purely elective caesarean

[April2012]

I am nearly 34 weeks pregnant with my first baby. Most likely this will be my only child due to personal rather than medical reasons. I am, however, in my mid-thirties. I have made the decision to have (and scheduled) an elective caesarean. Here in the United States, it is the most commonly performed surgery in hospitals. Approximately, one-third of all babies in recent years have been born via c-section. (I realize the statistics vary on this point a bit). Most c-sections aren't purely elective...they are either emergency situations or results of unsuccessful inducements.

I realize a caesarean section is abnominal surgery that requires healing, has its own set of complications and risks, and can be very painful. So why would I decide or "elect" for a caesarean? I have thought a lot about this, and have decided to have a caesarean for these reasons (not necessarily in order of importance).

1.) I live somewhere in which caesareans are performed routinely and successfully.
2.) I have health insurance that covers the surgery.
3.) I am healthy and a good candidate for the surgery with respect to low risk of complications and good potential for successful and speedy healing.
4.) I do not plan on having more children...certainly not several.
5.) Many women end up having a caesarean as a result of a failed inducement or other sort of emergency. So at least mine will be under the most controlled circumstances.
6.) I have tremendous support from family and OH to proceed with a c-section. My mother has had four caesareans. She lost her first baby after a c-section was performed too late.
7.) there is less potential of physical trauma to the baby by circumventing the birth canal. (I also understand there are benefits to baby by going through the birth canal...so I am not forgetting that.)
8.) there is less stress and possibility of damage to the vaginal wall--reducing possible vaginal prolapse. statistically, less incontinence issues in advanced age. (I also understand many, many women who deliver vaginally NEVER suffer from this stuff).

I guess I am just attempting to put my thoughts down, and I welcome any feedback or comments...whether in agreement or disagreement in whole or part. Note: I have conceded that my points are not the rule for every woman or even most women. They are just points I have used as "part" of my deliberation on the issue.

 

[Amber100]

I am in the UK & nearly 36 weeks & am having a cesarean for similar reasons. For me a vaginal delivery is too much of a Russian roulette & I've witnessed some very sad events from when 'normal' deliveries have gone very wrong. I've looked into both options in depth & am completely confident that a cesarean is the right choice for me. Good luck with yours.

 

[SabrinaKat]

I had to have an emergency c-section at 36wks due to pre-eclampsia, BUT from the beginning of this pregnancy, I wanted a c-section anyway -- for me, it was the fact that it was a controlled situation (I had a terrible mc) and there would be doctors looking after me and the baby, so your reasons make perfect sense to me (but I am a transplanted American anyway) -- I did find, that I was having to justify, e.g. baby was estimated to be big and I am small (small pelvis), when people asked -- if I could have printed out your list and handed it out, that would have been perfect!

My ob/gyn did agree with me on an elective c-section from the beginning, so I never had the 'problem' of persuading medical personnel to agree with my point of view, which was also quite liberating, but in the UK and Ireland, it is not common yet for elective c-sections and you might find a number of ladies disagreeing with you here!

best wishes

 

[susies7100]

I am having an elective c section on 14 March 2012. I am 37 weeks and 2 days now and in the UK. This decision is mainly due to my anxiety about childbirth. Have got myself in a real state about it over the passed 6 weeks or so and have actually put off pregnancy until it was almost too late because of this (irrational?) fear. Also my baby is breech and up until 35 weeks i also had placenta praevia, although the placenta has now stretched out of the way.

I found it quite difficult to convince the Consultant that this is the right option for me and feel that the maternity services need a link up with mental health professionals to help women in my position. If it had not been for a very focused and supportive partner, I believe I would still be facing a natural childbirth, which for me = trauma

I have found the anxiety of the impending birth has marred somewhat the pregnancy experience, which is shame as I intend this to be the one and only pregnancy and birth I experience.

I do feel like a bit lame too, as other women seem to take the whole pregnancy and birth relatively in their stride, yes, they get a bit apprehensive, but their apprehension doesn't seem to render them rigid with fear.

Has anyone else had these feelings ?

 

[April2012]

I am having an elective c section on 14 March 2012. I am 37 weeks and 2 days now and in the UK. This decision is mainly due to my anxiety about childbirth. Have got myself in a real state about it over the passed 6 weeks or so and have actually put off pregnancy until it was almost too late because of this (irrational?) fear. Also my baby is breech and up until 35 weeks i also had placenta praevia, although the placenta has now stretched out of the way.

