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  1. #1
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    Default Caesarean Section (CS) or vaginal birth (VB) & maybe an emergency caesarean (Em-CS)

    Hi all, I’ve been reading all the CS postings trying to decide between opting for a planned CS or a VB. A lot of comments say things like
    “I chose a CS because I didnt want to go through a VB again, I dont think I will ever be the same down there!” or “I was naive last time but I’m really hoping for a VBAC this time”.
    For us reading the thread the problem is they often they dont say WHY.

    My Obst has said that if I go into labour, I have a 50/50 chance of having a VB or CS, however because of my symptoms it is likely to be a “difficult VB” and if I then needed an emergency c-section (Em-CS) then the stats say there is 4x more chance of complications.
    I am now 36 weeks and he has recommended a planned CS because of 3 reasons: I have a large baby (measuring 90-97 percentile at my last two scans, however growth scans are only 60% accurate), I have a 10cm fibroid in my lower left womb wall (however bubs head has already got past that towards the birth canal, but it might make the birth harder to progress), and Im 39yrs old (so more chance of complications). My obst has said the final decision is up to me and to let him know soon.

    I’ve got a 50/50 chance but Im worried about trying for a VB and then after a long and difficult labour, needing an Em-CS (that is 4x the risk than a plannned CS). So I’m asking, what is it that would really make you want a CS or a VB. Details please.
    Last edited by Jazzz99; 29-09-2014 at 07:15.

  2. #2
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    First time I really wanted a vb. Went into labour, failed to progress in the way that I should have (long story) had an emergency c sect. Recovery was long and hard for me (after labouring for ages). Not knowing what a vb is like - at that point (hearing others stories about vb, being up and around that day) I would have said give me a vb any day. Naive probably but I have nothing else to compare it to.

    2nd time I had pp so while it was a planned c sect, it was necessary. Recovery (without labouring first) was amazing and I wish I had have experienced a c sect like that the first time.

    Now going for my 3rd and it will be a planned elective c sect.

    People make choices to suit their own circumstances and your choice is yours. I hope you come to a decision you are comfortable with :-)
    Last edited by KitiK; 29-09-2014 at 07:35.

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    Jazzz99  (29-09-2014)

  4. #3
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    I had an emergency CS with my first due to IUGR and bubs with a very low heart rate. I never went into labour naturally, baby had to come out then and went on to spend a week in special care. I think in that case it was 100% warranted, baby would unlikely have survived a natural birth. I was disappointed with my birth as it came as a complete shock and I had planned for a natural birth. I was young and healthy. With my second I opted for a VBAC and ended out having a 9.5lb bub 10 days overdue and truth be told compared to my CS it was bliss. I don't know about age or fibroids but I can tell you that baby size in my opinion would not be a contributing factor. I had no trouble birthing a big baby and my labour was relatively fast (I am not a big person either so size of person and size of bubs I see as irrelevant.) I'm now pregnant with my 3rd and will be aiming for a natural birth. In saying this when health of baby is at risk I would always allow a CS. Good luck with whatever you choose. Is it possible to go into labour and then see how you go, maybe you will be one of the lucky ones like I was who actually ends up with fairly straight forward labour. Recovery was 100 x better with the VBAC, however I do think the fact mine was an emergency CS and baby was unwell after birth were contributing factors to recovery from CS, maybe an elective would be better?

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    Jazzz99  (29-09-2014),KitiK  (29-09-2014)

  6. #4
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    Early in my pregnancy I had my heart set on VB, to try and go as natural as possible. However, I had high BP brought on by pregnancy and also GD which was diagnosed very early (at 10 weeks). My OB then told me because of those two issues combined, plus being 40, he would not let me go much beyond 38 weeks. I was then given the choice between induction and c-section. After doing an education session on induction and how that can turn into a cascade of intervention that 30% of the time results in emergency c-section, I opted for the c-section straight up. I figured an elective one was better than an emergency one.

    In the end bub had to come out at 37 weeks because of my BP and reduced fetal movement. He's 3.5 weeks old and I'm recovering well from the surgery.

