Anything you can do throughout pregnancy to reduce need for C-section?

[ttcsolomumtobe]

Hi,
Firstly I want to say I have nothing against Csection and fully understand some people need them in advance, on the day and some have them planned for a range of reasons.

my reason for asking is I'm currently in first trimester after a successful IVF FET, I'm doing this solo and although I have great friends who will and can help I do not have any family support that would be for a prolonged period of time after a C-section. I would need to be driving myself and baby to appointments, will need to be lifting baby and car seat, could hire a cleaner for a few weeks if needed but after reading a few posts around Csection I understand it can be restrictive and painful afterwards (understandably) so would like to know if there is anything I can do now and throughout the pregnancy to make the chances of being able to have a vaginal birth higher and more likely? Be it exercise things/food etc, open to anything.

Although my solo fertility journey has been in the making for 5 years I've never allowed myself to look into the pregnancy side incase it never happened and now feel like there's a whole world of new stuff to be known.

Thanks in advance

Not really, no.

One thing to bear in mind that it’s not the case that vaginal birth = easy recovery either. I had a severe tear that required surgery and the recovery was far more difficult and painful than the c section I demanded four years later.

I know with IVF pregnancies they will not let you go overdue. The problem with inductions on the dot of 40 weeks (as seems to be the protocol) is that if your body isn’t ready, you’ll have a difficult time ending in emergency c section - as is quite common with some inductions. So it’s worth having some conversations with your midwife about that.

So I really think you need to shrug off this idea that everything will go smoothly as long as you prep hard enough, and also that you’ll be able to manage the immediate postpartum period solo with no support. That’s honestly quite a worrying prospect and I’d be very worried for a friend who was planning that.

@wokbun I’m sorry you felt that way. I’ve had friends do the course and also have sections who felt it prepared them for their section as well, and they felt empowered in choosing and understanding the need of a section when it came to it

Thank you so much for all the responses, too many to tag each of you back but to touch on a few points I will defo have a plan for all outcomes, I'm an absolute planner and prep person and would rather know what a C-section will entail than feel panicked in the moment yet I know that it cannot always be controlled so I have to go with the flow and I totally am. Yet I always know a plan doesn't guarantee it goes smoothly.

I know there's no shame in a C-section or it seen as a failure, as I mentioned in my post I know it can all be based on the day and other factors not in my control and I'd rather baby arrive safely than lots of trauma to me or them just to avoid the Csection. I have seen some positive Csection stories and recoveries aswell as the bad ones but thought it was worth the ask.

I will defo be looking to get support in place such as a cleaner and Amazon delivery option and know friends will be happy to help where they can but they also have full time jobs and commitments. Also I think this is the part where pride may kick in, in that I've chosen to do this solo so I need to handle as much of it solo and trying to be in the best position to do so, yet I get that will likely change in later pregnancy and will welcome all the help I can get.

I intend to stay active with classes and swimming during pregnancy to help general recover anyways.

Thanks again for all the replies. I know too often people look back on a situation and wish they had known something before hand, guess I was asking for people's experience of that if they had them.

I just want to say that thinks are linked statistically but not necessarily causitavely. For example - if you have an epidural you have increased risk of C section. Yes, more people with epidurals have C sections. But what percentage of people that have epidurals are during spontaneous vs induced labour?

Induction, especially the drip, does increase risk of C section for reasons that have nothing to do with epidural. It's also more painful, so more have epidurals.

In a spontaeous labour stronger drugs can help mum deliver without assistance, especially in first babies. I'm not saying it won't hinder some but please do not categorically advice people not to use pain medication they may really feel they need based falsely off the notion it will lead to C section.

Study childbirth like you are doing an exam in it.

Read childbirth without fear, how to give birth like a feminist, Sheila Kitzinger etc.

Go to natural birth focussed classes.

If you are low risk consider a plannned home birth. Even if you transfer you have a lower chance of c section overall.

Avoid an epidural.

Stay on all fours a lot in the last weeks to reduced chance of breech. If you are breech do somersaults in a swimming pool to turn the baby.

Ask about a water birth.

Hire a doula.

Write a birth plan and make sure staff read it.

Decide now whether you'd rather forceps or a c section if the heartbeat drops & delivery needs to be quick.

I know you've said you want to avoid a c section but if it means forceps & episiotomy instead is that what you'd prefer?

Don't gain too much weight. Obesity is a risk factor for c section, as is gestational diabetes.

Also eat enough iron in your diet so you don't develop anaemia.

