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 did...
Ok, it was day 3, not the next day, but only because my husband talked me out of popping in to Tesco on our way home from the hospital.
Day 4 I helped host and cook a BBQ for friends and chased my toddler round the garden.
On day 5 we went for a day trip out to visit friends, I managed to bump the pram up and down steps to a cafe, walked around a bit, all fine.
Day 6 was a pub lunch.

Got the all clear from the midwife for sex on day 10, found time the next day...

We both had undoubtedly easy experiences compared to many, but for some people c section recovery is really fine (as for some people with vaginal deliveries).

I've had one if each. Recovery from a vaginal delivery is so much easier. I was back to normal virtually straight away, aside from a couple of stingy wees immediately after the birth( which were made massively less bad by putting water in the area as I peed) I felt totally normal. Second birth was a c section for medical reasons, regular it was like some kind of weird magic going in and just "getting a baby" half an hour later r recovery was so much worse than I expected. I was very fit or and during pregnancy ( both times) so that wasn't an impacting factor but just the tiredness from both the pain and discomfort and the healing was horrible. If you think about how much energy your body is putting into healing you from major abdominal surgery, plus mending the dinner plate sized round in your room you have either way it's massive, ask in to of having to be capable and like after a baby. I had some help after my baby was born but was able to do stuff pretty quickly, it was just so much effort, so painful and so exhausting. Id say to be fully recovered it took three months.
If I had to choose again I'd always choose vaginal, yes it's a scary thought, but it's amazing how it does just actually happen ( and how good i felt about it afterwards) but the recovery, I mean full recovery, would be the clincher for me.

Each CS is more risky than the last. As a generalisation, 2 is considered perfectly fine, 3 is riskier but acceptable, and with 4 you are starting to take significant risks of eg placenta accreta. Personally I wouldn’t risk 4 but there are plenty of women out there who do and are absolutely fine. But the risks of 4 c-sections outweigh the potential risks associated with vaginal births (for me).

It’s also worth adding that each CS recovery is harder than the last, whereas for vaginal births, they tend to get easier with each. Eg While a third of women need assisted births (forceps/ventouse) for first births, very few need this kind of intervention in second or subsequent births.

You already know what you want - so do what feels right for you 😊

I always knew that a CS could be necessary and appreciate people don't always get a choice but I would never have chosen it over a vaginal birth. The only thing I would change it if I could go back (two births) would be to accept the pain relief! I was determined not to have it but I would have enjoyed the experience more if I had. But once it's over that's it - no after effects of major surgery to deal with. So if you're lucky enough to get the choice, I'd 100% recommend a vaginal birth!

Just have an epidural. I had epidurals for both of mine and it was pain free. Better than a Caesarian anyway

I'm not the poster you asked, but my section scar was healed and stitches out at day 4! It was just a small thin red line by then.

(But personally I wouldn't have protected my husband from it even if it hadn't looked so good - surely he deserves to appreciate just a little bit of the reality of what you went through!)

If you want more than one child then opt for vaginal birth. I know a few women who had c sections, but it was either for their last child or they stuck with one child.

www.mayoclinic.org/tests-procedures/c-section/expert-answers/c-sections/faq-20058380

’a planned section by its very nature is not a traumatic experience (setting aside recovery)’

Sadly that isn’t a given: you can’t assume that. It is major surgery and in most cases you are conscious during it which even with the drugs many find stressful. My second C section was calmly and capably performed but a long, bad experience, due to complications caused by my first C section.

I don’t believe this mostly because any medical person I’ve spoken to advised against sex that soon, weren’t you still bleeding? Even if your section scar was miraculously completely healed in 10 days you still have a wound inside from the placenta?

Depends how much of a gambler you are. Best to worst I’d say goes like this: straightforward vaginal, planned c section, traumatic vaginal/emcs.

Obviously you don’t know which category your vaginal birth will fall into. So you can opt for planned c section and then avoid the risk, but also lose the chance of a straightforward one.

I had 2 fantastic, fast water births. Best days of my life.

Please go for the natural birth - recovery is way, way faster and you have less chance of an awful overhang of skin where they stitch you together.
I’ve had both.

My initial recovery from a csection was ‘quick’ (Sainsburys on day 3, walked round Ikea a week later) but in hindsight I wasn’t as recovered as I thought and I was probably doing too much… now I am recovered 1 year on I would say I felt quite spaced out for the first few days, physically exhausted in the first couple of weeks and had pain in my abdomen for about 4 months.

