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?

The thought of having major surgery, the pain, the recovery, and looking after a newborn on no sleep is terrifying to me!

I had long and painful labours (until I had an epidural, then it was fine!) but for me once the baby was born, it was over.
The thought of weeks of pain, wounds, healing from surgery, having to stay in hospital and struggling to sleep and get even pain meds is awful.

Just to reflect one what others have said, there are no guarantees either way. I had a 36 hour labour followed by forceps. I couldn't sit down for 2 weeks, and it was later found that my coccyx had been damaged. I have long term damage (sitting for long periods of time is painful 8 years on) and wish I'd pushed for a caesarean, particularly as a doctor later said they'd no idea why one wasn't given as it was obvious at 30 hours that it wasn't going to end very well. I'd rather have a scar on my stomach with six weeks recovery than the lifelong pain I've been left with.

I had a water birth with my first - went into spontaneous labour, everything straightforward and I had no pain relief because it never got that bad so I didn’t want any. It was all calm and tranquil visualisation etc and despite tearing, no problems in recovering from it.

Second baby I had to be induced and give birth on a bed; I hated it. I found the more medicalised environment made me tense and afraid and in a lot more pain. I had gas and air which I hated. I was too afraid of having any other painkillers because I often get nausea and vomiting as a side effect of pain medication. I felt constrained by the drip, the midwife wanted me to give birth lying down which I couldn’t bear the idea of. I went on all fours which was far better than being on my back but she was annoyed because it dislodged the drip in my hand.

Both times I was lucky to have quick births - 5.5 hours and 3.5 hours. Babies in a good position, no major complications. The lasting effects on my body come from pregnancy.

So based on my experience and feelings about hospitals and surgery, I would always prefer a vaginal birth if it was a safe option. I’m more afraid of the idea of a c-section. But both kinds of birth can go well or badly and there isn’t a way of knowing.

I did read Ina May Gaskin’s Guide to Childbirth which helped allay a lot of my anxiety around birth in my first pregnancy. I’d definitely recommend it.

My ELCS was far more difficult for me than either of my previous births (which had by no means been easy - 3 day long labour, episiotomy, ventouse, 3rd degree tear, surgery followed by 2nd birth a year later - baby in distress, induction, fast birth, 2nd degree tear, botched stitches, surgery).

My ELCS was traumatic, scary and very distressing. Recovery took a very long time and mentally and physically it still causes me difficulties nearly 10 years later.

All births can have difficult outcomes.

I had two sections by maternal request due to fear of birth but it was also due to worry about damage down there etc. Best thing I ever did. No regrets. Yes recovery was painful but after a week I was fine and it was just a memory.. and my bits were still intact. All my vaginal birth friends have incontinence issues and they had straight forward births.

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.

I've had two emergency sections and felt physically almost normal as soon as I could stand up (around 6 hours later). No pain, especially compared to my contractions, was walking around absolutely fine. Didn't need pain killers post theatre. With my first, the bruising from the failed forceps was more of a pain than the wound to the point that walking was fine, sitting less so. With my 2nd, I was out for lunch and then at Messy Church on day 2 with zero problems.

All recoveries are different. That said, I found choosing an elective for my 2nd very hard. I wanted to do it "properly" even though I know a wide range of vaginal birth stories covering the whole spectrum from negative to positive and my first experience of labour wasn't great (long back labour, pushing, failed forceps, NICU stay etc). As it happened, dd decided she didn't want to wait and I went into labour ahead of the date.

ELCS here with twins for various reasons.

Lifting the babies afterwards in hospital was much harder due to the scar. Limited mobility etc once I was home due to the Scar and mine healed well. Couldn't push the pushchair etc by myself for the first x weeks, or do much lifting.
11 weeks down the line it still hurts when I cough or sneeze, I can it when I pull myself up in bed, sex is still painful and my body has a major scar both internally and externally

I've had four c sections. Because my first was an emergency they found that I had a tilted pelvis and that I could never give birth naturally unless the baby was under 5 pounds. I would have preferred natural birth if I knew it was going to be straightforward, as c section can be a long, painful recovery and I've heard from women that have quick births and leave hospital straight away. However I know women that have had traumatic vaginal births and they have suffered more than I have.
You just dont know what experience you're going to have. There's plus sides and down sides to a c section so for that reason I don't think it's a good idea to opt for ELCS without good reason.

