C-sections

C-section or not... I've got a week to make the decision.

Well, my OB wants me to make the final decision between having a vaginal or c-section delivery and she wants me to decide by next Wednesday. No flip flopping once I decide. This is completely stressing me out! I feel like either way I go, if anything were to go wrong and cause problems for my LO then I'm to blame.

Here is the reasoning behind the choice. I have a history of vaginal trauma (not birth related) followed by recurrent and chronic vaginal fissures (small tears after sex or vaginal exam)and vaginal scar tissue (which doesn't stretch). My gynocogist, who has treated me for the tearing for the past 8 years recommended a c-section for me when I met with her for the preconception counseling. I haven't seen her since getting pregnant. My OB, who has only heard and read about my history, is letting me decide what is best for me but she says if it were her she would try vaginally because 'you never know if you will have a 4th degree tear until it's too late'.

I completely understand that she can't tell me what will or won't happen. I wish I could know!! However, with sex and/or a simple vaginal exam causing tearing and bleeding I don't beleive there is any possibility that vaginally birthing a baby can occur without major damage. With the pain and issues I already have tearing significantly could make this much, much worse. Could... Or could not, according to my OB.

So in the end, it's my decision. I have a medically justified reason to go either way. I am leaning toward the c-section but have to admit it scares me. I am so afraid of making the wrong choice and something going wrong with LO and it being my fault. I guess I am just hoping for some input, thoughts, advice, etc. from women who have had a c-section and possibly had to make a decision themselves, even if for different reasons. I know you can't make up my mind for me... I'm just looking for some points to consider.
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Re: C-section or not... I've got a week to make the decision.

  • That's a tough choice.  I got to choose between a c/s and a VBAC and I chose a c/s.  I know our situations are very different but I ultimately chose the c/s because with the risks with a VBAC I decided the c/s seemed more controlled (since it was planned) and therefore seemed safer to me in case something were to go wrong with a vaginal delivery.

    The recovery is harder with a c/s but if you stay on top of the meds it's really not bad.  I personally enjoyed knowing when my LO would arrive to make plans for my DD and I knew exactly when I would stop working.  It was nice to have control over the situation.  So for me, that's what helped me decide.

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  • Very tough decision. If I understand your scenario correctly and there would be a chance that sex would be nearly impossible after baby, I would choose a c-section. It may sound selfish in a way, but sex is an important part of any relationship and if I knew that the chances of tearing and bleeding after sex were going to be heightened after a vaginal birth, I wouldn't risk it. I should say though that while I dealt with a good amount of pain after my c-section, my recovery went very smoothly and I am pleased with the minimal scar that I have.
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  • image DGandDG:
    Very tough decision. If I understand your scenario correctly and there would be a chance that sex would be nearly impossible after baby, I would choose a c-section. It may sound selfish in a way, but sex is an important part of any relationship and if I knew that the chances of tearing and bleeding after sex were going to be heightened after a vaginal birth, I wouldn't risk it. I should say though that while I dealt with a good amount of pain after my c-section, my recovery went very smoothly and I am pleased with the minimal scar that I have.

    You are right. After delivery there is a chance that sex could be extremely painful. At this point, it is already moderately painful to the point where at times it is not possible. It already impacts our relationship a little bit, thankfully that is rare right now. I understand that the immediate recovery is most likely to be worse for a c-section, my main concern is long term recovery. At least with a c-section I know I WILL eventually recover. I think you unintentionally hit the nail on the head though, I am struggling with the selfishness of choosing the c-section and the guilt I will feel of I pick to save my body and then something happens to Emma.
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  • Wow that is tough.  I understand what you mean about feeling responsible for the decision.  It's nice that docs give us so many choices, but sometimes I just want someone to tell me what to do!

    Can your doc give you any odds or show you any studies on situations similar to yours?  Having as many facts as possible will probably make you feel better about the situation.  Either way, trust yourself to decide and know that baby will be just fine no matter what you choose.  Good luck!

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  • I have a somewhat similar situation; because of complications from Crohns Disease, I have a history of vaginal fistulas.  In theory, I could be able to labor just fine-or I could have life-threatening complications.  Both my OB and GI docs recommended a CS, although they would have helped me deliver naturally if I insisted.

    I had DD by CS, and will have a RCS with this baby.  While a CS carries more risks than a standard vaginal delivery, a "standard" delivery isn't our situation.  Both my OB and GI were visibly relieved when I opted for a CS, and I had a fantastic experience with my DD's delivery.  My recovery was easy, and the surgery was a breeze.  While I know that's not the case with everyone, for me, the lower risk of complications with a CS meant it was the way to go.  Good luck with your decision! 

