Giving birth with open wound

[MrsPotts18]

I'm just looking to see if anyone has been in my (rare!) situation before.

Currently 33wks pregnant. Had to have an open appendectomy op at 30 weeks due to perforated appendix. I had a thread running if you search my name. Op wasn't as straightforward as we'd hoped and I had my bowel repaired also. After the op I had a paralytic ileus and then a wound infection. Recovery has been horrendous and I now have an open wound. Part of my scar is healing nicely however I have to have the open wound packed and dressed daily by district nurses. I have limited mobility and my bowel is slowly getting back to normal.

So have seen the consultant and I'm having weekly scans due to fluid volume around baby decreasing. It's been mentioned that a c section will probably be the best option for giving birth. As much as I'm terrified about another Op, I just don't think I'd manage to give birth vaginally.

Consultants have been wonderful but say this is quite a rare situation and will make a final decision at 36 weeks for birth. I will obviously discuss in detail with the Drs but I'm just trying to get a heads up on what to expect.

I think I'd have the c-section in your shoes. Wouldn't giving birth put a hell of a lot of strain on your wound? Sounds dangerous and psinful to me! I'm not medically trained, though.

Hope it heals soon!

Please have an elective c-section.
Don't be worried - it is easy on you and the baby.
Please don't take the chance that your body can't cope with giving birth and baby suffers.

You could be very well healed in another month or more. If you were I would strongly consider a VB. I had a CS when I was fairly immobile and the recovery was no joke - became completely immobile, wound infected, constipated etc etc. The VB will be tough at the time but is likely to have a much better recovery.

I have not, but have had a midline c section (hysterectomy post delivery) so know about recovery after major abdominal op (I have also laboured twice and had 2 emcs). I would say they are right to suggest c section, I know it is another op, but there is a high likelihood that your internal tissues would not be fully knitted and the stress on the scar would be high during contractions which might risk it opening again.

Normal c section scar recovery is much easier than than from a midline op as the cut is much lower, the same recovery time and lifting rules apply and you will need help due to the recovery from two ops. The benefit of planned c section is you know when so you can plan this. A planned c section is also calmer than an emergency one if something did happen to your scar.

I think I'd prefer the c section even though I'm slightly terrified.

I suppose there's risks to both a vaginal and caesarean and I'm happy to go with the drs decision. I've never had one before and I suppose I'm trying to get any control I can and prepare myself. I can't find anything on google about c sections with an already open wound though!

You poor love.

I can not see how it would be in any way a good idea to be pushing and bearing down with an open would in the trunk area

Gosh you poor thing OP. I really hope you're feeling better soon. As someone who has given birth both vaginally and by CS, I would go CS in your shoes. The thing with the CS is it's risks are a relatively known quantity, whereas there are a lot of variables in vaginal birth. I think an open wound would be incredibly painful during contractions, never mind following eg an emergency section ( which is tougher to recover from).

My CS was pretty cruisy compared to my vaginal birth, in terms of recovery.

All the best to you! X

@WhatAmISupposedToBeDoing I may not have another Month till I deliver. My fluid levels are at the lowest number of 'normal' and consultant has already mentioned delivering before term. Surgeons have predicted another 6 weeks to heal internally and for the open wound.

I know I can't get answers on Mumsnet and I will go by the professionals opinion. I think I'm slightly traumatised by recent events and trying to prepare myself for a c section recovery as well as recovering from my op.

Thank you all for listening to my moans!

My section was easy, trouble free, it even any pain. I did the requisite no lifting etc until I was given the ok but wasn’t overly cautious. If it’s what your doc recommends, I’d go with it. Could your body really cope with what might be a long labour?

I would wait until closer to 36 weeks to make a decision. It could be clearer either way by then.

And I am not anti c-sec (I’ve had 2 and they were positive experiences) but things could change in the next few weeks and if you don’t need to decide now and you can manage the uncertainty then try to ‘park’ the decision in your head until then.

If you feel like you want to have a decision made, then I’d be leaning towards a c-sec.

I’m sorry for what you’re going through. It sounds very difficult. I hope your wound healing improves soon.

I doubt I could cope with a long labour tbh. And If I remember correctly the midwife has said that any strain on my scar/wound isn't advisable. I just don't think I could take any more damage to the scar I have. It's so painful already and I'm just miserable.

Id try to make peace with both options on the basis that you’ll see how things are nearer the time.

In another three weeks, you could be mostly recovered and feel ready for a VB or you could still not feel physically up to it and choose a CS.

C-sec then. That should put less strain on the wound than a vaginal birth where you’d be moving around and pushing.

They do push down hard on the upper abodomen to push the baby down towards the incision. I could feel the pressure (and see the surgeon leaning down hard with their hands). Where is your existing wound?

