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?

Haven't read the full thread, but personally I agree with you OP.

I've had two very easy planned sections. Recovery was pretty painless (I was actually googling 'when does c section recovery start to hurt') and I was out and about shopping within days both times. Blood loss was 200ml and 300ml. It was difficult picking up baby for the first 48 hours or so, but a steep recovery curve, so whilst that was tricky after 2 days, by 3 days I was pain free carrying baby up the stairs and doing light chores. I do have some issues with an overhang, but aside from that, it was lovely and pain free, and just very pleasant.

I had one ELCS. A doddle. No severe pain, quick and easy slit, here's your baby and the wound was not particularly painful.

One vaginal delivery which could not have been more dangerous for baby. Even the nurses were shaky afterwards. That was the end of my having babies.

Based on my own experiences, I have to say. I see where you're coming from OP. In many ways ELCS are a huge step forward from deliveries requiring interventions. But then vaginal births work beautifully some of the time and that's the ideal, if you can handle the pain.

The tricky part is not knowing what kind of birth you'll have. You have to weigh it up and make your own decision.

I was so set on ELCS as could only imagine the worst, but decided to try after long chats with my MW, NCT leader and DH.

So glad I did! I ended up with a fast labour (6.5hrs) no tearing, gas and air with 1 shot Pethidine and didn’t have the epidural I thought I wanted.

Within hours I felt fabulous, first wee and poo painless, didn’t even need as much as a paracetamol afterwards. Sex exactly the same, my bits are completely undamaged.

I am so glad I gave my body a chance. It was such an experience but nothing like I feared. It bloody hurt but it was different to my many injuries I’ve had (am scared of pain and pop pills like they are going out of fashion).

Oh and I am ancient according to MN (first baby at 41).

I’d 100% have ELCS if there were medical reasons but now I know what labour is like I’d do it again in a heartbeat.

@Mamabear88

1. You only have to stay one night, not two
2. the scar does fade (and is less obvious than stretch marks, and on your bikini line so not very visible).
3. yes you have to restrict heavy lifting (or should do, I didn't tbh) but there is zero reason why you can't do shopping or housework. I did both of those easily and pain free within 3/4 days. And I know I 'shouldnt' have, but was fine carrying my toddler after 2/3 weeks.

Oh, and Mamabear88, the NHS birth statistics show that the most common length of stay after a section is 2 nights, with some 1 night, and some 3 nights. People tend to stay longer after emcs than an elcs, but they are lumped in together here, so you really are looking at 1-2 nights for most people. Which is about the same (maybe half a day more, at most) than an average vaginal birth.

I stayed 2 nights with both, but that was.ky choice - I was offered 24 hour discharge, but declined, as I felt I'd benefit from the extra night (and quite liked postnatal).

@hugtheduggee well you're the only person I've ever come across that liked the post natal ward so you're in the minority there I think. Lucky you.

Honestly, not everyone's labours are like that! I've had 2 kids, the first spontaneous labour, 6 hours start to finish and codeine as pain relief. A great experience start to finish. Second, planned induction due to fast labour first time (a mistake in hindsight) epidural, baby in 4 hours. Up and about hours later with both, physical recovery great. It's your call but you could have a relatively pain free labour with quick recovery, not major surgery with limitations on what you can do afterwards. As an aside, your mindset towards vaginal birth already seems quite negative, if you do decide to try HYPNOBIRTHING!!!!!

I was in my own side room with DH staying with me on postnatal so I actually liked it too tbh. I was still desperate to go home anyway for home comforts and familiarity, and after moving to the room I was discharged within about 24hrs. I had a ventouse delivery with an episiotomy and just moderate blood loss and no complications with DD.

Hi @apples83 I haven't read whole thread but I would strongly advise reading some good books about this. You need some evidence based literature to make a decision like this. The positive birth book by Millie hill and expecting better by Emily oster both very good. Also, it's not true that you only have a 50/50 chance of having a natural birth if you aim for that.

Often the reasons why women end up having to have EMCS is because of the environment they labour and birth in. This is due to the need for oxytocin to be released. Birth is no walk in the park but neither is a C-section.
Also the idea we are completely void of autonomy during birth is also false. We have choices. You can control a lot about the environment you're in if you read up on it. Ofc there are emergencies that's can happen; best thing is to be prepared with a birth plan but be open minded about possible things going awry.
C-section doesn't sound like easiest option to me. And the bacteria baby gets from vaginal delivery is not just some little nice to have, it forms the whole entire basis of the baby's gut microbiom which will be crucial for that person's immune system for their whole entire life. If a c section occurs you can still build this up of course but it will be significantly delayed.

Would never have a CS unless medically necessary.
Wouldn't put myself through major surgery, give myself a massive wound(that can get infected/come open/not heal properly), experience pains when sneezing for months after (heard this is a common issue), not be able to lift anything heavier than a kettle or drive for 6weeks - and that's just problems for myself never mind the feeding issues and breathing problems for baby.

