Advice from second time mums who had c-section with first

[NEAKT5]

Hi sorry this is a long post, I think I’m just looking for a little vent and hopefully some advice from people who have been in the same position as I don’t know anyone who has!

Currently 27 weeks with baby boy number 2 and have my consultant appointment next week to discuss the previous emergency C-section and birth this time.

Little background on birth number 1, June 2020 (will be an 18 month gap between them) was in early labour for about 36 hours contractions on and off never consistent barely slept. Water broke at 4am on the Monday at home, waters turned green had to be monitored at the hospital from 8am. I ended up with a fever and high heart rate, covid test done and bloods etc which they determined was likely an infection but didn’t know what. Continued labour with gas and air and got to 9cm but was stuck for hours until they decided on the section at 8pm and had the section at 9pm. I was utterly exhausted and didn’t expect to be recovering from surgery with an infection. Baby had infection too and had to be on antibiotics too, ended up being e-coli in my placenta. We had to stay for 5 days, no visitors as it was at the height of Covid so fiancée wasn’t allowed back after he left the morning after baby was born and it was a very difficult and upsetting first week of my sons life. So all that has made be quite apprehensive of this next birth.

I am torn between another section and a VBAC every day and change my mind constantly. The VBAC would hopefully mean an easier recovery for me and no long hospital stay so I can get home to my son and fiancée with baby and I would love if I could have that. However the thought of all that labour experience again to end in another emergency section or worse the thought of the uterine rupture risk is putting me off trying the VBAC. My midwife has said there’s no reason I can’t do it but not sure what the consultant will say yet. I feel that the section would be the safest way to get baby out without the worry of him getting distressed or anything going wrong so that pushes me towards that but the thought of no driving, scar recovery and not being able to pick my toddler up is hard!

I suppose I’m just looking for what made people decide on another section or the VBAC because I just can’t stop changing my mind! I’ll need to have some kind of decision or at least a better idea by next week for the appointment!

Thank you if you read this far

@MsAdoraBelleDearheartVonLipwig I wish I had your confidence about the vaginal after having a worrying and stressful experience first time around! That's exactly what is putting me off the section is my young toddler at home, I'm glad it went so well for you!

@ShowOfHands Wow you sound like you were so chilled either way about it I wish I could be like that I just can't stop thinking about the decision! That would be the same as me, partner would go back to 12 hour shifts 2 days and 2 nights a week after his paternity leave is over so would have a newborn and an 18 month old (who I imagine will still be waking a few nights a week as he does now) on my own!

You're exactly right, it's not much of a choice!

@Willthewashingeverend Thank you it's always good to hear from a midwife who has had experience with a situation like this. I need to read a bit more into the rupture risk etc. but I know that it is small and other midwives I have had appointments with have said the same because my cervix has dilated before so would know what to do. I just worry I'll get stuck at that stage again and be in labour for hours and hours again. My partner and I had a discussion last night and he thinks that an option like that is sensible, book in for the section and if baby comes early we just go with it and see what happens. I think this is what I will do, I just need to read some more on preparing for labour again. I think the first time round I thought well your body should know what it's doing so I never read much on preparing for labour or positions and I ended up just pacing back and forward until I had to be on the bed for the IV drip and catheter because of the infection. It's just such a thought to go through that again!

@Idyllic Oh wow that sounds scary! I think you're very brave after going through all of that to attempt a VBAC. Especially with having bigger babies, well done you. That's always the worry isn't it, another long or complicated labour just to end in another emergency section again. I think I've decided to book a section for week 40 and if baby comes before that give it a go but I'll probably change my mind again, hopefully the consultant can give me some more information next week! Thank you xx

@ElephantOfRisk Oh that's worrying that they have said after the surgery that the scar wouldn't have held, you would think that would have been looked at more before your due date. I'm glad all went well with it, it's just a hard choice to make when it's your first baby you had a bad experience with. I will also have a small gap, 18 months so not as close but that's what I want to check with the consultant too is my scar with the close labours.

@Boobahs Thanks very much! x

Please don't compare your emergency section to a planned section. They are not alike. I had emcs with first birth, very similar story to yours. I decided on a planned section because there was a likelihood I'd have exactly the same problems in my 2nd birth as I'd had with 1st (stuck baby).

