Would you opt for a c section second time around?

[cherrycola66]

My birth was relatively quick but extremely painful, I was refused an epidural the entire way through and when they finally agreed I was 9cm so it was too late. I really dread going through that again, would I be silly to ask for a c section?

God knows, I went in around 11 to have waters broke. Contraction started around 4pm when having a coffee downstairs, I went up to the ward and the gave me it straight away

I think it does depend from trust to trust, and even on who is in charge on the day. Generally they don’t like to give you one before you’re 4cm.

I chose my hospital deliberately because I knew they give epidurals easily on request, and also have a low threshold for intervention (very important for me; I’m pretty medical in my approach to birth). The anaesthetist confirmed to me that they have a target of siting an epidural within 25 minutes of being asked for one. BUT that’s once you’re on the labour ward. When I was admitted at 4am I was put on antenatal, as I wasn’t dilated almost at all, despite strong regular contractions. The (agency) midwife there made it very clear that I wasn’t going anywhere near the labour ward, or an epidural, until 4cm.

The pain became unreal by about 6am, and I spent the next 6 hours howling in agony. I’m not a screamer at all, but I found vocalising was the only way I could get through it. In that time I begged and begged and pleaded for an epidural but was told over and over again no way until 4cm. I was offered paracetamol (complete joke!), codeine, and pethidine, which I absolutely did not want, but took in desperation after being told again no epidural was coming any time soon. The pethidine did absolutely nothing for the pain, but scrambled my brain and left me with several memory gaps.

Someone, I don’t know who, took pity on me around noon, and at still less than 1cm moved me to the labour ward, gave me the epidural and broke my waters. I don’t know who it was, but I’ll be eternally grateful to them, because I honestly don’t know how much longer I could have gone on like that. It was by far the worst pain I could ever have imagined, and to this day I can’t find the words to describe it. And the epidural did me no harm, because I dilated to 10cm within the next 4-5 hours after 18 hours of almost no progress at all.

That sounds a lot like my experience regarding pain relief, they offered me paracetamol which I actually got annoyed about telling them I’m in labour I don’t want bloody paracetamol what’s that going to do! I did take the pethadine which I now regret as it did not take the pain away in the slightest it just made me feel drunk and actually I think I was unable to control myself during contraction due to this I was like a zombie it was horrible, I will definitely look into which hospitals will give epidurals though, how did you find pushing with an epidural as I know some say it makes you unable to push effectively

To be fair, I couldn’t feel anything when I was pushing, though the midwife said I was doing it correctly. I suppose I could have stopped topping up the epidural and let it wear off a bit for pushing (it had a button I could press to top up), but there was no way I was going back to the kind of pain I’d been in!!

Ultimately, my daughter was in a very awkward position - she half turned to the side from back to back - so I don’t think she was coming out on her own. Her heart rate started to dip, there was some bleeding, they took us to theatre and got her out by forceps after failed ventouse. And just as well that they did because it turns out I was likely having a placental abruption- but that’s a whole other story.

I am in London and had a choice of St George’s and Chelsea and Westminster, and went for Chelsea and Westminster for the reason I mentioned. Not sure what your choices would be?

Same here. Horrendous.

OP in your position I would not go for the planned C section, and I say that as someone who had one emergency and one planned and recovered fine from both.

Although painful, it sounds like your first labour was relatively quick and with no complications. I would think about a different hospital and a clear birthing plan (including Epidural).

Wishing you all the best with whatever decision you make.

This was me just 8 weeks ago. I had a section and a just turned 2YO to look after. Worse experience I've been been through yet.

I wouldn’t. The recovery from a c section can be brutal. I am on day 10 of my third c section and still can’t look after my older children at all

have a vaginal with all the pain relief you want

So I had my c section first then I had the incredibly quick no time to have any pain relief as by the time they admitted I was in labour it was too late to have anything. even stitches was just a local anaesthetic

I was in hospital due to previous c section and waters breaking and was at 1cm for awhile then it kicked off and 3 hours later there he was!

I did give it a little thought when I was tempted by a 3 and here are my thoughts

1. the c section was calm (planned) and the actual birth pain free but the recovery was tough. Couldn’t move until the following day due to anaesthetic wearing off and catheter. Moving around was painful and the first few weeks took it easy just short walks and antenatal visits

2. the vbac did god was 3 hours of constant pain, everyone goes quick birth must be good. No the reason I had to argue I was in labour was because the machine connected to me didn’t pick up a contraction becuase the contraction didn’t stop. The pain was such I remember thinking I can see why if you don’t know you are pregnant you might die. I couldn’t stand still to be the pethidine! I did feel to push and the adrenaline rush at the end was amazing.
   recovery was far simpler I could walk that morning (the amount of times I said yes I can walk because I didn’t have an epidural) the stitiches were sore (2nd degree and internal) but baths sorted it. Was up and out quickly and within 2 weeks all was good.

