A week to go and doubting my decision :-(

[Tea1Sugar]

A week tomorrow I'm due to have an ELCS and I'm rapidly questioning this decision.

In May 2010 I was induced at 40+9 and had a 3a tear. No forceps or ventouse. I was stitched in theatre immediately and told that the "3rd degree but was minimal". Stitches never healed. Three months later I went for a full restitch under GA and whilst under the consultant did a minor rectocele repair.

Fast forward to this pregnancy. I've been adamant I wanted a section, still scarred from the carnage of the last birth (also had PPH and MROP). I've discussed it with a consultant three times who has supported my decision and the consultant who did the repair surgery wrote in my discharge letter that a section should be granted.

But now, with 8 days to go I'm really questioning it. I'm petrified of the op, I mean totally and perhaps irrationally paralysed by fear. What would you all do? Try a vaginal birth with a very strict and concrete birth plan for if things show that tearing again is inevitable? Have the ELCS?

Poor you. It sounds like you made the decision to have a CS for very good reason. I'm not sure how they could prevent a tear if it looked like it was going that way. Can you talk to MW or consultant?

I'm not an expert but I would have thought that by the time they know "tearing is inevitable" then it's too late for a section. I think you need to go through this again with your consultant, how likely another tear is. There won't be a "right" answer, trust your instincts and good luck!

I'm not due to see anyone between now and the section other than my pre-op check on Friday but I don't know who does that.

Can you call MW or consultant?

In your position I'd probably have a section too. There's no easy or "right" way to get babies out, and it sounds like you made the decision for good reasons.

I had a bad third degree year first time. Second time around it was better managed and I had minimal testing. In hindsight not having a section was right for me.

What are your reasons for changing your mind?

My understanding is that a third degree tear can happen again but isn't automatic. I got a much better midwife, had better care, didnt push too soon etc

I had rectocele repair after baby 3 and am having a c section in a few weeks for baby 4... The consultant told me if I have birth naturally there was a huge risk of the rectocele repost being damaged and I would be looking at double Incontinence followed by major surgery... I'm embracing the planned section as much as possible

Sorry you're feeling so scared! What is it your actually scared about, people
May be able to reassure you of your fears with their own experiences

i would talk to the midwife or consultant... either should be able to take a call at least, and hopefully see you for a chat in real life.

did you ever have a debrief after the first birth?

if you want to try a vaginal birth then you should. I don't know what the stats are for likelihood of tearing again, but you could have it in your birth plan that you'd prefer an episiotomy if you start to tear?
my friend started to tear down (towards the anus) with her first baby and they did an episiotomy to each side which stopped it going any further,

i can totally understand your fear, but equally understand why you would want to choose a section!

really though, i'm blathering now. talk to the midwife at the very least. talk about what both options would involve... see how you feel after that?

All of it! The anaesthetic - I hate being out of control, I'm a very anxious person and remember the horrible feeling of the spinal from the stitch up. Hated it.

The recovery time. I have a nearly 4 yo to keep entertained although I will have lots of support from oh and my parents.

The lochia - everyone has told me you bleed more after a section. I'm awfully blood phobic.

And I've just read a thread on here about someone who had a heart attack during the section which has pretty much tipped me over!!

I don't think that any of us can make the decision for you or even really advise you, but FWIW I think the decision for an elective CS has been made for a good reason in your case .
What exactly terrifies you so much?
The anaesthetic?
The actual operation?
The recovery?
Going home with the new baby?

Your pre-op assessment is v likely going to be with the anaesthetist so they are the best person to ask any questions about that aspect of things.

I've had VB and a CS and tbh, there is so much more to motherhood than how the baby comes out, that I don't have v strong feelings either way.

What exactly scares you so terribly??

Ah. Cross-post. Sorry.

Yes, spinal is odd. V disconcerting. Would you prefer a general anaesthetic? Or an epidural?? (That may be possible, but I am no expert).

Going home with new baby to active toddler. Hm. Yes, not easy, but doable. A nice relaxed CS should leave you less uncomfortable than you might think. Accept the Voltarol suppository you are likely to be offered in theatre - magic stuff . Have lots of pain relief at home and take regular laxatives (codeine bungs you up).

Lochia - how heavy or not they are depends on many factors, delivery is only one of them. Bleeding can be less long after CS because you will have had a proper 'clear out' while in theatre.

Don't focus on the rare and horrible things that might happen, but likely never will. Heart attacks in labour are as rare as hen's teeth, whereas nasty tears are not .

Or consider a water birth?? Seriously, v calming, v soothing and may make your labour easier. Would you consider discussing your fears and your options with the Supervisor of Midwifery?

I think you need to speak to your consultant about the implications of a vaginal birth on your tear scar and prolapse repair. I'm not sure anyone here can comment on the suitability of attempting a vaginal birth as none of is know the detail of the repairs.

If it is just fear of the section rather than a desire to labour, then I would use your pre OP check on Friday to ask lots of questions of the midwife (it's a midwife that does it). She should talk you through everything that will happen and answer as many questions as you have. If you're still not sure at the end of that appointment, as the midwife to arrange an urgent meeting with your consultant to discuss.

