Debating Planned C-Section v. Vaginal Birth (1st child)

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OP here - thanks for all of this feedback. My OB said she would schedule a C-section if I want one. Curious to hear more from women who had planned c’s on recovery time, level of pain, complications, etc.

I am not wrapped up in the “v birth” badge of honor or “natural way,” really I just want the best long term outcome for my pelvic floor and sex life after delivery.

Plan to have pelvic floor therapy no matter how your child is born is your best bet. Not due to an express need but for best recovery outcomes. Carrying a pregnancy is often as much the issue with post partum pelvic floor as any pushing. Plus pelvic floor PT can help with surgical birth healing - uterine incision healing as well as all the other layers. It’s really important for all pregnancies and often overlooked. Also important of you plan for additional pregnancies.

+1
The pregnancy itself is often the issue with pelvic floor problems.

No, this is unfortunately not true. Levator avulsion is only caused by vaginal delivery and is a huge cause of pelvic floor disorders (and cannot be fixed with surgery). Studies have estimated a 40-year old first vaginal delivery has about a 50 percent chance of suffering an avulsion. https://www.contemporaryobgyn.net/view/vaginal-delivery-and-pelvic-floor-outcomes-levator-ani-injury

[Anonymous]

I had a maternal choice c-section with Kaiser in 2013. Nobody batted an eye: the doc got a second doc to confirm my choice so nobody could say she'd pressured me, but there was no suggestion the doc would veto my choice.

OP, you might want to read the book Choosing Cesarean. It explains that c-sections are extremely safe for baby, somewhat riskier for mom on average but the type of risk is different (eg, no risk of prolapse if you don't push).

I had a healthy full term baby, no asthma or other issues, and I breastfed for 2 years. I also had bladder and bowel issues just caused by pregnancy: it's hard to know if they would have been worse after labor but I assume so.

I only wanted one kid, but I know women who've had 3 sections so it's not like you can only have one. Surgery can make it more difficult to get pregnant later, however, so weigh that.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OP here - thanks for all of this feedback. My OB said she would schedule a C-section if I want one. Curious to hear more from women who had planned c’s on recovery time, level of pain, complications, etc.

I am not wrapped up in the “v birth” badge of honor or “natural way,” really I just want the best long term outcome for my pelvic floor and sex life after delivery.

Plan to have pelvic floor therapy no matter how your child is born is your best bet. Not due to an express need but for best recovery outcomes. Carrying a pregnancy is often as much the issue with post partum pelvic floor as any pushing. Plus pelvic floor PT can help with surgical birth healing - uterine incision healing as well as all the other layers. It’s really important for all pregnancies and often overlooked. Also important of you plan for additional pregnancies.

+1
The pregnancy itself is often the issue with pelvic floor problems.

No, this is unfortunately not true. Levator avulsion is only caused by vaginal delivery and is a huge cause of pelvic floor disorders (and cannot be fixed with surgery). Studies have estimated a 40-year old first vaginal delivery has about a 50 percent chance of suffering an avulsion. https://www.contemporaryobgyn.net/view/vaginal-delivery-and-pelvic-floor-outcomes-levator-ani-injury

DP but it is true. There’s a whole universe of pelvic floor issues that aren’t levator avulsion and are caused by pregnancy, not delivery.

Not saying a c-section doesn’t avoid one particular sort of pelvic floor injury but don’t go into a c-section because you think it avoids anything/everything.

https://www.pennmedicine.org/updates/blogs/womens-health/2015/october/five-myths-about-childbirth-and-uterine-prolapse

[Anonymous]

I would do it if you’re in decent shape. But if you’re overweight it’s not a good idea. A friend who is an OBGYN said her obese patients do very poorly with c section recovery because it’s hard to sew someone up when there’s a lot of fat.

