Weighing up my options - Advice please

[bigbloomerz]

So my 1st labour was a forceps delivery with an epidural that didnt work and left me with back problems since, I had to be cut down there and when they stitched me up, it was too tight and didn't heal properly leaving a lot of scarring.
This has meant for the past 4 years sex has been almost impossible (unless drunk haha) and Smear tests have been excruciatingly painful to the point where the Nurse has had to use a "Virgins" Speculum.
I had to have a cervix examination last week due to some pains I was having and the pain made me jump so high, I pretty much hovered off the examination table. I hadn't really given Labour this time round that much thought yet the mindset of I'll worry about it nearer the time, but now after that experience last week I'm petrified of a natural birth. The though of a CSection petrifies me even more. I really wouldnt like to have another epidural or spinal block, last time put me off, which I'd need for the CSection. I'd love a natural water birth, but I just don't see it happening.

So basically just wondering what would you do if it was you? After weighing up all the options? x

 

[firefly15]

I have no advice over which birth option to choose, but I also had a forceps delivery and then stitches that burst. When it eventually healed up I had extra scar tissue that gave me ridiculous pain when it was touched (internally). I saw my gp who was brilliant and referred me to a gynaecologist and she used silver nitrate to remove the extra scar tissue. It was like magic, and I haven't had any pain since. I would really strongly recommend getting your gp or midwife to refer you to see if there is anything that can be done pre-labour. I was completely miserable and sex was impossible because of the pain so I understand where you're coming from

Get a referral because it may be that there is actually something that could help. x

 

[bigbloomerz]

I have no advice over which birth option to choose, but I also had a forceps delivery and then stitches that burst. When it eventually healed up I had extra scar tissue that gave me ridiculous pain when it was touched (internally). I saw my gp who was brilliant and referred me to a gynaecologist and she used silver nitrate to remove the extra scar tissue. It was like magic, and I haven't had any pain since. I would really strongly recommend getting your gp or midwife to refer you to see if there is anything that can be done pre-labour. I was completely miserable and sex was impossible because of the pain so I understand where you're coming from

Get a referral because it may be that there is actually something that could help. x

Thanks Firefly, I had a referral to gynaecologist who offered a Fentons procedure (where they reopen and restitch up) but not until ive finished having children! helpful...I've not heard of the silver nitrate, i'll look into that thanks

 

[tryfor2]

Oh honey, I'm not sure I'd go the natural birth (without drugs) route if I were you. If it was a bad vaginal birth WITH drugs, can you imagine it WITHOUT? I can't. And I'm in a similar position to you as my birth was somewhat similar though not as bad. I had an epidural, episiotomy, vacuum suction instead of forceps, no problem with stitches (although I could feel my dr. sewing me up bc my epidural didn't work very well). Sex was uncomfortable/painful for 10-12 months afterward. Like you, I am quite nervous about this birth. Sure, I have an idea of what to expect this time, but considering how it went last time I think that's why I'm so nervous. My OB told me last time she had to do the episiotomy (not routine anymore) bc in her words I was going to "tear everywhere." I have a stiff perineum apparently. I figure it hasn't gotten less stiff in the interim so I am actually worried about attempting to give birth without an episiotomy! I can't just opt for a c-section here--there has to be a "legitimate" reason, so I'm looking at a vaginal birth again. I do plan on getting the epidural again bc as imperfect as it was, it did help an awful lot. I'd tried laughing gas and Demerol before that and they did NOTHING.

I understand your hesitancy to get a CS as I hear the recovery is tough--and it would be even tougher with having an older (heavier) child to care for as well. My SIL did too much too soon and opened her incision--twice. You're really out of commission for a few weeks, from what I hear. That said, last time my baby was breech for much of my pregnancy and my dr. was talking planned CS. I was on the fence but liked the idea of bypassing labour! It turned out differently in the end obviously, but if you did go the planned CS route there is that "plus"! And none of the swelling, bruising, burning, less bleeding, and incontinence and painful sex that often follow vaginal births.... It's a tough call. Only you can make the decision but having gone through my less severe version of what you experienced, if I had a choice I would probably opt for a planned CS. Women tend to really focus a lot on the actual birth of their child when really it is such a short period of time. Does it really matter how your baby comes into the world? I think we often get so hung up on the natural vs. CS, drugs vs. no drugs that we forget about the most important thing of all--that our babies get here safely and healthily. You must think of the repercussions. Another four years of painful sex vs. a few weeks' recovery from a CS? I know which one I'd choose.