Sex is still great, if not better!
Body, hmm well that's a working progress 😂
I came home the same day as giving birth and was back to normal almost straight away!

1st dc I tore and needed stitches,felt much better after day 10 s
2nd dc c section 12 weeks later before feeling semi normal,sca r still die and sensitive year later

I had an ELCS. It was a good experience but the recovery was much harder than I anticipated. I was basically housebound for a month, as i couldn’t lift my pram over the step out of the house. Feeding was very difficult to establish as my milk was delayed coming in. My stomach is still tender 5 months later.
No regrets about having it, but recovery was much slower than I thought it would be.

I've had to vaginal births. Straight forward, no tearing, " down there" not changed and sex still feels the same!
The next day up walking around in town with my pram etc.

I'm almost 38 weeks pregnant with my 3rd and I'm being booked in at 39 weeks for a c section because big baby is transverse.
I've been told all the risks to myself and baby and they seem SO much more than a vaginal birth!!
This is major abdominal surgery.. Also you keep bringing up these women you know who have it smooth etc. Not everyone unfortunatly has that same experience.

Each to their own with this decision but I would always choose a vaginal deleivery.
I'm really worried and scared this time around because of having a c section. I was looking forward to pushing and being up and around after with no scar, no surgery to recover from where I may not even be able to lift my new baby and have to stay in for longer than with my other 2.
Good luck with what ever you do.

As well as the books recommended above, I would also suggest you read ‘Choosing Caesarean’ by Magnus Murphy and Pauline Hull and ‘The Caesarean’ by Michel Odent. The more you read, the better informed you’ll be about which risks you’re prepared to take.

www.nice.org.uk/guidance/cg132

I’d also recommend reading this. If you look at the appendix there is a comparison of the risks for planned vaginal birth and planned C section x

@Mamabear88
My hospital is really really good. They cook in house, deliver food to your bedside, and the first time, there was the option of a homemade pasta bake rather than toast on arrival at the ward (made by one of the midwives and brought in for the women). And it was super quiet both times so one staff member to every 2 women. I can appreciate my experience may be in the minority, and would have been different if it had been busy. It had its annoyances, but can't really complain. If quiet they let your stay till you felt you were ready, especially if you needed extra feeding support.

It's all a side point though.

I had an ELCS for medical reasons. I would aim for a VBAC next time unless otherwise advised. I failed to breastfeed and developed severe PND. I'm sure not having the hormones from natural birth contributed massively to both things. DD also had a dairy allergy. Physically the recovery was fine - very little pain though a lot of fatigue.

Labour and a vaginal birth is very very painful but all being well it's much more straightforward than even a straightforward ELCS. I had two, had an episiotomy first time and natural second degree tear the second. The second time, I felt normal down below literally after about 2 days. My pelvic floor has never been effected, sex life is the same. Well not the same as 2 young kids = few opportunities, but the physical side is the same!

I would choose vaginal every time. I would opt for a c section over any instrumental delivery though as I think forceps CAN really wreck your vagina.

Depends on your trust I guess, but you can't just opt for an ELCS for no reason. It's expensive for the NHS as well as the much higher risks, so you would need a very good reason.

“ I would opt for a c section over any instrumental delivery though”

This was my feeling - I wanted to avoid having to recover from failed forceps + c-section and would have asked to go straight to c-section if instrumental were being suggested

I think if this thread indicates anything it’s that it is a mistake to think of ELCS (or any form of childbirth really) as the “easy option” as there can be tough elements to any pathway

Ivinghoebeacon my thoughts exactly. I distinctively remembered from the NHS antenatal classes, the midwife said the success rate for forceps is low, can't remember how much but they only try 3 times or something then they go for the section.

I had an elective caesarean. It was brilliant. I didn't have any of the terrible complications that are talked up about.

And had no problem with breast feeding.

TLDR

Two sections here and I cannot believe your staggering stupidity.
It is not easier, or better. My body is far more fucked from the emergency section and subsequent planned one. I have urethral damage from the catheter. I have a large stomach overhang that's totally numb. The pain afterwards was un fucking real.
Six weeks off my feet both times. Sobbing and screaming whenever I laughed, coughed, or moved. Oh my the trapped wind pain too!
Your vagina is designed to pop the baby out. Your abdomen... not so much.
I've never experienced pain like a section.
And I laboured for 24 hours.

I'd never intentionally chose to have my core muscles sliced open and sewn back together when there's already a perfectly good hole there to do the job. But that's just my opinion. Either way things can go wrong and it can take time to heal.

I know everyone is different but for me personally you really can't tell where I tore and my body really is back to normal now. Sex feels exactly the same too, it really does. So with a vaginal birth there is at least a chance that things go back to normal but with a c-section there is zero chance of this - it's 100% certain that you'll have some sort of scar.

FWIW I think c-sections are amazing and sometimes lifesaving so I'm in no way against them, I'd just never have one unnecessarily - it's a major operation with risks. That's just my own personal preference though, everyone is different.