ELCS or VB?

[EllsBells68]

I’m due with my second DC in a couple of weeks and have a birth preferences appointment later this week, so looking for advice/stories - appreciate it’s a very individual thing though. With my first DH, I had a VB that ended in an episiotomy (baby’s HR dropped) and PPH and blood transfusion as a result. I don’t think I lost a huge amount of blood but iron was low so passed out. Postpartum was ok, but the scar still bothers me now and has particularly towards the end of this pregnancy with the pressure.
I’m seriously considering requesting an ELCS when I speak to the consultant, because of the overwhelming anxiety/fear of being cut/tearing/bleeding again. I know it’s major surgery and there are risks associated, but I also feel there are risks associated with VB that HCPs are not as vocal about, and it’s particularly the lack of control and many different things that can go wrong that concerns me. The recovery with an CS would obviously be significant especially with a toddler, but we do have a strong support and DH would be home. Any thoughts or experiences would be greatly appreciated.

I’ve had two C Sections, one emergency and one elective.
the elective wasn’t really my first choice and whilst I was allowed to try for a vbac, I wasn’t allowed to go overdue and did not want an induction due to the elevated risk of uterine rupture associated with induction after c section.

personally I found the elective scarier than the emergency, the emergency had its traumatic moments but it all had to be very quick so there wasn’t a lot of time to really think, or overthink about it like I do. But I will say the elective was very calm, controlled and explained at every step, I was supported and taken care of. Personally for me I just overthink and panic but overall I’d say they make it as good of an experience as they can. I still had skin to skin and my husband cut the cord.
The second time around I really did want the recovery of a natural birth and to be able to move around straight away. I’m now at home 5 days post c section and it’s tough with a 2.5 year old but not impossible. If you keep up with your painkillers and don’t exert your core then most things are actually doable.

recovery wise, the emergency and the elective have been the same for me.

if it makes you more comfortable to choose an Elective C Section then it’s definitely not the worst experience in the world.

I had a bad VB - daughter got stuck resulting in forceps, episiotomy, PPH and many stitches. Recovery was dreadful.

Second child was ELCS. Wonderfully chilled. Recovery so much better than the VB.

I won’t have a third but if I did it would be ELCS all the way.

Thank you for replying! Hope you and your LO are both doing well now.
I’m also an over thinker (hence the post 😅) so that’s useful to know. I wish there was a crystal ball that could just tell me which way to go!

Thank you - this is what I’m leaning towards! Many of my friends have had ELCS for various reasons and all agree it was very calm and recovery ok. My VB was far from the worst but I don’t think my mental health will hold up if a second attempt goes awry!

It’s a very personal decision. ELCS is very calm and controlled, but generally you can expect a bigger blood loss and recovery from major abdominal surgery with a newborn and a ?toddler is not easy. You’ve laboured and cervix has fully dilated previously, second babies tend to come quicker and easier… you can be prepared with active management of third stage and prophylactic medication to prevent PPH.

Thank you - appreciate your balanced reply! My midwife said the same, that they’d have a cannula inserted ready etc and every birth is so different. If I did go for a VB again, she suggested a water birth can minimise tearing (my PPH was due to the episiotomy) but not sure I’d be able to use the pool (or even the birthing centre vs labour ward) with prior PPH, so a Q for the consultant for sure!
One of the other reasons for not going fully into ELCS decision is whether baby is ‘ready’ to come out and potential issues with breathing etc that squeezing through the birth canal can mitigate.
I guess there’s no right or wrong, as you say, personal decision!

I had an EMCS with my first and an ELCS with my second. I have a lot of friends who had a traumatic VB then an ELCS and they've all preferred the CS x

Had a traumatic VB with my first. Similar to yours but worse and more dangerous for myself and the babies health. Was about to be wheeled into theatre and they decided to use the suction cup and managed to whisk him out, the impact of said whisk was not great on my poor vag 😂 I also had to have a transfusion which I had a bad reaction to. A set of unfortunate and rare circumstances.

I was so unsure about what to do but for many reasons opted for an elective c section. I must admit I had a panic when I walked into the theatre and was regretting my decision a little. Its a bit scary when there's loads of people and machines and equipment etc. But honestly it was the BEST decision I could have made. I was not able to hold my first for a good few hours as I lost consciousness and I was so unwell for weeks, physically and mentally and carried alot of trauma. My worry was I would go into labour and just freak out and not be able to do it!

I was robbed of experiencing the magical moments when your baby is born and I got to have that during my c section even if I wasn't able to move very much! It was painful and for 3 or 4 days I was pretty immobile. Hardest part was not being able to pick up my toddler etc.

I had a very good recovery and was up and about by day 5, no complications and am back to normal now 5 weeks later. Some are not as lucky. Just don't miss a painkiller and don't overdo it.

Whatever you choose will be amazing as you'll get to meet your 👶

Take care x

Yes many of my friends have said the same! Thank you.

Really helpful, thank you so much for your reply. I think I’m decided - seeing the consultant tomorrow so will obviously discuss with them but I feel much better just having made my mind up!
Im nearly 38 weeks so just hoping I can still book it before things happen naturally 😂

I had a ventouse and episiotomy with my first, had the same issues re: pressure on the scar during pregnancy and was terrified of tearing along the scar but I had my second 6 weeks ago and I only had a labial graze, so it is possible to avoid another episiotomy/tearing. I know everyone is different but I just wanted to share my positive experience with you.

Hi OP,

I've just been through this myself. Very traumatic VB with my fist resulting in PTSD and PNA and it was my MW who recommended a ELCS. I'm 10 days post partum with an ELCS and can honestly say it was the best thing ever.

Physically in a little more pain than my first labour but very manageable, I'm walking and have baby in sling just now. Able to sit on the floor and play with toddler but not lift etc. and mentally, so much better and not suffering from PTSD!

Good luck!

Thank you, glad to hear you had a positive birth second time around! The consultant I spoke with today said that’s usually the case in her experience so I feel reassured if I needed to deliver normally then it wouldn’t be as awful as the first time.

Congratulations! Having spoken with the consultant today, I’ve booked my C-section for 40w. She was fantastic, really listened to my fears and gave me a balanced viewpoint either way and we agreed 40w is right for me instead of whipping her out any earlier unnecessarily. I still may change my mind and go for a VB because she was so reassuring, but I feel so much better knowing I have a date booked - I can actually allow myself to be excited to meet our LO now!