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?

@Littlegoth thank you! do you get to choose spinal only? Good luck for dc2!

@snowflake29 thank you! If I could know I was going to have an easy birth or cope with the pain I'd find deciding so much easier 😂sorry to hear about your recovery. That's a fear for me. My dm tore when having my sister and she said it was awful. I was the smallest baby out of my two siblings and I was 8lb odds. All of my siblings and I are quite tall as is DH so I am expecting DC to arrive a fair size.

I had an ELCS and loved it. Brilliant recovery. I was a bit stiff and slow for a few days after but never in pain at all!

I appreciate that's not the same for every woman. But i really did feel fantastic and healed in no time. I was back in jeans and feeling completely normal by 2 weeks pp.

Like you I do not like uncertainty and loved having a plan and knowing wedge was going to happen. There were too many unknowns for me around VB's. I didn't want a forceps delivery, I didn't want to be left with long term birth injuries, and I didnt want an EMCS. So it was the right decision for me.

Oh, and I didn't tell anyone apart from medical staff (& husband!) that I had an ELCS - couldn't be dealing with the opinions. I knew what I wanted and waa fully informed. Nobody's business but my own.

@Dasher789 i suggested they might not want to do an epidural as I had a spontaneous spinal fluid leak a few years ago. I ended up having 3 long conversations where the anaesthetics team convinced me to have and epidural, then when I got there one of them poked me in the spine for a couple of seconds and said spinal only. I was a bit impressed that he seemed to have x ray fingers. I think you can state a preference, the only think is with epidural they can top you up and take a bit longer, with a spinal I think once it’s in they are on a limited time. Mine took about 38 minutes so swiftly done. Surgeon did a beautiful job too. I’m high risk for clotting and have had multiple previous abdominal surgeries so was classed as a complicated surgery. He went through an old scar and improved it, I healed well and was back to normal including driving within 2 weeks. hopefully same again

@Alfixnm thanks! That sounds just what I would like it to go. Did it bother you that you are still awake or was it fine? Can you feel anything? Did you tell people after or just keep it totally quiet. It is funny how judgey people get when you talk about ELSC.

Again, if this helps. I'm 6ft and DH is 6'7. My eldest was 9lb1 and I had a third degree tear. I was stitched in the delivery room and tbh I was so high on gas and air I thought I was on the beach 😂 I had no issues following that tear. No infections, no issues with holding wee, nothing.

I assumed I'd tear with my second as well. She was 9lb3 and not even a graze. I had the same midwife deliver both and she was v impressed with her stitching skills lol.

The head crowning felt the same with both. I had no idea that I'd torn with my son.

I have no issues at all with my pelvic floor or have any birth injuries at all. I can't see the scar from my tear either now.

Like I said, every birth is different and even the most planned section can not go to plan. It's a lot easier to make these choices with a second birth as you know what your body can do, with firsts it's a matter of luck either way.

Oh god I could write you a 4000 word essay in an hour on how good my section was. I’ve commented about it on various posts before so I won’t bore you with the entire thing! It was purely due to my overwhelming fear of birth, I wasn’t at any point on the fence though, there was only one way this baby was coming out of me and I didn’t get pregnant until I was absolutely sure I could get a section (researched on birth rights nice guidelines etc). The midwife was equally as horrified at me and repeatedly brushed me off til I was 22 weeks. At this appointment she tried to give me an email address for hypnobirthing and I’ve never been rude to a medical person ever and would always just sit and agree but in this situation I had no option but to almost burst into tears at how much this was not what I wanted. I physically felt like I couldn’t. Long story short I got to speak to the consultant and as long as I was happy with the risks that was fine, all approved. Had him at 39+4, the most amazing experience ever. None of it was sore at all. The cannula in my hand was the only nippy bit! The recovery was also completely fine, I just took it really easy. I’d built the birth up so much that I was just SO relieved he was here and we were both fine that I kind of forget the recovery. Only bit I didn’t like was peeling off the really thick sticky plaster from my scar 😭 I will 100% be doing it again, everything the exact same way. I have so many friends who complain about peeing themselves all the time and my pelvic floor situation is the exact same as pre baby. Literally the only negative is the little line you’re left with but who’s ever going to see it?!

The research shows outcomes for pelvic floor and continence issues are the same irriguardless of mode of delivery. It’s the fact that you’ve been pregnant that weakness the pelvic floor.

