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?

It's not the easy option by any stretch. I had emergency ones for both of mine but the second one was quite a nightmare. It turned out the epidural wasn't right despite a load of checks beforehand so I felt the cut and it was very painful (understatement
Then you're a bit bent over for a few weeks, can't drive, can't lift, in a fair bit of pain and can't really do much until 6 weeks afterwards. I always secretly envied those new mums who were back up and running almost immediately compared to me.

I wouldn't say it's an easy option by any stretch, just different.

Obviously there are pros and cons to both VB and CS - I cant see how any amount of research can lead you to any other conclusion?

I do think the OP is incredibly naive/arrogant to create a thread which is essentially "why would anyone have anything other than ELCS" when she hasn't yet experienced either.

My DS was an induced VB, and I plan to have another VB with this one. Without a medical reason, there is not a chance in hell I would opt for ELCS with a toddler to look after.

OP, I too was petrified of labour. I have a very real phobia of needles and blood, which as a woman is just FANTASTIC 🤪
Everyone I know that has had one of each (Vag & CS) would take the V any day and twice over on a Sunday. Pain is relative - what is painful to someone else may be a walk in the park for you. I found that as long as I kept the end goal in mind, and followed instructions (breathe, hold, etc) it really wasn't all that bad. Best of luck with his decision, but remember to be flexible, nothing worse than feeling helpless because things haven't gone to "plan".

I've had two ELCS. Two neat scars. Easy recoveries. Absolutely the right choice for me.

Do your research around both ways of giving birth, maybe conduct some family history too (all the women in my family needed EMCS following awful labours) and make your decision. Follow your gut.

I doubt that anything anyone here can say will likely make the decision easier for you.

You do (should) have the choice in this country as to what birth method is right for you.

Feeling reasonably qualified to comment as I've had one emcs and 7 vaginal deliveries. I'll take an uncomplicated vaginal delivery (even with a bit of a tear or a couple of stitches) over a c section ANY DAY!!
A c section is definitely NOT pain free! You don't need morphine after a vaginal delivery generally! Within 24hrs of my 8th (a normal vaginal delivery with no tears) I was doing the school run - walking pretty normally and feeling well.
I'm afraid giving birth no matter which way you do it is painful but worth it.

Not a chance. I was more scared of a c section than a natural birth. I've had two natural births. Yes, it hurts. My body isn't wrecked (just stretch marks) and my vagina is fine. Sex is mainly the same (although less frequent due to dc). Women's bodies were made to do this. First birth, I haemorrhaged and had lots and lots of stitches- couldn't walk for 10 days. I'd do it again to avoid a c section. Yes, you don't feel anything at the time but the recovery can be really hard. Just to give you my perspective, you do what feels best for you.

I am mid thirties and most of my friends have had kids. Probably about 25 women I’ve spoken to in gory detail about our births. 2 who have had both preferred VB, but neither have any long term issues. I know one woman who has to have ELCS and was floored for weeks, but generally people I know have been fine with them whereas most with VB (myself included) had complications or extended recoveries. We are in our thirties so had we all been 10 years younger I’m sure the VBs would have gone better - older mothers are at greater risk of tears and interventions.

So my experience speaking to others is same as yours OP.

I know this is anecdote - it’s in response to others’ anecdotes, not put forward as reliable data. However for all the studies in the world we cannot help but be influenced by those around us.

The only reason I would choose to have major abdominal surgery would be in an emergency circumstance.

It is a massive undertaking. The impact of a CS is also felt more with subsequent pregnancies. Risk of stillbirth, placental abruption or uterine rupture increases in later pregnancies. I wouldn’t be able to justify those risks to myself or my children.

I actually think it’s remarkable that major abdominal surgery has become a ‘choice’ that some trusts let women make without any medical indication. I think some things should be reserved for emergency situations, and cutting into the abdomen and putting a scar on a uterus is one of those.

Two straightforward vaginal births, paracetamol and some gas and air. Small tears both times but nothing that wasn't healed in a few days. I was home within hours with both and dancing at a wedding a few days later with DC2.

No issues with sex etc afterwards, I literally just pinged back to exactly how I was before (actually slightly better).

Before my births I was really bothered about tearing but actually most people do and most of the time it's not a big deal. You don't really feel it happening at the time.

For me the contractions were the worst bit not the actual giving birth bit.