I found it quite difficult to convince the Consultant that this is the right option for me and feel that the maternity services need a link up with mental health professionals to help women in my position. If it had not been for a very focused and supportive partner, I believe I would still be facing a natural childbirth, which for me = trauma

I have found the anxiety of the impending birth has marred somewhat the pregnancy experience, which is shame as I intend this to be the one and only pregnancy and birth I experience.

I do feel like a bit lame too, as other women seem to take the whole pregnancy and birth relatively in their stride, yes, they get a bit apprehensive, but their apprehension doesn't seem to render them rigid with fear.

Has anyone else had these feelings ?

I think it is very admirable that women are speaking up for what they want and what is best. Just because vaginal delivery is the oldest and more "natural" form of delivery, doesn't necessarily make it the best. we know caesarean sections save the lives of countless women and babies. i don't think anyone is arguing that caesarean sections have their place in obstetrics. the argument that some people advance (practitioners and women) is that unless you fit into the handful of "legitimate reasons" for a ceasarean, vaginal is best. But I disagree. I believe that where we are in medical advancement, c-sections offer women the ability to have controlled, safe, less traumatic births...and that isn't only a valuable proposition for those in "emergency" siutation, that is valuable to all women planning to deliver a new life.

Susie: I would try not to get bogged down with how other women embrace vaginal delivery. you are a unique woman unto yourself. other women haven't seen or lived your life. what is right, doable, exciting for them, isn't necessarily your truth. this is your body, your experience and your child. you are brave enough to advocate your position on what is best for you and your baby. that isn't lame at all.

 

[SabrinaKat]

Susie -- I agree with April and completely understand -- it was also psychological in my case and both my GP and ob/gyn were in complete agreement, so how you feel is not unusual at all!

I had a mc and two chemical pregnancies before getting my LO and was afraid throughout the pregnancy that I would lose him and knowing that I was going to have a c-section made that aspect feel like I had some 'control'; in fact, that I had an emergency c-section is irrelevant as I felt so calm and relaxed (even with pre-eclampsia) because the baby and I were fine! I had spent countless nights worrying about the worst that could happen and what if's? YOU are not alone with your fears, so push for the birth experience that is right for you!

I look down at my LO and thank god/am so grateful that medical intervention saved my life and my LO as well -- in your case, it is the best decision because a medical procedure will mean mommy and little one will be safe (both physically and mentally!)

best wishes

 

[saoirsecian]

hey there im living in scotland and i have opted for a c section due to severe anxiety,,, i have had 2 naturel births previous to this one.. and i do not want to go through that again.. i also am having my c section in march 14th and im praying i do not go into naturel labour... my consultant is the one who put me in touch with a mental health professional which helped me make my decision on a c section... you are right all women should have option to speeck to a mental health professional if they have any fears of vaginal birth...

 

[arj]

I am actually feeling guilty for considering a C section! I wish I was as fine about it as you all. I had two terrible natural births resulting in episiotomies and damage to both babies heads due to metal instruments, and am having twins this time and am worried about things going wrong.

Its a hard call for 1st time mums tho I think, C section is a major surgery where a good normal vaginal birth is a walk in the park (Ive been to 3 normal ones and it was fine) and recovery is better and no ugly scar. But it seems that half the births out there lately have something go wrong! (like mine did)! I think tho now days there is that choice and its yours to make, no matter what you choose it's your life and your decision and try not to let old schoolers tell you what to do (MIL and Mum are both saying Im silly to want a C section) :/ All the best with the C sec!

 

[Arisa]

arj, after what you went through I think its very sensible you are opting for a c-section
I know lots of women recover fast from a vaginal birth but I have been surrounded by women and girls who have had bad vaginal births and found the recovery hard if not worse than that of a section recovery.
If you are fit and healthy and do not need assistance like ventouse or forceps then yeah a vaginal birth is best. I would rather have my stomach cut than my vagina personally. my MW said you can be up and about and walking properly within two weeks post partum but this is my first and only baby so this is one of the reasons I can get one too, she said if it was my third or fourth child then I would not be given the option IF I had healthy vaginal births but with such a traumatic experience that some of your ladies have had I would opt for a C section, most doctors are on board for it anyway.

