Having second thoughts on natural birth after traumatic first birth

[Bumblebee412]

Really need some advice please

I am due my second child in a couple of months and really starting to have second thoughts on the birth.
For context my first child was born nearly 8 years ago and resulted in a major PPH and 3rd degree tear. I needed a blood transfusion and ended up with Post natal depression/psychosis and ptsd.
I have healed both emotionally and physically from all of the above.

This time I am consultant led and have had one telephone appointment to discuss if I wanted a c section or natural birth. It was agreed that the failings in care last time are what caused my issues with bleeding and an inexperienced student midwife being left to deliver her first baby and contributing to the tear. We decided on a natural birth as the reasons above could be avoided this time and I have been happy and confident with this until the last few weeks.
Baby is measuring large at the midwife and at 32 weeks is predicted to be 4lb 15oz which is apparently the cusp of where I would be referred to discuss an elective for a large baby but not past it so they won’t. I have been tested for gestational diabetes and I don’t have it, I also don’t have excess amniotic fluid. Baby also has a potential heart defect.

It just feels as time goes on a natural delivery is becoming more and more risky. A big baby increases the chance of a tear and PPH which are obviously already increased because of last time.

I can’t decide if I’m being stupid by not accepting the elective c section, or if I’m just desperate to have some kind of birth like I wanted the first time round. I am petrified baby will get stuck and I will have made the wrong decision trying to push for natural.

The birth is going to be very medical I have already been warned to expect a cannula in each hand, consultant and senior midwives only. No water birth, blood on standby and baby’s heart will be constantly monitored so I won’t be able to move around much if at all. So all in all nothing like I would choose.

My partner does not like the idea of a c section but if we were told it was safest or I said that’s what I wanted he would support. I almost feel like it needs taking out of my hands and someone saying a c section is safest for both of us.

any guidance much appreciated

Congratulations on your 2nd pregnancy! I myself had a very stressful birth with first child, long induction, long labour, haemorrhage and tears so I was extremely apprehensive about the 2nd birth. I was adamant that I wanted a c section but was advised against as 1) I had a natural birth before and 2) risks of infections and healing is so much slower. In the end I went into labour naturally and delivered my 2nd DC with only gas and air, my body knew exactly what to do and it was the complete opposite of the previous birth. I was up and moving about within an hour of having him. Its very unnerving but I'd try to avoid a section if possible

I'm sorry you've been through this, it sounds absolutely awful. I only have to say your partners view is irrelevant. If you want a c section, if you think that would be safest for you and your baby then do that.

An elective c section is a calm and beautiful thing, IME. The are usually straightforward and predictable and you don't have that element of anxiety of things going wrong. I would 1000% choose an elective section over am emergency section or a risky natural birth.

This is very much your decision and can only be "made for you" in an emergency situation which you are looking to avoid.

Ignore your partner not wanting a section. Completely irrelevant.

I don't understand why you are saying he/she will be big at 4lb. That's tiny. I had 2 births at 9lb9oz no pain relief first time G&A /water birth at home second time. No tear second time, small tear first. So even if baby was 6, 7 or 8lb that's all very normal. My friends dd was 11lb3oz, again a home birth (third baby) so natural birth of larger babies is also possible.

You need to be able to labour upright not lying on a bed. Ask how this is going to be managed. Ive known people manage it.

Bear in mind the doctors will be encouraging natural birth based on cost as well as recovery times being shorter all going well.

I am very much a fan of natural birth for myself but in your situation a planned section could be a good idea. It depends because a section carries risk too. Particularly of infection.

Fwiw a bad tear less likely second time around.

You've just got to decide what you want to do and then do it. You should try and keep your confidence up whatever your decision and do your research to decide how best you are going to cope either with VB or CS.

Don't be scared. You can do this.

I guess the emphasis is on "usually" because there's definitely problems resulting from them. I have known two friends end up in intensive care with kidney infections.

The friends who had elective sections after bad first births had 2 out of 2 bad birth experiences but that's just anecdotal from me to you.