Aside from @frillyfarmer's comment (leave the personal insults out of it please, it's really not helpful), I've found the personal insights on both sides very illuminating - thanks for sharing.

I've had an emergency section and an elective. While the elective was NOT AWFUL, I can't imagine it was as good as a healthy, uncomplicated vaginal birth. Giving birth in any way has risks, and while I'm 100% behind women taking control and making their own choices, the vaginal birth is statistically the safest (assuming low risk pregnancy).

My own elective was RELATIVELY straightforward, although of course it involves surgery, anaesthetic, lots of drugs, spinal block, a scar and the obvious aftercare of that, giving birth in a theatre with a team of medical personnel. As my baby hadn't been through the birth canal (which squeezes fluid out of their tummy), my baby got poorly a few days after birth and became jaundiced, sicky and unable to feed properly because he was struggling to get the fluid out of his tummy. While in the past I've tried to reassure anyone facing a planned section that it can be positive and recovery can be quick and straightforward, and indeed there are some benefits to sections, particularly faced with complications in pregnancy, it wasn't a walk in the park. It's taken a toll on my body and it's not what I would have preferred, just the best choice given my own circumstances.

Make sure you're aware of the risks and benefits to you and your baby of the different options and make a decision that's right for you and your baby.

I'm currently pregnant and have to have a c section for medical reasons, I was feeling ok about it but having read this thread I'm now shit scared and wishing I could give birth naturally

I’ve had both. I had to have an ELCS with DS2 because I have silent labours & he was breech - it was just too dangerous. My recovery after my first, vaginal Labour was so much quicker. 6 months later I still gets aches near my CS scar. So I much prefer a vaginal Labour but since I don’t feel contraction pain I’m not sure my opinion is worth much!

@slipperskipper exactly what happened to me. I had an ELCS following an EMCS and they are like opposite, incomparable experiences. The EM seemed really brutal, took me weeks to recover from, was scary, seemed rushed, I was totally out of control. The scar was a mess because, quite rightly, they had become so worried about my baby that the only priority was to get him out.

My EL was calm, relaxed, I knew exactly what was going on. The surgeon repaired my original scar, so now I have a much neater one. I was up and about that evening, walking to the shops with the pram after a couple of days. I couldn't do that after my EM.

It's all just a bit of a lottery I think. My consultant said the (very basic) stats for attempted vaginal birth was 50% natural spontaneous, 30% instrumental, 20% emergency section, which doesn't seem great to me. There's also some research to suggest that if you're over 35 an ELCS is slightly safer for baby than an attempted vaginal birth (taking into consideration that it might end up as an EMCS). I can dig out the paper if you're interested.

The most convincing argument for going for a vaginal birth first time round seems to be that it will make your second birth easier, which obviously depends on whether you want a second child. I don't, so am very much swayed towards an ELCS.

Also, for me at least the pain of contractions, or the pain in the first few weeks after a section doesn't really come into consideration.. I'm sure it's horrible but at least it ends. It's the outcome for the baby, plus the long term affects on me (be that birth injuries or a c section overhang,or the rare but very bad long term injuries that can be caused by c section) that bothers me.

I wonder what the cost of an elective caesarean is to the NHS?

I wouldn’t imagine it’s cheap and that’s a lot of money when there’s no medical reason for it.

Are you able to just request an elective??

There's also some research to suggest that if you're over 35 an ELCS is slightly safer for baby than an attempted vaginal birth

I'm late 30s and am undecided whether I'll have another child at this point (or even whether it'll be possible given my age!)

I have tokophobia which, once pregnant, developed into extreme terror and constant anxiety, especially when I found out I was having twins. I managed to eventually get an ELCS agreed but it was a battle, even with the issues I had and the fact it was twins.

Unfortunately I needed an emcs 3 weeks before the planned one, but I never went into labour.

The spinal was very traumatic as it went very wrong and took a lot of attempts. They got it in just as I was about to be put under. After that the surgery was quite straightforward but not a pleasant experience - I don’t really remember any of it, nausea and very low BP set it, drugs were given and I don’t remember anything after that.