 

[purple_kiwi]

I had an emcs with my daughter and because of it i decided to go with a planned c-section this time. I have had a few comments from people but my doctor gave me the choice to choose and supports my decision. It was just to stressful to go through labor then almost having my daughter die to repeat it again and i don't trust my body to try again as it failed me the first time. I believe any well informed person should be allowed to choose a c-section if they want.

 

[iow_bird]

I had an emcs with my first and it was traumatic to say the least. I will definately be opting for an elective this time as I feel the situation will be more in my control. I had a hideous experience with my last labour, luckily both me and bubba were fine, but I can't go through that again purely because I can't mentally handle the idea of it. I had post traumatic stress and nightmares.

Good luck with your deliveries ladies x xx

 

[arj]

I had and emcs with my daughter and because of it i decided to go with a planned c-section this time. I have had a few comments from people but my doctor gave me the choice to choose and supports my decision. It was just to stressful to go through labor then almost having my daughter die to repeat it again and i don't trust my body to try again as it failed me the first time. I believe any well informed person should be allowed to choose a c-section if they want.

Amen!

 

[sunshinegal]

Hi ladies,

I realise this thread is a few weeks old, but I was wondering, at what stage did you ask for an elective c-section? I am only in the early stages of pregnancy but after witnessing a very traumatic birth I feel sure that a c-section is the right choice for me.
Who did you first bring it up with and at what stage?
Thanks in advance for any suggestions! x

 

[April2012]

Hi ladies,

I realise this thread is a few weeks old, but I was wondering, at what stage did you ask for an elective c-section? I am only in the early stages of pregnancy but after witnessing a very traumatic birth I feel sure that a c-section is the right choice for me.
Who did you first bring it up with and at what stage?
Thanks in advance for any suggestions! x

I found that 32-34 weeks was a good time to make a request. it is about the time birth plans are discussed with the doctor. it gives your doctor time to schedule the caesarean with the hospital and for you to register with the hospital. it is also far enough along that the doctor can tell if your due date is on track so he/she will know when an appropriate time is to schedule the surgery. my doctor said that it is good to schedule the c-section at around 39 weeks in order to avoid possibly going into labor first. I am scheduled for the 10th of April and my due date is the 15th.

If you are thinking about a c-section for a specific medical reason known to you, it is possible you or your doctor will discuss that much earlier.

 

[chuck]

This is a great read
https://childbirthconnection.org/article.asp?ck=10166#systematic
it compares CS to VB after a systemiatic review of numerous studies and here are some of the highlights...

33 areas where cesarean section was found to involve more risk than vaginal birth, and
4 areas where vaginal birth was found to involve more risk than cesarean section.


Extra risks associated with cesarean section: Current research suggests that cesarean section has the following disadvantages in comparison with vaginal birth:

Physical problems in mothers: Compared with vaginal birth, cesarean section increases a woman's risk for a number of physical problems. These range from less common but potentially life-threatening problems, including hemorrhage (severe bleeding), blood clots, and bowel obstruction, to much more common concerns such as longer-lasting and more severe pain and infection. Even after recovery from surgery, scarring and adhesion tissue increase risk for ongoing pelvic pain and for twisted bowel.

Hospitalization of mothers: If a woman has a cesarean, she is more likely to stay in the hospital longer and is at greater risk of being re-hospitalized.

Emotional well-being of mothers: A woman who has a cesarean section may be at greater risk for poorer overall mental health and some emotional problems. She is also more likely to rate her birth experience poorer than a woman who has had a vaginal birth.

Early contact with, feelings toward babies: A woman who has a cesarean usually has less early contact with her baby and is more likely to have initial negative feelings about her baby.

Breastfeeding: Recovery from surgery poses challenges for getting breastfeeding under way, and a baby who was born by cesarean is less likely to be breastfed and get the benefits of breastfeeding.

Health of babies: Babies born by cesarean are more likely to:
be cut during the surgery (usually minor)
have breathing difficulties around the time of birth and experience asthma in childhood and in adulthood.

