Elective C-section v vaginal birth

[Hoping23]

Hi all, just wondering about perspectives on elective C-sections versus vaginal births (assuming that all goes smoothly in the latter case).

I’m giving birth in August and meeting with my midwife next week for the first time. I have heard a range of opinions on this subject but recently had a very strong opinion from a close friend that has made me want to look into things more.

My friend had three elective C-sections for her children and Is practically begging me to consider doing this myself.

There was no reason for her having the C-sections beyond maybe that she was in her 30’s rather than her 20’s. Her obstetrician strongly recommended it as a matter of course and the reason he gave is that vaginal births damage pelvic floor in a way that is often irreparable and will cause incontinence. He told her if she had a vaginal birth she would laugh at work and urinate and obviously that wasn’t a nice thought.

Instinctively I would lean towards trying to have a vaginal birth, just because it seems strange to me to bypass a natural process in favour of surgery. I’m also nervous about the idea of my stomach muscles being compromised by surgery (I know pregnancy is already going to do a number on them). I’m a professional dancer so this is foremost in my mind.

Anyway my friend was so confident and pressing with her advice that I don’t want to just go with my instincts and end up regretting it when I’m an incontinent old lady before my time! Also on reflection my sister in law chose an elective C-section for her birth and she is a doctor… I have to wonder if she knows something I don’t. We are not really close otherwise I’d ask her to weigh in.

Can I get opinions and thoughts from those who’ve faced this dilemma? Thank you!!

Oh and another aspect of this is that when I told my friend I would ask my midwife about the issue she said not to bother because the midwife will only preach about natural birth. This made me worry because I hadn’t planned to see an obstetrician yet unless something came up that required intervention.

Congratulations, not too long to go. You definitely need to hear a few more perspectives before making a decision. I can tell you my story, but it will contain a little TMI and when it goes wrong. Just giving you the option of scrolling past.

I have had one vaginal birth and two c sections. The first birth the baby was facing the wrong way, they turned her but she just went back the way she was. She got a little distressed, so I was rushed for a c section. They gave me one go to push her out with the suction cup. She came out in one go, but I suffered a third degree tear in the process. It was a severe one, I now have a little incontenance sorry about bad spelling. And a prolapse. I’m fine I just can’t run jump sneeze cough or vomit without peeing. Because of this the next two were c sections.

Recovering from a section is a bit more difficult than a complication free birth.

My honest advice is if there are no issues, I would choose a vaginal birth.

All the best for your big day.

I don’t think there’s a clear answer here. I was set on a c-section for no other reason than being terrified of the idea of child birth, then was later told I’d probably have a c-section due to my high risk pregnancy. At 38 weeks my midwife asked why I wanted a c section and I didn’t really have an answer. Before I knew it there I was having a vaginal birth and all went well!

I was an elective section for my mental health. I have PTSD and was having nightmares throughout my pregnancy about the worst happening through the birth so eventually asked for a section because then the onus was taken off me and left in the hands of people who do it every day. It was single handedly the best decision I ever made. I didn't find the recovery bad at all either, keep on top of your medicine (yes even the morphine) and although you will be sore it's surprising how fast you can get around.

I had a vaginal birth for my first, which resulted in a tear requiring getting stitched up in theatre after delivery. Then I had an elective section for my second due to breach presentation. Both were fine, both required a recovery process in different ways. If this is your first and there us no pressing reason for a c section (mental or physical health related) I would choose a vaginal delivery but it's a completely personal choice for you. There are pros and cons to both

I'm not surprised the obstetrician suggested a C section it's much more convenient for them, even though the risks and outcomes are much worse for mother and baby.

I guess it is a personal choice. I have had 4 VB and would be absolutely terrified and devastated if I had to have a CS this time. I have a fear of surgery so. I have no incontinence or problems down there btw so it's not a given.

It's also important to know that the issues with vaginal births are often due to intervention, ie being induced. If you can have a fully natural birth then that is the best thing. I'd strongly advice you to do your own research, we did extensive research when I was pregnant and I would have been devastated if I had a C section (obviously if it is needed, then that is completely different). Peoples experiences on MN aren't the same as proper research. Good luck with whatever you decide

From the way you write, it sounds like you are not in the UK. Different countries have different levels of risk awareness and risk acceptance around health in general, and birth and women’s health in particular.

So keep in mind that this is a predominantly British site and responses will focus on on maternity services available on the NHS.

About 30 years ago, an American survey of OB/GYNs showed that the vast majority (I think around 90%) would opt for a c-section. Things have changed and I am sure I read on a previous, similar thread that most (60%?) would now choose a vaginal birth.