You will need help unfortunately with a section. Try to organize things so you can do as much as you can on one floor of your house, to avoid having to take stairs all the time. I had an active, healthy pregnancy with well positioned baby and no reason to think I wouldn't have a VB - baby's head wound up impacted sideways and needed EMCS after a very long labor that was stressing us both. Best of luck.

Just to clarify - epidurals are associated with an increased chance of an instrumental (vaginal) delivery, but not an increased chance of c-section. The relationship between instrumentals and epidurals is an association though and not causative.

The ARRIVE study found that women induced in the 39th week of pregnancy had a slightly lower rate of caesarean than waiting (19% vs 22%). With IVF babies they tend to want to get them out sooner too, so induction at 39 weeks might be a good option for you.

Might also be worth keeping in mind that recovery from emergency caesarean is harder than elective caesarean, so if your risk factors start adding up and there's a strong chance you'll need EMCS, it might be worth considering an elective one. The other benefit to that would be being able to plan who is going to take you home and help with stuff the first few days since you'll know exactly when baby is arriving!

@SweetPeaGirl thank you for the info, I was aware of the IVF pregnancies not going over the 39 weeks.

I know I seem naive to it all but have just never wanted to research the pregnancy and birth side incase it didn't happen and then I felt like I had a yearning for the experience.

That's a great point about elective and getting to arrange the support around me if so.

OP you can’t do anything to prevent a c section should you need one but you can prepare your body as best as possible for a recovery from one. It’s like any surgery in that respect.

Your core will be shot to pieces. Focus on exercises that will help you get out of bed or up from the sofa will no core. Lots of squats and glute strengthening is great for this. The other aspect that helped me was strengthening shoulders and back muscles. I had a heavy baby via emergency section and found my back got really sore breastfeeding,
just holding the baby in the position for long periods of time was tough. I was much better prepared for this the second time round.

If there were things that could help women to avoid sections the NHS would tell us.

There really isn't. If it happens it happens.

Hope for the best and plan for the worst.

I've had two and recovery from both was bloody awful and lengthy. Many have better recoveries but not all. So
here are my tips.

Batch cook and freeze meals until your freezer is bursting. It is possible to get fed up with takeaways.

Sod the housework. It can wait. If you can afford a cleaner that would be perfect.

Online shopping.

Arnica tablets to help recovery from bruising inside and out.

Stay on top of painkillers. Don't be a martyr if you need stronger ones demand them. I needed them for severe weeks.

It took me several weeks to manage to drive. My HV did home visits. There really wasn't any need for me to drive. Apart from my wish to get out.

Breastfeed. Means you don't have to be faffing around preparing bottles and when you do get out and about you don't need tons of equipment.

@Businessflake thank you, I know it can't be helped if it has to be the way but even the heads up re the core/back and shoulder exercises is helpful, I have returned to swim and adapted gym classes but know I could be doing some lighter but effective weights at home too. I will have a look for training specifically to help strengthen back etc.

@WeeSleekitCowrinTimrousBeastie yes I will be batch cooking a ton and got a second freezer a few months back to try cut costs with general inflation so sure that will come in handy.

Although I know a cleaner for the first month would seem a luxury yet I think it will be worth the financial cost for me to rest, spend time with baby and not feel stressed by things being a mess. I can save it from elsewhere without feeling too impacted.

I hope to breastfeed but yes will get some convenience ready made stuff just incase.

We're there any items that you felt made those couple of months easier for you when recovering? Be it simple practical stuff such as a changing station downstairs or certain gadgets that helped?

I don't wanna get drawn into buying things I don't need but also would like to be prepared.

With it being so early I haven't told any of my friends who have had babies in the last couple of years yet as it's been a bumpy ride and still getting used to it myself so haven't been able to ask them but I know they will give recommendations etc.

I know 2 of them have the 360 car bases and have found that a mega help with lifting the car seat, early pregnancy when a little sore and as their babies have gotten a little heavier also.

I ended up with an emergency section due to cord prolapse. In that situation, nothing could have predicted nor prevented it. Sometimes things happen out of our control. I know from what other posters have said there are ways to prevent known things i.e breech baby, but really hope everything goes to plan for you 🩷

We're there any items that you felt made those couple of months easier for you when recovering? Be it simple practical stuff such as a changing station downstairs or certain gadgets that helped?

I had a changing station that was also a baby bath. I found both really useful as it meant I didn't have to do a lot of bending and could maintain a good posture.

A really good breastfeeding cushion also was essential.

OP I think it’s bodyfit by Amy that does a lot of pregnancy safe workouts on YouTube.

Absolutely this.

