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?

I suppose the thing is we all want a certain type of vaginal delivery (straightforward) or a certain type of Caesarian (also straightforward). I imagine the latter has a few more controllable factors but neither is guaranteed. It’s all just managing risk factors one way or another

@SpiltMilk100 I agree- if you have a straightforward VB obviously that is much better than CS and many women are lucky enough to have that, particularly when not their first.

In terms of all the women enjoying their 'normal' VB, I was the one in HDU having blood transfusions all night long, obvs had to have a catheter, space boots on etc etc. So maybe you just don't see the ones who have the issues. Think I'll try the ELCS risks this time instead!

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.*

Because honestly those first few days/weeks when you can function normally with a newborn especially if you already have a toddler are just magic.

Like an earlier poster sex is fine, no unrinary issues (after 2 vaginal deliveries) and no scar. Why not go for it ? You can always have c-section if it gets hairy. Put simply the rewards of a straightforward delivery were worth it for me.

I’ve had a vaginal delivery with DC1 and and had a CS with DC2 last week. First baby - long labour, episiotomy, forceps, big bleed and spinal headache. The labour itself was awful but after I had recovered from the spinal headache my recovery was great, minus a small scar I looked and felt pretty much the same down there. I didn’t experience much pain in the recovery at all. However I’ve heard this isn’t the case for all vaginal delivery’s.

Second baby the CS itself was fine, no pain during the actual procedure but it was painful as hell for the two days after. I’m now just over a week in and I experience some mild pain but not much. However I have been left with what will be quite a sizeable scar and can’t care for my toddler properly for another 5 weeks. I was totally reliant on my DH to care for me and baby up until around 5 days post CS and there’s still a lot he’s needing to do.

Neither option is ‘easy’ but as PPs have said you can have a great vaginal birth and a terrible CS or visa versa. CS doesn’t guarantee an easy ride.

Also @heather12911 it can be very difficult to have a sensible discussion with some obstetricians about this. I had one threatening that I would end up with a stoma if I had a ELCS. Was not able to give me statistics on how common an outcome that was. Plus finding a study looking only at ELCS not at EMCS as well (where by definition there is already a problem and a big time pressure) outcomes seems very difficult. Would love to see such research is anyone has found it already!

Promised I could have a VB in an operating theatre if I wanted in case of another life-threatening problem. I mean really?!

I had one due to keloid scarring and the size of the baby (10lb 1oz)

Baby was stuck and needed forceps but no other complications.

I'm glad I did it, it was right for me and my baby.

Recovery was incredibly hard, the first week was utter hell and due to pain I struggled breastfeeding and bonding with the baby.

2 weeks on things started to get better and after 3 weeks I was up and moving without any pain.

No issues with scar.

It's hard, so please think it through. I've never had labour, so I can't compare.

Because people don’t know the real risks , as simple as that. They shove the risks of sections down your throat like they’re almost a certainty and make you sign a consent form - and nothing of the sort for natural (which I think will change as birth injuries are becoming less taboo and a more open topic)I don’t think women talk about what can happen. Also you get railroaded by the midwives, they minimise the concerns and dismiss them. I just wish I had had the sense you do, 100% go for it. I’ve had both and c section was better for many reasons...good luck x

I'm pregnant with my first and have read this with interest as I'm sure most woman need to consider the options.
From what I've read here (I know I'll need to do research from official sources too) I am thinking back to my own experience of surgery to remove my appendix. That, quite simply was awful and it was only key hole, 3 little scars. However, one was infected, recovery was a few weeks. I can't even begin to imagine something the size of a baby needing to be cut out... So for me I'd was natural based on my own experience. If you've never had a difficult response to surgery I can understand why you might think it's an easy option. But I do not think getting a baby out, by any method, can ever be described as easy.
I hope that whatever decision you make OP, that it'll all go smoothly.

Can't make a decision for you that's one for you and hosp staff but I had a c section. Recovery was hard, very painful, couldn't sit up probably for days and sex is still painful 2 years on. Despite the fact I've never delivered vaginally I now find sex rather uncomfortable

Had two sections here too. I'm not sure it was the better option either.

