Major Decision to make - please help!!!

theemilygrace · June 2009

Okay ladies, I just got back from the doctor, and I really need your input. ?Heres the situation, sorry if this gets long:

I need to decide whether or not to have a c-section or want to risk a natural, vaginal delivery. ?Here's the story...

About 4 years ago I suffered a series of (sorry TMI) anal fissures and a small fistula. ?I had 4 surgeries over the course of a year (it was HORRIBLE). ?The fissures/fistula were not large, but they put my sphincter muscle in danger (your bum hole, sorry for being so graphic!) which of course is really scary because I ran the risk of going incontinent. ?Since then, I have only had one other minor fissure, but was able to heal it without surgery. ?I do suffer from the occasional hemorrhoid, but that doesn't seem to have much bearing on the rest of my issues.

Today, my wonderful ob/gyn explained the risks associated with natural birth that might lead to fissure/fistulas given my history, high risk, and tendency towards the issue. ?She sincerely told me that she never recommends c-sections and it is not her preference, but that due to my history I needed to know the facts and she wanted to send me home knowing what decision I was really making. ?I love her for that! ?She also encouraged me that the midwife would do all she could to prevent tearing if I chose to go naturally. ?(In other words, she was not pressuring me one way or the other).

Here's the thing....1) I want to go naturally...for many of the same reasons some of you do, and I want the birth experience via natural birth (not c-sec) if it can be avoided. ?2) I want lots of kids. ?I would love to have 3-5 kids naturally (we also plan to adopt) and the higher risks of c-sections really only limits me to safely have 2-3 kids. ?3) Here's the kicker - if I go naturally, tear, then I could (most likely would) suffer more fissures/fistulas and that could lead to yet another series of surgeries. ?Not only is it totally no fun to heal from, but it would be horribly difficult with a new baby and it would also put me at risk with my sphincter muscle again, which could lead to even greater risks.

But - I'm afraid if I don't try to go naturally with this one (my first) I never will...and I might regret that. ?(I'm already disappointed that I even have to consider a c-section).

WDYT?? ?What would you do???

Do you have any suggestions to sincerely prepare yourself for little-to-no tearing at all????

Thank you for reading!!! ?Please help!!!

Sus77 · June 2009

I think if I was in your position I'd be tempted to go for the c-section but I guess you have to do what feels right for you.

blessedinthewest · June 2009

It seems to me that your doctor should give you a medical opinion one way or the other. Without being a medical expert I don't see how you can make that decesion yourself.

ellemoney:) · June 2009

I understand that it's a completely tough decision. ?However, what if you would have to be induced? There are many reasons why you may not just naturally go into labor, kwim??

There are pluses to the c-sect, you would be able to plan in advance, you would know what to expect, etc.

It would suck b/c you wouldn't be able to experience the whole vaginal birth, but with those side effects, would you really want to?

It's definitely a lot to think about. ?I think if I were you, I'd seriously think about scheduling the c-sect. It sounds like you have a great doctor who is wanting to keep you informed of your options and not want to pressure you in any way.

Good Luck with your decision! ?

adriannk4 · June 2009

Boy you have a really hard and long decision to make. To be honest... I would go for the c-section yes this means that with all your other births you will need to have a c-section as well, BUT this also means you will not suffer for those fissures/fistulas for long term. I have never heard that having a c-section limits how many kids you are able to have, not that I am doubting this by any means but when it comes down to it you want to be healthy and the baby needs a mom who isnt in and out of the hospital because you needed to feel the birth. You know?

xnbride · June 2009

I have a few questions: how tall are you? How big where you and your DH at birth? What ethnicity are you?

The reason why I ask is because the size of your baby can play a part in your final decision. When do you need to make your decision? I would wait until the very end after an ultrasound in which they can kind of guage how big the baby will be.

I had a very small baby 6lb 1oz and did not have any problems whatsoever with tearing or anything. Just a little "rug burn" and that was that. He just kind of flew out (ok maybe not quite but it was only 2 pushes and that was that).

Ask the doctor how much your pelvis can accommodate (they can get a rough estimate). Women of Asian decent typically have a smaller pelvis than women of African American or European decent so that can also factor into your decision. I know the pelvis is not the rectum, but it could be a factor in your decision depending on the size of your baby. I would not have to labor in vain if I knew from the begining that a vaginal delivery was not that likely.

And definitely do your excercises (kegal and perinium massage-your DH can do that one).

Also ask her if an enema prior to L&D will help as that may help to relieve some of the rectal pressure during delivery.

thats all I got for now....hope it at least helps

epphd · June 2009

I think that given the risk not only of additional surgeries, but possibly incontinence that would be a lifelong burden, I would opt for the C. Also, it's one thing to say that you want 3-5 children; many people change their mind after the first one or two, or have difficulty having additional children. In my mind, it is too big a risk to take on the assumption that you would want or could have that many children.