What have the doctors said about PPH happening again? To present a balanced view because I really do think you make your own decisions, I've had several friends have PPH too. The two I know about were second or third births.

There are bad things that can happen either way. The norm is healthy baby healthy mum.

Fwiw you have had one bad experience and you'd hope your luck changes next time.

They believe he is going to be big because he already weighs just under 5lbs with 8 weeks to go still basically and if he follows the predicted he will be over 10lbs (apparently, I know a lot of this isn’t always accurate too)

I know no one can make the decision for me and I have to be a big girl and advocate that myself, I am just so unsure. Pros and cons to everything. I really don’t want to have a c section ideally but scared I’ll end up with an emergency one.

The plan at the current moment is to see what measurements they get at the next appointment, if he goes above the current centile they will send me for another growth scan and go from there but the wait makes me so anxious

Thanks everyone who has posted so far.

I think there’s a good chance that I haven’t got over the trauma the first time as much as I thought I had (took both me and my mum a good 2 years before we could talk about it without crying)

The first time it was thought my waters had gone and they hadn’t but I was induced with the drug drip anyway. This was turned too high and I was getting another contraction before the first had even stopped then my baby’s heart rate hit 199 is when they realised my waters hadn’t gone and broke them as she was distressed. The senior midwife let the student deliver but she didn’t turn baby as they were coming out and apparently that’s what caused the tear. My womb has been overstimulated and wouldn’t contract and they couldn’t get me to stop bleeding despite drugs injected in both thighs, jumping up and down on my womb and Someone manually fishing the blood clots out of me. ( nothing like having that emergency button pulled and feeling like there’s about 30 people running in the room) They managed to stop it just as the brakes were being taken off to rush me into theatre.
I remember being so proud of having done it with just gas and air and then ended up in theatre with a spinal block to stitch me back up.
I spent 5 days in hospital recovering and should have had another blood transfusion but they were uncertain how much I lost and didn’t want to give me too much apparently. It took a good year for my body to recover.

The consultant wants to do a sweep at 39 weeks and then at 40 but the midwife has said she will only do that if it’s documented but as I had a phone call appointment it isn’t in my notes. I wish I could have an actual face to face with the consultant because that might help.

It's so nerve wracking when you have had a bad first experience. I agonised over whether to go elective after a 3rd degre tear with DC1 (born nearly 11lbs). Consultant and midwives all said they would support what I wanted which in some ways made it harder to choose. DC2 was measuring bigger than DC1 so I chose induction at 38 weeks with a very low bar to move to CS.

In the end, I had a very straightforward time of it second time round - where I had been actively "pushing" for an hour and a half with DC1, my body literally did it for me second time round in 2 contractions, 23 minutes after I'd been at 4cm dilated. The whole "natural" experience (i.e. no time for painkillers) was pretty horrific in my mind, but the recovery was just a completely different thing compared to the first time.

Don't forget that your hormones will be all over the place as you gear up for birth - it's normal to feel anxious. If you feel that opting for ELCS will ease that, go for it! But if the doctors and midwives are advising natural is doable and safe, I would put some store by that.

I kept being told my baby was huge and it turned out to be total rubbish, so I wouldn’t factor that too much into your decision.

it sounds like a horrendous experience and I think it’s admirable you’re even contemplating a natural birth again. I would suggest doing the positivebirth company’s digital hypnobirthing pack, it really made me feel a lot more comfortable about birth.

if not, it doesn’t matter what your partner thinks, an elective c section would reduce a lot of the fear and anxiety.

All I can add is that I had an emergency C section and its not nice not being able to get up the stairs, lift the baby etc. Recovery takes so much longer

They have said that a PPH is more likely in a c section than a natural. However if I was to tear badly again it’s likely to have more serious outcomes and not heal aswell potentially leading to lasting affects. There’s a plan for a really slow delivery of the head of to try and prevent it etc.

Whats new since I spoke to the consultant is the potential heart defect (paediatrics have been informed and will be at the birth) and the fact baby could be large so I don’t know if this changes what the consultant would recommend. My midwife is very nonchalant about everything in general tbh, she only works one day a week and I just feel like none of my concerns are a big deal to her .