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  • I chose the C-Section route. LO was frank breech and my OB offered to do "The Version" for me @ 37 weeks but in my mind, the risks to him out weighed the fear of the C-Section. I wanted to do whatever was going to give him a safe delivery. The recovery was not too bad. (I don't know what a vaginal birth recovery is like though) I agree with PP, just keep up with the pain meds when you need them and you'll be fine. I was afraid of the Section too, but in the end, I knew when LO would be here and I didn't have to wait around for labor to kick in. Surgery scares me in general but it was a quick process and only a little uncomfortable (pushing, pulling and pressure). I hope this info helps! Good luck and best wishes no matter what delivery method you choose!
  • C/s all the way, given your situation. The risks of a c/s are so extremely low, and the risks of a vaginal birth not working / causing short term or long term damage or agony for you sound far worse.

    Best of luck whatever your decision.  

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  • image RoxBride:

    C/s all the way, given your situation. The risks of a c/s are so extremely low, and the risks of a vaginal birth not working / causing short term or long term damage or agony for you sound far worse.

    Best of luck whatever your decision.  

    All this.  Risks for your are lower with a c/s than with a vaginal birth, no doubt, given your situation.  Risks for your LO are quite low with a c/s and possibly even lower than they would be with a vaginal birth, if you are likely to have a difficult vaginal birth anyway.

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  • I would also agree with c section.  I would think if you occasionally have problems with sex and tearing that you would probably have a really hard time with delivering a baby.  One of my friends had a fourth degree tear she said sex has never been the same. She had a catheter for a week because of the swelling. She said after the baby she didnt have sex for 6 months and she said it hurt very bad when she finally did have sex. She said looking back she wished she would have had a c section.  I was very scared of tearing but ended up with a c section and my recovery was good. I labored all day and then had the c section. I had heard scheduled c section you recover better. Good luck! 
  • that may be one of the hardest decisions you have to make until you're deciding between pampers and huggies (i'm a huggies girl, myself). i had an emergency c-section, and let me tell you, it's no picnic. the actual surgery is nothing to worry about, nor is the epidural. it's the recovery. as soon as they wheel you out of OR, they make you wait for HOURS until you can meet your baby, and they would't let me breastfeed for some ridiculous reason. those 8 weeks they tell you to take it easy after a c-section are a far cry from the two months that you'll probably spend trying to just lie in bed and relax. also, if you plan on breastfeeding, it's extremely painful with a c-section scar. i'm not trying to discourage you in any way, i'm just giving you facts from my experience. i've never delivered vaginally, so i have no opinion on that whatsoever, though if you have such serious issues with tearing, you may have to lean toward the surgery. i just want to warn you for how painful the recovery is, not to mention the horrible ugly scar. even though every mom who has a scar should be proud of it, it's hard. but it does get better eventually. you just have to remember that.
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  • image brookuhnina:
    that may be one of the hardest decisions you have to make until you're deciding between pampers and huggies (i'm a huggies girl, myself). i had an emergency c-section, and let me tell you, it's no picnic. the actual surgery is nothing to worry about, nor is the epidural. it's the recovery. as soon as they wheel you out of OR, they make you wait for HOURS until you can meet your baby, and they would't let me breastfeed for some ridiculous reason. those 8 weeks they tell you to take it easy after a c-section are a far cry from the two months that you'll probably spend trying to just lie in bed and relax. also, if you plan on breastfeeding, it's extremely painful with a c-section scar. i'm not trying to discourage you in any way, i'm just giving you facts from my experience. i've never delivered vaginally, so i have no opinion on that whatsoever, though if you have such serious issues with tearing, you may have to lean toward the surgery. i just want to warn you for how painful the recovery is, not to mention the horrible ugly scar. even though every mom who has a scar should be proud of it, it's hard. but it does get better eventually. you just have to remember that.

     

    Like anything else, our bodies respond differently but I just wanted to say that my experience was very different than the above, and I am not even 2 weeks out yet.  I got to hold my son as soon as they finished stitching me up, and even before that DH and the nurse held him to my face.  We were able to BF in the recovery area immediately after.  Yes the first couple days after were rough but staying in top of meds and moving, even through discomfort and pain helped a great deal.  By the time we were discharged on day 4, I was able to walk out of the hospital myself and did just fine at home - stairs, tall bed, and all.  The only negative so far is the 'shelf' above my scar.  I'll be honest, that bums me out.  I've got a good 40 lbs to lose donate it will get better but for now I don't see myself ever wearing a swimsuit in public.

      It is what it is though... I have a healthy son and that was the most important thing all along.  So while I didn't want a CS per se, I always knew it was a strong possibility because of all the problems with my cervix.  My OB encouraged me to try for a vaginal delivery which I did -in the end I never even dialated past the 2 cm which I was at for many weeks.  Turns out my cervix was covered with scar tissue so a CS was the only way for DS to come out.

