Csection after vaginal delivery?

KimmySchmidt · July 2016

I know that trying to deliver vaginally after a csection is a fairly common experience, but I find myself in the opposite situation.

I had a vaginal birth last time and it went very poorly. There were 4th degree lacerations and the recovery was very slow and painful. At 6 weeks I could barely walk around my neighborhood, and I was in physical therapy for my lady parts for a year. Frankly giving birth was the worst experience of my life. (Save for the baby, whom I love, blah blah blah.)

My doctor tells me that my previous experience is enough to warrant a scheduled csection, particularly if this baby is any larger than the first (which was only 7lb11oz) but that he would support my decision if I wanted to try a vaginal delivery. He said I would be very unlikely to tear again, although he acknowledged how unlikely my injuries were the first time.

I don't know what to do. I'm not at all concerned about the baby's health. I'm confident he or she will be fine either way. My concern is with my recovery, and caring for a two year old throughout it. I hear about csection recoveries being worse compared to vaginal, but there's no way it could go worse than last time.

I was was just curious if there was anyone who has had one of each and can speak to the recovery process. I don't know anyone IRL who has been in the situation of having to choose a csection after already having delivered vaginally. I have a mix of people in my life telling me that second deliveries are so much easier, and also people telling me they would get the csection to avoid the risk of a repeat performance of last time.

mrsvoorhees-2 · July 2016

I don't have any experience with this, but I can say that I know a lot of people who've had c sections and none of them were in the pain you were in at 6 weeks. I think if I were in your situation, I would opt for the c section too. A year of physical therapy and all the issues that go along with a 4th degree tear would be a lot to handle if it did happen again, and more than likely, you'll be healed jn a few weeks with a c section.

Thscary · July 2016

My MIL had a vaginal birth followed by c-section and said the recovery from the c section was worse. Keep in mind that this was almost 30 years ago, so a lot has changed.

SuperFudge00 · July 2016

I am having a repeat c-section. Although unpopular, my first was scheduled. First time we were concerned with placenta marginalis/Previa so I prepared for a section. When my 33 week scan revealed that a vaginal delivery was possible, I decided to stick with our plan because my ob assuaged my concerns about health risks and I preferred the known cut to the unknown cut.

My recovery was phenomenal and I hope it's the same this time. I had to take DS back in at 1 week because of jaundice and I was on my own since DH had started a new jobs couple months before. I was walking, having family over, going up and down the stairs, with minimal pain relief. I was taking Tylenol #3, Motrin 600 and flexeril 10. After the Tylenol #3 ran out, I made due with the other two.

I asked my ob at my first follow up why I was recovering so well compared to the horror stories. First, mine was planned and not emergent. Second, I happened to be healing well. And third, his technique sees each individual layer together to prevent additional injury and promote better healing.

If this isn't the normal practice, I don't understand why. I have nothing to compare it to.

AMT1107 · July 2016

I don't have any experience with this either, but I just wanted to add, every c-section is different. Mine was an emergency c-section after being induced and then laboring for hours. I had no problem with recovery, c-section happened about 2:15PM and I was up and walking next day (doctor's orders). It's all about how you handle and manage pain. I took a percocet every morning as soon as I woke up for the first week and continued with tylenol throughout the day as prescribed and I was functioning at home, I wasn't spring cleaning but I was still able to do things.

I'm sorry you had such a rough delivery and recovery with your LO, I wish you the best in which ever decision you make

asht · July 2016

Mine was also an emergency. I was off pain meds as soon as I left the hospital and after about a week there was no pain and was moving fine.

OBMommy · July 2016

I've been through both (vaginal, then stat C/S, then vbac) and recovery is crappy with a c/s but is nothing compared to 4th degree lacerations. Good luck!!!

CoffeeBeanFiend91 · July 2016

While my c section recovery was rough I could walk around for short periods by 2 weeks post partum. I still have occasional pains 3 years later. Given your situation it would probably be worth it.

CRich15 · July 2016

I have had 1 emergency c-section and one scheduled c-section. The was just so tired after my emergency c-section it took me a good day to get out of bed and start moving around while the scheduled c-section, I was up and about after the anesthesia wore off. Both recoveries were different and the second was better than the first. I was moving around just fine within a week of surgery and feeling pretty good. The vaginal birth you had for your first sounds awful and I would most definitely take the c-section over that any day.

abberson · July 2016

One of my best friend suffered severe lacerations during her first birth, it took her months and months to recover and sex was painful for a long time, she could sympathize. I had a scheduled c section due to breech shortly after that and my recovery was easy in comparison (I walked to the bathroom later that night and around the halls by the next day). My friend was given the CS option for #2, but opted a vaginal birth again and everything went great this time. Labor was actually slower (not slow, just reasonable whereas her first came really quickly) and she recovered super quickly. A vaginal birth that goes well is the easiest recovery and hopefully what you would end up with if you go that route. A scheduled CS is probably the next level, but was not overly difficult to deal with in my case (with many helping hands). I'm not eligible for a VBAC and am a little nervous about 3yo hugs and jumps while holding a baby during CS recovery this time. It's a personal decision though, good luck with whichever route you choose!

fireflygirl12 · July 2016

I'll start by saying that I have no experience with c-section recovery and definitely feel bad for you having to deal with 4th degree tears! I think my decision would revolve around how much help you have available post partum. While having severe tearing is obviously painful and may limit your mobility, I believe that c-section recovery requires you not to drive for a period of time or to lift anything heavier than your baby? My main concern would be taking care of the toddler and also making sure they don't aggravate your wound (mine likes to randomly kick during diaper changes and I frequently get elbowed/kneed in the ute when he climbs on me). But obviously people do cope with taking care of other kids post c-section, but that would be my main concern.