 

[bigbloomerz]

Thanks tryfor2, nice to hear what someone in a similar situation would do
It's something I'm going to have to sit down and do a pros and cons list for I think.

A C Section is something I've never wanted to have unless in an emergency, the recovery time is longer than a natural birth, and I have a little girl starting school 5 weeks after my due date, I'm going to have a busy summer, I can't afford to "take it easy" haha.

But like you i'm worried about the " swelling, bruising, burning, bleeding, and incontinence and painful sex" again afterwards! my bladder hasnt recovered from the last labour and is also on the list to be fixed (it would be a joint operation with the fentons) there is just so much to consider, and yes I probably should have thought about it before getting pregnant lol. x

 

[BunnyN]

I can see why you are worried and it's worth looking into your options. On the side of natural birth I have read birth stories of women in a similar situation that said for some reason their next birth actually 'fixed' their issues. Another thing is that there are a lot of hormones that help you cope with pain during a natural birth. I hope you can find a solution that works for you. Hugs

 

[Dimbo]

I had internal 3rd degree with first, second was again natural home water birth, but as he descended it burnt like nothing I've felt before, it was painful. It turns out he was large, and I had torn almost exactly as before. As you can tell, I'm all for natural home delivery, but in the right circumstances. If I were you, I'd investigate The option of an epidural to start with and if that doesn't work, then anaesthetic. I'd hate to have had another set of surgery at a later date either time, and anything to reduce the pain and worry. I beleived in nmy body 99% bit that 1% still had doubt and I worry that if you're not totally trusting everything will be fine, it'll make it harder on yourself.

At the end of the day, go with your gut and what you truly believe to be the right option xx

 

[Kittycat155]

I hardly ever say c section but I think in your case that may be best under general. I would worry about tearing in another spot and having same thing happen again. I do not have kids so keep that in mind:S But The risk of a tear again being the same as last time with 2 to care for this time around would scare me. Your vagina is obviously not normal at this point if the exam and sex hurt that bad.

If you were just afraid with no pain I would have another take and lean more towards vaginal birth with a note on file that you had issues with last epidural. Tlak it over and see if she can put you in touch with someone who may have had similar issue.

 

[teal]

I had an emergency forceps delivery, espitiotomy and separate 4th degree tear. It took three hours being stitched up in theatre. I had a follow up with a consultant at 8 weeks post and was advised I was lucky they could repair the damage and if I tore again there isn't any guarantee a repair would work and I could end up incontinent. My tearing caused so much pain and I needed physiotherapy for a prolapse. If I ever had another child I would opt for a section.

 

[Bambino123]

My first was a 35 hr posterior labour resulting in massive episomity and a severe prolapse. This resulted in 9 months of intensive Physio. I honestly think the epidural caused most of the damage. When it got to the pushing stage I felt nothing and couldn't tell what muscles to relax and where to push. I have a naturally tense pelvic floor due to lots of horse riding. So essentially I was pushing against a brick wall. This time I'm concentrating on trying to relax my pelvic floor, which I can't do if I get an epidural. So I'm doing lots of yoga, listening to hypno birthing cd's and hoping for an epidural free labour. And a baby that is facing the right way too!

Best of luck

 

[Bambino123]

I don't know how to edit my post, I just wanted to add that obviously my experience was very different to yours, so I'm not suggesting you do the same thing, just sharing my reason for hoping for an epidural free one for me. Whatever you decide let's hope you have a much easier time!

 

[Banshee]

I haven't voted as I had two emergency c sections so have no experience of tearing or what it might be like for you to have a natural birth after what happened last time and the pain you are in. However, I did have a c section under general with ds1 and I would never recommend it to anyone. I really felt like I had missed out on something as I was unconscious when ds1 was born. You go under pregnant and wake up not pregnant, I found it very unnerving and struggled with the fact that I hadn't 'given birth' to my son. Also your partner can't be there if you have a general.
Just some things for you to think about.