That said, I had a c-section and a great experience.

Every patient is different so i think it depends very much on your particular circumstances.

I can only go on my experience. I had a vaginal birth during covid. Due to situation I stayed home as long as I could.

I got to hospital at 12pm ish and delivered my baby in the birth pool at 2.30pm. I did have a second degree tear which did lead to some incontinence for around 3 to 4 weeks but with exercises this soon went. After about 7 days the tear felt a lot better. My main worry about c section was not being able to drive for 6 weeks.

I managed to be home by 7.30pm same day and was so happy to be home with my husband. I will definitely be trying to have another vaginal birth this time. Good luck

@Hoping23 its definitely something to really think hard about.
I’d be the opposite as your friend and say opt for vaginal.
Ive had one vaginal (singleton) and one elective c-section (twins), and all going well with this pregnancy I’ll be hoping for vaginal again.
I recovered much quicker after vaginal, found it much easier to move around and also got back to driving in no time.

Having a section is by all means not an easy thing, it’s major surgery and can come with complications too. It’s a longer recovery time and you can’t drive for 6 weeks.
I suppose everyone is different and has different experiences of both births. Chat to your midwife about it too. All the best x

Which research indicated that it was more convenient for obstetricians if you have a c-section?

I think you should take your friends advice as just one persons advice, the vast majority of people would much prefer a vaginal birth.

I had a 3 day long labour which wasn’t progressing and needed an emergency c section. I was upset it resulted in a section but of course happy baby came out healthy. As someone who is usually in shape and exercises a lot I have found that only now 1 year postpartum am I just about being able to do abs exercises again without it ending up painful and just basically not feeling right. I still have that section belly pooch.

Of course everyone is different and has different fears, but I can honestly say that even though 3 days of labour was very painful, and even though it ended in a section anyway, I am still so happy that I had that experience of natural labour and that I did everything I could before needing a section. I know you could also look at it from the perspective of well it ended in a section anyway so you may as well have just started with that.
many people have a injury-free natural birth. Many have tears. Many heal quickly from a section, and many take longer. But if all is healthy in your pregnancy certainly don’t rule out natural vaginal birth.

I’ve had both, including a very difficult and complicated labour with tear etc, and a VBAC that went really smoothly. The recovery from the elective section was much much harder and despite being very slim I have a tiny little ‘pouch’ over my section scar which I absolutely hate. I have some issues with stress incontinence but very mild and I had it before I even got pregnant, I think I’ve always had a weak pelvic floor. If you’re a professional dancer your pelvic floor is probably in good shape anyway and you’ll be disciplined enough to do the exercises needed to get it back into good shape afterwards. I’d choose a VB every time.

I don't believe there's a "one size fits all" choice here, you have to toss a coin, really.

I've had 2 extremely easy vaginal births.
I've had 1 horrific vaginal birth with many complications and long term consequences.
I've had 1 ELCS, the surgery itself is fab, the recovery is really, really NOT fab (or wasn't in my experience, I know lots of women who breezed through it, so again, no one size fits all!)

I'd choose an easy vaginal birth over a CS every single time, but I'd choose a CS over a horrific birth. See? Coin toss!

I'll just add my stomach muscles are absolutely fine a year on, I can do anything I did pre CS. My pelvic floor is fine after my vaginal deliveries too. It's not a given that they'll be shot to shit.

OP, you can't choose how you give birth based on your friend's decisions. It sounds like she is trying to browbeat you into choosing what was right for her, rather than ELCS being something you're actually interested in.

I really, really hate when people do this but unfortunately people can become very fanatical about their own birth choices. I am a huge proponent of home birth, and it's fine to talk about it as an option that friends might not have considered. But I would never harass someone to consider it who wasn't already that way inclined.

This friend sounds meddlesome and I'd steel yourself for future conversations. It's your birth, not hers.

Well, everyone is different. I've had both, vaginal birth that was pretty much straight forward but left me with a partially prolapsed bladder and more recently a c section. I found the recovery for both okay, obviously my stomach hurt after the section but my vagina hurt after the vaginal birth and I couldn't wee properly for about two weeks because it stung so much, I would opt for a c section again if I have another.

I’ve had two c-sections - an emergency and an elective (had planned a VBAC but developed complications that meant it wasn’t possible).

They were both fine, but if I’d been able to have vaginal births instead I would have. C-section is no joke. It’s major surgery. It takes a good while to recover. You’re basically recovering from a major abdominal surgery while caring for a newborn - I found that very hard with DC1.

(Your tummy is never the same again, either. Don’t be fooled by the celebs!)