Also just reading your comment above.. so ridiculous that people think they have any say in how someone else’s baby comes out of their body! It couldn’t involve anyone else less, even you’re partner for all they were involved in making the baby only one of you is dealing with getting it out. At the start I thought I’d tell people how he was coming but after telling one judgey woman at my work and her sighing and saying I’d regret it, I decided there and then I www telling no on else. My close friends knew before I was ever pregnant that’s how it would happen and so did my mum etc but the in laws didn’t. I knew my MIL would have so much unwanted advice so I decided we weren’t telling her til after. She even started asking about my birth plan and pain relief etc. I had to just brush it off like I was taking it as it came 😂 She started telling me not to take an epidural and all this because she didn’t. Even if I wasn’t having a section, what business is it to you what pain relief I want?! 🤦🏼‍♀️ just told people after he was born and anyone I couldn’t be bothered going through it all with I just said it was a low placenta. No one really cared, except her!

Didn't bother me at all being awake. It was actually lovely! Everyone in theatre was in great form, we were laughing and joking pre-op, it was a lovely, exciting, happy atmosphere.

I didn't feel any pain, you can feel a bit of rummaging around when they're taking the baby out, that's it.

I told people it was a planned section due to a breech baby. Only my husband and doctors know the truth, that it was maternal choice. I know some of the opinions of my nearest and dearest on the topic and didn't need their lectures or judgement. Nobody's business but my own!

Whatever you decide OP - best of luck.

Recovery from my c section was so much worse than my planned epidural which was perfect

The head crowning felt the same with both. I had no idea that I'd torn with my son.

See, that's not reassuring at all. How much other pain must there have been to not notice that you were literally tearing apart of the most sensitive bits of your body almost all the way to your bum.

Ok please bear with me for this essay because this really triggered me, obv through no fault of your own but I feel so strongly that you should trust your gut on this one.

I’m going to try and type my experience and opinions without trying to scare or convince you either way if that makes sense.

This is my birth and my thoughts for me. I don’t want to scare you but I do feel strongly there’s some kind of cover up about birth that no one tells you until you come out the other side which really pissed me off to be honest. So I refuse to sugar coat or downplay anything.

Anywhooooooo. I had a natural birth, first baby so no idea what to expect. Nothing super traumatic happened. I had quite a long labour for like 3 days, but like the scenario you mentioned unfortunately of the birth centre I had chosen being full happened. They tried to fob me off and I could tell something was wrong when I kept going back and the midwife told me to come back when my contractions were 1 minute apart or I couldn’t breathe. I ended up at a different hospital in the end which was so lovely but not what I’d planned.

I got put on a drip to induce/ speed things up and had a cannula (which was my top phobia even over the epidural) They didn’t have any info on me as this wasn’t my hospital or even the same trust so they had to take all of my bloods again, I hate having bloods taken too so to be honest this was the worst bit for me 😅

My waters broke naturally just as she was going to get the needle thingy to break them so I can’t comment on that. I had gas and air and was so fucking high. I think I had a couple of new or trainee midwives because I was so high and can’t remember most of what happened but I remember when the anaesthetist came in he thought I was too high and it took all my contraction to pretend to know when my contractions were happening I was so scared he’d confiscate it 😂 I cant really remember properly consenting for an epidural as I was so high, but I’m glad I did. Felt nothing when it went in and had to have a little top up about half an hour later as I could still feel him touching one of my legs.

You can still feel the contractions though and the few times I did mess up on the gas and air it was so painful I just had to groan through it. You can’t feel anything at all once you start pushing which is why the midwives tell you when to push as so you’ll have no instinct on when you need to.

I had an episiotomy as baby got stuck, I was knackered by this point as it had been days and I think I’ve got some proper nerve damage from the whole thing. I know it’s only been 4 months so I should probably give it more time and my opinions may change but I still can’t feel anything when I have sex or when I poo. Initially I couldn’t control wind or poo and it was awful and so embarrassing but it’s getting better with time however I still can’t actually “feel” when I poo if that makes sense. I have the sensation I need to poo but can’t tell when it’s coming out or when I’m done. Note earlier I said I didn’t have that traumatic a birth because some people have it much much worse but no one ever talks about it, it’s annoying.

This is an essay and I promise I’m getting to the point. I wanted an ELCS up until literally a few weeks before. I told everyone I wanted a section and said to everyone. Everyone tried to push me for a natural birth though, the senior midwife they referred me to, the girls at work, my boyfriend who had talked to loads of his customers so I caved and convinced myself it was what I was naturally made to do.

