ELSC or Epidural

[Dasher789]

I had my first ante natel appt yesterday for DC1. At the appt (I had no idea what to expect) I was asked about giving birth.

Pre appt, I'd been set on an elective section. I'm no good with the unknown or pain so felt this took the worry away. When I said ELCS though, the midwife looked horrified. She said I could have it if I wanted but strongly recommended against it.

She suggested water birth but after some research I don't think a water birth is right for me because of the lack of pain relief.

After some deliberation, I am between ELCS and epidural.

I am interested to hear expriences if you have given birth in the last 5 years (as I understand epidural changed around then) via either of these methods, the pros and cons you experienced and if you were pregnant again did you/would you choose the same?

Thanks to anyone willing to share their experiences. Also does anyone know when you have to have made a final decision?

Hi there,

Epidural by choice for my first birth. Was firm from the moment I stepped on the labour ward (had also various times advised I wouldn't want to be on the midwife led unit) that I wanted the epidural and repeated this several times.

Anaesthetist was in our room within 15 minutes and managed to successfully place the anaesthetic. It was in place with the top up button/control which you self-manage (but controlled doses etc.).

Up until then I had spent almost 72 hours at home in agony in a slow labour at home. I had no energy, I was exhausted and in a lot of pain. Nonetheless even prior to that my birth plan said labour ward and epidural as first choice.

Once the epidural kicked in, I found it utter bliss. For me it worked fully, I understand it can sometimes not work fully for some women. Yes, you're going to be confined to your bed as you can't move your legs much. At least that was the case for me, I have heard about mobile epidurals but at my London hospital it doesn't seem an option and I would say UCLH is pretty advanced. You'll have a catheter placed as you won't be able to get to the bathroom. You'll be monitored closely and so will baby be as it can lower blood pressure.

From 2pm to approx 10pm I went from 3cm to 10cm dilated not feeling a thing, resting. Didn't feel any pain through active labour / pushing. Second degree tear which I was happy with considering first birth, no intervention, no assisted birth tools used otherwise. Stitches done in our room.

Recovery was personally 'easy', could walk within a couple of hours, and was then fine thereafter. I was lucky in that sense, I think elective sections could make this more challenging but again everyone has their own experience.

I'm expecting my second. Without going into details there were issues with my first baby's health and I'm being closely monitored. My options are early induction or elective section. I haven't decided yet but have a call with a consultant midwife next week to review.

Do lots of research on NICE and RCOG research, and make up your mind based on the info you find.

Stories are of course anecdotal!

I had a battle to get my epidural, they kept on telling me how I didn't need it and was nearly there... I was in agony and just so tired ! Eventually the student midwife told me to push too soon, my cervix swelled and I got the epidural. I heard the senior midwife say "oh well she'll have to have one now won't she" in a really nasty tone.
30 mins later I was eating a snickers !
Just be firm if you go for an epidural because you hear alot of stories similiar to mine where they try and put you off. I was only young and didn't really know what to expect but I do believe the senior midwife that day wasn't a very nice lady and took advantage of the fact I was young and naive

Btw I didn't get my epidural until I was 8cm, I had been in established labour for hours. Try and get it asap if you do choose that route because transition isn't pleasant and trying to stay still while in that phase is very hard !

Ask very clear questions about staffing. At night or weekends especially there’s no guarantees of an epidural being available when you need it.

@swayingintime this is one of my major concerns. I have the option of a couple of hospitals but the closest one is being pushed upon me. It is the main hospital in the area and very busy. At times the maternity unit has to close and you are sent to one of the other ones which happened to a friend of mine. Another friend was planning a pool birth but when it came to it there were none available.

The busyness of the main hospital is encouraging me to consider one of the two smaller options. Out of the two, my preferred option is actually in a neighbouring health authority and uses a system which is incompatible with my home one therefore the hospital wouldn't have access to any of my ante natel notes. Obviously I would bring them but I don't think they will have time to read much of them. So far iv only had the one appt but my blood pressure and weight is fine. Unless I start to show abnormal results, I am not sure how concerned I should be about this.

