C section or Vaginal Birth

[CarlaBarcelona]

Hi there, I wondered if I could ask for some advice on C sections vs vaginal births. I'm trying to decide what's best. My pregnancy has been fairly healthy and I'm also quite a healthy person (despite being a slightly older mum at 37).

However, everyone I know who has had a baby in the last couple of years has ended up having unplanned C sections after long and difficult "natural" births. Our local hospital is well rated for maternal care but we've had a poor experience with some of the midwives so far. My thinking is just to skip the trauma of that and head straight for an elective C section.

However, is the recovery really terrible?

Any advice, very welcome. No judgement please :)

My NCT group of 8 had 2 emergency c sections and 6 vaginal births - from recollection 2 needed interventions and 1 was induced. The recovery from one of the c sections was more straightforward over the course of the first 6 weeks post partum than the woman that had the episiotomy but she had a serious side effects of c section in the days afterwards that required an ambulance call out but after that her recovery was ok.

I had a very straightforward vaginal birth but there were a couple of points in my labour where it could have gone either way. My water broke before labour started so I was booked for an induction 24h later due to infection risk. One of the others in the NCT group had this after 72h and had a difficult birth experience as a result. Then her shoulder got slightly stuck on exit but freed itself before needing intervention
I would treat vaginal births and a series on continuous decisions each one could go in your favour or not.

I'm pregnant again and have developed some complications and am likely to need an induction. My plan is to start with a vaginal delivery and make decisions stepwise.

ELCS is a totally different kettle of fish to an EMCS so it’s hard to say really! My vaginal birth was pretty much ruinous, my first ELCS (because of terrible previous VB) was pretty terrible, lost half my blood, but recovery was still light years better than VB. Second ELCS was wonderful. Days-long labour into an EMCS must be the worst option, I’d do (and did) anything to avoid that.

It's a gamble. A long horrible vaginal delivery and /or emergency c section is the absolute worst.

I had a planned C section and it went great. My recovery was much longer than my friend who had a straightforward vaginal labour but I have 2 friends who had HORRIBLE vaginal deliveries and will never be the same.

Also, with a c section, you sort of bypass the midwives. You don't need them as much which where I live is a good thing as they're terrible.

I’ve had two lovely planned c-sections and couldn’t recommend them more. The only thing I’d add is if you want more than two children or want them close together then maybe put some more thought into it and try for the vaginal birth first. I’m considering a third now but have been told my scar had really thinned out at my last csection and was at risk of rupturing. The risk of that happening during the third seems higher and when you already have two kids seems a lot scarier. A third c-section is quite a bit riskier too, so if you’re having two go for it but any more than that maybe discuss it a bit further

I was in labour for around 17 hours with my first. The pain was fucking horrendous. I remember thinking I would let them chop my legs off if it would stop the pain. Eventually the midwives and Doctors started arguing about whether to give me a C section and fortunately they did. Honestly trying to give birth naturally was probably the worst experience of my life. I was so gobsmacked and traumatised after because no one told me it was going to be like that. Recovery was quick. It was sore, but I was walking the prom 4 days later.

I booked in for an elective section 2nd time round. It was such a nice calming experience. I would recommend it time and time again. I did take a lot longer to heal second time round and it did hurt to move for a month or so, I think.

I would say though, I’ve had friends who have given birth in an hour, another friend had 3 kids and told me it wasn’t bad at all. I think everyone has such different experiences.

I’m pregnant with 3rd now and will be booking in for another C section.

If you're really worried, would you consider hiring a private midwife or very experienced doula? We had a retired midwife as a doula, who turned a long and difficult labor into a successful delivery without intervention and easy recovery. The baby was face first so it was a long and painful delivery, but he turned in the end after lots of work from all the midwives. The team were good too but she made sure all the information was passed to everyone as shifts changed and helped us make good choices.

I had an emergency C-section following a difficult birth then a VBAC for my second. I requested an elective C-section after my first CS experience (devil you know and all that) but couldn't have it because I went into pre-term labour and it was too risky for baby.

Given the choice, now having experienced both, I'd go for a vaginal birth every time. My C-section recovery was awful - scar was repeatedly infected and didn't heal for six months. I was in and out of hospital with infections and in regular pain. I've also lost sensation around my scar area and have a one sided overhang/pouch which I struggle to accept having had a flat stomach before.