I’m still devastated. Would I have been worse if I got a c section, I really don’t know but I wish I had have stuck to my guns. Luckily my outside body’s “snapped back”, my bump was tiny and I have no stretch marks so I don’t even look like I’ve carried a baby from the outside but my insides are a bit of a mess and I’d rather have a scar or pouch over this. But then I might have wished for the opposite, he insight is always 20/20. I do wish I could go back but you never know how you’re going to recover or what will happen either way so I’d analyse what your priorities are, I know it sounds shallow…

Do you enjoy sex and would you be able to live with any potential changes that may happen below or

would you prefer to have a non scarred body/ tummy
psychically are you quite small? Is your vagina small? Are you worried about the baby fitting? I think statistically most women tear the first time so that’s more than likely to happen in all honesty. This was my main concern as I can only just about have sex comfortably with my partner and everyone told me it would be fine and kept telling people I was too tight/ small.

Sorry for the absolute ramble. But please read as many experiences as you possibly can, watch as many videos as you can on what can go wrong and right on both sides and just follow your heart. I didn’t and I wouldn’t say I regret it but, yeah I wish I was more loyal to that inner voice.

Sending soooooo much love and congrats!!!
xxx

@xxcatcatcatxx thank you so much. I'm so sorry for your experience and the after effects. I agree with you it feels like something isn't right. Why can we not have an open conversation and impartially get all of the information without being made to feel like we are doing something terrible.

I'll clarify. It wasn't pain. It felt like doing a huge constipated poo.

I didn't think I'd torn because it didn't hurt, it didn't feel how I expected a rip almost from hole to hole to feel. I expected huge pain, but there wasn't any.

Same with my daughter that didn't tear. I assumed if it happened once it would happen again but it didn't.

I don't think risk of tearing is related to baby size, lots of people I know had easier births with big babies.

I feel comfortable with my choice this time, and every Dr I've seen this pregnancy has agreed with me that if it was them they wouldn't be risking another vaginal birth either, so I've had no problems getting an ELCS approved.

I would see how your pregnancy progresses. If you continue to be low risk then you might want to consider a MLU but choose one attached to a hospital with a labour ward in case you decide you need more pain relief. An epidural increases the chance of further intervention like vacuum/forceps/episiotomy which can cause issues afterwards.

With all the surgery and stitches I had, I was discharged with 2 weeks strong painkillers along with an antibiotic and normal paracetamol too, and honestly I can't remember being in pain at all. I healed really well, it was just a bit of a slog due to the limited movement while healing and the anaemia.

With the best will in the world you can plan to have an Elscs, however there is also the chance that you could go into labour before and it may be too late to conduct a LSCS if the baby is on their way!! Have you thought about exploring the possibility you may be tocophobic? Phobia of childbirth? I wonder whether you would benefit from a meeting with a Consultant midwife to go through your options and maybe have some psychological support too?

I have to say first off every person is different and every birth is different. I went into having my daughter with the attitude that things may not go the way I want and take the changes as they come. Most importantly though remember this is your birth. The midwives can make suggestions and you can say no or you would prefer xyz. Obviously in emergencies you should always do as they suggest.

My honest advice after my birth would be to see how you get on with contractions. I'm a big wimp with pain and particularly period cramps ...I hate them! But I started having contractions 2.30am Wednesday. Went to the hospital 7am Thursday after no sleep for 2 nights I was 4cm. Baby didn't arrive until 1 49am Friday. I wanted a water birth really badly so couldn't have any pain relief bar gas and air and cocodamol but I thought its fine I'll be in the pool. But then was told I wasn't allowed in the pool till much closer to pushing. I considered more pain relief but I really did want the pool birth so refused. In the end when I got in the pool I hated it there was no way to get comfy in it and left. Birthed baby on the bed with a 2 degree tear but honestly I'm glad I didn't have Any other pain relief. The gas and air was enough.

So I suppose my suggestion would be see how you go. Remember as well c sections can be very painful after so it's not a pain-free birth. Epidural is a good shout but just make sure you've read all the benefits and risks.

Lastly. Totally understand. As a first time mum you have no idea what to expect or how to make these decisions. Just do research abd see how you go

I had to have a planned section, went into labour early and so whilst not quite planned I still had a very calm section. It was the most beautiful experience of my life, music playing, husband by my side, skin to skin, and they latched on whilst I was being sewn up. Great recovery, walked around the park on day three, only had to take paracetamol for one day, and even the pain wasn’t as bad a regular period pain. I would say I recovered quicker than those in my group who had a vaginal delivery, two of which still have issues a year later. Even if I didn’t have to have one, I would definitely chose a section again.

I have yet to give birth, my first is due in 5-6 weeks, c-section at my request. I'm sorry you had such a pushy response from the midwife. I think that's really bad. No one would talk to me about birth plan until 28 weeks, by then it's really too late to arrange any therapy for tokophobia... But that's aside!

