ABM and Tess re: elective c/s

KonrsBride

First, ABM, thanks so much for sharing your story about your 2nd c/s. After my first emergency c/s where I also had to be knocked out because the epi stopped working, I immediately decided I wanted a c/s. I switched OBs even because my first OB didn't do them.

I've been doing more research, and now I'm conflicted. I'm worried I could go through the whole process again, full labor, and not deliver vaginally, or worse, have something happen to me or the baby where we couldn't be together after the birth. I wasn't there for the birth of my DD, and I still get teary when I think about that.

What kinds of preferences did you list? Were you freaked out about being awake during the surgery? How did your DH handle it? 

Tess, why are you planning your c/s? I just want to hear other moms talk about this in a non-judgy way. 

Thanks.

DG1

::butting in::

I had an elective c/s with #1 and don't really regret it at all.  There are risks with c/s, yes, but the anti-c/s movement often neglects to mention that there are also risks with vaginal birth.  They're not the same risks, so you're forced to make an apples-to-oranges comparison.  

Vag birth risks to the mother include hemorrhage, pelvic nerve damage (up to and including paralysis), excessive tearing (there are some moms on this board still trying to heal), plus any risks of anesthesia used.

Vag birth risks to the baby include brachial plexus injury (up to and including paralysis), plus any risks associated with assist devices (vacuum, forceps).

C/s risks to the mother include standard surgical risks (primarily infection), plus the very rare possibility of nicking the bladder or bowel during the surgery. Recovery is (typically, but not always) longer.  

C/s risk to the baby is mostly the respiratory transition because the amniotic fluid doesn't get squeezed out of their lungs. There's also the possibility that the baby would get nicked/cut during the initial incision.

Both birth methods have a very remote possibility of death to the mother and/or the baby.  (Sadly, we've seen recently that this does really happen.)

It's very difficult to compare studies, because many of the c/s studies don't account for the *reason* the c/s was done. They sometimes include mothers who had to have emergency c/s as early as 24 or 26 weeks because of pre-e, HELLP, or even just traumatic injury.  So yes, if those data are included, outcomes are much worse for all involved.  

The American College of Obstetrics & Gynecology (the ones who put the "FACOG" after your OB's name) issued an opinion on the matter in December 2007. You can read a summary here:  ACOG Committee Opinion No. 394, December 2007. Your OB can probably get you the full article if you ask. (It's short and not too difficult to understand.)

Basically, the article doesn't come out for or against the elective c/s but advises that (1) it should absolutely NOT be done before 39 weeks and (2) risks increase dramatically with the # of c/sections. (So if you want a bunch of kids, it's probably not a good idea for you.)

Do know that recovery from a scheduled c/s is (typically) much better than a post-labor c/s.

Anecdotally. of the (admittedly few) women I know who've had both, half say they'd do anything to avoid a c/s and the other half say they'd never even bother with vag birth again.  I think a lot of that had to do with individual outcomes (one had an infected incision, for example) and can't necessarily be used to predict how anyone would feel about their own experience.

Your mileage may vary, of course. But talk to your OB if you want more information.  They're not as evil as Ricki Lake would have you believe. (And if you feel like you're being pushed one way or another instead of being given unbiased advice, ask a different OB).

Tess12

I'm planning a repeat c/s due to the long labor and lack of progress the first time.  Madeleine was 8 days late, she never dropped, I never dilated past 4 or 5 (depending on which nurse you asked), and was in labor for 41 hours.  My fear is that I will have another long labor that will end again in c/s.  If labor starts differently and all sign points to steady progress, I will try the VBAC, but I don't have high hopes.

disbride061103

I had a scheduled c/s because ds turned breech 5 days before my edd.  I had a c/s two days later.  I do want to try for a VBAC, but if for some reason I need a c/s, I will probably be ok with it. 

 I had a great c/s experience with ds.  I didn't freak out at all about being awake.  I couldn't feel a thing, not even the tugging and pulling.  Even when they were taking ds out and told me that I would feel a lot of pressure, I didn't feel a thing.  DH did great.  They let him stand up and watch as they pulled ds out.  He didn't think he was going to watch, but when they told him that he could stand up, he did. 

Overall, I was happy with my c/s.  Next time I will have a c/s birthplan with specific wishes.  Some of them are things that happened with DS, that I would like to have happen again (repeat).  Others are things that I want to change (new).

No arms strapped to table (repeat)

Cath placed after spinal (new)

lower curtain or place mirror in OR so I can watch baby being born (new)

hold baby up for me to see before being cleaned up (new)

hold baby before leaving OR (repeat)

baby to stay with me and not sent to nursery (repeat)

bf within an hour of birth (repeat)

no one other than medical staff or DH will hold or see the baby before me (repeat)

MrsPreK

My first c/s was emergency and I too was knocked out like you and ABM. NOT fun. This was after 24 hours of labor and 3 hours of pushing. I was just about delirious at that point.

This time I had a c/s - although it was not elective. My hospital/OB does not to VBAC's and it was wayyyy to soon to even try for a VBAC anyways. 

I did not have a major list of wants though and I did end up going into labor 4 weeks early with DD. I went to the hospital and my OB who was on-call took her via c/s. 

She spent several days in the NICU and came home with us. 

My recovery was just as easy the 2nd time as it was the first time too. I was running again 3 weeks PP and having sex at 3 weeks PP also. 

GL!!

KittyCatBio

I am not pro-any type of birth, but had a scheduled c-section with Kat b/c it was the safest for her of the choices I was presented with.  My birth story is in my bio.  In my practice with your first you are given the choice to revolve doctors, given that you might want someone different for your OB than for your gynelogical care, and for me I had a NP doing my gyn care, so I had to test out all the OBs, plus then if you meet everyone then if you have to have whoevers on call then you know them. I saw 4 different OBs in the final 3 weeks of my pregnancy, and all of them (and all women, for the record-my practice is strictly female) told me they thought I needed to prepare myself for the possibility of c-section. 

During my last visit my doctor (the one i had chosen) sat down and held my hand (for those that think that evil doctors are pushing the c-section for their own nefarious purposes) and told me the risks I was facing trying to go vaginally.  I freaked out a little, and then said Ok. 

14 months later, my recollection of my c-section is pretty much rosy. I went home from hospital a day early. I do recall having to hold a pillow to my stomach when I laughed, because that hurt.  and the first week sitting up in bed was a PITA (a=abdomen), but I was running errands with my DH and baby (DH driving) 7 days pp.  we were successful with breastfeeding, and no one had any complications, so I always feel very lucky that we were the story where everything goes right (my incision is a work of art, too).