Future reproductive problems for mothers: A cesarean section in this pregnancy puts a woman at risk for future reproductive problems in comparison with a woman who has a vaginal birth. These problems may involve serious complications and medical emergencies. The likelihood of experiencing some of these conditions goes up sharply as the number of previous cesareans increases. These problems include:
ectopic pregnancy: pregnancies that develop outside her uterus or within the scar
reduced fertility, due to either less ability to become pregnant again or less desire to do so

placenta previa: the placenta attaches near or over the opening to her cervix

placenta accreta: the placenta grows through the lining of the uterus and into or through the muscle of the uterus

placental abruption: the placenta detaches from the uterus before the baby is born

rupture of the uterus: the uterine scar gives way during pregnancy or labor.

Concerns about babies in future pregnancies: A cesarean section in this pregnancy can affect the babies of future pregnancies.

Studies have found that they are more likely to:
be born too early (preterm)
weigh less than they should (low birthweight)
have a physical abnormality or injury to their brain or spinal cord
die before or shortly after the birth

Planned cesarean compared with unplanned cesarean: A planned cesarean offers some advantages over an unplanned cesarean (a cesarean that occurs after labor is under way). For example, there may be fewer surgical injuries and fewer infections. The emotional impact of a cesarean that is planned in advance appears to be similar to or somewhat worse than a vaginal birth. By contrast, unplanned cesareans can take a greater emotional toll.

Planned cesarean compared with vaginal birth: A planned cesarean still involves the risks associated with major surgery. And both planned and unplanned cesareans result in a uterine scar and internal scarring and adhesions. This means women with planned and unplanned cesareans face similar risks in future pregnancies and for problems related to scarring and adhesions at any time

Extra risks associated with vaginal birth: In a few areas, mothers or babies with vaginal birth have poorer outcomes in comparison with cesarean birth.

Perineal pain: While a woman with a cesarean birth is more likely to experience more intense and longer-lasting pain overall, a woman with a vaginal birth is more likely to experience pain in the vaginal area in the weeks and months after birth.
Incontinence: A woman with a vaginal birth is more likely to leak urine (urinary incontinence) and to leak gas or, more rarely, feces (bowel incontinence). Pregnancy itself and other factors such as the woman's weight play a role in these problems. Few women experience troubling symptoms beyond the recovery period in the weeks and months after birth.

Nerve injury in babies: In comparison with a baby born by cesarean section, a baby who is born vaginally is more likely to have a nerve injury that affects the shoulder, arm or hand.

I would never choose to increase so many risk for an illusion of control.

BUT that said you have to do what is right for you.

 

[Winks]

Interesting stats. But stats can usually be read either way. It would be interesting if emergency vs elective stats were included. My doctor indicated that an elective c-section was far safer than an emergency one.

My first pregnancy ended in an elective C-section due to pre-eclampsia. I didn't go into labour at all. Had the best experience. Think the drugs made me feel completely in love with everyone - especially my baby. Great recovery, can't see my scar unless you really stare down there.... Breastfeed easily. Ofcourse it didn't change the sleepless nights!

Each to their own - my plan is to have another C-section this time too

 

[chuck]

Winks if you read the article it does include some EMCS vs. ELCS info.

But all of those risks for mother and baby are apparent in EMCS and ELCS, without going through it now (its far too early LOL) I think an EMCS give a higher risk of hysterectomy.

 

[littleblonde]

I have had 2 sections. My 1st section was due to a breach baby. So was taken out of my hands. This went like a dream and i had no complications and was perfect. i then wanted a vbac for my 2nd but i had a failed sweep so i went for section number 2. I won't go into to much detail but i almost lost my daughter. I just want to get out there that people (me included) had no idea that a section can be just as complicated and have just as many risks as a normal birth. By daughter got stuck coming out which is something i never expected, the decision is between you and your dr but if i have another i will once again push for a vbac x

 

[Scuba]

Hi ladies, I have tested positive for having GBS infection - not carrying it, actually having the infection - in a high vaginal swab a couple of weeks ago.. I'm now really worried and want a c section as I feel from what I've read online that having a normal delivery would increase babies chances of contracting the infection as they pass through the birth canal.
I'm in the uk, what ate my chances of being able to get a c sec?xx

 

[momofone08]

I personally had a c-section because my daughter was breech. I am opting for a vbac this time. I personally would not decide to do a c-section for my first if I don't have a history of complications and if baby is okay. However, this is 100% your decision and I hope you get the experience you are hoping for.