I had a scheduled c section in my late 30s. The doctor said I’d recover well because I’m thin- funny because I’m not actually thin, she just meant not overweight. She was right. My pre-pregnancy BMI was 23 and I stopped jogging early in the pregnancy; my only exercise was a daily 40 minute walk. I didn’t eat super healthy and gained 30 lbs. I had no pain, recovered pretty quickly, and was jogging 8 weeks post partum. (The jog itself felt great but I don’t recommend doing it that soon because afterward, my guts felt jostled around and I had some discomfort a few days.) I was also very careful to not lift much weight during the first 12 weeks.

I’m pregnant again and 100% will schedule another c section. It’s not advisable if you plan to have 3 or 4 babies but 2 c sections is fine.

The main risk with a c section, I think, is that you’ll grow scar tissue on the inside that could adhere to your organs, causing pain or complicating any future surgeries. But vaginal deliveries have risks too, so I think it’s fine to make the decision based on your personal preference.

[Anonymous]

I had a C section from a failed induction, virtually no dilation so it should have been similar to a planned C, resulted in a severe C section isthmocele that was threatening to spontaneously rupture in the next pregnancy (if that happens it is fatal to the baby). The care I received before, during and after that pregnancy was absolutely horrific, I think because it was an iatrogenic injury and doctors didn't want to deal with it because it hurts their ego, embarrasses their colleagues and reminds them most C sections are not necessary. The next C section resulted in symptoms, a thin band of scar tissue holding the sides of my scar tissue, endometrium colonized by enterococcus (poop bacteria) and required another $20,000 specialty surgery to correct.

As for pelvic floor injuries: do not push for more than 2 hours and say no to forceps or vacuum. Even after what I went through I would say no to forceps.

[Anonymous]

Anonymous wrote:

Anonymous wrote:My friends who asked for planned csections in recent years were denied. I wouldn’t assume it will be offered.

+1 unfortunate but true, they are discouraged even though it should b your choice. I had one th first time for a medical reason. I chose it the second time. I wouldn't go into the surgery and recovery lightly, but it was manageable. 2nd recovery much easier.

A lot of OBs go this route due to what they've seen (like your L&D friend) and they have colleagues who will do it for them.

You mean they know the OBs who are competent surgeons and won't leave your uterus a hack job. The first surgeon who butchered my uterus was recommended by my midwife.

[Anonymous]

FWIW, I had two vaginal births and zero tearing. So, it's not a foregone conclusion that you would have to deal with that.

[Anonymous]

Anonymous wrote:I would do it if you’re in decent shape. But if you’re overweight it’s not a good idea. A friend who is an OBGYN said her obese patients do very poorly with c section recovery because it’s hard to sew someone up when there’s a lot of fat.

I had a scheduled c section in my late 30s. The doctor said I’d recover well because I’m thin- funny because I’m not actually thin, she just meant not overweight. She was right. My pre-pregnancy BMI was 23 and I stopped jogging early in the pregnancy; my only exercise was a daily 40 minute walk. I didn’t eat super healthy and gained 30 lbs. I had no pain, recovered pretty quickly, and was jogging 8 weeks post partum. (The jog itself felt great but I don’t recommend doing it that soon because afterward, my guts felt jostled around and I had some discomfort a few days.) I was also very careful to not lift much weight during the first 12 weeks.

I’m pregnant again and 100% will schedule another c section. It’s not advisable if you plan to have 3 or 4 babies but 2 c sections is fine.

The main risk with a c section, I think, is that you’ll grow scar tissue on the inside that could adhere to your organs, causing pain or complicating any future surgeries. But vaginal deliveries have risks too, so I think it’s fine to make the decision based on your personal preference.

Unfortunately, being overweight increases the risk of vaginal delivery complications too

[Anonymous]

Anonymous wrote:I had a C section from a failed induction, virtually no dilation so it should have been similar to a planned C, resulted in a severe C section isthmocele that was threatening to spontaneously rupture in the next pregnancy (if that happens it is fatal to the baby). The care I received before, during and after that pregnancy was absolutely horrific, I think because it was an iatrogenic injury and doctors didn't want to deal with it because it hurts their ego, embarrasses their colleagues and reminds them most C sections are not necessary. The next C section resulted in symptoms, a thin band of scar tissue holding the sides of my scar tissue, endometrium colonized by enterococcus (poop bacteria) and required another $20,000 specialty surgery to correct.