Very different experience to having a healthy baby because my twins were taken away immediately and I didn’t get to see them at all until the next morning.

My recovery was mostly okay but my twins were in nicu so I didn’t have to care for a newborn while recovering.

I was so swollen from my toes to my hips I couldn’t walk properly, for weeks, and I ended up with cellulitis in my knee. I hated leaving my twins in hospital every night but at least I got to recover properly.

I know lots of women who’ve had ongoing problems following vaginal birth but cs is not an easy option - it’s open abdominal surgery. I do know one woman to had to have an immediate hysterectomy due to haemorrhage following an elective section and a couple of others who ended up in HDU or ICU.

I wonder what the cost of an elective caesarean is to the NHS?

Considerably cheaper than my first emergency section ended up costing them.

Hospital time to confirm my waters had broken, home visits from a midwife to check on me, over 12 hours on the labour ward with 1 on 1 midwife care. An hour and a half in theatre. 5 hours in recovery. Ds had 3 days in NICU. I had 3 nights in hospital. Oh and 5 years of mental health support including 18 months of psychotherapy and 6 months of cbt.

Plus in trying to diagnose why my son has muscle weakness in his mouth/tongue which causes some drooling/speech issues, they are saying it might be damage from the failed attempt to evict with him with forceps. Luckily he's now getting a lot better but if that's correct, we can add 6 months of SALT and a few hospital appointments to the total.

I had an ELCS at maternal request. Mainly driven by the fact that DS was predicted to be big (he was). The actual procedure was fine. We had skin to skin. Recovery was pretty straightforward. I was driving after 5 weeks.
However I really struggled to breastfeed, my milk took 5/6 days to come in and DS being a big boy wasn't happy. He lost a lot of weight and is now formula fed. Could be a coincidence, I'll never know.
There are pros and cons to all options, you just have to look at the risks and make an informed decision.

I'm not sure what Country you're from but I don't think you can opt for an ELCS on the NHS unless there's a very good reason for you to have one (correct me if i'm wrong) - no offence but the reasons you've given won't cut it (excuse the pun!).

I had an emergency c-section. It's major surgery. I was terrified. You have to spend 2 nights on the post natal ward which is living hell, you have a scar after which no doesn't fade and it has a 6 week recovery period (assuming all has gone to plan) where you can't drive or lift anything heavy e.g. shopping or do any housework etc.

I'd seriously think about it as it certainly isn't the easy option you're making it out to be.

why would anyone want major surgery when there is no need.

Not all births last for hours I've had both my kids naturally and my vag is fine.

With ds there was talk about a c section and I was shitting myself for weeks thinking I would need surgery thankfully I didn't because hemturned and come naturally. Our bodies are made to give birth so why not let our bodies to what they are meant to do. unless there is an emergency.

@Mamabear88 technically "maternal request" is reason enough but not all consultants agree.

You have to spend 2 nights on the post natal ward which is living hell, you have a scar after which no doesn't fade and it has a 6 week recovery period (assuming all has gone to plan) where you can't drive or lift anything heavy e.g. shopping or do any housework etc.

Not in our local hospital you don't. I stayed one night after dc2's arrival by emcs which unless there are complications or you want to stay is the usual. My scar has faded to a thin white line which even dh needs to look for and I was doing both housework and shopping way earlier than 6 weeks.

The thing is we are all different, neither your experience or mine are universal. All we can do is talk about our own not generalise.

I couldn't get over how much better the section was.
The vaginal was long, extremely painful, I was sick, had catheters in a couple of times during, and an episiotomy and ventouse at the end. Worst experience ever (until the end, of course, when it was absolutely euphoric!)

The section was very calm and seemed to be over quickly. Highly surreal being operated on wide awake. I was slightly sick after the epidural but it was fine.

Sadly didn't get the immediate skin-to-skin with either child as they needed checking, and I was being stitched both times!

There's no nice, risk-free way of giving birth and no doubt some women have straightforward vaginal births and some have problematic C-sections, but for me personally the section was a comparative doddle. Recovery was fine (and no painful toileting after!) and my scar is barely visible. If I had a third child I would 100% want to choose another section.