Elective C Section

[AmyLou32]

I am 16 weeks with DC2 and have been assigned to a consultant due to 3rd degree tearing In first labour.
I had an assessment yesterday and immediately it was suggested to me that my best course of action for this pregnancy is to opt for ELCS

It's not an absolute given I have to go down this route but the consultant is suggesting that is the best course of action if I want to avoid future damage to my lady bits!!

Now I'm a bit miffed by this as I always been pro 'natural' labour and with this pregnancy, have thought the same until yesterday! And I thought it was bloody impossible to get ELCS on the NHS unless you have serious health problems etc!

I am keen to save myself further damage down there, as things have never been the same since, but I just can't imagine it could do further damage?? wouldn't I just stretch more easily this time, or am I being naive and should I just go with what the consultants are suggesting?

Anyone any experience of this, for this particular reason, I have no other health issues, that means I need to have an ELCS.

Thanks

Well if you don't feel comfortable with it just because of that reason (the tear), don't do it. It's YOUR decision after all! I think you have a point there that it would go easier this time because your body has already done it once and will remember how to do it again.
Another thing to consider - you have already damaged one part of your body, would you really want to damage another part (in this case your stomach) as well?
I'm sort of on the other side; had two emergency cesareans and opting for an elective one this time. But I think it's important that you go with your gut instinct and make your own informed decision rather than having the consultant make it for you.

Hi Amy

The consultant is right in that the only way that you can guarantee no further damage down below is by having a C Section, but of course that comes with other risks.

I've just had a look at the guidelines for this (women with prior 3rd or 4th degree tears) and essentially they say that

1. Women should be counselled as to the risk of further damage
2. It's a bit difficult to say what the exact risks are as the results of studies are quite conflicting
3. Women who still have symptoms from their tear should be offered the option of ELCS.

There are tests that they can do to assess how well your anal sphincter is working (manometry) and this might be something you could discuss with your consultant.

How have you left it with your consultant? Have you been given the option of attending a birth options clinic or similar?

Thanks Jolly B,

Basically I have just been told to come back at 36 weeks for further discussion and a decision, no other information has been provided as to options, so I would like to be as clear as informed as possible before I agree to either route.

Is the guidance you are referring to readily available or are you a specialist jollyb?

I'm a HCP but nothing to do with obstetrics. The guidelines were from The Royal College of Obstetricians website.

I'd strongly suggest asking to see the Consultant again (or even requesting to see someone else) as it is a big decision for you to make and you need as much info as possible.

www.rcog.org.uk/files/rcog-corp/GTG2911022011.pdf

Thank You for this JollyB, I never would have known where to find this type of information so will read carefully.

I appreciate your guidance
x

FYI you don't need massive health issues on a second pregnancy. Just clear reasoning on your preferences.

You can have one on your first too if you argue carefully enough.

I was emc first. Argued well via help from mn and was elc on second. Never been so happy! It was wonderful.

Hehe - really Dacky, what support did you have in place for you and your toddler during your recovery period and has everything following your CSec been ok? No issues at all?

I had similar issues. My tear was only 2nd degree but I was stitched up too tight and had lots of problems afterwards. When ds was 8 months I had to go and have it all re-done under general anaesthetic, which I found much more painful than initial recovery from birth. I had other problems in labour (shoulder dystocia, PPH) so when I was pregnant again I didn't really fancy another go at natural birth - it wasn't an easy decision though, as I was worried about cs recovery with a toddler (ds was 2.5 when dd was born). Plus, everyone says your second labour is much easier, etc etc...in the end, I decided my fanjo had been through enough(!) and went for the elcs.

I am sooo glad I did. It was a truly lovely experience - my overall memory of ds' birth is being doped up on pethidine, feeling out of control, and then a gruelling recovery afterwards. With dd it was calm, really relaxed, I wasn't exhausted from labour which made recovery on the postnatal ward easier, and the mws were really helpful (wouldn't let me pick her up but insisted on passing her to me etc - after ds I was very much left to my own devices). I found recovery at home very straightforward - the only pain came from sitting up in bed at first. By two weeks post-birth I felt completely back to normal. You must do what's right for you, but my own experience of elcs was a very positive one.

Thanks for sharing your experience lurcher, it's great to hear different views and highlights things I haven't considered before now x

You could also look at the C-Section Birth and VBAC Information Group UK x