Considering requesting an elective c-section. Opinions?

[Toastedsesame]

So my son is now 3, I got to 42 weeks with him and he wasn't budging.

Went in to be induced and they discovered waters were bulging and I was already 1.5cm dilated. My waters were popped and I was told to go for a walk, get something to eat etc they'd be putting me on a drip later... Less than 3h later baby was born. It was a very quick and very traumatic birth. Baby was in distress after waters popped, heart rate all over the place. my contractions were thick and fast and I got to 8cm within an hour.

Baby was delivered after an emergency spinal block and forceps delivery. I lost 2L of blood and had to have an episiotomy and had two tears (one labial, one 2nd degree) My son was beautiful and healthy but his cord was wrapped round his neck at the end so could have been very different. I suffered from postnatal depressed for a year after my sons birth, I think this is partly due to the trauma of his delivery.

I am now pregnant with baby number 2, very early days but I am already considering asking for an elective c section this time. I know I can do this... but my question is should I? I think the thing drawing me to it is knowing that it will be scheduled, I won't need to go overdue, I won't need to experience tearing and blood loss (hopefully) or the joys of incontinence issues after another forceps delivery (thankfully now resolved) however, I'm not an idiot and I know the recovery from a section is not a walk in the park.

Experiences / opinions very much welcome!

Pph is actually more likely with csection. Also, I take the opinion that I've already ruined my pelvic floor; do I want my abdominal muscles ruined too.

Please please discuss the risks with a consultant and make your decision based on what is best in your circumstances.

I’m having an elective c section, it’ll be my first baby. The reason is to avoid traumatic experiences like you had, I’m so sorry you went through that.

My mum had two c sections and found the recovery fine although it’s not like that for everyone.

A c section does not ‘ruin’ your abdominal muscles as the above poster suggested.

Do what’s right for you - it sounds to me like you would benefit from a planned c section xx

Ok ok 'ruin' is an exaggeration (obviously??!). Vaginal birth doesn't 'ruin' your pelvic floor either, but has a large effect. It's not something that a lot of people consider, so just thought I'd throw that in the mix that you may find Both pelvic floor and abdominals changed/ affected by the two births.

The damage to abdominal muscles is something I have considered. Tbh I'm pretty sure the muscles are separated from my first pregnancy already, so either way I think they are going to be ruined.

I will ofc speak to my midwife. Just wanting to gather opinions first. Was hoping someone who has done both may contribute.

Thanks all for responses so far.

My scar is way below my abs. I have a 6 pack sort of - well a flat tummy!
Loved my planned c section and would actively look forward to another. It was just a happy day with no fear of pain.
Recovery not too bad if you have a helpful partner/parent who can hand you things/baby. I walked the dog within a week but it is different for everyone.

I had an elective section after having a very traumatic emergency section with my first. It was medically recommended but I would still have made that choice because after my first traumatic birth I needed to feel that I had a bit more control over the birth, that risks were being managed and I knew that if my second birth had followed the same pattern as my first the trauma of the first would be triggered. I also did not want a heavily monitored medicalised natural birth as it would have triggered some of the trauma from my first pregnancy.
I’m always a bit cautious when people who haven’t had a baby yet say they want a c section as it is a major operation and the recovery is hard but equally the recovery from a difficult natural labour can be equally as hard.
I also don’t think a c section has done much to my abdominal muscles, they are definitely not ruined and my stomach is pretty much as flat as it was before I had my two babies (apart from all the maternity leave cake I’ve been indulging in!)

I had a traumatic birth with my second.
Had a 3rd degree tear and a 2l blood loss.
I questioned a csection because I was worried about tearing badly again and started having panic attacks at the thought of it happening again.
My consultant basically said it wasn't a good idea as the chances of hemorrhaging with a csection are far higher than with a vaginal birth and already having a previous hemorrhage, they werent keen on the idea.

2 breach babies and 2 elective c-sections here! I know experiences massively vary but both of mine were great experiences. Calm delivery, not a lot of pain, easy recovery. I would do it again in a heartbeat.

