can anyone offer encouraging experiences of planned c-section?

[fluppy]

I think I will need to have a planned section if I decide to have another child and the thought terrifies me. I am worried about the experience of surgery and the prolonged recovery with what seems to be an exhaustive list of complications. Also, after a traumatic delivery and a poor surgical repair first time around (see below), my husband and I find it hard to trust anyone with this sort of major surgery. Can anyone help?

The background to this:
After some nasty third degree tearing during an emergency forceps delivery (baby 'stuck' and in distress), I have needed further surgery to re-cut and stitch (sorry!) the repair, and am still (9 months on) seeing a consultant about some minor urinary incontinence. Advice about whether a subsequent vaginal delivery could lead to tearing/double incontinence has been very variable, but the excellent uro-gynae consultant I am seeing says a normal delivery would be possible 'if it is very well controlled to avoid tearing'. My last delivery was truly awful and anything BUT controlled (midwife refused to examine me despite my explaining family history of fast labour - instead tried to send me home and then disappeared never to return; although my husband kept going out and asking for gas and air it took 1h 45mins before anyone even CAME IN to the room, which was only 15mins before I started pushing etc.etc.). So I don't feel I could trust anyone to oversee my labour, and that leaves me with a planned c-section which terrifies me. HELP!

Yeah they talk to you all the time, explaining what is going on etc. We had the radio on too, and it was a very relaxed atmosphere.

I've had 1 emergency and 2 planned and was (needlessly) petrified for each of them! The staff were absolutely brilliant each time but particularly so for my last one (they were all at the same NHS hospital.) I got to meet the "team" the evening before to air any concerns (of which I had plenty) and even got to choose the music played in the theatre.

I was talked through each operation as it happened and my DH was allowed to walk around snapping photos of the whole process (makes me feel ill to look at the photos but they are absolutely amazing!) I cannot speak highly enough of the whole process but the key to it all, for me, was having fantastic support - not just at home from family and friends but whilst in hospital from staff, family and friends.

Recovering had good days and bad days but the excitement of having a beautiful little bundle seemed to override the bad days.

I'm not going to have any more but if I did I would elect to have a section every time. Anyone who has had a vaginal delivery should have a medal IMO!

Yes, fluppy, they do talk to you. I found that because I wasn't in pain, I was more 'present' and could participate in it more. And my dd1 was taken from me and had to go to Nicu, so I was unconscious when she was born and unable to see her for nearly a day, whereas with dd2 I have photos of her bfeeding in recovery.

The only bit of my elective that I didn't like was when they put the initial anaesthetic in, but that was more nerves than anything else. I did 'feel' my section in that I felt a tugging but it absolutely does not hurt.

depserate housewife - my hospital (Vancouver)has single rooms for everyone, so there was a fold down chair/bed thing for DH. It was pretty uncomfortable though, and I sent him home the second night. The conventional birthing rooms have a bed that is actually a 'procedure' table and my neighbour siad it was soooooo uncomfortable. I think it is to encourage mums to go home ASAP!

I'm dreading the thought of doing all this again on the NHS - shared rooms, no definite time for your CS etc etc

I had a planned section with my DD 15 months ago (after a horrid 3rd/4th tear with DS 18 months before her birth) also to prevent double incontinence. It was great overall.

Good points - I knew when I was having the baby so I had childcare sorted for DS. I could also arrange for family to visit, and look after DH and DS while I was away. While it was an operation, the 'theatre' staff were fab and it was just as exciting and much less scary than my first birth. It was a medical scenario but they were delighted for me and there was a really happy atmosphere when DD arrived. I felt I was being looked after properly, e.g. I said I felt a bit strange (low blood pressure making me faint) and it was dealt with immediately. Due to the drugs and endorphins it was one of the best days of my life. I was able to really enjoy and gaze at my new baby (after DS's birth I'd felt like I'd survived a car crash)

The aftercare in the hospital I was in was rubbbish but at least I knew we were both healthy and we were out with 36 hours. What I'm trying to say is that I felt I had the decent care during the scary, potentially life threatening bit of childbirth and afterwards it didn't matter so much that the hospital was understaffed, etc.

Bad points - The recovery took a long time (despite my tear the first time, I recovered physically very quickly). It was frustrating to still be in pain a week on especially with an 18 month old around I wanted to look after. Breastfeeding was difficult but I think that was due to DD and not really the section (it's taken her a long time to aquire the skills for eating and drinking). DS was already going to a childminder so we upped his time with her for about a month while I found my feet with DD which was great as we don't have any family nearby.