The planned section was so gentleman's easy compared to emcs. I don't want to minimise surgery, but everything was better - the scar was better (they even tidied my original emergency scar), the recovery was easier, I was mentally better, feeding baby was better. I was not the exhausted wreck I had been first time round (3 day labour and then looking after a baby while poorly?). I went home the next morning after my planned section and i pushed the pram to the shop the next day. With emcs I remember giving up going to the supermarket a week after giving birth because I couldn't even walk from the car to the shop door.

It's your decision, and there's no right or wrong, only what you want, but a planned section is a totally different kettle of fish than what you experienced!

Gentleman's??? Gentle!

@spudjulia oh no I expect they would be very different, I think it’s just the prospect of not being able to pick up my toddler and him not understanding that I can’t that I worry about more than any other aspect of the recovery!

Exactly as you say it’s so tough because no one can decide but me and I’ve always like someone to help me with big decisions haha!

One of the reasons I preferred a cs was that I could plan for my toddler better. There'd be no ringing round for help in the middle of the night. We didn't have any family around.

I don't think it was very long at all before I was picking him up again. And there was lots of cuddles on the sofa, in bed etc. He mainly wanted to cuddle his new sibling though!

Good luck with your decision. It's like all of parenting, isn't it? I just want someone to tell me the right answer!

I had a vbac with my second after an emergency c section with the first. For me everything went well and the birth went relatively fine. I actually preferred natural as I got to hold my baby straight away and I did feel that rush of adrenaline after I pushed the baby out. The worse part for me was the contractions but I had strong contractions with my first and ended up having the emergency c section. The pushing was ok for me and the recovery time was quicker. Obviously that's just my experience. I'm done having kids but if it did happen I would op for natural if possible.

@spudjulia yeah that’s understandable, we do have my parents close by so that wouldn’t be an issue thankfully.

Exactly if only there was an answer that for everyone!

@Beebababadabo that is one thing I’ve thought about too if being able to feel bonded to my baby straight away and maybe make breastfeeding easier this time as it was a struggle with my first!

I think I’m worried I won’t progress again because in the back of my mind I’ll be worrying about the baby and another section.

@T0rt0ise I just thought I’d update you since you were facing the same decision as me. I had my consultant appointment today and the same as you she just went over the risks and benefits of VBAC and elective section and said it was my choice. Obviously the VBAC has many more benefits compared to the section and the section has possible longer term risks although rare. When me and my partner read the articles and risks of the VBAC we just knew we would both spend labour worrying that something would go wrong with my wound or failure to progress again, so I decided to book the section. I wish I felt more comfortable and confident to try for the VBAC but I don’t feel like I can take the risks to the baby and the section feels like the right choice to get baby here safely even if I have a longer recovery.

We’ve decided this is our last baby so some of the risks I will avoid as won’t need a third section anyway so that’s something to consider.

I am obviously not looking forward to the recovery with a young toddler but I thankfully will have my partner for two weeks and my parents can come help if I need it as they live near us.

I hope you are able to make the right choice for you too X

That's really helpful to hear. Thanks for the update 👍 think I'm probably swaying that way too but still undecided lol

I looked at the data. Having had one section, if you opt for another the risk - on average - is slightly higher to the mother than going for a VBAC. However, that stat is scewed because the VBACs that are on average more successful are women who have had at least one successful vaginal birth previously. So say one vaginal birth, one section, then expecting third baby.

This makes complete sense because it tends to indicate that there was a specific issue with one pregnancy that required a section but the woman's body is capable of natural birth and no indication of being prone to issues with that e.g. narrow hips, poorly positioned cervix, large babies etc etc. This means that it is unclear whether the risk to the mother is greater for the proportion of mothers who have had one previous problematic birth that required a section and never given birth vaginally - and given that the difference in overall risk is marginal - I suspect it isn't.

In contrast, if you have had a section previously there is a higher risk to the child from attempting a VBAC than having another section irrespective of previous births, which will be heightened for the babies of women who have not had previous vaginal births.

For me therefore, a second section was a no brainer and I am so glad I did that. A planned section is all very calm and was actually wonderful, to watch them being born. I was out of hospital 18 hours later.

