Caesar vs Vaginal Birth & Episiotomy
For those that have had BOTH
, Nov 05 2012 07:31 PM
34 replies to this topic
Posted 05 November 2012 - 07:31 PM
I have been thinking about my vaginal birth of my DD and the recovery - she was an 8 hour labour, 9pd baby and I had an episiotomy due to risk of tearing (Dr's words). The stitches came out (the outside stitches, I think the internal ones were ok) about two days later and couldn't be re-stitched so I had to simply let an open wound heal naturally. I had baaaaad haemorrhoids and anal fissure, a 500ml blood loss after birth and generally felt pretty crap. I couldnt drive for 2-3 weeks due to pain and swelling from the episiotomy.
So, I am wondering, for ladies who have had both a vaginal birth with episiotomy and so forth (particularly a drawn out recovery) and a Caesarean, what was better/worse in terms of recovery, pain etc?
I am considering an elective c-section next time
Thank you for sharing.
Edited by MissM86, 05 November 2012 - 07:32 PM.
Posted 05 November 2012 - 07:39 PM
I've had both and the VB for me was much worse. Though that was more than likely due to the 28 hour labour beforehand!
ETA - I never had haemorrhoids or a fissure either, but I wonder if also since DS was second baby I wasn't an overwhelmed first time mum either. That would've helped. I also couldn't drive for at least three weeks with both, was still in pain for several weeks.
Edited by *Relish*, 05 November 2012 - 07:41 PM.
Posted 05 November 2012 - 07:39 PM
I only have had a c-s , considered elective even though for medical reasons ..was not an emergency...the recovery was great...really you are tender for a few weeks but up and about same day... My scar was tender but that's me... You have to be careful bending and picking up... Only allowed to carry bubs at first...
Depending on your insurer and recovery no driving for 3 weeks... I am not good with pain so was rather surprised at how relatively good it all was and the quick recovery compared to what you have described....
I have no other issues...
Posted 05 November 2012 - 07:42 PM
I had an episiotomy twice & both times hardly noticed it in the days following, other than some mild stinging. However I also had a broken tailbone for my second and that was the reason I had an elective Caesar for my third birth. It was the right decision. Recovery was much much harder than the natural birth / epistiomoty but not even close to the tailbone.
Posted 05 November 2012 - 07:42 PM
I had a non-elective CS first, and even after 20 hours of labour, the recovery was a breeze. I was up and showering within 4 or 5 hours, walking the dogs and doing the shopping a few days later.
Second birth was a shorter labour for a VBAC with an episiotomy. I had some issues afterwards with wound healing etc, and was rather sore and sorry for 2-3 weeks.
So for me, the CS was much easier physically. My second baby was also fairly drowsy and a bit wiped out (probably from some opiate analgesia given a bit late in labour), so she didn't take to breastfeeding with the same gusto as my first (CS) baby, who was bright and alert and looking for a feed even as we were wheeled into recovery. Having said that, I would almost certainly go for another VBAC if I were having a 3rd. But that's probably because I had a disappointing VBAC experience and would like another shot at it...
Posted 05 November 2012 - 07:44 PM
I've had both. My vag birth was 28 hr labour (posterior position) with episiotomy, failed vacuum and subsequent forceps delivery. My c/s was elective (breech presentation). I went on to have another very quick, drug free vag birth with slight natural tearing. There was no way I would have voluntarily had another c/s. My c/s recover was very straight forward but the vag recoveries were so much easier and quicker, even the first "traumatic" one.
Posted 05 November 2012 - 07:45 PM
Even without an episiotomy, your perineum will be sore.
I've not had a Caesar, but I've done them... And I'd take my vaginal births with episiotomies any day! (Both mine had mild shoulder dystocia so as far as I'm concerned the episiotomies were justified!)
Posted 05 November 2012 - 07:46 PM
It took me 2 1/2 years to finally stop feeling pain from my natural birth. I have also had an emergency section and an elective. I would pick a section over a VBAC any day of the week! Both recoveries of my sections were a breeze.
Posted 05 November 2012 - 07:48 PM
My 1st birth was a Vaginal one with an episotomy which got infected in the week after, which meant I was sore, feverish and on oral ab's with an extended recovery down there and have scar tissue which is enough for Drs to comment on when I get examined for the pap smears
....the actual birth was pretty standard i think, 16 hour labour, 2 hours of pushing and the episotomy and he was 8 p 7 oz. with a 36 cm head. He was posterior but "turned at the end"
My 2nd birth was the polar opposite.. I was 7cm dilated when I got to the delivery suite, I dilated much quicker, but then labour slowed down, she turned posterior, had heart rate declerations and I ended up with a failed forceps, emergency cesear delivery where she was born feet first cause her head was so wedged in my pelvis and she was resuscitated succesfully. Interestingly, her birth stats were smaller at 7p 1 oz, head of 34 cm.
That birth had blood loss, my Hb was under 80, and I had urinary problems but I felt fantastic after the birth so much that I went home on day 3.