Two of my friends have given birth at the smaller hospital outwith the health authority and they really rate it. One has given birth their twice so others are doing it successfully but my midwife didn't seem that positive about it.

Agree with the posters who say do lots of research yourself, and don't be afraid of your own decision. It's your body, and therefore your choice. Midwives are just people, and like all people, some are nicer than others! Recent reports suggest that a large cohort of midwives are inexplicably insistent on natural, drug free births, completely aside from whether that's in the best interests of the baby or the mother.

If you’ve not already found it, the labourpains.com website may be useful - it’s the patient info site run by the obstetric anaesthetist association and has a load of info about pain relief options and anaesthesia for the different modes of delivery. HTH.

Sorry you’ve have this reaction from your midwife - she is only one person though, so maybe you could ask to see someone else.

I recently asked for an ELCS and my midwife didn’t question it. Just seen the consultant today, and again, she was fully supportive and got straight onto offering aromatherapy and music etc. Hopefully you’ve just come across one negative midwife - the rest could be as supportive as the ones I have seen.

Best of luck to you.

I have had an emergency c section with epidural up until 9cm dilated and a home birth with some gas and air.
I had the epidural after the drip to speed up labour which is synthetic oxytocin and it was good except I wanted to be on my side, not back so it only worked on the side I laid on.
That being said the contractions with drip are more painful than without and I could deal with "natural" contractions at home with no pain relief more than those synthetic ones with an epidural.

Experience tells me to decide what you want and advocate for that! If you make an informed decision and tell them so then they are supposed to take that into account.

I would agree with the PP and ask what the staffing is like and what the pre requisites are to an epidural in your trust so you are aware.

Had my baby girl in January this year and opted for epidural right from my birth plan. I ended up being induced then went into labour and had my epidural but unfortunately ended up with the spinal headache after it and needed a blood patch treatment. I ended up with an emergency section in the end anyway, so basically the point of me telling you all that is if I do it again, I will opt for a planned section as it was great and wished I had done that from the start. Goodluck!

Had an ELCS for my first - he was breech. Was all fine, though found recovery painful. Decided lack of decent painkillers, if you ask me!

Had second VBAC. He was pretty quick, so I had gas and air. It worked for me, I understand it doesn't for everyone. I think on my birth plan I said I'd ask for whatever pain medication I wanted - would have continued increasing whatever I required as necessary.

I'm due in October with DC3. I found recovery from vaginal birth considerably easier, so will aim for that again. I found losing the use of my stomach muscles affected me hugely - mobility wise, but it also knackered my back for ages after.

You're well within your rights to ask for whatever you fancy. Hope it all goes well.

@barneymcgroo thank you. Could I ask, after your c section did you find it harder to lose weight or get active after the birth or after 6 weeks or so did it feel okay to get moving? Good luck with dc3

@AHobbyaweek thank you, what do you mean by pre requisites for the epidural? It really is a minefield!

I would never choose to have major surgery unless it were totally necessary. Sp much recovery time afterwards when you have a new baby. Without it it's all over as soon as the baby is here. I chose no pain relief both times, and both times I decided I wanted an epidural but too late, so only had the gas and air. If I were doing it a third time I would just go for the epidural from the off.

Would highly recommend the book The Positive Birth Book. It clearly explains all options in simple terms but with no horror stories so will help you make a clear informed decision.

I breastfed both for about two years, and found weight loss similar in progress, I think. Definitely found it easier to get moving after vb, but after 6 weeks or so after cs wasn't too bad. Pain around the scar lasted a lot longer.

I tried to use a sling to carry ds1 - it landed painfully on the scar, so was a bit of a nightmare.

Incidentally, found sex after cs incredibly painful. Weirdly, after VBAC was fine.

Two planned sections here. Both were virtually pain free, with quick and easy recoveries. I've had worse periods tbh.