I find that the NHS is very unbalanced in how it communicates risks to mothers. The risks of sections are highlighted very strongly but not set in context with the risks of vaginal births for comparison, because C sections tend to cost more. I was only ever going to base my judgement on actual data on the probability of outcomes. Data is published online by the Royal College of Gynaecologists and Obstetricians.

Interestly I am reliably informed that the vast majority of gynaecologists and obstetricians opt for c sections for themselves and their partners, even for their first child. That speaks for itself really.

Also if you have one child already bear in mind that it's easier to plan childcare etc for the existing child it you know when the birth is happening.

[quote NEAKT5]@ShowOfHands Wow you sound like you were so chilled either way about it I wish I could be like that I just can't stop thinking about the decision! That would be the same as me, partner would go back to 12 hour shifts 2 days and 2 nights a week after his paternity leave is over so would have a newborn and an 18 month old (who I imagine will still be waking a few nights a week as he does now) on my own!

You're exactly right, it's not much of a choice![/quote]
Bwahaha. To reassure you, I was not chilled. I was anxious and worried and on the day my waters broke, still not sure what I wanted. I knew what I didn't want. I had a lot of tears.

I probably sound chilled because dc2 is ten years old so I have distance and perspective.

If I'd had a third, I would have hands down had an elcs without hesitation. I realise now that it was the way for me to feel in control and even if I'd delivered naturally with my 2nd, the whole labour was tinged with anxiety about a repeat performance of the first emcs. The second emcs as I said before, was extremely positive.

I am far enough away from it to not feel the sting of worry so keenly. You'll be there one day too. It'll just be the story of the day you met.

Good luck to you.

@OddSockReunion Exactly that’s where I felt the information is unfair, there’s no guarantee that you could fully progress. I had an infection and got to 8/9cm which they said meant I had a very high chance of giving birth vaginally but again there’s no guarantee! The exact same for me, the potential risk to the baby of a Vbac just concerns me too much compared to the section.

I’m currently scheduled for a morning section and she said if all goes well I could be out at lunch the next day and I would love nothing more than that after a 5/6 day stay with my first during covid where my partner wasn’t allowed in.

Can I ask if you have any tips for recovering at home in those early days? The only positive to the hospital stay was the bed that could move and even then it was tough getting up those first few days!

Exactly I know he can go to my mums and my partner can collect him again before bed so it will be like a normal week day for him! Although I am already feeling a little sad at the thought of him trying to jump on me with excitement and having to stop him.

@ShowOfHands It really is so difficult even once you’ve made your choice you second guess it everyday!

Exactly I have told myself that it doesn’t matter how he’s born as long as he’s safe and I’m safe there’s no point in dwelling on not being able to push my babies out.

Thank you X

Not quite the same situation but I had an emcs in January this year and was out in 36 hours post surgery. Quicker than when I had my first vaginally.

So if a long hospital stay puts you off - it isn't always the case.

I also didn't have any risk factors, no infection etc.

My toddler coped really well with my recovery, I still gave him loads of cuddles and could have him on my lap if I was careful or he sat beside me on the sofa for a snuggle. It really wasn't the issue that I thought it would be.

I bought lots of things I could still do like sticker books etc that he could sit with me to do and he understood I had a poorly tummy.

@welshladywhois40 thank you, I’m hoping for a shorter stay with it being an elective this time around so fingers crossed 🤞🏻

@Sunshinegirl82 that’s a good idea I’ll make sure we buy some things that I can still do with him whilst on the sofa thank you. He’ll only be 18 months but hopefully he’ll understand a little!

@NEAKT5 I fractured my back at the end of July and was stuck in bed and things I could do with the toddler (he was 16.5 months at the time) included; books, iPad, Duplo, 'stargazing' at a projector, shadow puppets. Post EMCS mobility was better as you can sit up a bit but hopefully that'll give you some ideas.

@T0rt0ise oh I hope it’s better now. Those are great ideas thank you I’ll have to start making a list! I don’t like to prep too early as I’m a bit paranoid about that but I suppose 11 weeks isn’t too far away now so I’ll need to start soon!