Natural birth - Do you have any lasting 'effects'?

[Curiosity101]

I'm currently pregnant and leaning heavily towards an elective section this time as my first pregnancy ended in an EMCS due to pregnancy complications.

The main thing that has swayed me is the long term damage that is more likely to be incurred as a result of a natural birth. Statistically I have a 75% chance of having a successful natural birth if I opt for it. But that includes all manner of outcomes (including forceps and ventous) and all manner of tears. It's probably 50% chance of a 'normal' natural birth with 'normal' levels of tearing etc. Short term I'm happy with that risk and the recovery/pain. But I really worry about the long term effects from natural labour and that is what is currently swaying me towards an elective section.

For example research I've read suggests overall long term urinary incontinence levels are double for natural births. ~7% for CS Vs ~15% for natural for example. But anecdotally it seems to be agreed/accepted from all mums I've spoken to that after you have a baby you can't go on a trampoline or sneeze or cough without the potential for a little bit of an accident?

So... If people wouldn't mind sharing their thoughts and if they have (or haven't) got any lasting effects from birth I'd appreciate it. For me having had one baby via EMCS my only lasting effect has been that I have the CS scar and a small CS 'shelf' 😅 but neither of those things bother me. I'm trying to work out if statistically it makes sense to roll the dice with a natural birth when (statistically) I'll probably be no worse off long term with an elective section. But the idea of being up and about in a matter of minutes/hours and not going through major surgery is definitely attractive. DH will be home for the first few weeks so we'll be fine either way... Just trying to gather as much information as possible.

I had 10 natural births. No pain relief. No stitches. No tears. No trauma.
Then had an emcs. Yuck. Separated stomach muscles and a shelf and scar!

DS1 forceps delivery, episiotomy. DS2 episiotomy. No long term side effects at all. Home same day with both DSs.

You’ll never get a more balanced answer than the underlying data though, which you’ve quoted.

I was nearly 39 when I had DS and have no after effects. Bowel, bladder, vaginal muscles all recovered. I'm 50 next birthday and can safely bounce on a trampoline.

I got a 3rd degree tear with our 3rd and the scar tissue is a bit thin but other than that nothing that couldn't be fixed.
I was left with diastasis recti, a destroyed core and joint instability from my twins but powerlifting in the gym fixed it all. My ligaments between my upper abs did pop at 15wk with this one but I'm still powerlifting with them like that. I was diagnosed with osteoarthritis in 2017 so that added to the join problems but they are much better with the lifting too and spd/pgp has not been as bad do far compared to my last 3 pregnancies.

Long labour, failed ventouse, forceps, stitches. Weeks of pain. Coccyx fractured. Still unable to sit on hard surfaces (like a bench) for over an hour without pain. Wish I'd had a CS.

Had the twins by elcs too, only notice my scar at af and after heavy deadlifts.

3 children, 2 episiotomies and 1 second degree tear.
No lasting affects (apart from an ugly vag but there are no pretty ones 🤣) fortunately!

Accidents while running or coughing or sneezing etc are absolutely not the norm! Very treatable and something every woman should take care of, regardless of how you give birth, or even if you never have children. Never put up with that!

I've had both c-section and vaginal births, both went well and you need to take care of your pelvic floor with both!

Two natural births with large enough babies and I can go on a trampoline and sneeze with no accidents.
I think because I am slim, I was told pregnancy did a lot of the damage to the pelvic floor
2 episiotomies too. I have no lasting damage

No problems here, 3 natural births. I think your pelvic floor is impacted by pregnancy anyway so you need to do your exercises regardless!

Yes, I think you need to use the data to make a real judgement, not responses on here. It's luck of the draw who responds to your thread after all.

I've had one vaginal birth, I had a ventouse delivery with an episiotomy, no other tearing. I wasn't really 'up and about' quickly. I mean, I could shuffle around straight after birth, but I had significant pain at my episiotomy site for about 8 weeks, in part because a tiny section tore open at about 5 weeks PP which set me back. I had some pelvic floor symptoms for quite awhile after - pain at the episiotomy site (internally and externally), pain when using tampons, odd rate occasions of mild stress urinary incontinence mostly associated with vomiting, and general mild tenderness in my pelvic area. I had pelvic floor physio at 9 months PP and was told my pelvic floor was quite weak (2/5 on strength scoring). However obviously I don't know what it was like pre-pregnancy, it's not the case that all women are 5/5 pre-pregnancy of course. With pelvic floor physio guided exercises I was pretty much symptom free in about 12 weeks. I'm pregnant again with no.2 and I know my odds are much better this time for an unassisted vaginal delivery without serious tearing so I am probably going to opt for that and hope it's better this time around. Trying to be more vigilant with my pelvic floor exercises this pregnancy than last time! I've got HG, although thankfully recovering, and luckily I've had no stress incontinence related to vomiting which I was very worried about. I figure my pelvic floor is still functioning pretty well despite it nor being that strong. If I had been experiencing incontinence with my vomiting I would probably have requested a section but luckily that hasn't happened and not much else puts that severe pressure on the pelvic floor than severe repeated bouts of vomiting over a period of months!

