Elective C Section?

[orphanblack1]

So, am 31+3 and saw my Consultant today - toying with elective C section. Had a good chat with him, now need to make up my mind and let him know.

My circs: I am quite an anxious person generally and like to know what is happening and when (I'm a lawyer so think a large part of it comes from that!). I'm not really scared of the pain of birth as I figure there's gas and air, plus it will be over at some point and feel I could cope with the pain. However, it is tearing I am worried about and the after effects of that (again, not the pain of the tear itself as that will all be caught up in the labour etc anyway) for 2 reasons: 1) I have an eczema type condition down there (not lichen sclerosis) which means skin is tighter anyway and quite friable so sometimes I cna get small cuts/irritation anyways and 2) I used to do medical negligence cases for the NHS, specifically obs and gynae ones so have seen lots of after effects of tears (I know I only got to see the really bad ones).

My Consultant said that the stats are that 80% of women experience a tear with a vaginal birth. He didn't have much to say on my skin condition other than, if I do get cuts etc easily (I was seeing a different consultant for treatment for this who has now retired hence has has no direct experience of my condition) then the likelihood is I will tear.

He was willing to offer an elective episiotomy but I have said no to that (again, because I've seen horror stories re this on real live cases) but he is willing to do an elective c-section at 39 weeks and would be with him.

I feel torn (pardon the pun!) as to what to do. I like the idea of the "surprise" of going into labour and having a "natural" birth. However, I am also alive to the possibility that this may not go according to plan and I could end up with a c section anyway. If I am going to have a c section, much better it is planned and controlled. Knowing my anxiety, I am worried if I go for a natural labour I may distress my baby and be so overcome with fear that there's a failure to progress and I end up with an ECS anyway!

On the flip side, this is major surgery and the recovery time (i.e. not driving) is a good 4 weeks.

Does anyone have any experience they can share? Would be interested also to hear from people who have had both a natural birth with one, then a c section with another.

In terms of future, I am 40 in 2 months so whilst I'd love love love a big family, the likelihood is we will probably only manage 1 more child (if we are that lucky) and I think 2 c sections is probably ok.

Any advice/support gratefully received.

I only have one child (expecting my second but not as far along as you) but I can tell you that I had an episiotomy and my recover was not smooth. Obviously everyone is different however that alone worries me for this next labour.

My sister had an ejected section with her second and had a great experience, said if doing it again she would certainly want it again.

Not sure if I've really offered any help but thought I'd share what I had x

I have a consultant appointment tomorrow to discuss the possibility of an ELCS. My reasons are mental health based, coupled with the fact that there have been a LOT of traumatic births on my mums side of the family (stories about which haven’t exactly helped the mental health...!) I’m very much taking the stance of ‘a good birth equals a healthy one’ for baby AND mum and I’m not really bothered about the whole vaginal delivery being the bebsll and end all.
Just wanted to let you know you’re not the only person out there considering it, as I’ve felt pretty lonely and unable to talk about it openly. Especially in an antenatal group full of anti-epidural women!

I had my final meeting with my consultant yesterday to confirm a c-section, after a 3b degree tear with my first baby four years ago. The labour wasn’t long but due to featal distress they had to do an episiotomy with a ventouse which lead to the tear, and honestly the recovery from it was horrendous! I was taken to theatre to get stitched up and was in there for nearly two hours, I was black and blue from bruising to half way down my thighs for weeks, and just walking/sitting/going to the toilet was agony, and the feeling of the stitches inside was so uncomfortable even after all the bruising/stinging went away! I think it contributed to my PND as it was just such a bad starting point!
I explained all of this to the consultant and discussed it with my midwife from the beginning and thankfully they fully understood where I was coming from and he booked me yesterday for 12 days time when i’ll be 39+3. He explained all of the risks of a section, and assured me that if I was to go into early labour that I’d be allowed a section too, just that it’d be an emergency one. It’s made me feel 1000% less nervous, tearing was one of the biggest things putting me off having a second baby, and it’s such a relief knowing that won’t be happening again!

With my first I had an episiotomy and honestly don't think it was bad. My recovery seemed very quick and I was walking about pretty comfortably reasonably quickly. Stitches weren't that painful and healed quickly. The labour itself I really didn't cope very well with the pain but the recovery afterwards was very speedy.

I can't compare to a c-section but I have had my appendix out and remember the recovery was so long and painful and the scar from the surgery took ages to heal! I'd like to avoid anything similar to that if I can help it, so hoping for another natural birth, even if it means another tear/episiotomy.

Just want to say I had an ELCS last Tuesday. It was delightful! Recovery over the first 48-72 hours was hard I was sore, it’s not easy. BUT I feel great today. I’m at about an 85-90% recovery.
I was discharged the day after the section and got everything I asked for on my birth plan - skin to skin, delayed cord clamping, it was a lovely experience as these things go!

