C-Section or Episiotomy?

[Anonymous]

I know once you see the baby and it's all said and done everyone feels like labor was the greatest thing in the world---however, as someone anticipating labor for the first time, I'm looking for your advice.

This may even be an assinine question, but humor me, please.

Which might be easier to recover from? A c-section or an episiotomy? The thought of an episiotomy or any kind of natural tearing freaks me out and I feel like a c-section might be better in the long run. Am I way off base?

Thanks!!!

[Anonymous]

I don't think so. I had two elective c-sections because I preferred that option to the potential damage of vaginal birth. It's a very personal decision, though, and you'll definitely find moms on both sides of the issue (i.e. everyone will think her way was the right way when really it was only right for her). My recoveries were both a piece of cake, but that is not always the case with either manner of delivery. Best of luck to you.

[Anonymous]

If memory serves, there was a loooooong thread on this topic -- or something really close -- on the old DCUM site. You might want to check that out.

My two cents, based solely on my own experience, is that I'd rather have a vaginal delivery w/o episiotomy -- I had minimal tearing delivering a 6 lb 12 oz baby. A C section is major surgery, and my recovery would have been more difficult, I think. But everyone is different, and every pregnancy and delivery are different. Have you talked to your OB/midwife about your concerns?

[Anonymous]

Thanks to both of you. My OB is a bitchy sort and I am looking to switch. The switch will occur after the next upcoming appointment, so I think I will sit tight until then. At 27 weeks, the baby was weighing in at 2.5lbs, so I tend to think he may be on the bigger side. I'm 5'6", fairly average weight and not particularly athletic. So, no idea on what my pushing skills are like. A c-section *is* major surgery and I know of people who've bounced back without any problems. And then I know of others who tore and bled and what not. I guess I'll just have to hope for the best and trust the OB on call.

[Anonymous]

I can only speak from my own experience but I would chose the vaginal delivery over a C-section any time! A C-section is a major procedure, takes time to recover from and leaves a scar.
If you're stitched properly it will only be irritating the first day or two when you pee but after that you wouldn't know you had the ep.

[LRP]

I am also considering an elective c-section and posted on this board for advice on the old site. It became a very long thread with a lot of just people snipping back and forth at each other but there were also helpful people who shared their experiences with both c-sections and natural births. I believe you can still look up the old threads. Best of luck in making your decision.

[Anonymous]

Vaginal birth without episiotomy, in my opinion, would be the easiest recovery. I had a natural birth this summer, with one small tear and two stitches -- the tear didn't bother me at all, in fact I couldn't tell you which side it was on. My recovery was very smooth. If you think that it's a choice between a C-section and episiotomy I would definitely ask what's behind door number 3 -- it's possible not to have either. I know that some people have bad tearing, but I think it's relatively rare and there are ways to try to avoid it, i.e. perineal massage. I remember being very worried about incontinence and so forth from having a vaginal birth, and I had a little bit of that for a few weeks but it resolved pretty quickly. Although it's not intuitive, apparently women who had Cs don't have a lower rate of incontinence. I don't have anything against women who want C-sections, but I don't identify with that at all -- I was dead set on avoiding one.

[Anonymous]

I was also dead set against having a c-section. I've now had two vaginal births -- first one ended in a vacuum delivery due to a heavy epidural and inability to push and second one was a very quick natural delivery.

In hindsight, I wonder if I made the right decision. I'm probably too risk averse to have ever fully "elected" a c-section. But given the fact that my first delivery was probably almost a c-section, my guess is that had I been at all inclined in that direction, I could have had one but my doctor -- knowing my preference -- was trying everything possible to avoid it and managed to do so.

The recovery was horrific. I had no episiotomy but the tearing must have been ridiculously bad. I was in horrible pain and on percoset for a week and in pretty bad pain for a week after that -- I couldn't even walk. It's hard to imagine that the recovery from a c-section could have been any worse. And I have had incontinence issues ever since. However, once I had one vaginal birth, I certainly did not want a c-section the 2d time. I figured the damage had already been done in one place,no reason to experience it somewhere else.

