ELCS - why wouldn’t you?

[apples83]

I’m due to give birth to my first child this summer and am feeling nervous about labour. I’m concerned about the pain, the tearing, that it’ll permanently wreck my body, that sex will never be the same again due to stretching down there.

I’m therefore wondering whether to go for an ELCS to avoid all this. Several friends have done just that and all have had very easy, positive experiences and been back in their feet in no time. An ELCS is surely safer for the baby too as they’re whipped straight out, rather than having to go through hours of labour during which time they could potentially become distressed if there’s complications.

My question is - if you can have an ELCS then why on earth wouldn’t you?

There are many many potential complications with a CS - it’s major surgery.
Would I have a CS - yes if the benefits outweighed the risks.
Would I have an ELCS for no medical reason - not a chance!!

ELCS is fairly major surgery - all surgery comes with risk. There's also a not insignificant recovery period. I gave birth vaginally. Yep, it hurt, yep, I tore. But I was out of hospital next day, able to lift/carry more than my newborn's weight, able to drive, no scar infections to worry about. My body is ruined at sex is still great.

I'm not against ELCS by any means. But I feel it's a little foolish to think it's the easier option.

My body ISN'T ruined and sex is still great that should say 😳🙄

I had 2 c sections for medical reasons. They weren't a walk in the park. My friends who had vaginal births were out of hospital quickly, I was not. My first I lost 1.8litres of blood and ended up in HDU. My second was more straight forward but looking after a baby and toddler after major surgery was not easy. I still have the C section overhang and don't think my stomach will recover.

Having C sections was the best for me as I had 2 breach babies but it wasn't the easy option in my opinion.

The most straightforward and medically safest delivery is a spontaneous vaginal delivery. As a first time mother your chances of achieving that are around 50:50.
Babys are designed to be born that way, sometimes they run in to trouble after a c-section (both breathing and feedimg problems more common). Similarly womens bodies are designed to give birth, the pain only lasts a few hours, then you can get up and go home. Superficial tears and grazes heal very quickly (days for me, my,mum and my sister). Breast feeding is easier to eatablish after a vaginal birth and is better for mum and baby too.

Quick answer: there's no good way to give birth but it's something you're going to have to do, one way or the other. Vaginal and c section both carry risks. I've had both. C section wasn't great to be honest and recovery took a long time. It also puts more risk onto your next pregnancy, and there is growing evidence it is not good for the baby in terms of lack of exposure to gut microbiomes. But then I know people who've had terrible vaginal births with longlasting effects. At my age, and being a bit overweight, I'd go for elective if I had another, but my vaginal births are actually one of my best memories of my life.

Birth is one of the highest risk activities for you and your child, no matter which way you give birth. Thank God we live in the developed world so those risks are still tiny.

A vaginal birth is actually better for the baby in some respects (they pick up good bacteria from the vaginal canal and also the squeezing and pressure helps them eject mucus. Section babies are often very mucusy. My DD was bringing up loads of gunk for a few days post section) so it's not entirely straightforward. A straightforward vaginal birth is better for a baby than a section, but a section is generally better than a traumatic labour where a baby gets stuck, for example.

The thing is, it's a crapshoot. You could have a vaginal birth with no issues and be home in six hours. You could have an awful vaginal delivery where your baby gets starved of oxygen or you get a third degree tear. You could pick up an infection from your C-section or any number of other risks that come with major surgery.

There's no right answer, there are only variables. For every person's great vaginal birth, there is someone's horror story. For every person's smooth section and recovery, there is someone's horror story. Childbirth is a dangerous business and we lose sight of that sometimes I think, but women still die giving birth every day, even in developed countries like ours.

Oh yes and no scar, I have worn a bikini every summer since giving birth.

Being pregnant has done more damage than giving birth and I needed stitches!

Varicose veins, stretch marks etc = from pregnancy

I was offered an ELCS second time around but I felt that my body was designed to give birth. Plus with kegel exercises, my bits recovered well.

I was scared of an ELCS and that’s having given birth already.

Also babes being 'whipped out' isn't really how they're intended to be born. There's a biological purpose to the mechanics of labour and the journey of the baby down the vaginal canal, rather than the sudden shock of being plucked straight from the womb into a brightly lit operating theatre.

Because I got to give birth in the nice MLU my hospital has attached to it and didn't have to go into surgery. Which it is.

I support women having a choice but there are lots and lots of risks associated with birth regardless. My friend got an infected wound post CS. She was in agony for what felt like weeks and weeks although I admit I can't remember how long it lasted until she was sorted. I was sore for a few days post delivery but otherwise ok.

It doesn't impact on sex because you've delivered a baby naturally and the pain is a thing, sure, but it has purpose.

The most straightforward and medically safest delivery is a spontaneous vaginal delivery. As a first time mother your chances of achieving that are around 50:50.

