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?

You also have to consider longer term too? How many children would you like to have. A scar on your causes risks in future pregnancies - not just the risk of uterine dehiscence or rupture, but also can affect placental implantation which can the cause a whole other host of issues!

I can tell you now as a wife of a husband who delivers babies via c-section whether it’s planned or emergency cases , it is MAJOR surgery and has risks to it. Huge risks. You say all the friends you’ve spoken to have said the pain of natural birth lasts more than a few hours, and also say that your friends who had a section had a quick recovery . But everyone is different, you could have a really great vagina birth , equally you could have a really shitty time in surgery.
I am due in the summer with my first and I have a medical condition which means vaginal delivery could be risky to me but I’ve said I’ll opt for that and should there be any complications I’ll have an emergency section . I’d much rather leave that as a last resort . If you’d had a really traumatic time with a previous birth I would understand why you’d want to have an ELCS but seeing as it’s your first I’d give natural a go and see how you get on, like I say just because your friends have been lucky doesn’t mean you’ll have a text book surgery. My husband does it day in day out so is the best to say what it’s really like for women , I hear it every day 🤣

@apple83 I've had 2 c sections for severely premature babies, for 6 weeks after delivery I couldn't stand up straight, couldn't drive and dtruggled to hold my children. I had a large 1100ml blood loss after the first section and babies are more likely to have respiratory symptoms after Csection as they're not compressed like during vaginal delivery so can struggle to clear fluid off their lungs.

Don't have a section unless you need one in my experience

I think you are set on a c section regardless.

I'm from the other camp. I would rather avoid major surgery if I could help it.

I had both mine without drugs (they don't agree with me), it wasnt too bad. 2nd at home and I was helping to clear up an hour later (rush of endorphins). Didn't have to stay in hospital with either, got to be at home in my own bed and sleep, which is difficult in hospital.

Plus in the majority of cases it's better for the baby as well.

I’ll say this as politely as possible - it doesn’t seem like you’ve researched properly.

C-sections are major abdominal surgery so there will be more pain overall, and the recovery time is much longer.

There are greater risks of postnatal complications for a c section, and an element of risk to subsequent pregancies due to the increased risk of uterine rupture.

Babies born via section have lower apgar scores and are more likely to need intervention than babies born vaginally.

In summary - whilst section may seem more
convenient to you, or carries a higher risk to both the mother and the baby and that’s not a everybody wants to take.

I had an elective. Stood up and walked next day, scar healed fine, didn't think it was painful at all. - that said I think I'm a rarity!

Do your research and pick which birth you want OP.

Will they let you have one, anyway?

Most obstetricians I know would rather not.

I’ve had 3 csections. First one was incredibly painfully afterwards for a couple of weeks; I had a mild infection. Second and third were better. Second one I had a massive bleed about 4 weeks after.

You can’t just get out and about as normal; you can’t carry a pushchair or an older child. You can’t look after a toddler easily due to no lifting. You can’t exercise or walk far for at least 6 weeks.

You have to walk and shower on your own the same day as the csection and are sent home the day after, which is hard going.

Benefits: much calmer and less traumatic than emergency section.

I've had different types of births. Straightforward, instrumental and elcs.

ELCS was amazing. My absolute favourite.

This rather bold claim is based on a tiny, genetic study.

Yet the study I linked to had nearly a 1000 babies take part in the research
You find a study with under 100 babies

I've had vaginal and elcs. C section is waaaay better and easier. There's a lot of scaremongering on here about c sections, which people only ever compare to straightforward vaginal deliveries. In my experience, a traumatic birth is painful for far longer and takes a lot longer to recover from (I could hardly walk at 4 weeks post partum and still needed physio over 2 years later). By comparison, I was up and about within 24 hours of my cs, I didn't require any painkillers at all from 10 days post partum and felt fully back to normal after 2-3 weeks. I genuinely wish I had had a c section for my first and I would definitely have one again.

I've had both. Neither were easy. After the C section I couldn't even stand up straight for days. It was very painful. My scar got infected and I had a couple of weeks of antibiotics. My scar is still obvious 12 years on. My stomach was numb for a couple of years. Not driving for weeks was really hard, I felt very isolated.

Hey OP, if I can recommend one thing it's this book:

www.amazon.co.uk/Positive-Birth-Book-Approach-Pregnancy/dp/1780664303?tag=mumsnetforu03-21

It helped me immensely to overcome my fear of natural childbirth. It discusses caesarians too & how to make them a positive experience also. Really highly recommend.

www.medicalnewstoday.com/articles/256915

This study has over a 1000 babies and has the same results as the studies in Germany www.webmd.com/allergies/news/20041020/c-section-may-increase-kids-allergy-risks

I've had 2 sections and due my 3rd in 4 weeks.
First was an emergency section and 2nd was elective. I would say the first 2-3days after surgery are painful, not unbearable, just take your meds every 4 hours. After day 3-4 I was fine, walking around normally, pushing pram and out and about. Just make sure you take it easy and don't do to much you will be fine

I have no idea how you've come to the conclusion that it's safest for baby.

Perhaps do some serious research on natural vs elective c section

I had a c section and couldn't walk for a week

“if you can have an ELCS then why on earth wouldn’t you?”

My friend has had two ELCS - first was straightforward, second has resulted in huge problems with infected scar that has had a big impact on the postnatal period as she can’t lift, drive, cuddling her toddler and baby is very sore. These sorts of outcomes are unpredictable on an individual basis.

