Elective casarean? VBAC?

[tex111]

I had an emergency C-section with my first baby three years ago and I'm seriously considering an elective C-section this time. My first section was a very positive experience and I was showering and walking around the following day. I know each birth is different and there's no guarantee that another section would be the same but I know what to expect with a section and the thought of surgery doesn't frighten me. It certainly didn't hurt DS either so what are the reasons to consider a VBAC? I should also add that this will probably be my last baby.

My concerns with a VBAC are:

• possibly rupturing my scar. I understand that this can be fatal for me, baby or both and the thought really frightens me. I've been told that it happens about 1 out of 400 VBACs but I can't find any stats on mortality rates or the damage it can do to mother and baby. Does anyone have any information?
• my piles. I never got to the pushing stage with DS and I've still had really dreadful piles since his birth. I'm afraid that if I actually attempt labour again I could do myself some serious damage. Going to talk to my midwife about this but haven't yet.
• that I'll try for a VBAC and end up with a second emergency C-section. I've heard that this puts the most stress on mother and baby and I would much rather just schedule a section than go through the pain only to end up with one anyway.

Things I like about an elective section:

• being able to set the date and arrange childcare.
• knowing what to expect.
• the extra time in the hospital. I actually liked my stay with DS and I think it would be especially nice this time to have some alone time with the baby before going home.

I've never felt that I missed out by having a section the first time around. Is there any reason I should change my mind to VBAC?

My first birth was induced when I was 10 days overdue. After every intervention possible - prostaglandin, sweep, waters broken for me, drip, etc and over 24 hours of labour I was still only at 6cm. Baby was fine but they decided I would need the cesarean. I knew it was coming so I wasn't too upset. Just a bit disappointed but by then I was so tired that I just wanted to get the baby out.

After the birth they said that DS had such a big head they weren't sure I would've been able to push him out anyway.

It's so interesting reading about your experiences. I did wonder about an epidural masking unusual pain that I should be taking notice of. Thanks for pointing that out Ellbell.

I'm going to see my midwife today and I'm taking a list of questions with me.

I had to have a meeting with the consultant and they made the decision for me to have an elective section, but that wasn't until 36 weeks.

Keep an open mind and don't let anyone talk you into having something you don't want.

Tex11 - re big babies, dd1 was 9lb 10oz and the m/w said afterwards it was probably for the best that I had a section as she was huge. However, dd2 was 9lb 5oz, and she came out fine so I don't think size really has a bearing on it tbh.

I meant to add... I got loads of articles and advice from Gina Lowdon, who was based in Basingstoke. Don't have her contact details anymore, but if you google her, you may find something. Sorry it's vague, but she was very helpful.

Found this link in my researches and thought some of you guys trying to make the same decision might find it useful.

VBAC/Cesarean

hmmm... don't know if those views there are unbiased. I only skimmed the document, but it seemed a bit slanted toward VBAC.

Oh well, I totally agree wit Aloha (and others) that everyone should do what is best for them and it's no one else's business.

My personal view is that a caesarean is the safest mode of delivery for mother and baby so long as mother doesn't go on to have a lot of caesareans.

I absolutely loved my elective caesarian.

I had an emergency section first time round and was just knackered. With my second child and an elective caesarian it was a calm, serence experience.

A very personal choice though, so go with your heart

Did you find peoples attitudes different between your emergency and your elective? I find that people raise an eyebrow when I say I had a section and then they go 'ohhh I see' when I say it was an emergency. As if that makes it ok in their eyes. Makes me v annoyed.

there are of course the "normal" risks associated with surgery, and these should be taken into account by you/your medical team when deciding what to go for. but it is up to you.

Yes, I agree. It makes me very when some says something like "too posh to push?"... particularly when that someone is a man.

Anyone see today's Guardian G2 section, where there's an article on how gruelling a c-section can be? I have to say that my section was nothing like that at all - the pain wasn't unbearable at all and I was walking around within under 24 hours (albeit a bit cautiously!). Interesting, though! And it just goes to show that, whatever 'variety' of birth you have, people's reactions to it and ways of dealing with it will vary massively.

here

If I ever did it again, would definitely have an elective. My first c-section was an emergency one after 30+ hours of labour. Have had PN PTSD ever since. I simply could not face another trial of labour and then another emergency section. Would think booking it and going in calmly would be bliss!

Saw the midwife today and she said that they were encouraging women to have VBACs if at all possible. But, she just gave me the NHS policy spiel rather than talking about my personal situation. It seemed like my leaning towards an elective made her uncomfortable which therefore made me uncomfortable so we didn't discuss it in any depth. My God, I can't believe how much this is getting me down.

If I try to remove all outside input and determine what I really want I do think it's an elective section. It's just such a pain to feel as if I'm going to be up against certain people (yoga, midwife, etc) with my choice and it sounds like quite a few of you have experienced some judgement about your decision for an elective too. Yuck.

Think I will just have to learn to deal with it and do what I want. Horrible to feel so much guilt and confusion over this baby already but I guess that kind of goes with the whole mothering package.

