Help deciding on birth options after traumatic first birth

[Confused789]

My first birth wasn’t straightforward, as a lot of peoples aren’t. But it could have been worse. It was more traumatic for my baby though. I’m now pregnant with my second and I can’t decide whether to try for a natural birth again or opt for elective C-Section.

For my first, my waters went during a sweep, which meant I had 24 hours to go into spontaneous labour before they would have induced me due to risk of infection. Labour started soon after but it was a long 36 hours. Baby was back to back and ended up being born via ventouse. I had an episiotomy but didn’t tear. However, baby was born with head trauma, leading to a hospital stay for 6 days, trips to NICU and an A&E trip for a CT scan to check for skull fracture at 8 days old. The pain he was in made establishing breastfeeding very difficult. He still has effects of this head trauma today at 3 years old, although it is now just cosmetic and doesn’t impact him at all/isn’t visible now that he has hair.

My physical recovery was ok. My stitches did tear but I felt fine after 6 weeks. I did however end up having PND and PNA. Whether my birth experience contributed towards this, I don’t know. I did find those first few weeks post birth more traumatic than birth itself.

I now need to decide what I want to do for my second delivery. I’ve been advised second births are quicker, less likely need interventions etc. but I’m terrified of the same head trauma happening again and I have a lot of anxiety around this. I’m worried the shape of my pelvis could have contributed to what happened but I’ll never know if that’s true.

If you were me, what would you do? Vaginal birth or ELCS?

You asked above why I went for ELCS for my third. First was an induction, ended up with forceps and healing was terrible. Second was a standard vaginal delivery which was much easier and went fine but the stitches from the episiotomy got infected and I ended up back in hospital for surgery. Third time my (private) consultant recommended ELCS as so much risk around tearing/healing if vaginal. I honestly can’t recommend the ELCS enough. (Though the second vaginal was also fine until the healing problems).

Another thought. Is the hospital you’ll deliver in ok? It’s not one that’s listed as failing by the Care Quality Commission or has a low caesarean rate or a bad reputation locally or renowned for low staffing levels?

Take all that into the mix in deciding if you’re likely to have decent care on a spontaneous natural birth whenever you rock up, or on a planned section.

@EvelynBeatrice I think it has a good reputation but good shout, I’ll look it up and check.

I had a traumatic first labour. Very simlar to your story: waters first, drip to get contraction to speed up after a long labour, ventouse, baby in bad condition with an infection, bruising and severe jaundice.

I went on to have two homebirths in birth pool with gas and air.

What I mean is that there is a specific thing you can request called a birth debrief/reflections service - they call it different things in different areas, but if you ask at your next appointment, they should know what you are talking about. You might also be able to find a referral form online in advance.

It doesn't matter if it's the same HCP as you actually saw previously during your birth, they will basically go through the notes and be able to understand from that and give the hospital/medical side of things. If it is the same hospital and the staff member(s) are still there they might be able to get context from them as well.

A lot of people find this really helpful especially when a previous birth has been traumatic and they are planning for the next.

Good luck with whatever you decide, I hope it goes well.

I had a traumatic first birth (emergency section, 7 litre PPH, ITU admission etc) and chose an elective section for number 2. I knew I didn't want more children after no. 2 so.no risk from repeated sections and I felt I'd be too scared to ever be relaxed enough to give me a decent chance of a normal delivery. Elective section was a very positive calm experience, discharged home after 24 hours. No regrets.

I really agree with this!

Elective c section - very calm experience and safe for mum and baby.

If you're still thinking about your birth plan, just to say an OA baby is so much easier to get out than OP in my experience. My first was OP induced, and my second was OA spontaneous. Second births are usually easier anyway, but I found a world in the difference. They should be able to tell you baby's position from external checks.

Also ask your consultants about their rates of assisted births with epidurals. I declined one the second time, because they had a 90% rate of assisted deliveries with epidurals in my hospital.