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

Can you plan for a natural birth but have a low threshold for a csection eg not allow any intervention or think in advance what intervention you would allow? I asked for the csection as my waters broke and labour didn’t start and I didn’t get much push back, op was done later that day.

Genuinely my experience from my own births and what i've seen from friends and family is the fitter and more active you are during pregnancy the easier your birth. I was 30 and 33 when I had my children, and found labour and vaginal birth very empowering, did both with no pain relief and no intervention, very little after effects, needed 2 stitches after first birth for a "graze" and no stitches after 2nd. I get this isn't everyone's experience but I don't think you should jump straight to a c section because "just in case" birth is bad

I am a worrier and would love to find reassurance either way but I’m not sure that’s going to be possible which is adding to my fears unfortunately

Where do I get this kind of advice from or who do I tell? The midwives haven’t mentioned anything about a birth plan, does this happen later in the pregnancy?

I had a planned c-section when I gave birth to our perfect baby girl nine weeks ago. I have a complex medical history so was advised by a consultant at twenty weeks that, while they would support me if I opted for vaginal delivery, they had grave concerns about this and I was advised that they would consider a caesarean section the safer option in my case. It's a good thing I was down for a c-section as baby was in a transverse position, making vaginal birth impossible.
I had my planned section at 38 weeks and it could not have gone more smoothly. The team were excellent, kept us fully informed every step of the way and there were no complications. I had a spinal anaesthetic which took a little longer to administer due to my disability, but they were prepared for this and had allowed extra time for that very eventuality. I felt nothing during the procedure, not even the tugging or rummaging sensations I was told to expect. I was out of bed and in the shower a few hours later and barely experienced any pain following the procedure, in fact, I really couldn't believe I'd had abdominal surgery as I was experiencing so little discomfort. I took the proffered painkillers for a couple of days as I know it's easier to tackle pain before it peaks, but then I stopped as I really didn't need them. I have a very neat scar and have been as mobile as usual since the operation.
They made sure I had skin to skin contact with our lovely baby as soon as she had been given a quick once over, which was utterly amazing and really put my mind at rest about not having the same bonding experience as if I'd given birth vaginally.
I personally found it a wonderful experience but you must only do what feels right for you. Best of luck.

You only have to read this thread to see there is no typical experience when it comes to giving birth. Like you I worried and worried and worried and worried before I gave birth to my first child (I was 34) and my worry was compounded by the fact that I was giving birth in France and French is not my first language. I read loads of books, heard all the horror stories, generally worked myself up into a right old panic. In the end I had the most straightforward, calm birth imaginable with a relatively quick labour (7.5 hours). What I learned from that experience was what a waste of time all that worrying was - it made no difference at all to the eventual outcome. So many of the factors - the position your baby is in, the shape of your pelvis, how long your labour is likely to be (ask your mum how hers was) are beyond your control. Noone can tell you what your experience will be like, I'm certainly not going to tell you what to do. I just wanted to say that I understand your anxiety and to reassure you that it will almost certainly not be as bad as you imagine in fact you might actually enjoy it (I did - and the birth of my son two years later which was even easier). And remember, the birth is just a short moment in time in the grand scheme of things - natural to focus on it when you are still pregnant, but over in a flash compared to the rest of your child's life. The great advantage of a vaginal birth is you can be up and about immediately as you launch into the great adventure of being a mum. Good luck whatever you decide.

You do make a birth plan, I made mine around 34 weeks, however you are free to decline any intervention during labour and they will then give the other options eg if baby needs to be born and you decline an induction you would be within your rights to ask for a caesarean instead. I think it’s worth keeping an open mind about the whole process as there’s so much that can change both with you and baby. I would have considered myself fit and healthy, low risk pregnancy until 36 weeks when baby stopped growing, later was found to be IUGR and hence I had an induction/caesarean at 39 weeks. I declined the oxytocin drip and had a section instead as that was a personal ‘red line’ for me.

You seem pretty set on a caesarean going by your replies.

I was scared of labour but terrified of a c section.

Go with what seems less scary to you x

One option you could look at OP is a 39 week induction https://www.unimelb.edu.au/newsroom/news/2023/may/mothers-choosing-to-induce-labour-at-39-weeks-have-better-health-outcomes then if induction doesn’t progress you have a good clue that vaginal birth won’t be straightforward and can ask for a c section and get sent to theatre? That way you’ve given straightforward birth a go but are in the right place to have c section and your baby is very monitored throughout. I also found that I started to get really scared about baby in last few weeks of pregnancy, constantly checking for changes in movement etc, so I definitely didn’t want to just wait for baby to come for weeks - a booked induction felt like best of both worlds.

I had a planned section 9 months ago. I have 0 regrets.

I have OCD and just couldn't cope with the unknowns of labour. For me the known risks of a section was by far the best choice. I also didn't want the chance of severe tears or lifelong continence issues.