Good luck, whatever you decide to do :)

I would avoid a water birth if you are at increased risk of tearing tbh

I had a CS and it gives you so much more control over the situation, don't be scared, the staff will be wonderful, we brought in our MP3 player and they played out favourite song when our baby was born, the staff and I all sang together, DH was in a state of shock!
With support and DO NOT over do it in the early days, you'll thank yourself for not having to worry about complications down below.
But if you want a vb then go for it and tell the stuff to stitch you up 'properly'
Congrats

Write all your questions down.
Make sure you get to ask them all.
Can somebody go with you to act as a 2nd set of eyes and ears and to back you up?
Are you at increased risk of tearing this time round?

Like I said, none of us can truly advise you here; you need RL advice about the pros and cons.

What do you normally find helpful for your anxiety? Anything to help calm you, to allow you think through your options calmly?

I have had both and regarding the lochia, I had much less after the section as they sort of clear it out of the uterus.

Also, I had an epidural for my vb and a spinal for my cs, nothing between them and it was ok.

My recovery wasn't amazing compared to some women I have spoken to, but it was not bad. I was driving within 3 weeks and managed to walk to the shops (very slowly) about a mile away on day 4. I had the cs at 6pm Saturday and was out at lunchtime Monday.

Fwiw I am a proponent of vb but I think you are doing the right thing, I suspect the cs recovery will be easier than what you went through last time.

Can you google some natural caesarean techniques to make you feel more relaxed about it?

www.mumsnet.com/Talk/pregnancy/2047185-Section-in-3-days-Is-feeling-really-sick-normal-Bah

look.. your not alone :)

it IS a big thing, but having a baby (whichever way) is :)

Discuss at your pre op options to have a sedative, its something im going to discuss as iv heard its really effective at keeping you calm and taking the edge off nerves.

Make sure they know how nervous you are and they will i am sure be great with you..

My first birth horrific, pph, episiotomy, tear, you name it. My second c section, lovely. Don't worry.

I had an amazing ELCS last time. Lochia cleared up really quickly, I'm guessing because the surgeon cleared most of it out. Didn't even get halfway through my packet of mat pads, switched quickly to regular Always. Was walking round Tesco with DS over my shoulder after three days. Was sent home with an awesome bag of drugs.

The spinal terrified me too, so much so that they couldn't stick the epidural line to my back because I was sweating so much. But honestly, compared to the hours of pain my friends who've had VB described, it was nothing.

Childbirth is scary, full stop. But an ELCS really isn't a bad way to do it :)

I had a third degree tear first time round and am having ELCS on wednesday. I am nervous BUT I have spent a lot of time researching positive ELCS stories. They were easy to come across. It does seem like the 'norm' with ELCS is an uncomplicated and quick delivery and that the recovery is usually not that bad either (in so many cases people told me- you will probably feel fine after a few days so make sure you don't overdo it). My cousin has her ELCS last week and described the experience as 'lovely'!

As someone has suggested here, it's a good idea to write down all your questions. Speak to your consultant or midwife (whoever you trust) and let them help you to make the decision. very best of luck to you. Soon it will all be over and in a matter of weeks you'll be feeling fine again- before the summer :-)

Hey Tea, after 40 hours labour with DS1 I was taken for an ECS due to failure to progress and like you I was petrified as I had never even had so much as a tooth out! All I can say is if I could take the worry away from you I would as there really is no need to worry. The bleeding afterwards is a lot less than a natural pregnancy as they remove most during the procedure, plus I was on my feet a few hours after the op.

I have to say and sorry for TMI but the worst part for me was the extra "wind" post op, apparently they pump a bit of air in so trapped wind is very common.

As for feeling out of control I think regardless of what path you choose there is always an element of "feeling out of control" as we put our trust in the professionals and as I said the anaesthetic wears off fairly quickly afterwards. I have another CS booked in for DS2 on 7th May but I'm more worried about it all starting early again and having a natural labour! lol, anyway good luck in whatever you choose and try to relax and not worry xx

I had a third degree tear the first time round - complete shock to me as it was a scenario I had not thought about or planned for. I was whisked off to theatre not long after dd was born (although did get to hold her and cuddle her etc while they were debating if it was a second or third degree tear!). I had a spinal block and was stitched up in theatre. I healed well but it took a long time (and I mean over a year) to feel 'ok' or anywhere near normal.

Most of what I found traumatic was the unknown. I just didn't know what was happening. I was high on adrenaline of having a baby but felt completely out of control and what I thought would happen after giving birth.

I'm now 33 weeks pregnant and am planning on having a vaginal birth. I have discussed it at length and want to do it again as it doesn't mean it will happen again, I feel I know what to expect and also know that i probably pushed too hard and she shot out of me which is why i tore! I considered an ELCS but actually felt more scared about that than a vaginal birth - I think because I have done it once so know what it is like whereas I don't know what a ELCS is like.

But that is me. I think you have to sit and really think about what you want. Not what you think you should want or what you would want in an ideal world, but what you feel most comfortable with in this situation.

Good luck and I hope whatever you decide it all goes well!

You don't have to have a section, your next birth might well be much more positive. You need to speak to your midwife and see if you can get an urgent appointment with your consultabt to discuss things again, especially your obvious fears.

Do you have good support for the birth, partner, parent, or doula etc?