I am really shocked they did a ARM and didn't have you monitored afterwards using the CTG. I would be asking whether that is standard practice.

I also think 2nd time around due to the cord issue and rapid Labour you would get more appropriate care.

C-sections are major surgery, baby gets delivered earlier than perhaps when they are fully cooked (I have super long pregnancies too 🙄), the baby misses out on microbes from not having vaginal delivery.

I would be asking to discuss your previous birth notes because you feel you didn't get appropriate care and what would be done differently to ensure that the same issues didn't happen again?

All that aside if you aren't confident to go vaginal absolutely ask you have c-section.

@user1493413286 I am aware it’s major surgery.... 🙄

Overall, an elective c section feels less traumatic to me than a vaginal where I may end up with tears/blood loss/forceps/emergency c section/baby in distress etc.

Am I scared of potential complications during and after surgery and the recovery? Yes of course, but for me it’s the lesser of two traumatic sounding things.

And that’s MY choice to make.

The majority of births are not this “traumatic” as you say Cafeaulait27 and as I’ve seen with so many of my Csection friends their abdominal muscles never fully recovered and they’ve been left with rounded, saggy stomachs and couldn’t get back into pre baby shape thanks to it. So it does and can happen. Quite frequently.
About to have my third DC, having had previous 2 naturally. C section would be my absolute worst scenario.

I booked a cs for my second and ended up with a vbac, my choice, as she arrived early.
It would probably be best to talk to the consultant. They did say to me they didnt leave 2nd time mothers as long and were much more careful with them! I definitely wouldn't have the drip again after my first.
My stomach is no longer flat and it was after my first, I think that's down to having to babies. I was incontinent after my first born by emcs but that was probably down to carrying a large baby but not after my vbac.
My mother had 2 cs and has the same slight leak issues as her sister who had 4 vb.
Its a vert personal decision. I don't regret booking an elcs and I don't regret actually having a vbac.

Completely agree user1493413286 I really disagree with first time Mothers requesting elective C Sections. Having had natural birth then Csec as baby breech I’d definitely never want another C Section.

@DollyParton2 I am aware of all of these things. Vaginal births can go wonderfully, c sections can go terribly.

I find it quite irritating that so many people assume that women who haven’t given birth before and want an elective c section haven’t fully thought through the risks and benefits and all the options.

I’m only 9 weeks but if I manage to make it til the end without miscarrying again I will let you know how it goes 🙂

I had an elective section with my second after an emergency CS with my first.

To be honest the psychological benefits outweighed the physical risks for me. I needed to feel that I was in control the second time around. I was terrified of another VB going wrong as it had the first time, to the point that I had to go for counselling before I could even consider having a second baby.

I had no issues with getting an elective CS agreed, actually I think the consultant also agreed that it would be the best option.
The actual CS was lovely. It was a really relaxed atmosphere in theatre, my DH cut the cord then DS was placed on me for skin to skin while I was stitched up.
I had quick recovery times after both of my sections and was driving again after 3 weeks.
Good luck whatever you decide

Thanks for all the responses. Lots of food for thought.

@randommess Sorry but I'm not sure of those acronyms, can you clarify?

Lots of people mentioning the look of a tummy after a C-section. This is not my concern at all - my tummy now is like a deflated balloon with an overhanging section. My main concern is the health of me and the baby.

I chose one, I'm a researcher and spent a long time in my first pregnancy weighing up the risks - in the end, I decided I preferred the risks of a c-section.

I know many people who have chosen a c-section because of the trauma of their first birth, I think that's likely the most common reason and it's completely legitimate. Planned c-sections are very calm and controlled, mine was absolutely lovely (best part of the entire pregnancy for me to be honest).

If it's helpful to summarise some of the risk differences I'll do it quickly here. Your consultant should run through them with you but frankly it depends on the consultant and a lot of them are very opposed to women choosing a c-section so will only list the risks of the c-section rather than comparing them.