Strangely though I don't know what I'd do next time. I'm hoping my tear will have recovered even more and that I might be able to try for a vaginal birth. There are lots of complex psychological and emotional issues around childbirth but in a ridiculous way (and I know it is ridiculous!) I didn't feel like I deserved DD as her birth was too easy. Something of the physicalness of birth was missing. Of course, everyone points out that we are all well and healthy, that I didn't have the traumatic birth I had with DS and didn't end up incontinent but it's there nevertheless.

I can't imagine this has helped much but I suppose what I'm trying to say is that the surgery was fine, painless and exciting.

On the contrary, Gem13, it IS very helpful to hear your story. And I do take your point about feeling detached from the process of birth. On balance I suspect that I would have fewer psychological issues to grapple with after a section than I did after such a traumatic birth last time round. And the continuing urinary continence problems I am having - though minor compared to many people - have caused me a great deal of distress. So I can't imagine how I would deal with double incontinence if a subsequent vaginal birth went the same way.

While I would not opt for major surgery lightly, it does seem to be my best option on a number of levels, given what people are saying here. And I wonder whether it might lay a few ghosts to rest for me if I did have a more controlled and exciting (rather than frightening) experience of birth.

Not only that, but my poor husband could actually enjoy the experience instead of spending his time trying to find someone to provide some gas and air or chasing my bed down the corridor to theatre!

god i was in a shared room with 26 other women and my husband was forced to go home. I cried! It was horrendous. not a wink of sleep because there was always a baby crying (or a mum!)

I'll echo the positive experiences with a planned c-s. Dh and I walked calmly down to theater together having chosen the CD we wanted on for the op (most theatres will let you do this). Everything was very calm, relaxed and friendly. The anaesthetist and dh stayed up near my head and I was able to say that I felt a bit sick at one point so the anaes. gave me some oxygen and I felt fine. The surgeon chatted to me throughout, talking through the main bits and warned us when dd was to be delivered.

She was lifted above the screen to the sound of 'let there be love' by nat king cole and dh and I both burst into tears. After she was weighed and checked I had her straight back and we were able to cuddle from then on. I stayed in recovery for half and hour, which is normal, but it just flew by, then onto the ward. The morphine, I have to say, was marvellous and I felt no pain at all and had a lovely old time for the rest of the day. Managed to sit up and have some tea and toast after a few hours. Got up and shuffled off to the loo by tea-time and had a shower the next day. Was able to cradle her and cuddle her from the off, sitting up. She wouldn't breast-feed which may have been due to the section as I had her at 37.5 weeks, but I decided not to stress about it and she went onto the bottle the next day.

I had her on the Monday and we came home on the Friday. I was able to walk and carry her with no probs. I would say accept all the help you can and rest as much as poss. Don't be a hero! Accept all pain relief and keep up the tablets prescribed for as long as you need them. Dh was off work for 3 weeks and that definitely helped - make sure you've got hands-on help for at least a couple of weeks, and don't even think about anything else apart from you and the baby, i.e. no lifting, cooking, housework (yikes!). Let everyone else bear the brunt of that.

I'm 19 wks pg now and it looks like I'll have another elec and I can't say I'm worried at all. Good luck!

i had 2 sections - both emergencies!

The first one was because her head got stuck & just would not budge. I was in labour for 10 hours with awful contractions but she could just not progress down so I never even got as far as pushing - I'd had gas & air, pethadine & they tried to give me an epidural but the needle came out (sounds much worse than it was). They wanted to do another epidural but lets just say I had gone way past the lying still stage so in the end I was under GA - This was 13 yrs ago and I still remember the pain when I started to come round - I have no recollection of the first 3 days of my daughters life because I'd been given so much pain relief and was off on another planet for a while so BF was out of the question.

Second time round (10 yrs later)I was told I could have an elective section because my pelvis is on the small size (despite my enormous hips) and so I wasn't worried during my pregnancy - I was told I could have a spinal block (most fantastic experience I could imagine) - even though I was supposed to have a planned c/s, I developed a problem with my placenta (started coming away) so 4 weeks early, I had another emergency c/s at 2 in the morning!!!!

I remember the staff were so nice and kept me & dp at ease during all of it - the anaesthetist was cracking jokes and when they said it was a boy, I was so chuffed.

I've had experiences of emergency c/s and both have been opposite sides of the same coin - I would definately go for a spinal block - I was up and around later the same day, had almost no pains and felt absolutely back to normal within a couple of weeks.

Lots of luck to you

Hi. One positive experience to add. I had a planned section at term + 7 days with 2nd baby (1st was emergency & they didn't want me to go too overdue).