I’ve had both. In brief, I really wouldn’t recommend a c-section unless it’s recommended or advised for mother or baby’s health & potential risks. That’s not to say there’s anything wrong with a c-section, I have no regrets about mine, but weighing it up (especially for a first time mum) I’d go natural. Everyone will have good and bad experiences with both sides but your birth is individual to you. Your friend might wax lyrical about sections but equally another mother might say natural is 100% the way to go. Neither is wrong or right, you have to do what is right for you.

I’ve had two elective c sections and my pelvic floor is in a worse state than my stomach muscles!

I think it’s very personal. The real difficulty with vaginal birth is that you just can’t predict whether it’ll all go smoothly or not. My c section recoveries were far easier than friends who had difficult vaginal births, harder than the friends who had easy vaginal births. I had various risk factors which lowered the chance of an easy vaginal birth.

Being pregnant and carrying around all that weight also puts strain on your pelvic floor. Obviously giving birth can be a huge strain on it. However you end up giving birth, I would recommend you find a women’s health physio for after your 6/8 week check up. You can search “Mummy MOT” if you are in the UK.

I have had two vaginal births, at 40+2 and 40 weeks, 7lb and 9lb baby. I did have a prolapse after baby number 2. I have had approx 4 months of physio and would be able to laugh and not wee. Mine was more around a dragging uncomfortable feeling especially when I wanted to start running again.

Both labours were quite short and intervention free. 8 hours from first contraction to birth, 8.5 with second. I used a tens machine, low lighting, quiet music in my local midwife led unit. The pushing stage was about 2 minutes. They were both really positive experiences.

I think a lot of people who have bad experiences with sections have had emergency ones.

My decision to have planned sections was one of the best choices of my life. The actual procedure was totally pain free and meant I could enjoy meeting my child, rather than feeling relief that pain was over.

The recovery was a doddle both times. Certainly less pain than an average period for me. I'm not good with pain normally - total wuss, but I literally googled 'when do c sections start to hurt' because I kept waiting, and it so hadn't started hurting.

Back to normal activities within a few days.

In my nct group, only 1 person managed a birth without intervention/loads of stitches. We had inductions, forceps, vacuum, emergency section, the lot. Lots of very unpleasant tearing. I was in less pain after a week than some of them were after 3 with their vaginal births.

Realistically it's about your acceptance of risk. With a section, I was never going to waltz out of hospital 6 hours later, but I was also not going to be in the agony of labour. I took the certainty of being cut up and sewn back together but painlessly, than the (pretty high) risk of tearing/being cut but feeling it. About 90% of mums will tear in a first labour, though some won't require stitches. I accepted the risk (didn't happen) of infection etc but knew that I wouldn't risk something significant like a 4th degree tear.v I've lost some sensation near my belly button, but compared to the person I know who tore their clit, I'll take it.

Choose your risks. You never know, you may get lucky. I just want willing to risk it.

Ps: the not driving for 6 weeks thing is a myth. I didn't drive at the time but I know a lot of women that were driving within a week or two.

I had a vaginal birth which was really fast (1.5hours from start of contractions to baby being born) which resulted in a 3rd degree tear, haemorrhage and baby being taken from me for 2 hours while I was being stitched in theatre.

I've also had an elective section and it was honestly so lovely in comparison. Baby was out within 4 minutes and had skin to skin with me for the rest of the op.

It's really hard to find true stats on elective sections as all the official ones lump elective and emergency sections together which make it look like the outcomes are poorer. I was in less pain and recovered more quickly after the ELCS than my vaginal birth. It was sore for a week but then rapidly improved. Neat scar, no infections, back to driving after 3 weeks because at that stage I could do an emergency stop without any pain.

Are you in the UK? I'd be surprised a Uk obstetrician recommending a CS for the reasons your friend described. It's well known that it's actually pregnancy that weakens the pelvic floor, not just vaginal birth

Hi! I also dance, though not professionally, though I had friends who do.
Like PPs I think as easy VB is better than a CS, but a CS is better than a tricky VB. I had an induction that ended in EMCS and the recovery was fine pain-wise, though it took about 5 months before my stomach muscles got back to the same strength as before. No incontinence issues.
Maybe plan a VB but if things start going down the interventions route ask for a CS instead?

My friend had three elective C-sections for her children and Is practically begging me to consider doing this myself.

She sounds weirdly invested in your decision here. Telling you not to bother speaking to your midwife about it? She needs to pipe down a bit.

Do your research, speak to your midwife, but nothing is guaranteed. You don't know how a vaginal birth will go, but you also don't know how a c section will go, how you'll recover etc etc. so it's about weighing up what is most important to you, and what health considerations may apply to to you specifically.