Elective C-section - the right choice?

[CalFairy]

I have an elective c-section booked in a few
weeks for a number of reasons, not limited to but including:

• I have ulcerative colitis and I am concerned about going into a flare post-partum after tearing, the stress of labour on my body etc.
• The vast majority of friends/work colleagues/women I know had a traumatic vaginal birth with some kind of intervention (forceps, days long labours, emergency c-section, theatre post birth due to haemorrhage or placenta issues etc).
• I’m 35, a FTM, have terrible SPD and baby is currently back to back, which I know all increases likelihood of tearing and intervention or it being a difficult labour.
• I’m high risk for preeclampsia, although currently stable.
• I’ve read many positive stories regarding planned sections, and I like the idea of knowing what to expect from birth and recovery.

My issue is that I keep having doubts that I’m making the right choice, for myself and for the baby. Will it all go to plan, will baby suffer any
negative effects due to my decision (allergies etc). But I’m equally scared that I’ll end feeling as though I should have a vaginal birth because it’s the ‘natural way’ and it all goes horribly wrong and I regret it.

I’ve kept the csection mostly to myself, but the few people I have mentioned it to have been opinionated - questioning why I’m not doing it vaginally, I’m missing out on the experience, I must be scared of the pain, it’s what women are meant to do, why would I want surgery (which baffles me how people can be so strongly opinionated on something that’s not their body or baby).

Has anyone been in a similar boat? And did you regret your choice in the end either way?

I don’t think it’s accurate to say more babies need intervention post CS. Happy to be corrected but I always thought that EMCS stats are lumped in with ELCS where baby might already be in distress so there’s no accurate data out there for just electives??

I’ve had 2 lovely ELCS’s and unless I totally got the wrong end of the stick I thought that electives are riskier for you but less risky for a healthy FT baby vs a vaginal delivery? Recovery is very personal but mine was fantastic. They gave me all the good painkillers from the get go so pain was never an issue. Anecdotal but friends who’ve had bad tears with VBs are the ones who have suffered the most in terms of recovery and lingering issues.

OP, your body your choice. Do your research and make the right decision for you. Good luck.

Hi OP. I haven’t read all the comments but I have had a few csections (elective) and they’ve been very smooth. Best decisions ever. My breast milk came in fine and I was awake during the whole thing but obviously numb. Best of luck.

I had a shitty natural birth with a rough recovery, and then an amazing ELCS. My milk came in faster and everything was better with the ELCS. In your situation, I wouldn't think twice.

As soon as I saw UC I was like - yes! I have small bowel Crohn's so it's a bit different for me, but UC with any kind of tearing would be hell. Especially if you get it in your rectum, or have had it there previously.

Also, honestly, just wanting an elective caesarean with zero medical reason is fine. It's your decision. There are risks either way, and it's a personal thing to decide which risks (and pros and cons) you would prefer to face. I don't think there's a 'right' way to birth, just what feels best to you.

It was the right choice for me - I've had two ELCS as both my babies have been breech. They don't like to draw attention to it but something like 1 in 5 attempted vaginal births end up as emergency c-sections (they told me this when I was deciding between VBAC and ELCS before we knew DC2 was breech), which will have higher risks than ELCS. It seemed to me like there were maybe more risks to me but fewer risks for the baby if I went for ELCS and the impact of the risks felt like they would be lower.

Everything was fine and very calm (I know it won't be for everyone but really any way of getting the baby out has risks), baby was skin to skin with me while they stitched me up again and I was breastfeeding in the recovery room. Will you have help at home when baby is born - you may not be very mobile to begin in!

I loved my ELCS. I had terrible SPD - was on crutches but even with those could barely do anything, pain was hideous. Baby was big and I had excess water. My main fear was not being able to have an active labour and needing intervention so I made the decision for my own peace of mind and to get her delivered safely. It really helped my mental wellbeing knowing, all being well, she would be arriving on a certain date. Had a brilliant recovery, apart from some epic swelling in my legs/ankles but that went. I was a FTM and knew no different and appreciate I was lucky with the whole experience.