For me it was great. V. calm atmosphere in surgery. Staff were relaxed and all went to plan. I breastfed in the recovery room, got feeling back quickly and was off the drip by tea time (op was about 10.30 am). I was in hospital 2 nights, stitches out & off the painkillers within a week & driving 3 weeks later.

I'm not saying it didn't hurt - it did - but it was bearable & probably no worse than what you've been through anyway.

Good luck whatever happens

I had an elective section with the DTs and it was calm and lovely. It was helped by having a gorgeous anaethetist

Thank you all so much for sharing your experiences.

I can see that there will, of course, be some recovery time but, as discussed below, this will probably be about the same as last time. In the long run, did anyone have any problems as a result of having a section? It would be silly to try to avoid continence problems if I just ended up dealing with other medical complications as a result! The textbook answers on this seem to suggest that 'complications are rare' but then noone would have predicted my first delivery either...

And does anyone know if there is anything one can do ahead of conceiving to help to recover from the surgery? I'm going to post-natal pilates - presumably continuing to go to that will help my stomach muscles to be in good shape. I'm also blasting my pelvic floor with an electrical stimulator from my physio to try to sort the continence. Any other hints on how to be physically prepared?

Just general exercise so you are fit, plenty of rest so you are able to recover, and arnica tablets from 2 weeks before hand to reduce the post op bruising

Hi fluppy

I had a similarly horrid first birth to yours - baby stuck, emergency forceps, episiotomy and then third-degree tear. At least I didn't have to be restitched, but it had a similarly long recovery time - walking painful and tiring for nearly 6wks and I was a total emotional mess because it was all so shocking and unexpected - I thought I'd be one of those people who gave birth on a Monday and was in Sainsburys by Wednesday afternoon!

Second time round I knew I was going to opt for the elective c-section, and it was made easy for me as my consultant at Queen Charlottes in London even suggested it at our first appt, as my notes from birth no. 1 catalogued the whole sequence of events. I would have done ANYTHING to avoid another natural birth, so this was a huge relief.

The actual section was such a lovely, positive experience. I felt totally in control, the theatre staff were lovely, and I held dd2 immediately after they delivered her (first time round, they took away dd1 for nearly 30mins and I was puking for nearly 2hrs after epidural

Yes, the first night was tough, but my recovery from the c-section was much quicker than my bad 'natural' birth.

I still have minor incontinence problems from my tear. In contrast, my c-section scar is the only reminder of dd2's birth, and that has faded so much it's hardly visible to the naked eye.

belledejour - sounds just like me! I practically 'skipped' through pregnancy, and fully expected to deliver fast but successfully (as is the norm in my family) and be discharged the same day. In fact, after my re-stitch last week, I haven't even taken so much as a paracetemol - I tend to ride these things very well, so being so incapacitated for so long was a terrible shock. Made worse, really, by the knowledge that it probably needn't have happened if I had been monitored at all during my labour .

I am so encouraged to hear everyone's stories. I was devastated to find myself feeling unable to go ahead with our planned second baby as a result of what happened. Now I think I will take up the offer of a consultation with the ob-gynae consultant prior to trying to conceive, to discuss options. And after reading all your replies, I'm hoping he will agree that a planned section is the way forward. God knows, I don't think I could go through nine months wondering what was going to happen at the end...

Hi fluppy
I too had a third degree tear and a ventouse that sounds quite similar to yours, and can really sympathise with your predicament, especially the fact that the birth leaves physical as well as emotional scars. I am also a midwife and have recently looked after a couple of women having elective caesareans after third degree tears - they have seemed to find the experience of a c/s (during the first few days only - I work in hospital and don't see women for long) better, or comparable with recovery from the tear. It's great that you feel more settled in your mind after reading the messages on the list. However,without wanting to confuse you more, you are right to be aware that a caesarean is major surgery and is associated with more complications than a straightforward birth (e.g. infection, possibly finding it more difficult to conceive again, increased incidence of breathing problems for the baby at birth, to name a few). I guess this has to be weighed against the complications of a vaginal birth for you, and the obviously traumatic experience you had first time. Maybe you might want to ask more about this if you do go for a consultation? I am weighing up the same issues myself and there is no easy answer, but a friend of mine gave me the advice: 'pick the complications you think you can live with' (e.g for me, having a caesarean is probably preferable to the increased risk of faecal incontinence from another vaginal delivery, even tho I don't really want a caesarean).
Hope this helps! And one other thing - do make a birth plan and if you feel you can, stress that you were left alone last time and were not happy with the care. Most midwives will feel bad that you had such a bad experience first time, and any that don't will be worried that you might complain and treat you with kid gloves! Cynical but it works.