I had an episiotomy and like a PP the recovery was actually fine.

However if you're the type of person who likes to be in control I'd think an ELCS might be your best option? They do tend to be less unpredictable than vaginal births. If you search on here you'll find loads of positive stories of elective c sections.

In terms of your antenatal group, I wouldn't worry too much - people have all kinds of opinions on birth, feeding and raising a baby which often change once they've actually experienced it!

Thanks ladies - this is all really helpful! It’s such a hard decision. I also don’t cope well with vaginal examinations which is another reason.

Thankfully my consultant is fully on board, said it was very much maternal choice and didn’t try to put me off it.

Keep the experiences coming - have a little while to make up my mind but determined to be as informed as possible

My experience of an episiotomy was positive on the whole. Being stitched afterwards wasn't an experience I would rush to repeat, but it was over in 20 minutes. I was sore for a while afterwards, but it quickly went from very painful (a few days) to just uncomfy, and healed well.
I was TERRIFIED of the idea of an episiotomy (or tearing) but when push came to shove I just wanted the baby out and didn't even feel the episiotomy - partly adrenaline and partly the local. It did the trick too, baby was out next push. I think tearing would be worse and more painful overall, as you don't have a local anesthetic, obviously.
I was induced (drip) and used a Tens machine for pain relief.

Personally I hate the idea of the c-section. Not for any "natural birth is best" reasons, but because the idea of being cut open and the healing of the wound afterwards gives me the heebie geebies! Not entirely rational reasons, but there you go.

I personally think every woman should get the birth they want. One benefit of a planned section is that (assuming you are happy with the section aspect) you can have just that, as it is all planned and you know what will happen and when, and your birth preferences should be respected. With a vaginal birth it's a lot more unpredictable and, as I found, birth "plans" often go more or less out of the window. Although for me vaginal birth would still be my preference regardless (it was exciting and wonderful), but I can understand why women opt for planned sections for a myriad of reasons (which can be equally exciting and wonderful). One isn't better than the other and only you know what's right for you. Hope you are able to come to a decision you are happy with OP.

I've had two vaginal deliveries, and have lichen sclerosis. I had an episiotomy both times but that was apparently due to positioning (they were both back to back and got a bit distressed so needed to come out quickly). Honestly recovery was fine. I felt a bit bruised but it was manageable with paracetemol and ibuprofen and I was up and about very quickly. I don't know if the LS made it more likely to tear or not.

I've noticed a lot of people going for a section because they are scared of tearing and I honestly think when you look onlune you only hear the horror stories. Very serious tears make up a very small percentage of all tears, and in most cases women do recover quickly- it's what that part of the body was designed to do!

Google Prof Dietz work on levator avulsion. At your age you're at greater risk of this complication and there's currently no fix. I had a calm, drug free water birth and have an avulsion and prolapse. I couldn't walk for 5 days postpartum due to the severe pain (I only had a first degree tear).

This injury is something most people don't know about (including OBGYNs) so just giving you another piece of information. I hope you are happy with whatever decision you make, and remember, whether vaginally or surgically, you will still birth your baby 😊

For very different reasons, I've decided (I think) on a c-section. I'm really nervous about the recovery but I'm forcing myself to remember a c-section at least eliminates some of the trauma I had in my first labour. The consultant tried pretty hard to persuade me otherwise though but it's only since yesterday that I realised they aren't specialists in my medical condition. Slightly concerned by their insistence that pethadine is an acceptable drug to give epileptics when I know that it is a trigger. Wondering if I should let them know - sorry, that wasn't the point.

I’m pregnant with my 4th and have had 3 vaginal deliveries so far. I had an episiotomy with my 1st due to her being back to back. I didn’t feel it and baby was delivered straight after. The midwife stitched me up and did a brilliant job. Yes I was tender for a few days but healed lovely. Next two births were straightforward and very quick. I had a very very small tear on my 3rd which didn’t need stitches. The position you deliver in can help to reduce the likelihood of a tear so you could look into that maybe. For example I was stood up with my second (actually on the toilet) and didn’t tear at all.
Good luck I hope you find the right situation 😊 xx

I tore quite badly with dd, had 30+ stitches. The recovery was a walk in the park! I slathered on sudocreme which soothed stopped my stitches sticking to my pad (ow ow ow!) and within a week I was pretty much back to normal. I honestly don’t think I would have coped with major abdo surgery and a newborn, but that’s just me. You have to go with what you feel absolutely comfortable with, because if you go with the option you’re not keen on it can easily be looked back upon as traumatic if something goes not how you expected it.