 

[3Minions]

I know your first birth was traumatic but I think if I were you I'd try for another vaginal birth.... There's the chance that you'll tear right through the scar tissue and they'll sew you back together properly, solving your other problems.

 

[Jencocoa]

I would not do medical like c section unless medically necessary. As far as pain med, my opinion is give it a go without meds. I think it's commendable to try but then you have the right to change your mind if you feel u need meds.

 

[bigbloomerz]

Thank you all for your replies, I'm thinking of going down the route now of still trying for natural and if it hurts then it hurts lol. I may regret saying that at the time! I do not like the thought of a C Section and think they should be for extreme circumstances, I don't think they are the "easy way out" by any means, I'd be horrified if I had to have one. At the end of the day it has to come out and in the best way possible for us both, so once discussed with the Midwife and Consultant hopefully they will help me decide on what is to do for the best. The thing that worries me the most about a vaginal birth is the amount of internal examinations they do whilst you are in labour! But I suppose I could maybe "opt" out of some of those if necessary.x

 

[BunnyN]

Honestly if labour is progressing normally there is no reason you must have any internal exams, just say that you don't want them.

 

[MindUtopia]

I think you can always prepare yourself for a natural birth - and really prepare, look into natural coping methods, try hypnotherapy, hire a doula, etc. - and then see what feels right when the time comes. To be honest, I found sex and cervical tests (before I had a baby) to be painful and sometimes stressful, but having a completely natural birth was nothing like that. I didn't even use gas and air, just a TENS and natal hypnotherapy (and I had a home birth, so an epidural wasn't even an option). In fact, the only painful parts were having my cervix checked (so much so that I won't consent to one again in my next labour) and getting stitches, but giving birth as a whole, even the crowning bit, was totally doable and not overly 'painful' (I also had a 2nd degree tear which I honestly didn't feel). I hated the cervical exam in labour, actually my birth plan said I didn't want any, but they asked to just do one to check how dilated I was because they didn't think I was really in labour (turns out I was fully dilated). You absolutely can decline any internal exams and I'll be doing just that next time around.

In your case, trying hypnotherapy would probably help tremendously because it would help you to learn to relax those muscles (tightening up when you're feeling tense or worried about pain actually causes pain) and to teach your body to release endorphins to deal with any pain. Even if you decide to go the epidural route or have a c-section, it's still an incredibly helpful tool to use to help you stay calm and manage discomfort and feel positive about what you're doing. I think it's worth a try. You can always ask for an epidural or a c-section on the day if you feel you don't want to try the natural route, but you can't go the other way if you get an epidural or plan a c-section and then feel differently in the moment. You will probably surprise yourself at how much you can handle and that could be a really empowering and positive experience for you.

 

[shinona]

I would try for a natural birth if I was you but be open to the idea of an epidural if you need it.
My first delivery was foreceps, epidural, spinal block and episiotomy in theatre. It was awful and really traumatic. I've had a few issues after though nothing as bad as you. My mw really put my mind at rest before dd's birth and sure enough it was a smooth birth, exactly what I wanted. Contractions for 10 hours approx, one hour of gas and air then 3 pushes and she flew out. I did tear but it healed quickly.
Are there other pain med options for you.? Does your hospital offer remiphentinol (sp?) for example?
xx

 

[BunnyN]

Another thought that might be encouraging. It may be that most of the pain you experience during exams and sex is very superficial. By that I don't mean that it's not real but it could just be coming from the nerve endings on the surface of your skin. There are a lot of nerves close to the surface on your skin which is why sometimes a pin prick hurts more than a cut. It seems like the nerves in your scar tissue have been left more sensitive than normal. It may be that you don't actually have more pain than normal during birth because it is a different kind of stimulation that doesn't effect the nerves on the surface so much?

I can totally see why you might choose a c-section but personally that would be my last choice because the last thing I'd want was to risk a totally new painful scar.

 

[bigbloomerz]

Good point Bunny I hadn't thought of that. not much longer till I see my midwife and see what she thinks, Today I have another worry, which School my 4 yr old is accepted into!