You have a very good reason! Is there any reason why a vaginal birth would be better for you? Except knowing you’d ’done It’? I’ve have two c sections now after two failed labours. I’ve given labour a go and I would not do it again.

You don't need to justify yourself to us or anyone else.

If you feel like trying vaginally and your health allows, you can do so.

If you feel like having a planned CS, have a planned CS.

I had a planned CS. Originally thought about it because I lost babies in pregnancy before and considered a planned CS less risky for DS and more controlled for me. Then, like you, I had many thoughts and wanted to try vaginally. It turned out I had gestational diabetes and doctors thought DS would be pretty big. Considering my posture they said planned CS or induction (which I definitely did not want). The choice was obvious then.

I never regretted it. It went really well, it was peaceful and I have wonderful memories from his birth after few very difficult years and a difficult pregnancy. The birth was an absolute highlight.

A planned CS is a much better option that trying vaginally, struggling and then having an emergency CS. It's a completely different experience and much harder healing process. All of my friends who went through it regret it in a sense they'd have made different choices knowing what they know now.

I have no regrets, just occasional curiosity about what it would have felt like vaginally.

DS has no allergies, very rarely does he have any chest infections, and he's a thriving little boy. It's to do with the environment you'll provide to your child, CS or not. Good luck and trust your instincts - it's your body and you know best.

I can hand on heart say I only have two friends (I’d say, 10-12 in total) who have had a straightforward vaginal birth. Everyone other one has been a disaster, about 80% ended in emergency section, the other 20% involved forceps, tearing etc. obviously we all want to be the two friends who has a good experience, and it has to be someone so it may be you, but in your situation I would absolutely opt for a section.

Meant to say 2 friends out of 10-12 friends

Yeah the idea of a vaginal birth with this scares me and I don’t even have it!!

@SweetPeaGirl Yes mine is unfortunately from the rectum upwards, it’s where my worst
inflammation is. Bowel incontinence also scares me, as as you probably know, it’s already something we struggle with in a flare!

@JC89 I have seen those stats, and im almost certain I’ve read once you’re 35+ those odds increase to 1 in 3 (but don’t quote me on that!)

@Ididivfama No, no other reason particularly aside from saying you’ve tried it and the research around microbiome from a vaginal birth.

Thanks @PurplePansy05 thats reassuring to know, sorry to hear of your losses.

@Anotheranxiousone Same as me! It seems few and far between that people I know have had a straight forward birth unfortunately.

My first was natural, she was back to back and I ended up with a third degree tear and 2 hours in surgery straight after her birth to repair it. Recovery was hard and I didn't actually realise the effects it had had on my body until I was pregnant with my second.
My second was an elective section (she was also back to back throughout the end of my pregnancy) due to the tear and the risk of causing further damage. I'd recommend a section to anyone, compared to my first it was actually a lovely experience. Recovery was fine, just keep ontop of pain meds and listen to your body.
It sounds like the right decision for you so I'd go with your gut. People are always going to have an opinion on your choices (get used to taking them with a pinch of salt, it only gets worse when baby's here) you just have to go with what you feel is right for you and baby, ignore everyone else.

My thoughts exactly. I had a caesarean last year and don’t regret it all. Especially when l went to baby groups and had to hear lots of horror stories including inductions that went on for days, tearing, forceps, faecal incontinence etc. No regrets at all.

@CalFairy do what’s best for you. I am swaying toward a c section as baby is measuring very big and they don’t want me to go past 39 weeks so have offered induction or section. I am swaying more towards a section as I have a lot of strong opinions on inductions and always wanted to avoid one and go into Labour naturally if I had no risks. However now baby has been measuring big consistently since 30 weeks and I am 37 weeks on Tuesday, I want her here safe and sound.

