C section or natural birth?

[jenhens]

I suffered a damaged coccyx due to forceps after #1, and an anal fissure post giving birth which still hasn't completely healed two years on!

Currently expecting no2. Due to my coccyx I really struggle with sitting on anything but a sofa - office chairs, planes, the car.. all cause me agony and I have to shift around constantly.

I pushed for 4 hours with #1, was eventually cut and forceps used.

I have a consultant app next week due to the birth injuries to discuss options for giving birth to #2.

My preference is a natural birth. But would I be silly not to have a c section considering the injuries I sustained?

Any advice welcomed!

It would be hard to say, you’d be best waiting and speaking to your consultant and getting the medical side of things

It’s up to you but it’s important to hear what doctors say. Personally I’m very pro c section and plan to have an elective c section if I become pregnant again but women should make the right decision for themselves. We’re all different.

Well, you’re not silly but if you still haven’t recovered from the last birth, I would seriously consider CS.

My ELCS was great with no complications. Of course there can sometimes be complications but it’s about weighing up risks. Are you more likely to exacerbate old injuries with a natural birth or have complications from an ELCS?

Hopefully your dr can advise on the less risky approach for you.

I can only comment on the anal fissure as I've still got a chronic fissure from having my daughter 6 years ago(forcep and episiotomy delivery). Diet and and the occasional stool softener keeps it at bay most the time now. Anyway had my son naturally and my fissure wasn't remotely affected. Obviously I was lucky to have an easy birth the second time around (even though he was 9.5pounds!). However I would still speak to your consultant about it and see what they say, especially given your issues with your coccyx. Good luck to you and congratulations.

I am currently 33 weeks pregnant and having an elective c section at 38 weeks due to previous births, weighing up the risks I feel it's the safest option for myself and my baby. I have had 2 previous births, one natural and one emergency section. I also would prefer natural but I don't want to take the risks. My consultant gave me literature to read and that's what made my mind up to go for elective section. My advise is do what feels right and best for you and your baby

Hi!!! I’m pregnant with my second and I’m so nervous about giving birth cause I have an anal fissure from postpartum with my first that went away after I stopped nursing after 18 months but is back now that I’m pregnant. I’m glad to see you said your second birth didn’t effect your anal fissure. Did you have an active one when you gave birth?

Hi @BobBeans

My fissure was terrible in pregnancy and the first 3-4 weeks post partum.

I don't think a natural birth made it any worse at all though.

I made sure I was on2-3 sachets of stool softener and LOADS of water and it soon got better. It's mostly fine now unless I get even slightly constipated so it's manageable and I'm just so used to it now.

@BobBeans mine is a chronic one so in a way it's always there. In fact when I gave birth last Friday to my 3rd the consultant even had to take another look after to check it wasn't a tear. Anyway I can now say that both subsequent births haven't affected it. It's just something I'm going to have to live with. My diet will always need to be a good one and I have stool softeners (Movicol) if anything kicks. You can get surgery or Botox for them but generally mine behaves itself unless I've had a bad few days of diet. Anyway congratulations on your 2nd pregnancy. Get some Movicol if it gets bad, sorts it right out!

I have a similar decision to make after forceps and a third degree tear.

I had a fissure that healed after 3-4 months but still struggle with some mild prolapse symptoms if I'm constipated... I always have movicol and fybrogel at the ready! I'm still BF, which probably doesn't help as the relaxing hormones cause symptoms to be worse I think.

I'm due in June 2024 so it's very early days, it would be good to hear more positive stories about planned c sections and the recovery.

I've heard a planned c section doesn't necessarily remove the risk of prolapse anyway?

I’m glad to hear delivery didn’t make the fissures worse. Were the deliveries vaginal? I’m just so scared to push cause of them lol

I couldn’t heal mine when I was breastfeeding no matter what I did they came back every month or two. As soon as I stopped BF with my first they healed up and I was able to get off stool softeners and eat normal again, and I had a doctor say the fact that they weren’t healing while I was BF had nothing to do with hormones. So have faith they won’t last forever❤️

What are your reasons to prefer a vaginal birth? I don’t think you are silly to have a preference but I don’t understand why this would be preferable if you are still recovering from your birth injuries from DC1.

I requested a CS for DC2 due to previous birth injuries from an instrumental delivery and for me it was absolutely the right decision. My recovery was much quicker and easier than my first, vaginal birth.

May I suggest that you ban yourself from using the term ‘natural’ birth? I find it really loaded. ‘Vaginal’ or ‘physiological’ might be less emotive for you. My first birth might have been vaginal but it took place in theatre and was anything but ‘natural’, if ‘natural’ means straightforward and low-intervention. It sounds like your first birth might have been similar.

@ThanksItHasPockets I agree vaginal makes more sense to use than natural.

There are benefits to the baby of having a vaginal birth on their own timeline, rather than a planned c section. Exposure to the bacteria in the vaginal canal being one benefit, a lower risk of respiratory issues initially and a lower risk of issues later in life being others. I don't say this to make anyone feel bad, I'll probably go for a planned CS, but it's not a decision that I feel I can take lightly considering my symptoms are still mild and I'm still BF (which anecdotally prolongs symptoms). I was also lucky that I had no emotional trauma at all during the birth, I was in high spirits and was 100% going to have another vaginally (even commented to the surgeon as such while she was stitching me up!) until I realised how long and hard my recovery was.

I ideally want the same birth again without the tear and any worsening symptoms, but obviously that may not be possible. I also have mild diastasis recti, which I believe can be worsened by a c section... I don't really want a c section shelf and an even weaker core, which could make existing mild prolapse issues even worse.

I had an emcs which was the last thing I wanted at the time (I was fully bought into the whole natural birth thing, and endured being fruitlessly induced for ages before begging for the CS eventually) but I'm planning an ELCS with my second.

Just a few points to balance out what pp have said:

Diastasis recti is not more likely from a c section. It's being pregnant that weakens/possibly separates your ab muscles, not giving birth by either method. My abs were my strongest asset before my first pregnancy and I did build them back up by about 1y postpartum - sure it was slow, but I wasn't in a rush. No diastasis recti at all.

The c section shelf, similarly, is not guaranteed at all. I never got one. I think if you're very overweight pre-pregnancy you might be more likely to have it but there are things you can do to reduce/prevent it, like physio.

All my friends who sadly got lasting injuries from birth, like your coccyx injury or prolapse issues or other issues, all had vaginal births with instrumental interventions. A c-section has a slow (and v painful) recovery but once you've recovered, you're right as rain generally.

Sure, I have a raised scar (keloid scar) and it still gets itchy if I wear tight jeans or in hot weather. But that was the only lasting mark on my body - in the grand scheme of things I think I got off very lightly. I'm really glad I'll be having another CS with my second.