All of this stuff is just managing risks - I felt an ELCS was introducing more risks unnecessarily given the information I had about my pregnancy. You might feel differently about your own pregnancy. I had a straightforward vaginal delivery, healthy baby, no tearing, no longterm changes to my body that would have been caused by labour in itself (pregnancy and breastfeeding would have happened anyway!). It turned out i was right about which form of childbirth was best for me and my baby, which includes quite a bit of luck. Your perception of risks relating to your own pregnancy and childbirth may be different and that’s fine

OP I was one of the unlucky ones who had a car crash first birth. Put me off having another for years. Am now pg again and going through the process of getting ob-gyn to agree to ELCS as am more comfortable with the predictability of it - there is no guarantee that any of the multitude of problems I had last time wouldn't recur and the experience last time led to a difficult mental recovery. They are still dead set against it.

On MN threads from people who have actually had ELCS rather than just have a 'view' I have found hardly any who regretted it or found the recovery unbearable.

How much help will you have post-birth though? I am planning to have DH for 3 wks, poss doula and then DM/DSis if still bad when DH back at work.

**There are greater risks of postnatal complications for a c section, and an element of risk to subsequent pregancies due to the increased risk of uterine rupture.

Babies born via section have lower apgar scores and are more likely to need intervention than babies born vaginally.

Is this based on elective sections alone or does this include emergency sections as well? I had two elective sections and really struggled to find any statistics based on elcs alone. An elective section is quite a different procedure to an emergency where there is already distress to mother and/or baby.

You need to have the birth that you feel comfortable with op. Anecdotally my 2 elcs were fantastic experiences. I was home the next day, could lift and move around. Only took paracetamol and drove after 6 days.

I've had 2 sections and I wouldn't wish one in my worst enemy.

First was in hospital 5 days. Whilst all the vaginal birth mums were sat up next day enjoying their babies I was in agony waiting on my catheter coming out. They went home that day. I stayed another 4 nights.

I was in huge pain for weeks. On strong pain meds for 12 weeks. Couldn't walk more than a few minutes for weeks. Couldn't drive for 2 months.

Didn't feel ok for 4 months.

Second second got post op complications and ended up on high dependency ward. Didn't meet my baby for 3 days. In hospital 10 days.

Got a wound infection which had to be packed and dressed every day by the district nurse for 3 weeks. That was so painful I couldn't get out of bed for an hour afterwards.

On strong pain meds for 12 weeks. Wasn't ok for 5-6 months.

I would have done anything for a vaginal birth where I could have been like all those other mums I saw in hospital going home the next day and getting straight on with life and enjoying their babies.

3 vaginal births, first had assistance with ventouse, second and third both unassisted, no pain relief, no tearing. I was home within 6 hours with all three and wouldn’t say there was a ‘recovery period’ as I felt absolutely fine straight afterwards.
Personally I wanted to avoid major abdominal surgery if possible.
I’ve had friends with good vaginal births and bad ones. Friends with straightforward recovery from c-sections and some with serious complications.

I had an emergency c-section with DC1, and an elective with DC2. The elective was lovely, pain free and I recovered pretty well. But it was lovely in comparison to an emergency section. I have nothing else to compare it to.

I was in terrible shock after my first birth. I’d never had surgery before and I can tell you, major abdominal surgery is shocking. It was so brutal. The drip and the catheter and the stitches and looking down and seeing and feeling a wound in your body. Urgh. It wasn’t in any way a breeze.

My stomach has never recovered aesthetically, either. I was model slim before my first child, and was left with an overhang.
My kids are teens now and I’m at peace with how they were delivered, but if I’d been able to deliver naturally it would have been preferable.

Just adding my experience, I had a very traumatic labour that ended in a EMCS. I was literally crying and screaming as they wheeled me to theatre, that's how scared I was and how much I absolutely did not want one. The surgery part wasn't great but I think I was just trying to calm down after the initial panic. I was up and about 6-7 hours later and felt really good. The pain wasn't that bad at all and I coped with just paracetamol and ibuprofen as the tramadol made me feel incredibly sick and drowsy. The hospital stay was the worst part and I couldn't wait to get home. My scar healed really well and you can barely see it now 3 years on. As for the not driving part - they recommend not driving for 6 weeks but I was ready after about 4. Doesn't mean you can't leave the house though, I was still able to push the pushchair and walk short distances to the shop, the doctors, my mom's etc. I'm due DC2 in the summer and am having an ELCS, quite looking forward to it actually. All I can do is hope that my recovery goes as well this time and I will be asking to go home early so that I don't have to stay in a horrible over crowded noisy roasting hot ward any longer than absolutely necessary. I think the people that are so anti C-sections, on the whole, have had a positive birth experience themselves so obviously cannot understand why someone would want one. Given the choice of a guaranteed straight forward birth (no complications/interventions needed) or a c section, obviously everyone would rather the straight forward birth. But given the choice of a traumatic birth needing interventions, resulting in serious long term issues for the mother (prolapse etc), I'm sure a lot more people would consider a C section.

If you want an ELCS, go for it! There are risks with all of the ways of giving birth, and if the risks of the ELCS are more acceptable to you, then that's ok. Other people have different perception of risk which is I suppose why others feel differently. FWIW I don't know why there aren't more ELCS. I'd take a scar and a few weeks extra rest over potential incontinence and painful sex for the rest of my life.

I started the thread because I want to hear of other people’s experiences and thoughts so I can make a more informed choice. I don’t see anything wrong with that?

OP, this suggests you are using anecdotal evidence to make your informed choice. There are various degrees of quality of evidence and anecdotal evidence is the poorest and is NOT representative of the truth about the risks/benefits.
Please speak to your midwife/obstetrician as I am sure, providing there is no other medical reason, that they would recommend you go for vaginal delivery as there is much stronger evidence (than anecdotal) that this is the best option for first time mums with low risk pregnancies.