OP, you say you're a planner, so plan the shit out of your own labour. I did and it definitely helped me. I read a lot of books and the studies quoted in the books. I asked a lot of questions and made myself very familiar with all relevant NICE guidelines. You need to take ownership of your birth in order to get the most positive experience possible.

Yes, things happen sometimes you cannot control and there is absolutely no 'failure' in any kind of birth - you need to have a plan that works with all possible outcomes and make your peace with all of them.

As it happened, I had 2 wonderful homebirths. There was an element of luck involved (in that neither of my children were breach, or had growth issues), but I don't doubt my research helped me have the birth outcomes I did have. For example, I refused induction despite it being hospital policy to push one on me given my age - but I read the statistics behind the policy for myself and took my own risk assessment based on my own circumstances and not those at a population level. It's that kind of thing you can do that can help (given the increased chances of c-section following an induction).

Birth is an emotive topic, but the most important thing is that women should be empowered, and never shamed, for how they birth their own babies

I'd forget about making c section a crucial indicator of things being easy, accept that a lot of it is down to chance BUT think of it as anything you can do to recover as well as possible, whatever kind of birth you have.

This might be things like being totally sorted at home with nappy station, anything you need for feeding, etc. get a friend who has had babies to come and kind of audit your house. It's so easy to focus on teddies etc and forget about basics like what the baby will wear to bed.

Good diet and exercise help for best possible birth, plus not slobbing on the sofa - sit up and forward as slouching makes the baby more likely to go back to back.

If you're on your own, think about how you'll manage food when the baby comes. Good nutrition will help you heal from birth however it goes. It's v easy to reach for easy stuff like biscuits and pasta. Fill your freezer with batch cooking or plan fruit deliveries etc for after the birth.

I did hypnobirthing and acupuncture in preparation for second birth, no idea if acupuncture helped but it felt good :)

I had a vaginal delivery with my first and an ELCS with the second . With the section I spent less time in hospital, I was up and about quicker , I was driving quicker and I generally needed a lot less support than with the vaginal delivery - you just never know . Best wishes whichever way it goes for you .

I had an emergency c- section as despite waters breaking my cervix refused to dilate. It was physically impossible for my baby to get out! We'd both have died without a c-section.

I was fit and healthy, ate well, drank plenty and swam throughout my pregnancy. There's nothing I could have done to ensure my cervix dilated.

HELPFUL INEXPENSIVE THINGS THAT MADE LIFE EASIER.

An extra long phone charger
Netflix
A drinks bottle
A felt storage caddy. I would load it up for the day before coming downstairs and then would load it up for going to bed. It held pain meds for me and moistures as my hands were very dry post birth. Nappies/outfits and muslin for baby

Essentially the best way to try to avoid it is to very gradually work your way through the pain relief, having an epidural increases your chances of a c section, of course that isn't a reason to not have whatever pain relief you need when you need it, but the more intervention you have the more your chances of further intervention being required is increased, so you want to be sure you really need/want it before asking for it. If you are able to stay mobile and try to build on your pain relief iteratively, if your body manages to progress well you may be able to limit the pain relief needed and thus potential for further intervention. Of course this is assuming your body progresses well, some women have longer labours and so understandably need what support they can get.

But the key thing for me, is to stay mobile for as long as you can.

I was a solo pregnancy and ended up having a csection as dd was breached. I tried to move her position, considered vaginal birth despite breached, had Chinese treatment done but nope, had csection

It went seamlessly , I recovered remarkably quickly, as I took the painkiller on time using the Feed app, if I hadn't, the pain would've destroyed me. And on occasion when I didn't, it did. I couldn't pick up dd . So ! My only advice is if you have csecrion, take the ibuprofen and paracetamol on time!

I really liked the book birth skills by juju sundin (I think that's the name) it has great visualisations (one about a coffee plunger helped me a lot) and techniques to manage pain and it also is great in mentally preparing for any outcome c-section included.

Stay mobile as long as you can in labour. Helps bring baby down and get themselves positioned better. Won't necessarily stop you needing a c1 section but can help. Also when pushing being in a position that keeps you off your back will also help your pelvis open up.

Do your reading, Sara Wickham is good as are others that have been suggested.

If you have a bit of extra cash, you might also want to look into doulas - you can get them to help out after birth even if they don't attend during birth. If you can afford it, could be a godsend if you're struggling in early days.

I'd also swot up a bit on what good and bad wound healing looks like (Cs or vaginal) and what can help. There are loads of things that sound like they'd be easy to suss out but it's such a learning curve, the more you know beforehand, the better.

Same goes for knowing a bit about feeding - either bf or FF - where to get help if doesn't go to plan, what good latch looks like, what normal number of nappies is etc