My surprise big baby 10lb was my easiest birth! No one knew his size though. Plus I'd had the perfectish natural birth with my 1st!

Hiwever, even if its 1% not confident I would definitely, atleast explore other avenues.

Your partner can get stuffed. Have exactly what you want. YOU are having the baby. He isn't. What about an epidural. I had one and it was great.

Haha he 100% can and will get stuffed if that’s what I decide and in all honestly he will go with what I want, he’s said this from the start. It was more a passing comment and no I think everyone thinks he’s an a hole but it’s not that at all

Your body, your baby, your birth, your choice. I know in some ways this makes it more difficult as the decision seems like its all yours.
I had a very similar situation with DD1, waters went, little progress, 38hours labour, failed epidural, on the pitocin drip with continuous monitoring etc, failed vontouse, then episiotomy and forceps (without additional pain relief, and after I said no) pph, large tear, sepsis and ptsd for me and hubby. When I got pregnancy with DD2 I was booked for a maternal request section, consultant encouraged me to labour naturally but I was too scared so was booked in for a section. I actually went into labour the morning of my section, arrived for my appointment at 'only 2cm' and had a 'perfect' birth 2 hours later before my section time slot. I was so shocked, as until I felt the urge to push I was still expecting the section, but actually in hindsight having a 'good' birth healed me a bit of the first births trauma, it showed me my body didn't fail me the first time. I'm now pregnant with DS1 and planning to go natural again, however he's also measuring big at 97th centile (my girls were 7lb and 7lb15oz) so I am worried about the potential damage from a big baby. My plan this time is to be open minded until closer to the time and see if this baby elephants growth slows down, but know either way my body can do it, and whether it's a section or natural I haven't 'failed'
You've got this mama! x

I had a horrible 1 st birth experience . Induced due to pre eclampsia, GD and cause I’m short I literally felt like I was being crushed in the inside from my DD . She turned out to be 7lbs 2 I think 🤔 . Induction took days to do anything, birth was slow in terms of she just wasn’t interested in coming out, I had horrific pain in my ovaries , two epidurals that did nothing at all and then had to have emergency forceps and to be cut. She was perfectly healthy and happy no issue ever but the utter shambles left my with post natal depression for months possible going on 2 years,
she’s now 5 and I’m preg with number 2. I’m consultant led and also debating what the best birth option is . Everything could be fine this time or could be a mess again. It’s very hard to know what to choose :( I feel exactly same

Hi @Bumblebee412 - I had an elective c-section and it was very calm and controlled; exactly what I needed. It wasn't totally smooth - the spinal didn't work first time, which they were surprised at and I had to prove by basically doing the can-can on the operating table, so they had to do it again, and then I felt sooooo sleepy afterwards I was struggling to keep my eyes open to see the baby; but that lasted just a few minutes. I would absolutely choose a c-section again, no doubt about it.

It sounds as if, even if you went for a 'natural' birth, it wouldn't feel very natural anyway because you'd be so closely monitored. I really think you should discuss the c-section further; reading between the lines, it sounds like you want that, deep down?

Good luck whatever you decide!

Sorry you had a bad experience last time.. I’m very much pro c-sections after having one last year. It was elective and couldn’t have been more calm and controlled. With all of your factors I wouldn’t think twice to take the c-section. I get that some women feel they ‘want’ to experience a certain kind of birth, whereas I just wasn’t like that at all and saw it as I was having a baby not a birth. Your husband most likely be less traumatised sitting on a little stool at your head behind a curtain for 5 minutes while your baby is presented to you, rather than enduring hours of worry that something could go wrong in a vaginal birth. Obviously there a risks of c-sections too but almost everyone I know who has had one has had a great experience and so many people spends hours or day trying for a vaginal birth and end up with an emergency section anyway.

Do what you’re most comfortable with, if you think you would miss out or regret not having a vaginal birth then go for it but a c-section is a great option and would be a completely different experience to your first

I had an ELCS after a difficult first birth with complex birth injuries and it was like night and day. The recovery from the CS was so much quicker and more straightforward in comparison.