There's the pain of labour and or pain of recovery. Trying to look after an active toddler after the second was hard work and quite stressful as I was so worried that they would hurt the wound. The possibility of trapped wind is hell.

There are layers and layers of stitches which can cause internal scarring. I was unable to run for over a year after and had to have physio to be able to move faster than walking. I would be in immense pain trying to keep up with my toddler.

I have the csection overhang which is entirely numb and am still be investigated for pains that they believe extra scarring has caused.

That said I happily breastfed both and an grateful for my super pair of children. I I had the choice I would have hoped for a spontaneous natural birth.

Being pregnant has a massive impact on your pelvic floor so don’t be fooled if you have a CS!

Pregnancy does put strain on the pelvic floor so CS doesn’t prevent damage but it does protect against it. There is plenty of evidence that rates of incontinence, prolapse etc are higher with vaginal birth, especially in the long term or with assisted delivery.

You also avoid the risk of perineal trauma by having a section.

You are bang on OP that the long term effect on quality of life of a VB can be massive if you aren’t one of the ones lucky enough to make a good recovery, and loads of women don’t.

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

Because you don’t get hypoxic brain injuries causing catastrophic disability or death when a baby is born by section. However baby is more likely to need a stay in the NICU so it depends how you weigh risk.

Perhaps do some serious research on natural vs elective c section. I had a c section and couldn't walk for a week

I had a vaginal and 2 years later it still hurts to walk.

I’m not here to say a CS is easy, and I’ve never had one so couldn’t comment! But some of the comments here about vaginally birth are extremely naive. The risks of section being mentioned include emergency section, which is a risk of VB not a risk of CS, because if you have an elective you won’t need an emergency.

If I had know then what I know now, I would definitely have had a section last time. Yes it’s major surgery and I am sure it is very painful in the short term, but my quality of life wouldn’t have been ruined the way that it has. Plenty of obstetricians or their partners elect caesareans.

Also with the advances of scanning facilities, they’re discovering that the rate of injury from VB is greater than thought. People can suffer latent damage that comes to the fire at a later date especially in menopause.

I had an ELCS, primarily due to chronic back pain but it was what I was hoping for. It was a calm & lovely birth, yes lots of staff but everyone was lovely & seemed genuinely happy for us when baby was born. I was able to rest at home with my husband & mum doing everything which certainly helped.

I had an elective c section with my first due to a low lying placenta and am electing for a second c section with my second due in May.
I recovered very well from my elective c section but life was still difficult and painful for about 2 weeks.
The only thing I would say is I found the actual operation terrifying and had a panic attack on the operating table (I have never had one before). Being sliced open while awake is not a pleasant experience! So keep that in mind.
Also would you actually be able to get a consultant to agree to a elcs without a medical reason? My consultant is reluctant to agree and I am 'entitled' to a section as I've already had one. I think you would have a fight on your hands!

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

Sorry for string of posts I can’t copy and paste on my phone from different pages of the thread.

OP it is unlikely you will get objective advice from your midwife or obstetrician. I am having a section in a few weeks, and when they were trying to scare me about the risks (while mentioning nothing about the risks of VB), thankfully my husband who is a doctor was with me and was able to call them out on some of the things they said which were very misleading. Maybe I was unlucky but I don’t know any woman who wanted a section who didn’t have to fight for it.

@apples83

I've had 2 CS. The first I had a 5 month infection, a wound vaccum machine was needed to heal. I spent 3 weeks with, a 12 week old baby and a machine attached to me day and night suckling me back together. It was hellish.

The second one I was healed in 4 weeks and driving etc.

You never know which option you will get, the same with a vaginal birth.

I had an EMCS with my first pregnancy. Different to an elective, however recovery was slow and painful. Struggled to even pick DD up which made breastfeeding miserable and difficult. 3 years on my scar still hurts if anything rubs on it. And I have pelvic floor issues from pregnancy too.

Pregnant again and will be having an ELCS. Hoping it’s a bit less traumatic and painful!

I had an emcs and the pain for a while after is quite bad. Especially getting in and out of bed. The large overhang of flappy skin it has left me with is horrible and this alone would put me off doing it again.