VBAC recovery was far easier and less traumatic. I did lose a lot of blood so immediate recovery was difficult but within a couple of days, I felt close to myself again and was far more mobile, which is helpful dealing with a newborn. The only discomfort I had was my episiotomy stitches healing (coughing and laughing were an experience) but it wasn't painful and passed fairly quickly compared to C-section healing.

That said, I think I also have minor pelvic floor issues following a forceps delivery but apparently that can happen regardless of delivery method and I'm seeing a physio for that.

The main benefit of my VBAC though is that baby was passed to me as soon as she was delivered, we had skin to skin and she breastfed immediately. I didn't have that with my C-section (not sure if that's normal or not) and it was such a wonderful feeling to hold baby after delivery.

I think both birth methods carry risks and, like you, I know so many people who have ended with an EMCS or assisted delivery. I think all you can do is research both and go with whatever method you feel comfortable with, keeping in mind the possible outcomes of each. A happy healthy mum is most important.

I had 3 vaginally. The first took a bit of recovery because I collapsed after birth and lost consciousness. The bright side is that I missed the meconium nappies. My other two were straightforward even though DC 3 was induced .

My DDiL had c sections and the recovery was much longer than any of mine

When I was pregnant with my eldest a colleague said to me.. the people who share their experiences with you in person are the ones with an experience to share. That means you will always get the awful tales of both options from those who had awful experiences.

Im sorry your friends had terrible experiences and emergency c sections. But statistically that isnt the most likely outcome.

Planned c sections are always preferable to emergency c sections. But a straight forward vaginal birth recover is almost always easier than even a straight forward c section.

I had two vaginal births. Both got complicated (first needed forceps to turn as he was stuck in cord, second got shoulder dystopia because he was 11lb 8) and I had blood loss in both but the experience for both was still very calm and I wouldn't hesitate to deliver that way again (if I had another which I wont).

With eldest, we were out and at stepdaughters sports day within 18 hours and with youngest we stayed overnight by choice as it was a late delivery.

My point is, try not to listen about other people's experiences. Do what is right for you.

I opted for a physiological birth because I thought the recovery would be quicker than a C section, and it wasn't tbh. Wish I had had a C section, all things considered.

If you do decide to go for a physiological birth, I personally recommend an epidural but you have to be **ing pushy because they will try to fob you off with other pain relief first and hope it will be too late to install the needle. If the unit you're giving birth at is midwife led, they hate calling in the doctors AND they are desperate to keep their births "natural" and epidural doesn't count for their percentages. Yet in other countries it is the norm and also what the World Health Organisation recommends :/

Personally I would say for a first baby:

1. Wait for spontaneous labour and try vaginal
2. If no sign of spontaneous labour choose ELCS over induction

I had two spontaneous and very straightforward vaginal deliveries with my first two and I was up and about straight after. Literally text book birth. Minor tear both times that was stitched up and healed quickly.

My last pregnancy was twins and I opted for induction over an ELCS but only because I’d had two successful vaginal deliveries. I didn’t need the drip which was good. Delivery was different to the others because it was more medicalised because of the twins, but it was still a very easy birth. No complications and no tearing.

Out of all my friends, the ones whose first babies were induced had a horrible time of it, but those of us who had spontaneous deliveries all had good experiences and were pleased to avoid a section.

If you can wait for spontaneous labour do that. If you have to be induced for any reason I would ask for an elective section instead.

I had an elective section for my first baby and I didn’t enjoy the procedure or the recovery, both of which were actually straightforward. I hated not being very mobile afterwards and having to have other people help so much look after my baby. And it took months for all the tenderness around my scar to disappear.

I’ve don’t both and the VBAC was easier.

There is a world of difference between the two. I wouldn’t have wanted a c section and it didn’t even enter my head.

I love the speed of recovery. The limited interference from anyone. Maybe if you think about it long enough a c section may be the best choice for you.

I had an EMCS first time, then ELCS the second. I had no choice in the first.

What I will tell you, it is major surgery, they cut through 7 layers to get to your baby. Normally after abdominal surgery of this kind you would have a 6 week recovery whilst everything knits back together (not all layers are stitched, some heal better not stitched) but now you have a newborn to possibly breastfeed and take care of solely before you are fully healed.

How much support would you have? How much time off work would your Dh/Dp have? How helpful will they be? Do you have anyone else to help out? The recovery can be straightforward or it can be complicated. For me, my recovery after my first was good but I couldn't drive for about 4 weeks and then I would only have driven if there was an emergency. I did drive at 6 weeks. My recovery after my second was harder, my scar was infected, the knot on the stitches was too big and had to be dug out and cut. It was not a fun experience.

