oh i can't make up my mind. can you all tell me if I should go for an elective c-section this time?

[oranges]

I tore last time, badly. a 4th degree tear after a fast labour. Luck and an incredibly skilled surgeon meant I don't have ongoing problems. Now I'm pregnant again. The midwives recommend a c-section. The doctors say I will be fine with a managed vaginal birth.
I'm 35 weeks and need to decide what to do soon. Help!

I went for an elective c section after an emergency one and it was the best decision i made, for me. My recovery was so much quicker than after the emcs and it was nice to know the exact day that ds2 would be born.

I have a friend who recently had a nightmare experience of elective CS (she had 3 previous emergency CS). All of of her emergency CS were better experiences. I guess that there is no easy way to have a baby...

If it were me OP I'd try for vaginal, because recovery is so much easier (as a rule).

did the docs know why you tore so badly?

Hi Oranges, I was on the other 3rd/4th degree tear thread a few weeks ago with you. Have the docs checked out the tear site now and decided that it can withstand another vaginal birth? It must be confusing to be given conflicting advice.

I'm seeing a consultant in a few weeks and was thinking about asking for investigations as to how the scar tissue has settled down in my vagina and rectum. Really don't fancy the possibility of double-incontinence, but abdominal surgery isn't exactly a picnic either.

Hi,
I did have scans done to check whether the scar had healed but no-one has sent through the results of the scan and the consultant seems unbothered about chasing it up - he just keeps saying "oh I'm sure you are are fine." and then adds if things go wrong I can always have surgery to correct it later. And ALL the midwives, and an incontinence nurse I saw say to go for a c-section and ask me to ask the doctor what he would recomend for his wife under the circumstances. I had al awful appointment with a registrar last week when I tried to talk about a c-section and his opening words were: "well there are risks to a c-section. You could die, you know."

No real idea why I tore so badly last time, except the midwife ordered me to push and made no attempt to cntrol the crowning - the baby shot out.

I'd have thought that your consultant would want to refer to your scan results before making a decision - both he and the registrar sound really helpful . Can you ask for/would you want a second opinion?

Unfortunately, whichever route you take will have risks. What are the C-section stats for your hospital like?

you'd think so, wouldn't you [hmmm]. how do I go about getting a second opinion? I just feel very upset and angry now about the whole thing - furious that I tore last time due to a mismanaged birth and upset about what's coming this time around. Major physical trauma whatever happens.

What tear first, ask questions later?

In your position, I'd have a c section.

Ask your GP to chase up the scan results for you

I've been umming and aahhing too- had emcs last time, and while there's no very pressing reason I couldn't try for a VBAC if I really want, there are a lot of lesser reasons why a CS might be better (big baby, unusually shaped cervix that never dilated last time, lack of confidence in VBAC, plus my horror of internal exams) and the consultant recommended it. So I've recently decided on the CS.

Friends have wisely said to me - listen to your instinct and gut feeling, what prospect makes you feel most relaxed and confident? - and do you have an emotional feeling of needing a vaginal birth to feel happy (as some women do)? Thinking about these helped me decide.

My doctors also seem to think: "well if you tear, and have continence problems, you just have to make sure you are near a loo at all times. no big deal"

And it is a big deal and awful what they think women should tolerate after birth. Yes, veering towards a c-section. I think I now need to start a thread asking for positive c-section stories and stop scaring myself with horror stories of scars not healing and stitches unraveling.

Not sure there's a point of a debrief of the last birth - it was at a different hospital nearly 4 years ago and I'm sure they've lost the records. They lost everything else.

Can't tell you what you should do but I would certainly have a c-section in your shoes.

MarineIguana, I thought your post was very eloquent and have quoted you in a new thread - I hope you don't mind!

All my friends who have had planned c sections have said it was a positive experience, and honestly don't know of any horror stories. Planned is so very different than emergency c section.

Oh please don't start a thread inviting comments about positive c sections as you may get all sorts of responses, some of which may not be helpful to you.

Amazing about the doctors though . Can you imagine a doctor saying to them, 'well, don't worry. Your penis is going to tear. Imagine urinating out a football. That's what it's gonna feel like, and if you tear, oh dear. Can give you the number of a reconstructive surgeon. But you can wee sitting down, right?'

No prob ghouls!

Oranges my last CS was also positive even though it was an emcs. I got great care and felt fully informed, and the recovery was OK (haven't got a normal birth to compare it to but I could move around, pain wasn't bad, scar has been fine, etc.)

I had my elcs at 9am and was up and about no problem the next day. After my emcs i was out of bed but it was much more painful the next day.

Like someone else said i had no pushing reason to have an elcs. I had an emcs due to failure to progress, back to back big baby (9lb 2oz) and in my 2nd pg i had GD and another big baby (he was 8lb 10oz at 39wks) on the cards so i opted for the elcs for fear of going into labour for hours and ending in an emcs again.

I think in your position i would go for an elcs but i know it is a hard decision to make.

Oranges, chase up your notes! I have just written a letter to the hospital that handled my last birth urgently asking them for the notes, and if they don't produce them asap there will be trouble! If you have had a difficult birth and are pregnant again you are entitled to the all of the information which is held on you in order to help you make educated decisions for next time.

I never had any explanation for what happened to me last time, but I need to know now to help me next time. It sounds as if it the same case for you.

this is such a helpful thread. I've burst into tears about it all and was wondering if I'm getting a bit too obsessed about the birth. But I think I'm going to insist on a c-section then put it out of my mind. Thank you.;

I also got a bit emotional over the decision - it is hard and it's difficult going over your thoughts with the consultant when it's such a personal thing. (Mine is a star and really lovely, but then that makes you teary too!) I kind of wish I 100% needed a CS, because then it wouldn't be "my" decision IYSWIM - which sounds ridiculous but in many ways it would be easier.

Totally understand how you feel: I had a emcs for DC1 and went through an emotional crash at 7mths pg with DC2 when the consultants were persuading me to attempt vbac. For various reasons (90 hr plus labour 1st time and medical incompetence included!) I finally decided on elcs. My midwife, who had been very supportive and objective throughout my decision making crisis, immediately blurted out 'Oh thank God!', and I was at peace!

A friend, who seemed at the time to have the perfect birth, has since had enormous problems with incontinence. It looks like they will not be able totally correct the problem as the damage is too great.

Obviously I am not saying this will happen to you, but I have seen the huge impact it has had on her emotionally, having to come to terms with this at a young age.

Interesting that the midwives are advocating elcs. If it was me, I'd listen to them.