I gave birth the same week as my best friend. She was adamant all of the way through the pregnancy that she was having an ELCS as she couldn't cope with the pain of childbirth and felt it would be inevitable that she'd end up with an emergency one. She got her ELCS after much argument and apparently it was awful. She now hates her body due to the scar, her recovery took ages and she said that if she has another baby she wants a vaginal delivery. That is a BIG thing for her to admit as she's saying she was wrong. I had the "dream" vaginal birth with a 7 hour overnight labour, most of it at home, and genuinely when the baby was born I thought "was that IT?" as I had expected it to be more painful.

One thing I want to pick up on: you said that if you could be guaranteed a great vaginal birth then you'd do that .... Unfortunately you're about to become a mum and that has no guarantees. Your baby could cry constantly and make your life hell for months or years, or you could get lucky and have a baby who sleeps through from a few weeks old. Decide whatever you want to decide based on talking to your midwife but don't expect either delivery method to be easy, and then once it's out then that's where the hard work and lack of guarantees really starts. As a first time mum your birth "experience" is really bigged up but tbh that's just a week (in an extreme case) in comparison to your entire baby's life.

It costs the NHS around £700 for a natural delivery and almost £3k for a c section. I have friends that have lost feeling in the stomach area as nerves have been severed, another friend had her bladder cut during the op and another friend who basically bled out and had to have a full hysterectomy as they again cut something inside. Then there's the not driving and not being able to lift anything for weeks after.

I've had 3 vaginal births, 1 elcs and 1 emcs. Elcs was awful, so much more painful than my vaginal births.

I opted for an elective section with my second baby following a traumatic first birth. Was booked for the day before my due date. However, I went into labour a week early at night and the only surgical team was doing an emergency when I arrived. I progressed too fast to wait for their return and gave birth vaginally. My first baby was also a relatively quick delivery. So be aware that you might elect for a section but may not get it. I gave birth in a large hospital and there was still only one surgical obstetrics team on overnight. For what it’s worth, I’m glad I didn’t have the section. I think it was a much quicker recovery and was better than the first one.

I was adamant that I would I would request an elective CS. DH and I both have massive heads, I was nearly 9lb (elective following EMCS) and he was 11lb (EMCS with a lot going wrong) and the thought of giving birth naturally terrified me.
Fell pregnant and starting thinking maybe vaginal would be an option. Started NCT and now I'm pretty adamant to give vaginal a good go with no pressure on myself, ie if I need an EMCS then I won't let myself feel like I've failed. It was fear of the unknown and I feel so much more comfortable about the idea now, and the thought of not being able to walk my dog properly for weeks or lift anything other than the baby really doesn't appeal as a first choice.
You may also struggle to have an elective if you have no real medical/psychological reason. In our trust, they pretty much refuse for first births and you have to push (no pun intended!) to get one after a complicated first birth. A friend tore in her first birth and needed surgery a couple of years later and the consultant talked her out of a CS!

I had an emcs nearly 2 years ago and an elcs 12 days ago. The pain has mostly gone for me now, but I still find doing certain things difficult, I have to be very careful of how I get up, when I cough or sneeze etc. I found the elcs itself pretty good, especially compared to my emcs, but I would much rather have had natural labour if it was a safe option for me (it wasn't). I'm now stuck at home for weeks because I can't drive, I can't pick up my toddler or play with him like I could before, and my stomach looks awful, the 2 sections have made such a big overhang.
End of the day, you choose what you think is right for you, personally I'd have much rather have had natural labour than serious surgeries, but it's your choice.

I had a fairly boring and straightforward vaginal delivery and felt physically almost normal very quickly afterwards. That wouldn’t be the case with even the most planned and straightforward of c sections. Of course it’s not guaranteed that a vaginal delivery will be like that - but I didn’t want abdominal surgery where I would be guaranteed to be unable to drive (for example) for a period of time afterwards.

Absolutely respect the right of other women to choose an ELCS if they wish, but it wasn’t what I chose for me, or what I would choose unless there were indications that labour wasn’t likely to be straightforward (e.g. baby measuring very large).