I agree midwives are very anti section; mine told me I could ignore the consultant and go to term and over as people have big babies all the time and the scans also have a margin of error (which I am aware) but why take the risk?!
Ultimately do what feels right for you. I’ve been going round and round in my head but like the predictability of a section rather than an induction that increases the risk of 3rd and 4th degree tears among other things.

good luck 🤞🏼 when is your section planned for? X

I had an EMCS with first son. I had an elective with second but actually ended up going to labour the day of! Section was great, was up and about 4 hours later. No pain, was driving a couple of weeks later after contacting insurance. I have a toddler son too and was able to play and lift him pretty much straight away. Compared to first son where I had failed forceps prior to EMCS it was a walk in the park. Good luck OP

Based on what you've said, I would go for the C section.

I had an emergency c section first time round after screaming in pain for absolutely hours. Horrible experience that left me mentally scarred for a long time after.

Opted for planned section the 2nd time round and it was absolutely amazing. So calm and peaceful. Yes, it's a bit painful but nothing compared to the pain of contractions.

Thanks all, some really reassuring comments :) it was always my gut feeling to go that route. I just didn’t want to feel like a cop out! Must just be nerves as well, it’s in around 3 weeks.

I was suppose to have a planned c section on 1sy Dec but bubba didn't want to wait and came on 30th Nov which ended in an emergency c section.. ilthat was mu 1st c section as my other children were born vaginally.

Although I had an emergency c section it was the best experience I've ever had.

I hope everything goes well for you

This topic still makes me mad and my DC is pre-teen now. I fought so hard for my ELCS. I’d known since I first learned how babies were born that this would be the only way I’d possibly ever consider having one.

DH brushed it off and said “I’m sure it’d be fine.” MiL was constantly asking why I needed a ELCS. The consultant literally listened to me talking about why it was so important to me and just handed me a pamphlet on vaginal birth. It felt like nobody was hearing me. I started hyperventilating in panic as she sent us away and luckily the midwives intervened and managed to sort it and make the recommendation.

Mine was on time, largely painless, recovery was fine apart from one little corner of my wound which struggled to heal but did in the end. My biggest issue was trapped wind so I was madly downing peppermint water!

I was so incapacitated by SPD when pregnant that c-section recovery was a walk in the park!

I think from what I understand electives are way easier and heal quicker than emergencies, for obvious reasons. Have the birth that feels right to you.

Just remember the recovery from a section is far longer than the vast majority of natural births. It's a bit of a gamble though - 80% os vaginal births are uneventful (whatever the tales people tell, remember people don't talk about the ordinary uneventful ones!) but if you need forceps, or need an emergency section then it's harder than a planned section.

I had my 2 naturally and walked out of the hospital just a few hours later each time, even went to the supermarket on the way home with one of them, not something possible after a section. Nobody can tell you if you can deliver without complications. Go with medical advice

@Nearlythere80

Some of us give birth naturally without much pain at all, I had no pain relief, no tearing, and was all over in 6 hours.... and left just a few hours later.

@CalFairy just wanted to wish you luck. Sounds like you know it’s the right choice for you!! And that’s the bit that matters x

@Callmemummynotmaaa Thank you, very kind! I think I do, but then keep doubting it haha.

That's a myth.

Recovery after a planned section is usually very good, unlike after an emergency one or a vaginal delivery involving tearing.

Yes, you need to get out of bed in a specific way, keep good hygiene and avoid lifting, but it's really not ridiculous. I was at the supermarket 5 days after my planned section and on a short walk with DS 3 days after, but really this isn't some kind of a competition, we all gave birth and needed adequate rest, end of.

I personally had a more complex recovery because I didn't have appropriate advice about getting out of bed and insufficient checks (Covid era) which led to some stitches reopening but this was eventually sorted with antibiotics and didn't cause me any significant pain or discomfort. Every single friend of mine who delivered vaginally had what seemed like a harder recovery time than me.