From a clinical stand the risk of adhesions from any abdominal surgery is high, these can cause complications later down the line and especially if you have a second c section.

From a cosmetic vanity stand I have a slight overhang and they are very hard to get rid of. I am also numb across the scar. My youngest child is 19 years old. Research it, there are lots of medical peer reviewed papers to look at for both vaginal and c section, get informed. I do agree with the PP saying wait for spontaneous labour to start (mine did it just went completely pear) but I would choose a c section over induction.

Adding my csection was ‘elective’ but I didn’t want it, the alternative was continuing with an induction that was going nowhere so I requested it. Mainly because on mumsnet I see lots of comments that elective csection recoveries were a breeze and whilst mine was straight forward I personally found it difficult.

I had one VB that was an absolute nightmare and left me absolutely wrecked . Induction, shoulder dystocia etc . Nearly died. Then two C sections that were an absolute breeze by comparison. I wouldn’t have opted for them though if I had had a choice. My pelvis is too small to enable VB safely.

Wow! Thank you so much for such generous responses. I’ve got my “birth choices” meeting next week and will ask about what level of control I have over choosing ELCS over induction - agree that this seems like the worst option at least!

It is also a birth centre hospital which, while brilliant for anyone in a straightforward scenario, does worry me with complications. Again, less about the skills and staff and more about the need to meet targets and delayed medical intervention. I’ll do a bit more research on this at the specific hospital.

so much to consider and such a minefield! Not sure if there’s any right or indeed wrong answer!

I’ve had 2 planned home births and I definitely wouldn’t opt for major surgery if I didn’t have to have it. There are lots of things you can do to increase the chances that you’ll have a straightforward birth that doesn’t need much intervention. Obviously, sometimes emergencies happen, but things like avoiding induction, staying upright and mobile, staying at home as long as possible, using pain management that is less likely to impact baby’s heart rate, etc. will help increase the chances you don’t need a section.

I had a vaginal birth with my first (forceps, ventouse and episiotomy) plus pph of 3L and elective section with my 2nd.

Recovery from elective was FAR easier than first birth, but my vaginal birth was not straightforward. Nearly 8 months past c section my scar is completely healed but my stomach is still numb. Which is weird. My core is much much weaker, but nothing that beginner core exercises don't help.

I must say though, despite a difficult first birth and recovery, my body is now completely healed and you'd never know any different. I think I will always feel and look different from my c section.

If you'd like the best chance of a physiological birth id recommend reading the positive birth book. Yes things don't always go to plan but please don't fall into the trap of 'whatever happens happens' because simply being in the system can escalate interventions needlessly. There are things you can do and ways you can advocate for yourself to give yourself the best chance of a physiological birth (not guarantee it, before anyone comes at me)

Secondly, statistically the best way to avoid a C-section is to plan a home birth. I'd recommend reading Why home birth matters, even if you don't think you'd want one, it's got loads of information about physiological birth.

I'd always try for a VB.
If all goes well, it is the best option for many reasons.

With DC1, I had an EMCS after spontaneous labour that never progressed past 7cm, despite oxytocin drip.

I tried for a VBAC with no. 2 as I hated the experience of being immobile and cut open, I didn't like how much pain I was in after surgery, and I felt a real regret and sadness at not experiencing natural childbirth.

Sadly, it was another EMCS, but I'm glad I tried.

I had issues with my ‘natural’ birth plan and ultimately was told an emergency c-section was best for both me and my baby. Personally, I didn’t have that much problem with recovery. The first week was a bit sore and second week I felt more pain but after that, as long as I was careful etc I could do most things. I know it can be harder and I was luckily, but you’ve just got to do what is right for you and your baby.

Many of my friends have opted for scheduled c-sections so they could plan their support network around it to help with recovery, if you do find it difficult - so if that’s an option, maybe something to consider.

Wishing you all the best for the remainder of your journey x

My first was an assisted vaginally birth. Not painful once I went for the epidural and it was a quick recovery with a neat episiotomy scar. My second was similar but my second episiotomy hasn't healed as neatly and it occasionally bothers me. My best friend had C sections; one emergency and one planned and she is healed up well now but she found the first six weeks when she had to take it easy and couldn't drive very difficult.

Sorry to hijack, but for those of you that had C Sections, how long were you in hospital for afterwards?