might help to make sense of what your concerns are and which might have a more lasting impact.

Good luck, just remember there is no perfect decision

We have discussed having 4 children but not even sure this would be likely for numerous reasons - financial, where life will take us, whether we suddenly only want two children after having two etc! Is there a maximum number of c sections allowed/suggested?

I think I am looking for certainty which I know deep down is impossible! My gut instinct is c section

First was a natural birth and second an emergency c section. I would choose a natural because for me the recovery was pretty much immediate. With the section I was limited for a number of weeks with recovery. I had no choice as my baby was stuck so I had to have a section.

I had 2 c-sections and recovered very quickly after both despite being over 40. Because of my traumatic pregnancy journey I just didn’t trust my body enough to give birth naturally.

Yes, I think this is a great point - what would you feel if either of your choices ended in a poor outcome? Which risks do you feel more comfortable "owning"?

No, there is no "allowed". Generally speaking risks increase with each section but I know plenty of women who have had 3+ sections with no issues (aware this is anecdata)

Had both, c section better than vaginal. Quick recovery, walking pushing a double pram about two weeks after. Vaginal - baby got stuck, ended up with ventouse and then a trip to theatre to be stitched back together. At least the c section was planned stitches and I could see them! Ideally avoid one of each - no point in destroying your vag and then having your stomach sliced open as well!

I know I would be so disappointed in myself if I opted for vaginal and it went badly. By contrast, if I opt for a section and something goes wrong I will need to live with my choice and will probably accept that no matter which way I went, a similar outcome was likely.

I've had both, and would choose a vaginal birth over a c-section if I had to choose. I found recovery a thousand times easier.

You were very lucky indeed.Neither of my two sections were wonderful experiences.
To be fair they were both 55 and 52 years ago now so things have changed.The memories of mine are still with me, nightmares they were!

I've had 4 vaginal births and major abdominal surgery. I would opt for a c-section if I could go back in time. Then again I'm a nurse so would know how to clean and dress my wound to avoid infection, I would know to eat good protein in the weeks leading up to it to promote healing and I would know to get up as soon as I could post surgery and mobilise. I would find this far easier to manage than an episiotomy wound that's hard to keep clean or a third degree vaginal tear. I have seen c-sections and vaginal births and would wish to deliver my baby in a matter of minutes rather than spend hours in labour. I also believe it's less traumatic on the baby, a forceps delivery is going to cause distress.

I had c-sections for both mine. One emergency and one elective. Both smooth and simple procedures. I recovered within a couple of weeks, and mine and DH's sex life was back to normal within 6 weeks of each one. Zero birth injuries.

If I went back in time, I would 100% choose c-sections ... Vaginal birth is overrated. 😬

I had a section and I feel really disappointed that I had it, I really wanted a natural birth but chose a section after a long induction and concerns for the baby. The recovery was fine but I wish I had the experience of ‘giving birth’. Once you have one section you’re probably going to have another, so bear that in mind. You’ll also ideally need to wait a couple of years between each pregnancy for your uterus to heal. I was desperate to have another after my first baby!

In your shoes I would plan for a vaginal birth and go into it with ‘red lines’ to ask for a section eg section over induction.

By the way I have a friend who has had three pregnancies, after two c sections in her third pregnancy the placenta implanted over the old scar tissue and grew into the bladder (placenta accreta). She has had to deliver third baby at 34 weeks under a GA, full hysterectomy and bladder reconstruction, spent 5 days in intensive care due to blood loss. It’s rare but complications can happen and these are the sorts of risks that increase with each csection.

Bottom line is that you can’t predict what will happen, which is what is so frustrating.
For me - One vaginal, epidural for pain relief. Needed episiotomy but otherwise fine. Episiotomy healed well. A sore tail end for a bit but perfectly manageable.
One emergency section, and I mean emergency. Abdominal surgery recovery hurt, but perfectly manageable. Limits your activity level more for a few weeks eg can’t drive.
When expecting 3rd started off wanting a planned section (to avoid repeat of previous experience) but was talked round. Third delivery (vaginal) was fine - again with epidural. No stitches needed anywhere. What a doddle.😁