Re: one of the comments above, don't worry if you go into labour early. I have been told that even if I go into labour early I will still be given an elective c-section, so you'd be very unlucky to go into labour and then progress so far you couldn't have a c section... Baby would have to jump out in an hour I think!

One of my friends absolutely wanted a vaginal birth, natural if possible and thought she could handle the pain of contractions... As it progressed she changed her mind as the pain was so bad and requested an epidural, but was then told it was too late in the labour to have it now and had to continue with gas and air only which was horrible for her. She said she would have an epidural with her next child.

I have loads of anecdotal stories, I am sure everyone here does... Ultimately it seems like a lottery to me. C-section recovery doesn't sound worse to me than the copious stories I have heard about vaginal birth recovery. Just different. I hope it goes well, whatever you choose!

I've had two children- first I was induced with epidural, second I had ELCS. The first was the most traumatic experience of my life, the section was one of the happiest memories of my life. (Both within the last 2.5 years so both recent).

I'm having my third in a few months and I'll 100% be having a section again.

It's all well and good some people saying that natural, non induced water births are the best option. I have no doubt that's true and if I could choose that for myself then I would. The problem is that vaginal births are just so unpredictable.

Like a previous poster, I had a spinal 'headache' after my epidural with number 1- it wasn't a headache- it left me unable to even lift my head off the pillow until I had had two operations (blood patches) to fix it. I was on the postnatal ward for 6 days essentially paralysed. I also hemorrhaged, had the emergency button pressed three times throughout the birth due to baby being in distress, tore badly and baby was born not breathing (came round after a few minutes and lots of intervention). On the face of it I was a healthy first time mum with no risk factors. Not trying to scare you- but just highlight that vaginal births can and really do go wrong (my plan had been water birth with gas and air).

Also, after all of that in the first birth, I STILL had midwives trying to tell me to go for a vaginal second birth. I stuck to my guns and had the section- 1000x better, easier and more enjoyable.

Also what finally convinced me to stick to my guns and demand the section for number 2 was when one of the consultants told me that sections are safer for babies than vaginal births (riskier for mums though). I looked it up and verified it with multiple peer reviewed papers (or the Emily Oster book is helpful).

Think that's not a fact that's not as well known as it should be, and just highlights how very unpredictable vaginal births are (of course sections are too, there's no straightforward way to give birth, but they are safer for babies overall).

I had an ELCS 8 weeks ago with my first for the exact same reasons. I was brushed off by my midwives who were horrified at the idea and just kept telling me to 'not worry about that yet'. In the end I sent an email to my midwife team saying I wanted an ELCS and to please refer me. After that I got a phone call from a senior midwife who listened to me and agreed it sounded like I was making an informed decision (I did do a lot of research and echo pp who said it's actually safer for the baby). There are quite a few relatively threads on this choice so would recommend searching MN for them as I also found other people's experiences informative and reassuring.

Ultimately I'll never know if I would have had a straight forward birth with no difficult recovery but I would not have changed my ELCS for the world! I wasn't seen until 1:30am as it kept getting pushed, understandably, due to EMCS, but it was so calm, the staff were lovely, and I didn't feel a thing. I was able to walk by 8am and had my catheter removed, and was discharged by 4pm. I made sure to stay on top of my painkillers religiously - setting alarms - but I dropped the dihydrocodeine after 2 or 3 days as it was making my stomach hurt. Obviously I was stiff and needed a bit of help to lever myself into an upright position in bed (could have managed on my own but would have taken longer) but I went out for a walk the day after! I would say I felt fully recovered - no pain, no stiffness, no exhaustion at all walking - from about 5 weeks but obviously it's a gradual process and so the preceding weeks were also varying degrees of fine.

Naturally everyone is different - I could have had it worse with recovery, I could have had a better vaginal birth, you never know these things, but I would do it again in a heartbeat. Yes it's major abdominal surgery but it's a pretty routine operation and can be easily managed at home.

Also I was told (I made sure to clarify!) that if I turned up in labour I was to just say I was meant to have an ELCS and I would still get one, it would just technically be classed as an EMCS as obviously it would need to happen pretty promptly! Oh and I was also told that if you aren't ready to be discharged for any reason - maybe you just don't think you'll cope at home yet or you're still in too much pain or you just want more support with baby - you can say you don't want to be discharged and stay on the ward until you're ready to leave so if you're not ready then stand your ground (or get someone to advocate for you!). I obviously left pretty promptly as my post natal ward was noisy and I felt fine to go but I did have latch issues once I was home and think if I had stayed in a bit longer I would have benefited from midwife support with my baby.

@bumpquestion @mrkb thank you for both of your experiences. I think you have both summed up exactly how I feel and described my worries. I really think elcs is right for me.