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    Jazzz99  (29-09-2014),KitiK  (29-09-2014)

  8. #5
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    With my first I thought I would try for a VB, but never got the choice as I ended up with placenta pravia and wasn't allowed to give birth naturally, so I was booked in for a c section. If I had of gone into labour before the set date I would of needed an emergency c section, but thankfully bub stayed put.

    I was disappointed when I first found out I would have to have a c section, but moved past it and just wanted bub delivered safely. The c section itself was fine and nowhere near as scary as I imagined. I did lose a lot of blood (a complication of PP) and my recovery was a bit slow as I wasn't allowed out of bed for a few days due to needing blood transfusions.

    Second time round I was contemplating trying for a VBAC and my ob was happy for me to do so, but I ended up going for an elective c section. I guess for me it was because I knew how it would all happen whereas a VB would be completely new territory for me. My husband also works away, so having a planned c section date made more sense for us.

    I don't regret it. My surgery went perfectly. No complications. I was up within 24 hours and my recovery was a lot less painful, and quicker than first time round.

    For me, c sections were the better choice, but everyone's different. Do what you feel comfortable with.

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    Jazzz99  (29-09-2014)

  10. #6
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    Reading your stories is really helpful. I am so confused about what to do. One minute I think that I may as well try a normal VB and see how it goes. Afterall, if nothing goes wrong then why not? Then I've heard that if you try a VB first, an emergency CS can have lots of complications. Why is that? Is it because the uterus has been contracting and so its more inflamed already? I know there are lots of different reasons why an emergency CS becomes necessary, but I dont know just how much easier recovery a from a planned CS is compared to an emergency one after trying for say 10 hours first.

    Then when I think about a large baby (with a fibroid) I get scared that I will have a really long labour and then end up with 3rd degree tears (or episiotomy) and a vagina thats permanently stretched out of shape. Id like to hear from some mums who had a difficult VB to know if they would have preferred a CS instead or if they healed ok. We dont really talk about this but if not on here, then where? I want to know how "different" a vagina can get after being stretched during birth..or what long-term problems there are that might make a CS more of a good option.

    Ive been thinking about this ever since my last obst visit and my next one is in a week. I change my mind several times a day, its just not an easy decision.
    Last edited by Jazzz99; 29-09-2014 at 16:08.

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    KitiK  (06-10-2014)

  12. #7
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    Hi all, thanks for your private messages. I really appreciate everyone that replied. xx

  13. #8
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    Hi @Jazzz99

    I had an emergency CS (or a 'crash' CS if you like, under GA after a code blue was called) and my recovery was really good.. so much so that I worry that my planned CS this time around won't live up to it!! (the recovery part, that is, not the procedure).

    I'm not sure where the stat about being 4 x more likely to have complications arises or what those complications are?

    My only insight is that even if I were allowed to try for VBAC this time, I would be naive to take the point of view that 'if I end up with a CS anyway at least I tried', I wouldn't want to risk the emergency CS because of the potential loss of control over the anaesthetic component of the surgery. With an elective CS the anaesthetic is obviously planned prior, not needing to be rushed and more controlled.

    Clearly not all emergency CS's have such urgency requiring a GA, but the type of anaesthetic can have a big impact on the experience and first few hours of recovery, so something to keep in mind / discuss with OB.

  14. #9
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    Hi GMO1, The anaesthetic is something I hadnt considered before. Thanks for the info!

  15. #10
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    I had a CS 16 weeks ago and it was awesome.

    DS was born at 39 + 6 via elective CS. Two weeks before he was born he turned posterior and also had a big growth spurt. My OB advised that labour for me would be hard due to my small pelvis, his large size and posterior position and the end result could be an emergency CS for me. Based on all the information provided to me I opted for the CS. To begin with when the idea was first presented to me by my OB I was a little disappointed but mainly because I has never considered the possibility that I might need one. However once I weighed everything up I was comfortable with my decision and looking back I definitely made the right choice. DS arrived healthy weighing 3.9kgs at 8.26am. By 6pm that evening I was up out of bed and able to shower. The following day I was walking round the ward. My recovery was great and much easier than I could have ever dreamed. I kept on top of the pain relief offered in hospital and believe that it was more painful having my wisdom teeth removed!

    We do plan in having another bub and I will have no hesitation in requesting an elective CS next time round.


 

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