As for pelvic floor injuries: do not push for more than 2 hours and say no to forceps or vacuum. Even after what I went through I would say no to forceps.

I am so sorry for your experience. Your doctors sound awful. Was that local?

[Anonymous]

Anonymous wrote:

Anonymous wrote:I had a C section from a failed induction, virtually no dilation so it should have been similar to a planned C, resulted in a severe C section isthmocele that was threatening to spontaneously rupture in the next pregnancy (if that happens it is fatal to the baby). The care I received before, during and after that pregnancy was absolutely horrific, I think because it was an iatrogenic injury and doctors didn't want to deal with it because it hurts their ego, embarrasses their colleagues and reminds them most C sections are not necessary. The next C section resulted in symptoms, a thin band of scar tissue holding the sides of my scar tissue, endometrium colonized by enterococcus (poop bacteria) and required another $20,000 specialty surgery to correct.

As for pelvic floor injuries: do not push for more than 2 hours and say no to forceps or vacuum. Even after what I went through I would say no to forceps.

I am so sorry for your experience. Your doctors sound awful. Was that local?

No, it was Canada, and I have made it clear to my husband we will be leaving. I am convinced the doctors Canada can attract and retain are inferior as a result of my experiences. They all have attitude problems because they get paid less than American doctors. There is also the CMPA, a multi-billion dollar government funded malpractice scheme, that they can hide behind. Very eye opening experience overall.

[Anonymous]

Vaginal birth at 38 via induction no tearing - easy recovery
C section birth (placenta previa) at 41- recovery has been harder

I’m active so it’s been hard slowing down after c section. I would only choose c section if medically necessary especially having gone through both

[Anonymous]

You reasons for getting a c are not great op. Talk to your doc there are more scary story complications from a c than vaginal. My friend had bleeding and they had to do a cross cut icu surgery to locate the source so she had a giant T wound that had to be packed for weeks following not to mention she could barely move around for risk of tearing.

Giving birth is scary. There’s no easy way out. But obviously most women do fine. Don’t invite additional risk for yourself for no good reason. Go to a hospital in case there are complications. Other than that try not to waste your worry energy on unlikely outcomes.

[Anonymous]

I had a planned c-section for my first at 36. I thought the recovery was minimal and liked that I had no tears and no issues with sex life. I couldn’t drive or lift for weeks, but it was fine because we had a lot of help. I wore a belly binder, did a ton of scar management, and really focused on my core strength when it was safe to workout again. The pain was managed via drugs at the hospital and home. The only discomfort was the shakes and funny feeling coming off the meds.

Currently pregnant with another and will do a scheduled C although my OB said I’m a candidate for VBAC.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I had 2 C sections and would never choose it. Recovery is much longer and more painful. You know it’s surgery right? The doctor cuts thru your stomach and muscles with a scalpel.

That's a myth actually! Your abdominal muscles are pushed to the side so that the Dr can reach the uterus but they are not cut.

You’re right! It’s not major surgery. There’s no recovery, no cutting, no anesthesia. It’s all rainbows and sunshine.

[Anonymous]

An uncomplicated vaginal birth is much easier to recover from than an uncomplicated/planned c-section. That said, a complicated vaginal birth is harder to recover from than a routine c-section. Personally in your shoes I’d try to have a vaginal birth. Especially at your age and if you might want another - it’s recommended you go at least 2 if not 3 years between c-sections, and if you have one C they will usually do all the other births c-section as well, unless you go into labor completely on your own and don’t need an induction or anything in which case most doctors will let you give birth vaginally a c-section. Not as many restrictions on length between vaginal births. Not a big concern if you’re having babies in your 20s/30s … a big concern if you’re already up against the clock in terms of age.