I had mine vaginally and both I was fully recovered in hours, went shopping following day etc - no way can you recover from a c-section like that. Whilst some people have slow recovery from vaginal births most do not

You can decline forceps. It as in my notes that if there were complications I wanted to go straight to c section rather than through the sliding scale of interventions - I was mostly worried about oxygen deprivation for baby.
as it was I went cat 1 section (most urgent emergency) as baby went into distress before my induction even started. I had a nasty reaction to meds an hour after surgery finished but once I’d got myself back together again recovery was absolutely fine. We were in hospital for 4 days after as baby needed antibiotics and it definitely helped me have bed rest as at home I’d have been up and out. As it was i did a 5km dog walk two weeks post C-section including climbing over stiles. That’s not the case for everyone though!

First birth was breech and had to have section, found the recovery really tough. Second baby I opted for a VBAC and definitely preferred that, no interventions and only gas and air. I too was anxious about the horror stories you hear about horrendous damage but I did my perineum massage and had a tiny labeli tear for an 8lb 6oz baby (and I am very petite)! I raised my concerns with the midwife re my fears and it helped to discuss with her- her opinion was I might as well give it a go, and also they gave me sessions with a CBT lady who I was able to discuss with.

I was exactly like you OP, scared of tears, forceps, birth injury to myself or worst of all, to baby. I had an elective c section and it was a really nice experience during the section.

Recovery was definitely a LOT, I know your logic is that it could be a lot with traumatic vaginal birth as well, which is true, but be prepared that you literally can’t do things like adjust your own pillows for about 2 weeks. I was technically “up and walking” within hours but walking is the easy bit! It’s all the twisting and lifting you can’t do which is the tricky part. So you definitely need a very helpful partner/friend/mum who is happy fetching you things constantly.

Additionally - the scar! You have a 10-20cm scar on your abdomen (will probably be closer to 10cm if non emergency but they aren’t plastic surgeons so unless you’ve selected a private consultant you are rather at the mercy of whoever is on shift in the NHS). You might have a pouch/overhang. I am seeing an osteopath for scar massage as scar tissue can worsen any overhang and radiate pain/tension throughout your body. So do know that c section doesn’t mean you avoid needing post birth rehabilitation.

Anyway, I am just adding this to your considerations so you’re not blindsided like I was. Make sure you google c section scar photos and scar massage etc so you’re prepped for the other side.

PS congratulations!! You’re in for a wonderful treat with your new baby, good luck with the birth whatever route you decide.

I’ve also had both - CSection was difficult to move, couldn’t pick the baby up from lying down in a hospital bed, feeding was difficult DH had to bath and change the baby. Walking to the toilet was painful. I could lift the carrier to take them home. I was recovering and family wasn’t that helpful. I was full of air, and weeing was painful I also felt hung over and incredibly tired.

I then had to fight the consultants to allow me to have a vaginal birth as I had twins. The worry being my C-section scar might split. Once born I felt I could run a marathon, I could pick up the eldest, drive, walk the shops, my legs weren’t swelled, less pain, less drugged.

I was advised to sign the caection paperwork should it be needed, which I didn’t, bit I’m glad I didn’t have to.

Can I ask how you have managed to get over the scar to have sex? I am 2 months postpartum and only just managed to show my DH the scar, let alone have sex with him! It’s still quite red and has only just stopped being sore, so I was waiting until it’s completely settled. Does it just not bother you as much or have you healed very well?

I had a planned c-section with my only DC when I was 43. It was the most straightforward process imaginable. In and out of hospital within 24 hours and recovery was easy. Just a few days taking things easy and then I was up and about as normal. I’ve had more troublesome dental work than the whole birth process. It was a breeze.

My daughter had an amazing vaginal birth with her first child and fully expected the same with her second…absolutely no risk factors,31,healthy lifestyle,swimming everyday,BPok ,but…the birth was very quick at 39 weeks,baby’s Apgar score 1 at 1 minute ,2 at 4mins and 4 at 15 minutes…I can honestly say it was the most terrifying minutes in my life, thought the baby was dead,absolutely no audible noise for 19 minutes .
Can say that those 19 minutes after baby was born are the worse minutes for myself , Mum and Dad .
If another child happens it will be ELCS ..am feeling quite emotional because baby was born on the 8 th March