For every horror story there's a good straightforward story but people who have had an easy time of it don't tend to talk about it much because there's nothing to talk about.

I'm sorry but a csection isn't the easy way out. I had an uncomplicated emergency csection (undiagnosed breech) and while calm and relaxed my baby was still in nicu as has every baby born by csection In my friendship group. I couldn't even open the door to visit him without help.

Your friends might appear to be fine quickly but internally nobody is recovered quickly. The scar from just the placenta is the size of a dinner plate apparently so while the outside might seem better you aren't.

Lol to the person who thinks its just a scar and a few weeks rest. Weeks of pain killers. No driving for 6 weeks, no real exercise for at least 10. Risk of rupture in subsequent births. Holding a maternity pad to your scar to pee for over a month to ease the pain. 4 years in there's still part of my belly I can't feel. But sure it's the easy option.

You seem to have a very negative view of all birth. Try something like the positive birth company or nct and do some proper research.

I’ve had 2 vaginal deliveries at 34 and 38, I had to have stitches for both but recovered fairly quickly. Both births were straightforward. 2nd one was very quick, 3 hours from arriving in hospital to giving birth and I was out and about with my baby and toddler a couple of days later so recovery much quicker. No issues with continence or sex since. Seeing as it’s your first you have no idea how it will go, but I wouldn’t chose major surgery if I didn’t have to.

It's a case of weighing the risks to you and the baby. A VB means a higher risk of of pelvic floor problems for you later in life, but also a better microbiome and a lower risk of allergies for the baby.

You also might want to think if you want any more children. Somebody I know had several ELCS that went fine. She then got pregnant again and the uterine scarring from previous sections caused a medical condition that almost killed both her and the baby.

In some ways a section for one pregnancy pushes the risks onto subsequent pregnancies.

I actually think it’s remarkable that major abdominal surgery has become a ‘choice’ that some trusts let women make without any medical indication

You might end up with a fourth degree test, doubly incontinent for life, have a complication which necessitates future surgery eg front wall repair, your baby might get stuck and end up with a brain injury, and a whole host of other complications to boot. Of course it’s fucking medically indicated to anyone except a misogynist.

If men had to undergo a process which includes the risk of totally ruining their dicks and their sex lives, but there was a routine operation which avoided this risk, they wouldn’t have to fight for the right to have it.

My birth plan was to have a midwife led waterbirth which didn't go to plan as I had to go in to be induced. I had mild contractions whenwhilst the pessery was in but once that came out they stopped. I was taken down to the labour ward to have my waters broken however within 15 mins of being down there I was being prepped for an Emcs. The OP itself was over that quickly I didn't really have chance to process it. I did lose over a litre of blood but after the original dose of oramorph I managed on only normal pain killers.

My recovery went well the only thing that I really struggled with was the daily injections to help prevent blood clotting, they made my stomach really sore and the bruises were horrible. my scar healed well but every now again it gets sore 15 weeks later.

The doctors have said that if I get pregnant again I will have the option of a natural birth or ELCS and to be honest I'm torn, I like the idea of a ELCS but because I never actually got to experience labour and have nothing to compare it to I would find it a difficult decision to make.

Clubfoot but sections carry their own risks. They too can have massive unforeseen consequences. Serious infection, ongoing pain, later infertility. I'm sure the woman I mentioned in my earlier post didn't expect to almost die due to previous medical treatment. She had massive blood loss and her husband was told that if she began to bleed again there would be nothing else the medical team could do.

The increase in sections hasn't improved neonatal outcomes as much as might have been expected, either (unless there has been some recent research of which I am not aware).

It's a balancing act. We all need to acknowledge that.

A c section isn't without risks. It's major abdominal surgery. It can have an impact on what you can and can't do after the birth. I could lift my baby for a while after. I couldn't walk very far and wasn't allowed to drive for a while.

Like any surgery it can have complications.

My c section led to uterine adhesions. I was in pain twice a month, starting a year or so after the birth - the type of pain that renders you incapable of doing anything, makes you physically sick and incapable of going to work. It wasn't properly diagnosed for ages. I think dd was around 5 before I got the treatment I needed. It involved two operations and lengthy intensive hormone treatment. After each op I was off work for 6/7+ weeks. It also left me with secondary infertility which means I was never able to have a second child.

So whilst most c sections are perfectly safe and lovely (my experience at the time was great) there is a real risk of health complications, just like there is with any surgical operation.