I'll just note due to above comments damage isn't a common risk of c-sections, your abs separate in pregnancy and in the c-section they will pull them to get to your baby, but that will only cause some abdominal pain in recovery not long term damage. Pregnancy generally is the bigger cause of abdominal damage.

Overall, for a vaginal birth your risks would be improved this time as it's a second birth. All vaginal births do come with the risks of tearing/needing operative delivery (forceps or venthouse)/emergency c-section, but they are much lower for second births.

A c-section comes with a longer recovery, and the risk of a wound infection (which can be very unpleasant, if temporary). Generally c-sections are of equal risk to vaginal births for the first two c-sections but the risks of complications start to rise after the third or fourth c-section, so family size is something to consider.

The benefits of a c-section that won it over to me is that they are slightly safer for your baby (you avoid the risks of the rare complications of vaginal deliveries which can be very scary to experience), the birth itself is very calm and controlled (perhaps the best benefit for you after your last birth experience) and the hard bit is all in recovery, when the baby is safely here. They are also better for your pelvic floor/prolapse prevention (something I find consultants really don't attach much value to).

It can sometimes be hard to convince doctors (there's a bit of a postcode lottery) but if you have any problems look up Birthrights and they should help you.

Huge help, thank you @vitaminb33 really appreciate you taking the time to write this.

Cafeaulait27 I find it equally irritating women women with no experience of birth make assumptions and scaremongering assumptions about natural birth when you haven’t experienced it!

No problem @Toastedsesame, honestly it's something I feel very strongly women should be given more information about so that they can make an informed choice.

Also - If you're on Facebook there's a good support group called the "Cesarean by choice awareness network" which I found really helpful.

@Iknewyouwerewaitingforme erm, I haven’t done anything of the sort??

I said: ‘Overall, an elective c section feels less traumatic to me than a vaginal where I may end up with tears/blood loss/forceps/emergency c section/baby in distress etc.

Am I scared of potential complications during and after surgery and the recovery? Yes of course, but for me it’s the lesser of two traumatic sounding things.’

The above is my opinion. If I had said ‘all vaginal births are traumatic’ I would get where you’re coming from but that is not what I said.

Thanks 😌

@vitaminb33 thank you for your kind and informative post. These reasons you’ve stated are a lot to do with why I would like a c section. It’s lovely to hear you had such a positive experience for yours too xx

It's just choice. If I was recommended to have a C section then I would. I certainly wouldn't choose surgery if it wasn't advised in my circumstances.

@Toastedsesame

ARM is artificial rupture of membranes when they broke your waters.

I've had it done twice (after 3 pessaries each time) and because they were broken for me it was done whilst strapped up to the heart monitoring machine precisely because it can cause the baby distress and because there is a risk of cord prolapse.

Each time I was wanted about the risks and that if prolapse occurred I would be whiskies into surgery for an emergency c-section.

The two times I was induced abs my waters broke on their own they did listen to the heart to check she was ok as it was still and induced delivery, the last time she delivered 1 minute later so no chance to check.

I was induced for being very overdue each time no other risks.

If your hospital didn't do those checks I would be raising a complaint, if they did those checks and failed to realise your baby was in distress from the trace the I would be raising a complaint.

I can honestly say that unless your 2nd baby was in back to back position then subsequently delivery is easier because your body is better at pushing.

Please insist on going through your birth notes and find out exactly what did happen. If nothing else you will know if it was "one of those things" (birth is risky for Mum and baby) or whether the hospitals was inadequate and actually reckless with your care.

To give you a different perspective, my first birth was induced as baby had stopped growing, quite fast, baby in distress, low heart rate and got stuck, needed suction cup and cutting too. Baby was taken away quite quickly to be checked on. Recovery was awful and had post natal depression.

Second baby, natural water birth, second degree tear which I didn’t really notice at all for recovery. The birth experience was what I felt cheated of with my first. It was lovely or as nice as birth can be hahah!

I would have a chat with your midwife, I echo pp that you might be more at risk of haemorrhaging with a c section over natural.