I was out shopping and going out to cafes by day 3, and with my second, was going down slides in soft play with my toddler in just over a week. I wore slings from a few days after birth.

The day after my first section, I literally googled 'when do c sections start to hurt'

I have zero regrets.

If I'd had an epidural, the likelihood is that I would have doesn'te the time before strait giving birth in agony, and exhaustion, before being given it. Instead, I went to the cinema and for dinner, and just turned up to my appointment very excited.

Its an intensely personal decision, but for me, to it was the perfect birth.

By prerequisites I mean you might have to be in a certain stage of labour, or have tried/declined certain pain relief first etc. it will likely just be their policy so not unchangeable but some points on it will be for clinical reasons. Ask them in advance if you can.

Thanks @AHobbyaweek

Iv just seen the thread that's trending about the poor lady who is stuck on a ward with her husband being sent home and the birthing unit is too full to take her so she has had no relief and is quite far dilated. That is my worst nightmare. I don't think I'd cope. I think if I could guarantee myself an epidural early on that would be my ideal but with the staffing problems etc, ELCS seems like the only guaranteed option even if it might take me a little longer to recover at least I could prepare for that.

I had a water birth with my second - omg it was amazing. I really wouldn't discount it if you remain low risk.

I could have gas and air in the pool and the warm water itself is a pain relief. There were a few contractions as I entered transition (the most painful bit) where I felt the tightening but no pain at all.

The water helped me to be comfortable on all fours which is the best position to deliver in. Daughter was born after a couple of pushes and I didn't tear at all!

Honestly it was the best birth. I was up and about straight away (had to get out the pool obviously) had a shower and was home in 4 hours.

I had to have a land birth with my first and it was still good and gas and air sorted my pain well.

I'd take another water birth over an elective or an epidural any day. The recovery for both were easy and less painful than my friends who had sections. I also didn't need to go to the post natal ward at all.

@twizbe you are a women than me 😃i just worry I wouldn't cope with the pain and also if I got there and there were no pools left like what happened to my friend and having to get my head around having a new land birth last min. Being able to get up and go is a huge advantage though

The thing is, all births are unpredictable.

Even a planned section can end up changing plans last minute. You also don't know how you'll recovery from quite a big surgery. I've got a friend who had both a serious emergency (under a general)section and a planned one. She preferred the emergency as she had no knowledge of it. She found the being awake for her second section really hard and a bit traumatic - she didn't expect that.

This isn't to put you off doing what you feel best for you, but if it's the uncertainty that's worrying you it might be worth finding other ways to deal with it.

I found it helped me to keep my birth plan to only what I could actually control. I could give my consent to a managed third stage and vitamin k. I could also stipulate that DH had to tell me baby's sex. Literally nothing else was in my control.

The pain of a vaginal birth is worse for some women than others - for me, contractions felt more like someone squeezing my tummy really hard, I wouldn't have described it as painful but it was a really uncomfortable sensation! I didn't have the typical period pain type pain people seem to describe.

In my case birth was so fast (waters breaking to baby being born was 1 hour 37mins) that I ended up with a 3b tear and had a spinal and was stitched in theatre...I felt horrendous for a few weeks afterwards and recovery wasn't exactly a walk in the park with that many stitches and all the bruising and I also lost 2L blood so was very anaemic after.

Im having an ELCS this time and I just think recovery can't be any worse than what happened last time. I can plan for extra help. But I agree with others that if you can have an uncomplicated vaginal birth then recovery is almost immediate.

I didn’t have time for an epidural - my labour was intense and painful but fairly short. Personally I wouldn’t swap it for a longer, less painful one. The quicker it’s done the better. But I’m just saying an epidural isn’t always an option if there’s just no time! So that’s something to think about.
I also wouldn’t prefer a C section because the recovery is long. But that’s just me.

I had an elective. Spinal only. It was brilliant. Will be doing it again in March