It sounds like a very difficult decision and I am sure I would be equally torn. Best of luck.

mrsmyers8 · June 2009

First i am so sorry you went through all the pain with the fissures. I had problems and had two surgerys. I feel blessed that they said i would be okay to have a baby with no problems. I must say going through the pain, if i knew it may lead to more problems i would do a c-section. Good luck and i hope it all works out....

theemilygrace · June 2009

hi xnbride! ?Thanks for your help!

FYI, I'm white, 5'4" and both my dh and I were about 7-8 lbs. ?

It is a horribly difficult decision. ?Of course I want what is best for me and the baby, but I wish I could see the future and know how easy/difficult the birth might go!

I'm tempted to try and go for the vaginal birth with the knowledge that once we get going it might lead to a c-sec. ?However, there are even greater risks with an emergency cs, and I would have probably pushed by that time, so it might not be worth it.

You can see why I want your help!!!

Thanks!!!!?

xnbride · June 2009

theemilygrace:

hi xnbride! Thanks for your help!

FYI, I'm white, 5'4" and both my dh and I were about 7-8 lbs.

It is a horribly difficult decision. Of course I want what is best for me and the baby, but I wish I could see the future and know how easy/difficult the birth might go!

I'm tempted to try and go for the vaginal birth with the knowledge that once we get going it might lead to a c-sec. However, there are even greater risks with an emergency cs, and I would have probably pushed by that time, so it might not be worth it.

You can see why I want your help!!!

Thanks!!!!

Yeah it is a tough call. I have never had a c-section so I don't know what it is like, but I have had a very good vaginal delivery experience so I guess I am probably a bit biased. So worst case scenario, what will happen? Will you need another surgery? or have to live with incontinence the rest of your life?

Like I said before, I think I would wait until I knew more about the babies size. I also recommend getting a second opinion from your midwife or another OB before making any decisions. GL. In the end healthy mom/healthy baby wins every time. You will have to make the decision that is best for you!

LindsE143 · June 2009

MrsGarciatobe:
It seems to me that your doctor should give you a medical opinion one way or the other.? Without being a medical expert I don't see how you can make that decesion yourself.

This. ?It seems like an awfully big decision to take on by yourself based simply upon opinions. ?Instead of asking our opinions, I would consider getting a second (or third) medical opinion.?

getnmarried910 · June 2009

Honestly, in the end, I would probably opt for the c-section if it's possible going natural could cause you to have surgery anyway.

Just out of curiousity, because I don't have experience with this personally, why could you only have two or three kids safely via c-section? My aunt had four and I have a friend having her fifth and her doctor will do up to eight. I'm guessing that it must vary from doctor to doctor, but can anyone with c-section experience help me out with that?

mtendere · June 2009

What about the doctor that treated you for the original fissures/fistula? Perhaps they would have more information for you.

If you have a valid medical reason to consider a c-section (which you do), then you should not feel bad about making that decision. You don't really know what would happen with a natural delivery, either. If you have complications afterward, it could impact later pregnancies/children.

You can also continue to talk to your doctor about it since you don't need to make the decision immediately. Write down your questions and concerns and discuss them. It's okay to take your time and get as much information as possible.

bostonbride! · June 2009

No personal experience - but I know a woman who had 5 C's - I have never heard of a 2 - 3 limit

dec13th · June 2009

If I was you, I would plan a C-Section today!

Good Luck!!

Switzerland · June 2009

I would definitely go the C-Section and avoid taking that risk on my body.

Megan7575 · June 2009

I would personally plan the c-section. I had to have one because DS was breech and it honestly was not a bad expierence at all. I think it is totally worth avoiding the possible risks.

sec18 · June 2009

I would speak to your doctor who did the surgery. He may know more about how the scarring would effect the fissures. Also think of things in the big picture. Vag vs. Csec in a year or so it will be a total non issue but if you loose your sphencture control that could effect you for 60 years. If you are planning on alot of kids ask your ob about multiple csecs. She may give you more info on how amny kids or what doctors will do. I wish you luck.

msyates03 · June 2009

I have had 2 C-sections and will be having my 3rd with this child. I am African American , 4'11 and my pelvis is small and both my kids were 8 & 10lbs which is why I have scheduled C-sections. I have never been told I have reached my maximum C-sections although I do not plan to have anymore children after this. Only you know the pain you have endured with your past problems while not pregnant therefore start there. Also, think about how tired you will be after the baby is born and pain in addition is not a good thing. You will be trying to get a newborn on a sleeping schedule and the less stress for yourself and body the better. Your baby will be adjusting to you and can feel if you're tensed and or stressed. So weigh your pro's and con's. Good luck!

blessedinthewest · June 2009

In the Business of Being Born they talk about the more C-sections you have the more risky they become. You may want to talk to a doctor about the risks of that if you intend to have a lot of children. I forgot exactly why but C-sections do become more medically risky after mutiple ones.