Elective C-section or not?

[HighOnStilts]

I currently have a 12 week old, 4.5 hour labour, waterbirth, ended up with 2nd degree internal tear. It's taken me months to recover and I forget the first week been back home as I was in so much pain and was losing lots of blood, it was awful. I also think I've had a mild prolapse but due to covid I'm unable to get to my doctors for an internal examination although I will be looking to book one very soon. Me and my partner both want more children, maybe 3 or 4. I am a little bit nervous about giving birth again and wondering what my chances would be to opt for an elective c-section the next time if I plan on having more children after? I had friends who gave birth around the came time as me and ended up with C-sections but seemed that they were back on their feet after a couple of weeks, I'm still suffering even now.

Just interested to hear your experiences! :)

I honestly wouldn’t think about it with a 12 week old, it’s all way too emotionally raw at the moment. Although your friends appeared to heal well, recovery from a c section isn’t always a breeze. You sound like you did absolutely amazing in labour, unfortunately the weight of a pregnancy often does significant damage to your pelvic floor, so you may still get issues with things like prolapses even if you elected to have a section. I would say if you were planning to have 3 or 4 children elective c section would not be advised due to the risk of abruption and placenta accreta with multiple c sections. I promise you it’s really not the easy way out.

@thetangleteaser thank you so much for your reply. I know it's still early days with my recovery I guess it's just frustrating! Think I was expecting to have bounced back after the first couple of weeks and that's definitely not the case.

You poor thing, how horrible, I’m so sorry. I wouldn’t even think about it now as it’s all so recent. I had a third degree tear with my last baby and am pregnant again. They offer c-sections to women with previous third and fourth degree tears in my trust. I’m sure it’s something you could discuss at the time though.

I completely understand,I knew I’d be tired and sore after a baby but I think I was surprised on just how much it all absolutely wipes you out! I’d say keep an open mind and if you feel that way in the next pregnancy, discuss it with the professionals😌 congratulations on your baby!

Poor you, I'm sorry you're suffering.

I don't know how much use anecdotes are to you but for what it's worth, I opted for a c-section for my first.

It was a lovely experience and had no complications. Had to roll sideways to get out of bed for a couple of weeks to avoid painful pulling on the scar but otherwise all fine. Breastfeeding, lifting baby, no problem. Minimal painkillers for a week.

All I have now is a very faint scar. No overhang, no other lasting effects from pregnancy (other than an extra half stone or so I seem to be hanging onto for sentimental reasons...)

It can go well or wrong either way, so I think you just do your research and weigh up the risks of each nearer the time.

Sorry to hear about your birth

I have been left with prolapse and pain after my first vaginal birth so opted for an elective caesarean for my second. I had to argue my case a bit but they did agree. I think it depends what trust as to how hard you have to fight.

Actually for me an elective caesarean was an easy way out. Rather than being in constant pain for months and struggling to walk, I was back on my feet within 24 hours and not needing any painkillers at all within a week. I can not believe how easy it has been.

Vaginal birth is bad for prolapse. Yes pregnancy can worsen it but don’t be fobbed off with that. Whatever pregnancy does to your pelvic floor, a vaginal birth can make it worse whereas a caesarean can’t.

However others would say they had a tougher time - sadly with birth you just don’t know how it will go. I would also say if you want another 3 children there are risk factors with a caesarean - not only can it affect future fertility but the risks increase with each section and you’ll need to bear that in mind.

I would say don’t make any decisions till you’re actually pregnant with your second at which point have a conversation with the hospital about your options and decide at that point. But the option of a section is there if you decide it’s what’s best for you

Just from my personal experience... I had a planned c-section with my first and will be having the same with my second. Absolutely fine! Hurts, but which ever way a baby comes out it hurts! I did an awful lot of research first time around and I was fully prepared. Everything went like the text book said it should! I did have a DH and Mother to help me recover. I stayed in hospital one night. Took baby out for a walk at three days old and went to the supermarket with him at 5 days old.

Wow thank you all so much for your lovely replies! It seems a lot of you were back on your feet in a fairly quick time after a c-section. It is definitely something I will discuss with the midwife the next time round. (I know I'm probably crazy for even thinking about having another one right now) but it has been playing on my mind since my birth. X

I would say that if you decide you want an elective c section, look at the Birth Rights website and research which hospitals include the NICE guidelines in their policy so you can't be refused. Only about 25% of hospitals do include them, I gather, but you can self-refer to one that does. I did this from the beginning (thanks to MN) and very politely made it clear that I knew their policy included the right to maternal request section so avoided all the drama and heartache of trying to persuade the hospital to let me choose.

@TheRainbowCollection Wow thanks, I never knew this, will definitely be baring this in mind next time round!