Unfortunately you never know how your body will react to things so it’s hard to plan ahead really. I had my twins in august….one vaginal birth and the other an emergency c section. They were tiny so I don’t feel like I can even count it as a vaginal birth lol, and I had an epidural in case I needed a C section with the second twin, so hardly felt anything.
c section in itself was fine, however I found recovery tough. Looking back it was fine and I don’t think I felt pain past a couple of weeks, but I had read all these scare stories online about c sections and that really had an impact on me!
my mum and sister have both had 4 vaginal births, no problem. I have friends who had tricky births and needed emergency c sections. I would look at how other women in your family have coped with birth. If you are worried though I would go with an elective c section as although the first couple of weeks are tough, you should recover fine….just make sure you have lots of help and a grabber to pick things up off the floor for the first couple of weeks, I even needed help having a shower after mine 😂

These kinds of threads are always going to bring up a lot of the traumatic birth stories. No matter what way you go, there will be cases of births not going to plan from both modes (vaginal and c section). There can be beautiful vaginal births and c sections. Trauma can happen to anyone for a multitude of reasons. Spontaneous vaginal birth doesn't always mean trauma, and planned elective doesn't always avoid trauma.

I think it's better to look at the statistics of each and read the evidence based research.

You said 'we want multiple children' so I would encourage you to research Placenta Accreta Spectrum (PAS). A majorly complex condition we're seeing skyrocket due to increasing caesarean section rates. Very important to be informed about if you're wanting a large family and repeat sections.

Well it's true. The guidelines don't give a time any more, just 'when you are ready' and I was aware of this, but because it was quite soon I decided to check with the midwife first.

I did 90% of my bleeding in the first 24 hours and there wasn't much. I switched to standard 'medium flow' sanitary towels on day 3ish and then pantiliners by days 5/6ish. I'd fully stopped by the time I spoke to the midwife. It must be quite common after a section because she didn't ask 'hows your lochia?' but 'has your lochia stopped yet?'

I'd had a terrible pregnancy that left me housebound and largely immobile by the end (severe SPD) and was delighted to be able to do normal things again. I did take painkillers in case it hurt without, but I was shocked by how ok I was as I'm usually a wimp with pain.

Look at your local nhs reviews and what your hospital is like and when you’re due. We can’t provide accurate advice because our experiences are local.

In my baby group of 4, all 3 who went spontaneous ended up having a horrific time due to staffing and bed shortages. I had planned section and it was calm, peaceful, and what I needed due to medical history. We were winter births.

This is very typical of my area, which is understaffed and particularly bad in winter. For planned sections, staffing levels are compulsory and our hospital is actually very good in its surgery outcomes - a top hospital for surgery in the country. The maternity wards would also be amazing if not suffering from staffing shortages.

What is your local hospital(s) like? What is the best / safest option for you? For eg, if you are in an area with poor surgery outcomes, but a great maternity ward, and you’re due in spring / summer, that might be very different than what we would decide in my area.

I was a happy with my elective c section but only do it if you don't want a very big family

Ps it was tough to recover from for me and my friends weirdly found it fine, so it's a bit of a gambles but I liked knowing what to expect and not having a risk of incontinence etc

If you want multiple children you should try to avoid elective c sections.

do t get caught up on a due date. A term pregnancy is 38-42 weeks. The ‘due date’ is only the midpoint.

most first pregnancies go to 41 weeks unless a planned c section or a problem.

How active and fit are you OP?

Posts like this are scary. Recovery definitely isn't always faster or easier with natural births and some of my friends have suffered horrendous long term effects after giving birth naturally. C-sections of course also have their own risks, but as someone else mentioned unthread, the risk profile of each option will be specific to the individual so it is essentially a gamble.

Research both thoroughly and then go with what you believe is best. This is all that anyone can do and ultimately means that even if the worst happens you will at least know that you went with your instinct and the best information available at the time.

I know, I can feel myself becoming more conflicted and anxious. 😪

Fairly fit and healthy. My weight is fine, I have a healthy BMI. I love walking but have asthma which has worsened during pregnancy so I am much less active than I was pre-pregnancy - it’s also winter though and I’ve really struggled with the cold so not wanted to go outside for months. Hopefully if we get some better weather I’ll be more enthused by the outdoors.