My order was great the longer recovery was far easier with DD than if I had DD and DS and the vbac meant I was back on the school run by the Tuesday (born Saturday).

the big one for me wasn’t the pain - overall it balanced out longer for c section more intense for VB and the recovery was much easier with the VBAC. No it was whether my second labour would be shorter (which tends to be the case) and how that would be handled. DS was in distress by the end and needed intervention. Would we have time for that? That would be the focus for me how that was handled in order for the baby to be delivered and if a plan for a vbac wasn’t properly thought out I would lean to a c section.

ultimately it was one factor in not having a third but I had 2 at that point. Becuase I wouldn’t want another c section but there were risks for a vbac

I feel I should say this to balance things out a bit. You are always warned of the risks of c sections, the painful recoveries etc. I don’t feel I was warned of the risks and painful recoveries after vaginal births gone wrong. It took me three months to sit down without a gutter cushion after my vaginal birth. The stitches got infected. My pelvic floor was trashed. My bladder stopped working and I went home with a catheter and leg bag, followed by a readmission when it still hadn’t been sorted out after a week. I was completely incontinent, had the worst constipation imaginable and spent five days in hospital on oramorph, having a blood transfusion etc. I could barely walk to the end of the ward, a school run would have been impossible for weeks. I couldn’t go to any baby classes for months because my back was too painful for me to get down to the floor; I could barely push the pram. I am lucky that this was my first baby, because if I had had older children I’d have been stuffed. I still have some mild incontinence and episodes of back spasm now, 5.5 years later. The two c sections were a walk in the park compared to that.

Your first birth sounds painful but straightforward, so with any luck a second vaginal birth will be straightforward too. But - not all vaginal birth recoveries are easy peasy, and not all section recoveries are awful. The other way can easily happen too.

Could you ask for a copy of your labour notes?
I had an induction with my first, ending in forceps and episiotomy - and swore to myself that with my second baby I would opt for a c section.
2 years later, I’m due my second. I initially wanted a c section and this is being arranged, however I also had a birth reflections meeting to go through why what happened happened, and I’ve been able to feed this into my birth plan - I now want a natural birth as I don’t want to deal with the recovery from a c section with a 2 year old.

you may be able to have within your birth plan for your next child, to have an immediate epidural. Now they know you have a quick labour - it can be factored in

I had an elective c section with my first and had a good experience. I'm now pregnant again and I'm planning another c section. My thinking is that vaginal birth is unpredictable and I'd rather take the known quantity of another section. But only you can make a decision that is right for you and your family.

How long after birth did you have the meeting? We had a pretty traumatic birth, partner is probably more traumatised than me. We were offered a meeting at the time but we just wanted to get on with things so didn't bother. But would really love to do it before we think about our second

Yes no qualms about it either .

I wasn’t offered one after the first birth - I just sort of put it out of my mind, and think my husband was more traumatised! But I couldn’t talk about not wanting forceps in the future without crying.
it was offered to me at my booking appointment for my second child, so much later on, and then I had it when I was 26weeks. I think it’s been far more useful to me having it during my second pregnancy rather than straight after the first.

Thanks I might get in touch with the hospital. I was put to sleep for c section, partner had no idea, he was waiting in his scrubs to come down, next thing he knew baby appears without me! So I missed it all but he's pretty shaken by it all

C section has much worse outcomes for both mother and baby, so I wouldn't take this option as a choice

This is not the case. In fact, if you compare planned vaginal births with planned c sections that are not due to either a vaginal birth gone wrong or a high risk pregnancy (I.e. maternal request c sections), the outcomes of the c sections have been better for both mother and baby www.theguardian.com/lifeandstyle/2022/feb/13/caesareans-or-vaginal-births-should-mothers-or-medics-have-the-final-say

I respectfully disagree, my husband and I did extensive research on the topic. Even things like vaginal flora all of these things contributed to my decision to opt for a vaginal birth if it was possible

The gut microbiome theory has been contradicted by recent research: https://www.news-medical.net/news/20230330/Babies-gut-microbiome-is-not-influenced-by-vaginal-microbiome-new-study-suggests.aspx

Even so, seeding, skin to skin and breastfeeding would all address that if the mother was concerned.

Outcomes like birth trauma for the baby and organ prolapse, and urinary and faecal incontinence for the mother are summarised here, and better for maternal request c section vs planned vaginal birth:

https://www.sciencedirect.com/science/article/abs/pii/S2589933323003282#:~:text=Planned%20cesarean%20delivery%20was%20associated,7.1%25%3B%20relative%20risk%2C%200.36%3B

https://www.cmaj.ca/content/193/18/E634

I’m not going to argue further on this because I don’t want to derail OP’s thread. The relative risks are not hugely different either way, and ultimately it’s about what she is comfortable with and works for her and her family. But I wanted to set out the facts, because, as I said before, there are so many warnings about the risks of sections and virtually none about the risks of vaginal births.
Very best of luck OP - whatever you choose will be right for you and your baby.

@earlgrey DH works in research for a living so I'm happy to go with his advice on this matter. Like anything you need to do proper research, talk to some experts, weigh up the risks and benefits and decide what's best for you and your baby. MN probably isn't the best place for that, although might be handy for some anecdotal advice. All the best OP with whatever you do.

As someone who’s had two planned c-sections, I would not choose one. Yes it’s quick and you may recover well, but it’s a major trauma to your body! I luckily had 1/10 pain with my first but 9/10 pain with my second where I could hardly walk for a month.

Plus if all goes well in pregnancy and labour and there aren’t any complications, it’s actually better for the baby to be born vaginally and be exposed to the vaginal flora and also have fluid squeezed from the lungs - probably amongst other things! I wish I had the option of a vaginal birth…

You can absolutely request a c-section, it would be called a “maternal request”. I would however really encourage you to ask for a birth debrief session to understand what happened and empower any future decision. I’ve had both a vaginal birth and a c-section. Both required a period of recovery and I would not necessarily advocate for either one because I think in our hearts we always instinctively know how we want to give birth and should be empowered to make those decisions for ourselves.

I had a planned section for a breach baby first time around, no actual issues but the recovery etc is very hard going and second time chose a VBAC and it was so much better and would opt for this again.

C section is much more painful after and longer recovery