Trgree1712 · July 2016

I also had a vaginal delivery with my first but will have a scheduled c-section at 38 weeks this time around. My situation is a little different I'm expecting twins and they are both breech. Since I'm 32 weeks there is not much hope for them turning.
My concern is my recovery will be greater than last time which will be a challenge with a 2 year old and two infants.

KimmySchmidt · July 2016

Thanks, ladies. Part of me feels like the societal expectation is to deliver vaginally if at all possible, and that "giving up" when it's not absolutely necessary would be a defeat. (It's like revisiting my breastfeeding failure with #1 all over again.)

ruemcclanahan · July 2016

@KimmySchmidt whatever you decide is going to be the best choice for you and your baby.
If I had 4th degree tears I wouldn't try the vag again oh my lanta. props to you for even considering it.

mrsvoorhees-2 · July 2016

KimmySchmidt said:

Thanks, ladies. Part of me feels like the societal expectation is to deliver vaginally if at all possible, and that "giving up" when it's not absolutely necessary would be a defeat. (It's like revisiting my breastfeeding failure with #1 all over again.)

Dude. No. When society gets a 4th degree tear, then they can speak. Until then, you do you.

asht · July 2016

I decided to go with a rcs this time around even though I had the option for one reason. I firmly believe my postpartum depression was triggered by my inability to do a normal delivery followed by my inability to breast feed. I decided I wasn't going to set myself up for the same disappointment and struggle as last time so decided a repeat c section is being done in hopes to help me accept my bodies limit. I am also trying to accept the fact that it is appearing as if I won't be able to nurse again this time around.

You do what you need to do to protect yourself and what is best for you not everybody else

Tippy05 · July 2016

KimmySchmidt said:

Thanks, ladies. Part of me feels like the societal expectation is to deliver vaginally if at all possible, and that "giving up" when it's not absolutely necessary would be a defeat. (It's like revisiting my breastfeeding failure with #1 all over again.)

I had an emergency c-section after laboring and I had a hard time recovering. After I got home, I thought I would be ok to carry on as usual and pushed it too hard, too fast. I wound up with an incision that didn't heal properly, back at the hospital a week later and a visiting nurse for month after that. The second time around was a planned c-section, but DS didn't want to wait and came early. I didn't labor for nearly as long with him, and knew better than to push myself when I got home, so recovery was better, even with a 20 month old at home. I'm planning a 3rd c-section this time.

It took me a really long time to accept that I wasn't able to have the vaginal delivery I was "supposed" to. I felt like a failure, like I didn't do something right and that I was somehow cheated out of that experience of "natural" childbirth. Now, I'm 100% ok with another c-section. I know that I need to ask for help and to really take it easy for the first couple of weeks.

Don't let societal pressure guilt you into something that you don't think is right for you/your family. If a c-section is going to be safer for you and you trust your doctor/hospital, then go with it. I completely understand where you are coming from, but you need to do you. You shouldn't have to answer to anyone about choices you make that affect your body.

JasonKristen · July 2016

Don't feel guilty about scheduling a c-section if that is your choice. It is your decision and you know what is best for you.

Do you they know why you tore so badly?

I had tearing with my first. DD was 6lbs 7oz and came out fist first. I am not sure the degree, but we were unable to have sex for 6 months due to the raised scarring. Recovery seemed slow for me too. I remember trying to go for a walk my first few weeks and it was terrible.

I did have another vaginal delivery with DS and recovery was a breeze in comparison. He was 8lbs and I had minimal tearing. We had sex 7 weeks pp and boy was I scared, but it was enjoyable and I was literally shocked.

I know that everyone is different, but the recovery with DS was so much better and I can only hope that if you go the vaginal route that you will have the same experience.

PSUBecky23 · July 2016

MrsVoorhees said:

KimmySchmidt said:

Thanks, ladies. Part of me feels like the societal expectation is to deliver vaginally if at all possible, and that "giving up" when it's not absolutely necessary would be a defeat. (It's like revisiting my breastfeeding failure with #1 all over again.)

Dude. No. When society gets a 4th degree tear, then they can speak. Until then, you do you.

This. You have a medical professional recommending a C-section for good reason. I know it's a tough decision but don't let society make you feel bad.

crispy11 · July 2016

Wow, just a hard decision! I think part of the problem is that now as a STM you are asked to make this choice and given some "control" in the situation but you can't predict what will actually happen either way this time so it's impossible to decide ahead of time. Now you're stuck in the stressful position of trying to pick the best option when you still don't know what will happen with your recovery either way (vaginal or c-section). Anyway, I had a c-section and then a vbac and my vbac recovery was much easier. It was great that I was able to do more with my toddler earlier in the recovery, but the driving force behind my decision was hopeful number of children (4+) which would have been a lot of c-sections. If I didn't have that, I would have felt more meh about vaginal v. c-section for myself... and I know women who had the vbac and then scheduled a c-section with #3 because they liked the c-section better.

My advice:
1. Screw society and the thought of a more "natural" way to have a baby. I had a c-section so I can relate to this feeling but try to put this out of your mind for now.
2. Try not to stress too much about this decision. You can't predict your actual outcome so do your best to pick one and then try to find some peace that you made the best choice you could and the outcome is beyond your control.

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