Good luck whatever you decide, I don't think there's a right or wrong answer.

No, no lasting effects. Had some grazing and stitches but healed pretty quickly.

I had an emcs and then my next birth was a VBAC with an episiotomy. I have to tense my pelvic floor when I sneeze but I haven’t been religious about doing pelvic floor exercises this time round. I do get occasional twinges/pain in my c section scar. I’ve never wet myself and I’ve had a cough and been on a trampoline.

From my research and my experience, natural births aren't likely to leave any long term after affects.

Your example of incontinence is largely due to lack of maintaining pelvic floor muscles. You should really do pelvic floor excercises during pregnancy and soon after but many women don't.

Also, media often depicts women laying on their back to give birth. I was actually a little surprised to discover that that's not the best birthing position at all. Tears are more likely when birthing lying on your back and it prevents gravity from helping the baby out.

It's not natural births that are the problem, it's other factors. That's just from what I've read.

There are obviously some women left with serious and ongoing issues following the birth of a child.

But there are many, many women that seem to ignore that pelvic floor muscles are, in fact, muscles that need exercising like any other. And for most women they don’t stay the same as pre-pregnancy without a little bit of effort.

I ended up with forceps in theatre but it was absolutely fine. No lasting effects at all for me. Right as rain!

One vaginal birth, no induction or assisted delivery. Bad second degree (almost third degree) tear. No lasting effects at all.

One vaginal birth, ended in forceps. Moderate Bladder and bowel prolapse. Still in pain 3 years later. Cannot do exercise without aggravating prolapse symptoms - I used to love it.

Honestly I don’t think I will ever feel happy again because I feel constantly ashamed and stressed about my prolapse and making it worse. I cry every day. I had no idea this could happen but from the support groups I’m in, and peer reviewed research I’ve done, I’m not rare sadly.

This is the condition I’m in after significant pelvic floor physio and being militant with my pelvic floor regime. Some people can be helped with pelvic floor exercises, not all can.

I’ve had a section for my second and it was an absolute piece of piss. I was very lucky there and not all women are. There are risks especially as it wouldn’t be your first, as I’m sure you know.

I would say it depends on your priorities. If your pelvic floor and condition of your vagina is important to you, have a section. There’s no question that vaginal birth is associated with greater damage there (obviously pregnancy itself can do damage).

However if you’re worried about the risks of surgery from a section the the potential damage to your pelvic floor may seem like a minor price to pay.

Best of luck with your birth whatever your choose

Gave birth vaginally last Monday.
Used to be dead set on elcs for the reasons you mentioned when i got pregnant.

But after careful consideration went for natural birth and no tear, no episiotomy, no assisted delivery (only manual removal of placenta as it didn't come out). Just a single stitch on the labia and urinary incontinence (related to pelvic floor muscles) as a result... that should get better with time apparently.

I would give birth vaginally again. Actively birthing my baby was probably one of the most special moments of my life.

4 vaginal births in under 6 years, sometimes have to wee during the night, but that is probably due to my advanced age.

Just my perspective. Two c sections (emergency)
Lot of recovery and permanent overhang but I'm sure if I worked harder at it I could improve it. Also feel weaker overall since. Maybe due to spacing between pregnancies (two in just over a year)

My aunt was left doubly incontinent after the birth of her first and only child. She's had surgeries and it still affects her a lot. She was squatting and said the MW encouraged her to push too quickly though.

I wouldn't risk it personally although I'm not too clued up on the risks for a CS. I suppose the fact you've already had one and recovered well means you're likely to again?

I had two VB, minor tears and I do need to be careful on a trampoline but that's it. I'm in my twenties and did/do my pelvic floor exercises.

I had forceps delivery, episiotomy and third degree tear. Healed and recovered really well, I feel like I got back to myself quite quickly after the birth. The only lasting effects I feel is my vagina and that area feels different, not bad but just different. Maybe slightly wider but that might also be from my hips and pelvis widening from pregnancy. My muscles and bladder are definitely weaker but not horrendous and haven’t had any accidents!

I just want to say thank you to everyone so far who has been kind enough to share their experiences. Whilst a PP is correct and the research is probably going to give me the more balanced view statistically, I actually thought anecdotally that if anything the research probably underplayed people's long term issues. However that doesn't seem to be the case so far reading all your stories.

Also one thing research won't tell you is how much of an affect it has on people's day to day lives. So this is all really valuable. Thank you again.

I've had three natural births:

1st long labour resulting in episiotomy
2nd home birth, minor 2nd degree tear with minimal stitching
3rd another long labour, baby had shoulder dystocia, I ended up with another 2nd degree tear

Worst recovery was my first birth, but even then I had recovered completely after 6 weeks. With my second and third I was pain free within 10 days.

Never had any bladder issues. I did have stomach seperation after my second and third and needed physio both times, but that was nothing to do with how I gave birth, it's just very common in 2nd or later births and I have a short torso so nowhere for my babies to go but out front.

I only know two mums who had long term issues. One was due to her waters being broken and her bladder being damaged during the procedure, rather than the actual birth. The other had two big babies- she suffered stress incontinence but with the help of a physio recovered.