O.P. if you don’t mind me asking - and I really don’t mean to come across as rude - What aspect of your labour did you find so traumatic? It sounds pretty normal/ even on the side of a good birth and 2nd degree tears are quite common?

I’m not being goady - just wondering why you found it difficult? As a PP said prolapse etc is often a result of the pregnancy and you can still get them with sections. You’ll also still have bloody discharge after with a section.

vinoelle - also without being confrontational, I've always been slightly baffled by the idea that women shouldn't be worried or traumatised about having their genitals tear on the basis that lots of other women experience the same thing. An extreme example, of course, but on that basis women in certain countries should be ok with their 'normal' or mild level of FGM. Obviously it's imposed on them rather than naturally occurring etc., I appreciate, but on the point of "it's normal" - so are lots of horrible things I'd try to avoid!

Someone's always had it worse but it's not hard to understand why someone is upset by unpleasant things even if it's not the worst thing ever to happen.

@vinoelle Sorry I guess I didn't go into much detail about my actual labour, I guess all things considered it was a fairly straight forward labour, I only had gas and air and a shot of pethidine but my contractions were intense and I was screaming in pain, so delerious with the pain that when it came to pushing I couldn't even concentrate on taking the gas and air, that in itself was traumatic and I'll never ever forget the pain. I was in a birthing center and at this point an epidural was out of the question. I birthed the placenta without an injection but the midwife pulled me out as soon as I did as she suspected I had some retained and did some manual removal when I was having my stitches done. I have birth during a pandemic and the midwives weren't overly keen on sticking around too long, even though at one point I was on the shower in tears and excruciating pain as blood was pouring out of me. So that's why I did find it all quite traumatic.

@TheRainbowCollection thank you for being understanding.

Please forgive my appauling grammer and spelling, trying to calm a whingy babe whilst messaging as I didn't want to ignore.

Also I will add - when I say I was losing a lot of blood after the birth (I know it's to be expected) I was passing really large clots too, on numerous occassions they were much much bigger than a golfball and even though I called the midwives I was just dismissed and they basically said look if you aren't feeling faint it's totally normal. At one point my poor other half had to scoop a huge clot out of my knickers whilst I was on the bed I just couldn't move as I was in pain and freaking out. Again, this was an all round traumatic experience in itself, yet other mothers I spoke to lost a few clots here and there but nothing like what I did.

I agree with @TheRainbowCollection that anecdote isn't evidence but the best advice I was ever given is 'you only give birth to your first child once'.

Generally speaking subsequent labours and recoveries are so much easier. I think you'd be mad to consider a CS with a toddler unless it's medically necessary. I felt like you after my first... I went to Sainsbury's the day after my second was born.

@RaggieDolls did you have a natural with your second? Any pain relief? My experience in the birthing center was out of this world as we had our own private suite but I'm thinking I may have been better on a ward with the option of an epidural, lol.

@HighOnStilts, sorry, yes. A natural birth with both.

I had gas and air with both. Second was a fantastic experience. First was hard and extremely painful with the long recovery OP describes.

I had a similar birth to yours with DD, I went on to have DS when she was 4. My consultant said I could have an elective cesarean if I wanted. I decided against it after becoming unwell and spending 10 days in hospital at 37 weeks. DS arrived a few days after I was let out. 9lb 3oz, 4 hour labour with gas and air. I needed some stitching but nothing major and was home the same day. Now patiently waiting on DC3 arriving, planing on a natural birth again.

OP have you had any sort of a debrief about what happened with anyone medical? My hospital offers a 'birth reflections' session where you can talk through everything that went on and understand it all a bit better. It might help you process it all and accept it. Birth can be very traumatic and it's important to process that trauma (even if you later decide that it's c-sections only in the future!). It sounds like you had a worse time than I did, and I didn't think that was possible!

@RaggieDolls it does seem to appear that subsequent births tend to go either faster or are a lot less eventful let's say. Congrats btw! ☺

@UnicornRainbow83 WOW!! You absolute trooper! And I thought I had a big baby at 8lb 6oz lol.

@CoolNoMore Unfortunately no, not to my knowledge anyway. I live 40 miles from the town I birthed her in now, so all my aftercare was transferred to the care team where I'm currently living - sounds a bit complicated but basically me and fiance had just completed on new house before I was ready to pop lol.

I would definitely recommend getting in contact with your hospitals after birth service to talk through your experience; I had a traumatic birth and it really helped me process it. My first child was born by emergency c section and due to medical reasons I had to have a c section with my second and was told by the consultant the risks do increase with each c section and recovery can take longer each time but it’s only once you get to your 4th section that they worry more.