Help- c section or be induced?!

[Zara1234uk]

Hello, I’m just looking for others opinions / experiences really as I’m stressing regarding delivery! I’m 28+3 and had a consultant appointment yesterday. This is my second baby, I had a vaginal birth via induction with my first, as I had late onset gestational diabetes and she was 9lb4 at 36 weeks born. She did have a short stay in Nicu for oxygen and antibiotics. I gave birth at at Mary’s in Manchester and had what I recall they told me was a 3rd degree tear. I had two docs stitch me up (took forever) antibiotics and laxatives afterwards. It healed ok and I’ve had no symptoms until being pregnant this time where I have experienced leaking urine (sorry tmi). The issue is my new hospital in Cheshire have requested my notes from St Mary’s and they haven’t replied so they’re now saying it’s too late and we have to plan my birth without them. I have to consider the tear, I have insulin controlled gd this time, I’m hypothyroid and have a 3yr old dd. Growth scan was normal but consultant said there’s still time for baby to gain a lot, so I’m just torn (pardon the pun) about how to deliver. I know a section is major surgery and the after effects terrify me, so my no means is it a get out of jail free card, BUT I couldn’t bare lifelong issues from another bad tear. If you read this far thank you! And any advice is greatly appreciated.

• St Mary’s

And * by no means is it

Sorry!

Have you had surgery before? I think how big a deal a c-section ends up being is really dependent on whether surgery overall is worrying to people (and, of course, all procedures go differently depending on the individual). I've had a lot of surgery throughout my life, and elected to have two c-sections, and I was fine. I took painkillers for three days, and after that was okay. Comparing it to the only tear I've ever had (rectum, so probably a bit different), I'd say the tear was a lot more painful and unpleasant and stressful in the long term than the surgery.

I was in hospital for a few days due to having a higher risk pregnancy, but not due to the c-section, so if that's a concern due to existing children - something to consider. The scar is faded well, and I've noticed no increased weakness in my abdominal muscles. Given the complications you describe, I'd want to control as many factors as possible, and a c-section does allow that.

The fact you have laboured naturally is a good thing and means induction is more likely to be successful. Have they said when you will be induced?

You can get lifelong issues from a section too. It really isn't clear cut (excuse the pun!).

My elcs was a fantastic experience and I recovered very quickly. EMCS following a failed induction was a horrible experience and I took 5 months to heal.

You have to decide what you want. Elcs takes time to recover. You can't move around as much, have you got support at home?

You could trying ringing your previous hospital to request the notes yourself as well?
Generally though I’m not sure whether the notes will make much difference - usually recommendations for CS after a 3rd degree tear are based around what symptoms you have. If you recovered well, with no symptoms, then there’s no reason to strongly recommend a CS - so it remains your choice. Urinary incontinence is not necessarily related to the 3rd degree tear - more to pregnancy and vaginal birth of itself. In that regard a CS may protect a little bit.
You would probably have a 5-10% risk of getting another 3rd deg tear - which might have more significant and longer term symptoms. That risk would be less if the baby was smaller (or if they used forceps/ventouse last time - in which case you can most likely avoid this time).
Don’t feel like there’s a hurry to make this decision - it can be decided right up until the last minute basically. I’d suggest consider waiting to see how baby is growing at 32 and 36 weeks, if baby is much smaller you may feel a lot more confident about vaginal birth, or if bigger a lot more confident in a decision for CS.
It’s one of those balancing decisions where no one can really decide what’s right for you - just take the time to think it all through and you’ll come to whatever is best for you.

Ps if not already doing - pelvic floor exercises and women’s physio can be super valuable regardless of what type of delivery you have, would start doing those now :)

Thanks for all your replies! I have spoken to the medical records team at St Mary’s today and have sent an email request for my notes. Whether they will respond is another matter but I feel stupid for not doing it earlier! I have never had surgery before other than ent procedures as a child so that’s what makes me extremely nervous regarding a section. And the fact that my 3yr dd will miss my attention as it’s the run up to Xmas!
I will see how my next growth scan goes in sept and take it from there I think!
Thanks for your help ladies