Do you mean that there’s a 1 in 2 chance that if I opt for a vaginal delivery, I’ll have to have an EMCS?

Similarly womens bodies are designed to give birth, the pain only lasts a few hours

From what I’ve heard from friends, the pain lasts a lot longer than a few hours unless you’re one of the lucky ones.

OP I had a lot of thoughts about this before I gave birth. Terrified of tearing & complications like incontinence. But a CS, even a planned one, has consequences too. Like posters above, I was walking around with the pram a couple of days after birth. I did have some tearing but it healed well. I know anecdotes are not representative but most people I know who had planned or emergency CS were stuck in the house for several weeks. In the days following the birth I really enjoyed how light & nimble I felt by the sheer fact of no longer being heavily pregnant - yes I was sore and bloated, but it was still better than feeling so rotund and cumbersome. Having an aching CS wound would not have been good.

But like @DesLynamsMoustache says you have no idea how it’s going to go and there are risks and benefits to all methods of birth. Have you spoken to your midwife about your feelings?

Have had a emergency cs followed by a vbac, was offered an ELCS and declined as I didn’t want to have major surgery without a reason.

For me it was the right choice, I was up and out the next day, even after a difficult delivery with forceps.

There's a biological purpose to the mechanics of labour and the journey of the baby down the vaginal canal

It seems a hell of a lot to go through just for your baby to pick up a few “good bacteria” and have less mucus, unless there are any other benefits I’ve missed?

Because any kind of surgery carries risks
Because it's a more expensive option and my health insurer may not cover all costs (am not in UK)
Because I am squeamish and hate the idea of having a cannula in, stitches in my stomach etc
Because I hate the idea of not being able to immediately stand up, carry my baby, drive a car, push the pram etc
Because VBAC isn't always an option and I wouldn't want to restrict myself for future pregnancies

Obviously all of the above are immediately void if a CS is required for medical reasons!

Am saying all of this as someone who has had two vaginal deliveries but was discussing a CS for #2, as baby was transverse until very late in the day.

I know anecdotes are not representative but most people I know who had planned or emergency CS were stuck in the house for several weeks.

That’s the thing - everyone I know who’s had an ELCS has found it really straightforward and easy and seem to have had no trouble breastfeeding, picking up their baby or leaving the house soon afterwards. Unless they’re not giving me the full picture?

I haven’t come across anyone in real life who’s had a bad ELCS experience, but I do know people who’ve had very traumatic “natural” births.

Two vaginal births here. With both babies I was out the next day.

I wouldn’t personally opt for a c section. Major surgery long recovery time can’t do any lifting driving etc for 6 weeks.

It’s not a walk in the park.

I've had two sections one crash, one elected. I would describe neither as 'very easy'. First one was after horrific labour so won't discuss for this purpose. Second one I reacted very badly to the spinal, nearly lost consciousness and couldn't not stop vomiting during c section or for the rest of the day.

The pain is bad for a good week, you don't get decent painkillers once out of hospital. You can't laugh as you can split your stitches open, you can't lift anything, drive, walking is tough at first, you can't wear anything near your scar for ages as it hurts. DH has to help me with my first shower as I could barely walk. My stomach is ruined, I sadly didn't get a neat scar after first one so may be different.

You also have to stay on the postnatal Ward for two nights normally which is hell. Noisy, hot, crowded.

But yes vaginal births have complications etc too but just wanted to take away the 'easy' factor.

I have had two vaginal deliveries and I would never choose a c section unless it were medically necessary for me or my baby. I hate the idea of being cut open whilst awake and the recovery from a c section looks much more difficult. I would want to avoid that with a newborn and definitely with a toddler. Also this is a bit vain but I didn't really want the scar and potential overhang.

Food intolerances for c section babies are no joke.

My dd1 has now developed food intolerances in her twenties and we hadn’t realised this could stem from c section. Obviously I didn’t have a choice - we’d both be dead. What other health implications though haven’t been linked, asthma? Could the rise in asthma be linked to the rise in c sections... 🤷‍♀️

Oh yes first child has multiple food allergies and I'm convinced it's from her birth.

But I didn't have problems breastfeeding.

Maybe your friends haven't really gone into the detail with you, most people don't with those yet to give birth.

If you are nervous, it is worth checking if you can have an elective as, if you can't, this thread isn't going to help. You seem dead set on the elective having more advantages. Actually, all birth is risk, for both baby and mother, just in different ways.

You seem dead set on the elective having more advantages.

Not dead set at all - I’m very open to having my opinion changed. I’m just saying that from what I’ve seen in real life, ELCS seems like the far less traumatic option.

It seems a hell of a lot to go through just for your baby to pick up a few “good bacteria” and have less mucus, unless there are any other benefits I’ve missed?

That good bacteria sets up their microbiome for life. It’s significant for future health.

I’ve seen many babies come out flat (no heart rate or respiratory effort) at elective sections because being born without labour is a massive shock and they aren’t ready.