    I guess  this is my long winded way of saying I'd choose a CS if I were you.  Where you already have known problems, it doesn't seen to make sense taking a chance on making them worse.

     

     

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  • Your asking women on the C section board, I bet you'll get different answers on the natural birth board. 

    That said, its your body, your decision.

    Best of luck to you for a healthy delivery and child!  

  • image brookuhnina:
    that may be one of the hardest decisions you have to make until you're deciding between pampers and huggies (i'm a huggies girl, myself). i had an emergency c-section, and let me tell you, it's no picnic. the actual surgery is nothing to worry about, nor is the epidural. it's the recovery. as soon as they wheel you out of OR, they make you wait for HOURS until you can meet your baby, and they would't let me breastfeed for some ridiculous reason. those 8 weeks they tell you to take it easy after a c-section are a far cry from the two months that you'll probably spend trying to just lie in bed and relax. also, if you plan on breastfeeding, it's extremely painful with a c-section scar. i'm not trying to discourage you in any way, i'm just giving you facts from my experience. i've never delivered vaginally, so i have no opinion on that whatsoever, though if you have such serious issues with tearing, you may have to lean toward the surgery. i just want to warn you for how painful the recovery is, not to mention the horrible ugly scar. even though every mom who has a scar should be proud of it, it's hard. but it does get better eventually. you just have to remember that.

     

    I am sorry you had such a bad experience, but I wanted to clarify that this doesn't happen for everyone.  

    For example, our hospital strongly encourages BFing for every baby.  After baby is born, she is quickly wiped off, checked by the pediatrician, and then given to DH for skin-to-skin contact while mom is stitched up.  As soon as mom goes into recovery, the nurse encourages BFing, and mom, dad, and baby are kept in recovery for around 2 hours to give them time to bond, do skin to skin, and BF. 

    For me, I BFed without a problem, and my incision didn't bother me at all.  I didn't need to take it easy for 8 weeks, I had no problems with stairs (even on the first day I came home), and no problems with the recovery.  But again, everyone is different.

    I also don't think I have a "horrible ugly scar", but I may have a different perspective since I've had abdominal surgery that opened me up from belly button to bikini line, with a scar much thicker.  In any case, the CS scar was well worth it to bring my baby in to the world with minimal health problems for us both. 

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  • Thanks for all the insightful input ladies! I am taking it all to heart. I am really leaning towards the c-section. A few weeks of recovery pain is better than a lifelong struggle with pain and possibly reconstructive surgery and all that would entail, in my opinion. I wish my OB agreed with me, but at least in the end the choice is mine and I know my gynecologist supports me. Getting past the guilt that I feel like I am putting my health over that of my LO, and believing that a c-section is pretty safe for BOTH of us seems to be my biggest struggle now. I'm sure I won't feel okay about that until I see that LO is healthy and happy.

    Also, for the OP at my hospital procedure is to keep the baby with the mother after c-sections. I won't go to a 'recovery' room, but will recover in my hospital room. I can breast feed while they are stitching me up if I avoid the anti-anxiety mess and am with it enough to steadily hold her. DH and LO will be with me the whole time except for bath time and time for the pediatrician to check her out (same for a vaginal birth). That is, unless she needs NICU time. However, I do understand that everyone recovers at their own pace, and I do appreciate you sharing your story. It is something to consider.
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  • god. my son is five months old and i'm still rocking the tummy shelf, but it's gotten better. i've been told by my family members that the hospital i went to acted horribly about my labor. i'm young and on welfare, and the nurses treated me accordingly. they were terrible. they wouldn't tell me anything about what was going on with the baby, and he was admitted into icu for ten days after birth. this is pretty excruciating when you're not even allowed to have your baby in the room with you. i guess because since i'm young, i'm too stupid to understand anything. but young or not, i'm a great mother. i read all the books during pregnancy, followed all the rules, including the stupid don't-lift-your-arms-over-your-head rule. the nurses gave my baby medications and procedures that i never consented to, or knew about for that matter. they gave him two spinal taps without my permission, an antibiotic called gentamycin, which is known to cause deafness in infants, and they wouldn't even get me a wheelchair or open the passcoded door for me when i had to walk to icu to see him. they told me if i wanted to see him, i had to get out of bed and walk my iv pole down the hall, the long way. needless to say, i was up and hobbling in a matter of seconds. they didn't follow my birth plan at all, they gave him pacifiers and formula when i specifically asked them not to give him anything  but my breast. i had issues getting him to latch on, at five days old when they finally let me try to feed him, and instead of offering a lactation specialist, they tell me to give up. "some people just aren't meant to breastfeed." i don't want to blame it on the whole branch of hospitals, but you can bet i'll never go to mercy again as long as i live.
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  • by the way, i apologize if it sounded like i was trying to persuade you against the c-section. i was simply sharing my story, as you said. it's true, you don't truly absolutely NEED to stay in bed all the time, but i can't lie that it was painful. and my incision bothered me. again, that's probably from the hospital's mistake. they removed my staples a week after they should've and by that point, the staples had become embedded. my entire experience isn't really one to rely on, because my whole delivery was completely screwed and i entirely blame the nurses and doctors. their practices are, of course, to keep baby with mom and to push for breastfeeding, and i saw that they did that for other mothers, but not me. they wouldn't even put me on paper as the mother of my child. they had MY mother on paper as his mother. they didn't bring me any of the paperwork i needed to apply for his birth certificate, which i still haven't receieved, they wouldn't even give me his footprints. i'm 18 years old. i'm aware that i'm young, but they treated me as if i were 7 years old and having a baby.
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  • Eh, I frequent the natural birth board and had hoped to have a natural childbirth with my DS.  I also hope to have a VBAC when I become pregnant again and think that the OP's decision is tough.