I think you will make life much easier for yourself if you ban yourself from using the adjective ‘natural’ in the context of birth. There was absolutely nothing natural about my first vaginal birth and from what you describe a second vaginal birth would be pretty far from natural for
you too, due to the monitoring you are going to need. It is a really loaded term and I think it’s stopping you from evaluating the risks.

Your partner’s views on CS are irrelevant.

I think if I’d have had my second earlier I’d have gone for ELCS but as times gone on I’ve considered it less. You’re spot on with its not going to be anything ‘normal’ and I bet the threshold for them taking me for an emergency section will be lower too.
I sway so much between having faith that it won’t be like last time to being petrified it will be worse.
The horrible thing is how unpredictable birth is for anyone, it can go wrong no matter how you birth the baby. I’m probably not helped by the fact I have anxiety in general anyway and had to stop taking my anxiety tablets when I found out I was pregnant. Most of the time I do fine and it could be general nerves now too.
Ive also been really surprised by two visits to the doctors (unrelated to pregnancy) and each time they’ve discussed the upcoming birth and literally said ‘I take it you’re having a c section after last time’ or something close to that effect, that’s another thing that’s making me question as they literally only have the brief notes in front of them too. I’ve pretty much decided that I’m going to request to speak to the consultant again when I next see the midwife

@Bumblebee412 what is your gut telling you?

I am currently pregnant with DC2 after a difficult labour which ended in EMCS last time there is no doubt in my mind the ELCS is best route for me. I am not going through a prolonged labour just to end in EMCS again. I have no desire to experience it again - I can remember what it felt like. I recovered well from EMCS and as I understand it recovery from ELCS should be more straightforward as won't have had the traumatic labour directly before.

Do what's right for you and follow your gut instinct on this one.

My first birth wasn't anywhere near as traumatic as yours but it was on the rough side. I also had a predicted large baby second time around and had discussions about induction/elective section. My other half was keen on the section but I wanted to try the induction and discussed whether we would be able to move to c section earlier with the knowledge that the baby was large. The consultant was very supportive of this. I did also feel in my gut that they were wrong about the measurements and that my body wasn't going to 40 weeks. Both were right and I went into labour on the day I was due to be induced. I actually had the birth I wanted on paper, not that it was easy! MLU and gas and air after forceps and an episiotomy first time. I'm really pleased I did it but I was mostly just happy to have my baby! Recovery was a lot better second time around too. I hope you can come to a decision you are happy with and that your baby is healthy :)

I don't know what you've been told but we don't turn babies as they come out. We aren't supposed to do that, which is why the student would never have done it.

Students delivering their first 5 (ish) babies do so with a qualified midwives hands over theirs for extra guidance. If it was the students first hands on delivery, there's no way they'd be left to do it completely on their own.

Very much sounds like they made excuses, and blamed the student.

Nobody can tell you what to do. It's your choice. If I were in your position I'd go for an elcs.

Quick update for anyone interested

I ended up giving birth a few weeks before my due date. Spontaneous labour and quite quick, baby was born within 6 hours of getting to the hospital.
We managed to avoid a pph (but only by 100ml) and avoid a 3rd degree tear. We did however have another emergency button pulled and a very swift ventouse delivery with episiotomy with no time to resite epidural which had alreadt failed first time. This was due to fetal bradycardia and rapidly dropping. I begged for a c section at this point bug was told no time. The massive baby I was meant to have came out at 6lb 13oz which is over a pound lighter than my first baby and lighter than the growth scan predicted 4 weeks earlier. Baby had cord around their neck when born but I found this out from my notes after birth so don't know if that caused everything. I definitely was not healed from my first birth emotionally, this one seemed to affect me worse and all i did was cry for the first week about it.

I can honestly say if I was ever to have another child I would have to have a c section, for my own mental health I can't put myself through another vaginal birth. I don't think I would be as lucky if I tried a 3rd time.

I'm sorry things were so traumatic for you. Congratulations on the arrival of your baby, I hope you can heal now x