The second delivery I tore again, but I had a relatively pain-free recovery -- probably because I was already all stretched out from baby no. 1. In any case, I don't know how others feel but to me it's like my vagina isn't my own anymore -- everything's different and shifted around and nothing feels the same. I have been told things may bounce back with time, but who knows. It bothers me.

My only consolation is that from hearing my friends (all of whom have had c-sections, none of which were elective) describe their birth experiences, I suspect I prefer mine. Most of them said they felt very disconnected from what was happening. OK, so that's a big "moment" I got to have, but it's just a "moment" and I'm not sure it's worth the trade off of an entire lifetime of potential issues with my vagina.

So in light of my own experiences, I have done a 180 on this issue. If you do not think vaginal birth is for you and your doctor is on board with that, don't force yourself.

[Anonymous]

I'm recovering from an unplanned C, and it's been horrific as well. I'm still hurting almost 3 months later. I'm sure this is rare, but just wanted you to know it does happen. Some people bounce back from C-sections very quickly, but in my (admittedly limited) experience, people who labor before the section have a much longer recovery.

Good luck to you. Whatever happens, the important thing is to have a healthy baby and mom. You'll do fine whichever way your beautiful angel comes into the world.

[Anonymous]

I intentionally didn't discuss episiotomy with my doc until I was within an hour of delivery. I said "Don't cut me" and she complied. I believe it is their legal responsibility to follow your request. It was my first and they used the vaccum to expedite. I only had a couple of stitches and they didn't bother me a bit. The crazy swelling was the hardest part of recovery, but that's for another thread. It took some time for the stitched skin to stretch back to normal, but I can't tell the difference now.

[Anonymous]

As the proud owner of three episiotomy scars, I can tell you it is NO BIG DEAL! I actually did not I had one until afterward and my feeling is it saved me from other unfortunate issues. At the point you are at it is normal to overthink this.....but it is seriously okay. ENJOY YOUR PREGNANCY!!

[Anonymous]

Thank you all very much. It's good to have all the perspective, since my OB, thus far has been utterly useless.
A healthy baby is all I am really praying for at this time. I truly appreciate your advice.

[HrCreuzi]

Don't assume you'll tear or will need an episiotomy. I'm not athletic in any way. I did practice kegels early on but stopped later. If you use different positions to birth in (not on your back) you're less likely to tear.

I was lucky: I was induced and had a 4 hour labor (2 hours pushing). I had no tearing just a small skid mark. I stayed off my back as much as possible.

Good luck! You may want to try and find a doula to help you.

[Anonymous]

Anonymous wrote:I intentionally didn't discuss episiotomy with my doc until I was within an hour of delivery. I said "Don't cut me" and she complied. I believe it is their legal responsibility to follow your request. It was my first and they used the vaccum to expedite. I only had a couple of stitches and they didn't bother me a bit. The crazy swelling was the hardest part of recovery, but that's for another thread. It took some time for the stitched skin to stretch back to normal, but I can't tell the difference now.

Another option would be to discuss your preference not to have an episiotomy with your provider ahead of time and see what they say. And to create a birth plan so that your preference is in writing. Here is wording about it from my birth plan in case that is helpful to anyone: "No episiotomy – prefer perineal massage, hot compress, and slower birth. I understand that I may tear naturally if one is not performed." If you talk about this with your provider and they say that they routinely perform episiotomies then you know that you may want to switch to a provider who is more in line with your views (and one who follows evidence based medicine).

[Anonymous]

Anonymous wrote:I intentionally didn't discuss episiotomy with my doc until I was within an hour of delivery. I said "Don't cut me" and she complied. I believe it is their legal responsibility to follow your request. It was my first and they used the vaccum to expedite. I only had a couple of stitches and they didn't bother me a bit. The crazy swelling was the hardest part of recovery, but that's for another thread. It took some time for the stitched skin to stretch back to normal, but I can't tell the difference now.

Another option would be to discuss your preference not to have an episiotomy with your provider ahead of time and see what they say. And to create a birth plan so that your preference is in writing. Here is wording about it from my birth plan in case that is helpful to anyone: "No episiotomy – prefer perineal massage, hot compress, and slower birth. I understand that I may tear naturally if one is not performed." If you talk about this with your provider and they say that they routinely perform episiotomies then you know that you may want to switch to a provider who is more in line with your views (and one who follows evidence based medicine).