    That being said, I think that if there was a real risk that sex would become very painful for the rest of I would seriously consider a c-section.  If I were the OP I would ask her OB if there was any medical literature that could help enlighten me on the subject, in addition to seeking an additional opinion from another OB.  If after doing that I found out that the risk was significantly higher than a routine vaginal birth for someone without fissures, I would go for a c/s.

    OP, good luck with your decision.  Also remember that even though a c/s has risks, they are mostly for the mom and not the baby.  Even then, both vaginal and surgical birth are (relatively speaking) low risk. 

     

    ETA: Meant to quote the comment about asking the NB board 

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  • I haven't read the other responses but here's my two cents. If a vaginal exam causes tearing, you're going to be in trouble during labor. they check your cervix a zillion times. That hurts even without issues, I can't imagine having it done with a vagina that injures easily.

    Also if you get scar tissue that doesn't stretch from just sex or exams, I would assume that you'll get significantly more from the cervical checks and birth process. Wouldn't that affect your ability to even have sex, or have sex pleasurably, down the road? I'm not sure I would be willing to risk that part of my relationship with DH. 

    CS are hard. There's no getting around it. But with your issues it sounds like you'll be in a lot of pain after birth anyway. I think I would chose the 'known' pain, ie CS. Good luck with your decision. 

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  • That sounds like a tough decision! I would also think about talking to a few other doctors, if possible. Can your OB point you in the direction of anyone who's treated women with similar histories?  

    If you decide on a c/s, can you wait until labor starts before having one? That way you can be sure your baby is ready to come out, and since it's your first labor, chances are you won't go from 0 to 10 cm dilated really quickly, anyway.

    Good luck! 

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  • image brookuhnina:
    that may be one of the hardest decisions you have to make until you're deciding between pampers and huggies (i'm a huggies girl, myself). i had an emergency c-section, and let me tell you, it's no picnic. the actual surgery is nothing to worry about, nor is the epidural. it's the recovery. as soon as they wheel you out of OR, they make you wait for HOURS until you can meet your baby, and they would't let me breastfeed for some ridiculous reason. those 8 weeks they tell you to take it easy after a c-section are a far cry from the two months that you'll probably spend trying to just lie in bed and relax. also, if you plan on breastfeeding, it's extremely painful with a c-section scar. i'm not trying to discourage you in any way, i'm just giving you facts from my experience. i've never delivered vaginally, so i have no opinion on that whatsoever, though if you have such serious issues with tearing, you may have to lean toward the surgery. i just want to warn you for how painful the recovery is, not to mention the horrible ugly scar. even though every mom who has a scar should be proud of it, it's hard. but it does get better eventually. you just have to remember that.

     

    Hold on a second!  Everyone has different experiences, and this sounds like a worst case scenario.  I had an emergency c-section.  It's true that I didn't get to hold DS for a couple of hours, but that was the worst part.  I was off piankillers within a week.  Breastfeeding WAS hard, but that had nothing to do with the c-section.  It was just hard learning to latch and all that.  I have several friends who either tore or were cut during vaginal delivery, and their recovery doesn't sound any easier than mine!  Also, yes, there's a scar, who cares?  It's in a place that only DH and doctors ever see.

    I had a choice for the second one, VBAC or second c-section.  I'm going for the c-section.  

    This is a hard choice for you.  Regardless of what you choose, do not blame yourself if something goes wrong.  I think that's a natural, but not a good, tendency.  Good luck!

     


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