Also c-sec would be another incision though, obviously. My c-sec incisions are low down, just inside pubic hair boundary, about 10cm long. Hopefully they would make extra special care to avoid another infection. For what it’s worth neither of my c-sec incisions got infected.

Jeeezo, that is a rough gig you've got.

Labour is hard. Recovering from illness is hard. Being in pain is hard. Having a bowel problem is hard. Having a newborn is hard.

You can control some of the variables with a c/section - you'll be able to schedule help and have a plan for your recuperation. You are already worrying about this (not at all unreasonably) - if you were mine, I'd advise you to do what the medics suggest and get a plan in place for help and support to let you recover.

C/S is not an "easy" option - but, it is going to give you "permission" to be able to demand ask for help.

How much help do you have? Because, now is the time to flag this up to your healthcare team, they will have support they can offer but it's best to get it sorted now rather than when you have a newborn.

Poor you!

In your shoes I'd go with whatever was recommended by the consultant when you get to 36 weeks. Just wanted to add though that if a forceps delivery is an option then that might be preferable to a c section. I had a forceps delivery 8 weeks ago and the recovery time was very quick, the cut they do to insert the forceps is controlled and a neat stitch up job afterwards and the amount of pushing you do is very limited (I think I only did about 5 in total). I was very anti forceps before delivery but DD was struggling with the contractions and wouldn't have coped with being pushed down the birth canal for any length of time (turned out she had the cord round her neck) so that was the option available. I'd happily go for a forceps delivery again, I was a bit sore for a couple of weeks but nothing some paracetamol couldn't sort out and I was up and about doing things as normal - DD was also absolutely fine. I think forceps get a bad rep!

I have lots of help at home thankfully. My DH is fantastic. I'm also very lucky to have a hands on & supportive MIL too. My DP's cancelled their holiday two weeks ago to help look after me and our two DS's. So from that point of view I'm ok lol.

My scar/ wound is on my right hand side. Runs from beside my bellybutton right down my side. I'd post a pic but not sure how well received it would be. It's pretty disgusting!

Gosh, so sorry you have had such a hard time.

I'm not medically trained but even if you heal really well during the coming months, internally you won't be healed and I would worry about the pressure of labour on the wound. All you can do is talk through options when the time comes and take your doctor's advice.

I have had an emcs and and elective. The first week after each op was tough but then things got much better very fast indeed. I will probably have another elective with this one too. You can plan for the extra help and care you will need following a section. In your shoes, the unpredictability of a vb and the status of the wound would worry me.

I had a ruptured appendix due to having a tumour, when I was 16 weeks Pg with my youngest DD. They went through my bladder etc to do the surgery but thankfully it was uncomplicated & I was due to give birth naturally. DD had other ideas & was breech, so I was booked for a C-section & the moomin turned that morning. I was told that I was at high risk of needing an emcs due to my previous surgery, so we went ahead.

Personally, in your position, I would definitely ask for a section.

Good luck xo

Is this your first?

I think I’d also worry about the impact of a long first labour when you are still recovering. But if you;ve had a vaginal delivery before you might want to just go with this.

I think it’s a tricky decision though...the main reason being that normal/average vaginal trauma heals MUCH quicker than abdominal wounds. Think about how quickly your mouth heals following a cut, burn, ulcer or tooth out -vaginal tissue is much the same. Of course this may not be the case for a complicated vaginal delivery. If your abdomen is well healed by the time you go into labour you might want to avoid any further abdominal surgery and the additional risk of hernias, abdominal adhesions, scarring etc.

This is my 3rd. 1st delivery completely uncomplicated, 13.5hrs start to finish.
2nd delivery was an induction at 36weeks due to pre eclampsia. Had a placenta abruption and a PPH however this wasn't considered a risk this time round for a c section. Last labour I went from 4cm to 10cm in 10 mins and baby was born in 2 pushes.

Thank you all for replying. I'm not sure how healed I'll be when the time comes for labour but then nobody has a crystal ball. Guess I'll have to take it as it comes. I'm feeling a section is safest option right now but I think that's mainly due to having a huge gaping hole in my side lol

Sorry to bring this thread back to life.. I'm in labour!!

Had continuous bleeding from last week so plan was to induce me this morning. Dr came in and found out I was already 2-3cm dilated. Could feel bulging membranes and baby's head. So got a good sweep and was asked to walk the hospital lol.

The stairs must be magic as I'm now contracting every 6 minutes. Still early but I'm managing. Plan is to attempt vaginal delivery with limited/no 2nd stage so will have forceps or vacuum to protect my open wound from bursting. Praying for a quickish labour... and an epidural

Good luck @MrsPotts18 xxx

Oh wow - good luck! Hope it goes smoothly (and quickly!)

Good luck!

Good luck! Though at contractions every 6 minutes I doubt you’ll be back to this thread till baby is here!