I have no regrets. It was a calm experience, and I picked out some nice music. They get the baby out in the first 15 minutes, so you spend the rest of your time in awe looking at your beautiful baby whilst they stitch you up. I would do it again in a heartbeat. My recovery was a breeze, and breastfeeding has gone really well.

I did haemorrhage, but I was at increased risk of this as I had Polyhydramnios. I didn't even know it was happening. I was exceptionally tired for many days after and had an iron transfusion, but otherwise it was all very smooth.

Severe haemorrhage and needing your uterus removed is very rare, and even rarer for an elective section. Most of the negative statistics come from emergencies.

I had one vaginal birth (traumatic, haemorrhage, 3rd degree tear, missed the golden hour after birth due to being in theatre, pain when walking and during sex for a year or more. Thankfully no continence issues although doctors seemed surprised to hear this given my injury).

Had an elective c section and it was a dream. Was back driving within 3 weeks without pain, had 1 week of stiffness and feeling like I couldn’t straighten up but then things rapidly improved. Scar healed so well you honestly can’t see it, it’s only about 10cm long. You can’t lift anything heavier than the baby for a while so used a sling instead of using the pram when I was by myself for the first 3 months. But absolutely no lasting issues at all, it was miles better than my vaginal birth.

An uncomplicated vaginal birth is miles easier to recover from I’m sure, but seeing as birth is so unpredictable you can never guarantee that that’s what you’ll end up with.

I’ve had two emergency sections and I would have wanted vaginals both times hands down

I had a planned section due to a huge baby, it was great, I was out of hospital 2 days later and out for lunch with baby in tow 5 days post-partum, back to driving 3 weeks later. I’ve never had a vaginal birth but would not choose to after my experience of a planned c section. Good luck whatever you decide to choose.

Have you thought about getting a doula OP?

Also, you don't have to agree to anything during labour. I had it on my notes that I did but wasn't forceps under any circumstances.
Do whatevers best for you at the time.

I had a vaginal birth, baby was in distress and I was rushed to theatre for a GA, but thankfully babies heart rate picked up enough for me to throw everything at pushing as they could see the babies head, I had an episiotomy and ventouse. Honestly, I found the recovery absolutely fine, I was out 2 days later at the pub, restaurant, going for walks, driving etc. Just to say, if you went for a vaginal and ended up with some form of interventions, it doesn't mean it has to be horrific. I was a bit out of my body at the time (I was unable to have any pain relief as it was so quick) because I was in so much pain I didn't really know what was going on but I do have some fond memories of the birth (more than my partner who was absolutely terrified!) If I had to choose, I have no idea what I'd do! Good luck x

Midwives point of view here!
im 16 weeks with my first baby and have seen it all. I am opting for a vaginal birth.
So many women really do just come in and push babies out! With no intervention, very small tears, minimal bleeding & home a few hours later. I have seen women do it with their first baby so many times. I think people love to share the horror stories, but even after the horrors I have seen, I’m not put off by vaginal birth. We can manage a haemorrhage quite easily with drugs, I’ve never seen a hysterectomy in 6 years. You could include in your birth plan to have a cannula in labour incase you bleed, if it is causing anxiety.
see if there is a birth choices clinic at your trust to discuss your plan with a consultant X

I had a vaginal birth with forceps and tears with my first, quite a rough recovery. And I just had a planned cesarean 6 days ago. Honestly, I would choose vaginal, even with the forceps, all day every day. This is horrible. I'm utterly useless and in a lot of pain. My baby is 11lb and even him lying on my tummy to breastfeed is super painful. With my vaginal, yes it was sore down there, but I was up and on my feet and could go about my day ! But everyone is different. I would be hesitant to plan a section for my 1st especially, it can impact later pregnancies and births x

I wanted a c section with my first, but it wasn't really as "elective" as they make out. MW convinced me to go for VB. I was overdue with my first and had to ensure an induction with the syntocin drip, a very very long exhausting labour and not what I expected. I had an epidural early, and as I got to the pushing stage it wore off a tiny bit (not enough to be in pain), but enough to push. No forceps or assistance needed, second degree tear was stiched. I went on to have a second VB, another induction, this time early term due to an unrelated complication. Induction was painful and exhausting, birth was great because it was what they call a spontaneous delivery. Another second degree tear in the exact same place, stitched up really well. Things look and feel the same as they did before. Both times I was showering an hour later, and relieved to be able to get up and walk, after spending time with baby. Dcs are 8, and 5 now.

I was pleased to escape invasive surgery, and be more mobile afterwards, which helped my recovery. The MW was right, in my case it worked out. My bladder control is great, I joke with dh is he the ones who had the babies because he's always at the toilet! You get horror stories about both methods of birth, but I wanted to give you a positive VB one, especially after inductions which everyone thinks leads to intervention. Mine didn't; maybe I was lucky I don't know?