Only one person I know had a planned elcs and she went into spontaneous labour 2 days before it was booked. The only reason she wanted a CS was because her last labour was prolonged, nothing else.

You may be lucky and have a fast labour. For me active labour was less than 20 minutes, however I'd been contracting for almost 3 days before hand. I needed stitches, my son would have been born in his waters, but because he was tearing me in 3 serperate places, front and back, the midwife asked if she could burst them. The only time it was painful was just before they popped his waters, I guess when I started to tear and that's the only time I cried out.

The stretching thing isn't true, you shrink back. The first time dh and I had sex was painful, but only like losing my virginity painful, you know that sharp twang as he enters you.

Personally I wouldn't have a elcs because I don't see the point in having myself cut open when there is a precreated exit route... Plus I have a tattoo across my stomach that they would have to cut straight through. However, I can deal with that if it was an emergency.

Also I doubt they would let me have one, considering they told me I'm the perfect candidate for a home birth.

Actually on that, have you asked your midwife if you would be a candidate for one? It's major surgery, they don't hand them out easily.

You obviously hear about people whose sex lives have been ruined by a vaginal delivery but you never hear about people who felt ex was better afterwards as it's not really talked about. For some of us it's absolutely better

Perhaps if you did some reading and research it would become obvious. ELC is major surgery and according to WHO the UK already has a higher rate than it should. Statistically it’s more dangerous for both mother and baby and recovery time is significantly longer.

HeyMac it’s been better for me too! Couldn’t orgasm through PIV before, now I can!

@ChipsAreLife You cant get food allergies from the way you were born...

@GrumpyMiddleAgedWoman I totally agree a section isn’t without risk and isn’t the easy option. I have said so upthread. But I do feel the risks of VB are underplayed and that women should be informed and be able to make a choice that they are comfortable with. I think the majority of women will choose a VB regardless, but the point stands.

OP I thoroughly recommend following The Positive Birth Company on Instagram and purchasing her digital pack. It really explains the mechanics of birth, exactly how your mind and body work together to birth a baby, how hormones, environment etc can impact labour. It focuses on hypno-birthing techniques, but gives great advice for all things birth related. You can watch the talks with your partner and it may help you make a decision. She does cover c sections as well, if that's the route you choose. It was the best money I spent and totally changed my mind set going into labour. I've had 3 straight forward, empowering vaginal births.

I had a vaginal delivery with DD.
I had an epidural & required intervention (forceps & episiotomy) and my blood pressure was sky high on the day (it had been fine throughout pregnancy)

DD was born at 2:02am and we would have been allowed to leave hospital at lunch time, had we not been waiting for her hearing test.

Even with high blood pressure, stitches and a large loss of blood, I felt fine after the birth. I took paracetamol every 4-6 hours for the first few days, but I was up & about, going for walks, etc.

It sounds like you have spoken to a select group (positive c-sections, negative vaginal births), maybe it would be worth finding actual stats to go off?
Plus I always find people aren't always 100% truthful when talking to friends about birth.
A c-section is major surgery, however you dress it up, and I don't understand why anyone would choose to have major surgery unless it was medically necessary

I had one because to me the risk profile of an ELCS for non medical reasons was better than a natural birth. It's hard to find stats for non-emergency, non-mefical reason C section so you'll need to do some digging. There are risks to both ways for you and baby but I was much more comfortable with the ELCS ones based on my situation.

The worst thing about natural birth for me would have been the uncertainty and relying on a potentially busy and distracted someone else to notice if things were going wrong and my having to make decisions about things in a high stress situation. By contrast, I felt that having a surgical team solely focused on me for half an hour oddly meant that I felt more in control and reassured. That's just me. The experience was indeed lovely and relaxed with me chatting to the anaesthetist until the moment my baby was born.

As for recovery, I had to roll around a bit in order to get out of bed for a few weeks (to avoid pulling on the wound) and take painkillers for about a week but that's about it.

7 months on you can barely see my scar and half of it has faded to basically nothing at all (you'd have to really, really peer to see it - it's blended in with my skin) and it's clear the slightly redder bit is on its way to the same. No overhang. I think I had a great surgeon and am probably just fortunate too.

Everything else is as it was before pregnancy (barring a little bit of leftover baby weight!)

I'd do it again in a heartbeat. It was right for me. Others will have different experiences. You pays your money, you takes your choice!