You should do exactly what you feel is right for you.I had an emergency c-section and- like you-it was all very positive and i was running around the following day as if nothing had happened. I decided to have a section the second time round which was exactly a year later and - although a little more painful- I reckon because everyone told me it would be!- I still had yet another one - my third!- exactly a year after that!!!!As far as I know,my kids weren't affected during the birth and-all being well-they are all normal,healthy kids now.

I haven't read the whole thread (so what's new) but just wanted to let you know that I had an emergency caes for ds1 and vbac for ds2.

With ds2 I really felt that the hospital doctors, and friends and relatives who were doctors thought I should have elective caes but were too cautious to come right out and say it. Just one of my relatives who is a doctor said that the only reason to try vbac was if I wanted to experience labour. He also said that after 2 caesarians his wife had been advised not to get pregnant again. This is what swayed me to opt for vbac.

Anyway, I really regretted it. It was very traumatic, they wouldn't give me an epidural (said no-one was around to administer it) had to have stitches which were much worse than the caes stitches and was therefore in a helpless state for much longer than with ds1. If I can going through labour next time then I will.

tex, can you book an appointment with a consultant? their "slant" on this will be slightly different, i'm sure.

sorry typo - if I can avoid going through labour then I will

I went into the consultant armed with the utmost determination to convince them that I wanted a casarean. They were reluctant, tried to talk me out of it, but not very hard. They gave me what I wanted. I wrote all over my birth plan that I wanted a caesarean and was prepared to threaten, maim (but probably not kill) to get it. If you really want this, then go for it. Put it in writing, then they'll give in because no hospital would want the liability of going against your wishes and then having something go wrong.

I know I sound a bit harsh, but the NHS speal today is to convince the patient to have a vbac. And it is my opinion that this policy has much more to do with their budget than it does anybody's health. I get so irritated when they recite a guideline rather than giving my their qualified medical opinion as it applies to my particular circustances. Drives me mad it does.

Anyway, do what YOU want, and don't be afraid to fight for it.

tex, I do think you are getting the pary line on this. As you may know, in the US it is generally just the opposite. We mainly go to an OB instead of a midwife and have a more "medical" approach to childbirth. I let myself get rather brainwashed into thinking that this was a bad thing when I was pregnant with ds with the result that the midwives almost let ds (and me!) die. Stupid, stupid women, more worried about their c-section stats than what was good for us.
Please follow your heart and stick to your guns. If I had gone with my gut instinct I would have left that group and hightailed it to an OB in my last trimester and not spent the next year dealing with PN PTSD (which I'm actually still dealing with, just not on an everyday basis anymore, thank goodness).

Sorry but what is PN PTSD? had an emergency c-section for first birth so following this with interest.

post natal post traumatic stress disorder.

My consultant was very breezy about my caesarian - my 2nd - and even suggested that there might be a 'next one' - and I was 41 when I had dd!

My sister had a natural birth, then an emergency section, followed by a natural birth (7 yrs after CS). Her last birth was by far the easiest.

Sorry I haven't read the whole thread, but I have to say you have to do what you feel is right for you and don't let yourself be pressurised either way by anyone else (easier said than done I know).

I had a horrible birth (failed ventouse, forceps, third-degree tear and haemorrhage) and would definitely go for an elective next time round, no question. Loads of people think I'm mad, but then they don't have to wonder if the further damage to their pelvic floor will leave them with permanent faecal incontinence (rather than just a week of it) next time!

I have loads of friends who have had caesareans (elective and emergency) and they all say my experience (mainly because it was so unpredictable and lengthy) was far worse.

I'm not meaning to sway you either way, just share what happened to me. Vaginal births aren't always smooth and easy. I know caesareans are major major surgery, with all the risks that entails, but I would rather go into that in a controlled and calm manner, than have my body torn apart the way it was this last time.

God, sorry. Didn't mean to totally 'splurge' like that. Still a bit wibblywobbly (PN PTSD as the PP said) about what happened to me!

Tex111 - lots of people have said it - but def do what you feel comfortable with - there are no medals for childbirth... ! I had emergency CS with DD1 and wanted VBAC for No2 - and actually ended up having DD2 at home as we didn't have time to get to the hospital. My midwife said that subconsciously I had wanted a home birth (but as a VBAC I was meant to go into hospital). In hindsight she was right - I don't like hospitals much and giving birth at home was wonderful (it's always going to be hard work but even so). The big thing for me was getting the support I needed - I had a midwife I knew and my DH's sister to help who was fantastic both before, during and after. The main thing for me about VBAC is that I wanted to try, due to the risks of surgery infection etc but more than anything with an energetic toddler I knew that I would probably recover faster with a VBAC - which pelvic floor excluded was true (even though I was quick with C secion).
I read loads of birth books and birth experiences which I found helpful (Ina Mays book on childbirth, Emma Mahony "Stand and Deliver and Other great ways to give birth", the AIMS VBAC booklet, etc). Hope this helps, good luck .