It's entirely up to you what birth you have, but don't kid yourself that a c-section is the easy route.

My c-section was a disaster. Got infected. Couldn't stand up straight for 5 months. Felt like a Chinese burn inside. Awful experience. I coped with it because it was the only way my baby could have been born. A vaginal birth was impossible due to complications.

@ittooshallpass Your experience is the sort of experience of nightmares and is why I get so wound up when I'm told that deciding to have a c section is much easier than dealing with the pain of childbirth. Ended up snapping at someone at work who suggested I was choosing the easy way out.

DC1 natural labour with no pain relief until it was pretty much too late. Incredibly painful as back to back & the fact I was induced (pessary) meant no one was prepared for such a fast labour. It was 5 hours from 1st contraction to delivery & active labour was 1.5 hours. No time for epidural even though I begged & only got the gas & air as baby was crowning. It’s a very weird sensation that as soon as the baby is out all pain just goes away. I had a very small tear & there was some debate if I needed stitches. In the end I got a couple & apart from some initial fear of going to toilet felt back to normal & didn’t felt like i’d given birth. This may be because all the sensation was in my bum and or because I did pregnancy yoga/pelvic floor work. After I was stitched I fell asleep & was up a few hours later & had an amazing shower. I was a little achy in my back etc but feel normal very quickly.

DC2 semi elective CS (tried to induce) & I hated it. Apparently I had a very good recovery but the shower after was awful. I felt completely out of control & was suprised at the level of pain. I had my appendix removed 18 yrs ago & it was worse than that. I think my problem was that I’d read lots of stories that people are up walking about asap etc but the walking initially is more of a zombie shuffle. Also I had a good experience to compare it too.

On the other hand, I had my 2nd emergency section 6 weeks ago (aged 40). Got discharged the following day and was out for lunch and at Messy Church on day 3 with baby and my 3 year old. Didn't need any pain killers post spinal and have been doing 3 mile walks with the pram since week 2. I feel absolutely fine and my scar is already fading in places.

Unfortunately other women's recoveries don't tell you much other than it's a massive spectrum.

be so overcome with fear that there's a failure to progress and I end up with an ECS anyway!

I'm not hugely convinced about that. I have ptsd and had massive anxiety in my 2nd pregnancy. I was going to have an elective under GA. When I went into labour before my planned date, despite being an utter terrified anxious mess, baby was coming whether I wanted it or not. By the time they got to me to theatre, I was already 6 cm. Plus my Grandmother had one of my uncle's during a bombing raid, she said fear had the opposite effect.

@ittooshallpass was that an EMCS or ELCS if you don't mind me asking?

sorry that was long! I would like another child but scared it will be a CS. For what it’s worth a CS was the right decision for DC2. Anyone who has one take peppermint tea/water to ease trapped wind & arnica.

I'm sorry I haven't time to read the full thread right now but having had natural/vaginal labours and one c section, I'd choose natural/vaginal all the way.

Dinosauratemydaffodils I was discharged next day too, could you walk completely upright the next day?

My neighbour is a surgeon (also had CS for twins). when she popped into see me she thought I was doing very well but I thought I was dying! 😂

I've had 3 vaginal births both with and without episiotomies. No c sections (yet). My biggest anxiety was always regarding tearing, fortunately it never happened. I would say I was very anxious about the birth all times but found that once labour had started it was gradual and not as frightening as I'd imagined. I found having confidence in the medical staff and being well prepared (mentally and practically) helped me reduce a panic feeling as it became clear I was actually in labour. That said, every woman every labour and every baby is so different I know it's impossible to try to replicate anyone good birth experience by copying a blueprint as it were, I just thought I'd add my tuppenceworth. Congratulations on your baby and I wish you all the best with the delivery 🙂

Plughole3 I could walk upright as soon as I got out of bed both times. Never had trapped wind either or any issues going to the bathroom. The mess they made of my cannula hurt a lot though to the point of needing to do everything one handed to protect my hand.

So no discomfort or pain when upright, I’m suprised but lucky you. That was one plus for CS, no toilet fear.

I’ve had a few ops & it’s a pain in the arse when they feck up the cannula.

I had technically had an emcs with my second after a horrendous experince having an inducation with my first I had agreed to another induction (due to reduced movements) on the condition that if it goes wrong they allow me to go to surgery. So when I stopped progressing straight away I went to surgery I could have waited much longer to see if anything happened but I declined. It was almost like a planned section in that I wasn't fully diated and baby wasn't in any distress so it was calm and a great experience.

If I ever have another I will 100% go for an elective section. I am a bit of a control freak I think I found the first birth so hard because I had no control the second time though I was induced I had a plan in place so I felt much better.