I can compare the two and if I had the choice of giving birth again, I would certainly choose the vaginal birth. Honestly, in my experience the recovery times for my 1st delivery was about 3 weeks, and for the 2nd one, it took me a good 3 months to get over, my scarline would be sore and get "puffy" if I did too much, and Im not talking alot! I was on iron tabs for a long time, and a year later my Hb had just got back to an acceptable level, but I still needed to take the Iron tabs. If I had to do that cesear scenario again, i wish I had gone with the blood transfusion to get that sorted out instead of it taking a year.
THe 1st birth scared me alot, I had alot of anxiety about giving birth the 2nd time, but when i was in labour with my 2nd, I was ok. If i could give birth for a third i would not be scared, I know it would be ok. good luck with your decision.
Posted 05 November 2012 - 07:55 PM
I have had both and I have booked in for a ceaser for my third baby. I recovered a whole lot better from my ceaser than I did with my vaginal birth. I had a 9lb 10 oz bub, with a episiotomy and also had a third degree tear, retained placenta which meant I had to have all stitches removed and redone after they had removed the placenta a week after being stitched. Very painful. I couldn't sit comfortably for weeks which meant I couldn't drive. My second was born via ceaser as I was having difficulties again and he could not get delivered via forceps as he had brow presentation. It was so much better and my recovery time was 3 weeks versus 6 months. It was a very easy choice for baby no. 3. I had too many stitches to count (doctors words...not mine!) and I know where I would prefer them. I was so embarrassed as I had to take a cushion to sit with me wherever I went to make it more comfortable for me to sit down.
I spent every spare moment in a salt bath to ease pain and keep clean for months. I also had significant blood loss requiring transfusion which meant I was on significant amounts of anti biotics to stop infections and was rushed to hospital hemreoging with blood clots because of retained placenta. Overall an extremely bad experience I would not put on anyone. I had no complications post ceaser at all and found it a lot easier to keep wound clean, a lot less painful and I was able to sit post delivery !
Posted 05 November 2012 - 07:57 PM
I had similar probs after DS (stitches didn't take, infection, open wound, two separate trips to hospital as developed abcess...surgery to drain....)
Dr said I could probably choose what to do if we have a second. I figure with all the bad luck of the first I'm due for a nice, straight forward birth second time round.
That's how it works doesn't it!!!
Posted 05 November 2012 - 07:58 PM
I had a hideous episiotomy after #1 it took months for it to be remotely comfortable whilst my close friend who had an elective C/S the week before my birth was back to 'normal' very quickly but my next 4 births were tears of differing degrees and they all healed very much better and were far less painful so having trouble first time does not indicate there will be problems subsequently.
I have seen some episiotomies and tears which required extensive surgery, far more complicated than a routine C/S so I was never so convinced that VB was going to mean a better recovery that I had a fear of needing a C/S.
My own DD had an awful first VB and an uncomplicated C/S for her second with a recovery that was so much better that she says if there is another she will choose C/S.
I think you need to talk to your caregiver but ultimately you need to be happy that the decision you make is right for you.
Posted 05 November 2012 - 07:58 PM
Your second birth is not likely to be as difficult as your first. You've done the hard work, why not get the reward?
Posted 05 November 2012 - 08:09 PM
My first labour was long with a POP bub (persistent posterior -she never turned). Tearing and stitches.
I was in the labour room 13 hours. Pethidine, epidural and gas.
Second pregnancy, another vaginal birth. No tearing. 13 minutes in the labour room (about 2 hours all up of actual labour). No drugs. Up and about very quickly.
3rd pregnancy was twins, emergency c-section. It was good, no complaints, but recovery was longer and I needed a lot more help from nurses etc. Longer in hospital away from my others too.
If I went again, I would be going a vaginal.
Posted 05 November 2012 - 08:16 PM
Your second birth is not likely to be as difficult as your first. You've done the hard work, why not get the reward?
I agree with your first sentence but I am not sure what you mean in your last one
Posted 05 November 2012 - 08:34 PM
Wow, thanks for all your replies, I appreciate your sharing of experiences. Mum always says the next births are easier so I understand where PPs are coming from who echo that sentiment. I will have to discuss this with my Obstetrician, I know, but I do like hearing from others!
Posted 05 November 2012 - 08:40 PM
I had a VB with an episiotomy (only small though) for my first and a c-sect for my second.
I was up and about the same day with VB and not too much pain (so different from your experience OP) and was able to drive when I left hospital.
With c-sect (which I am still recovering from) pain was a lot worse for me and not really comfortably mobile until day 3 (with pain meds) and still can't drive 2 weeks post c-sect. And probably not for at least another week. I can't do much at home, which is frustrating and can't pick up toddler/put her to bed/bath her etc and won't be able to for the next 4 weeks.
From my experience I'd go a VB any day over a c-sect but as STBG wisely pointed out that everyones experience is different so talk to your Dr.
Don't forget that a c-sect is considered major surgery.
Posted 05 November 2012 - 08:52 PM
I had an em c/s with #1 after a long induced labour. While the recovery seemed fairly simple, it was extremely painful to move, walk, laugh, cough etc for weeks/months. While pg with #2, I felt a lot of twinges along my scar line. 10 years later I still get the odd pulling sensation along my scar line.
The VBACs I've had with the other 3 children have been reasonably easy. TMI- However, after all 3, I got terrible haemorrhoids. So bad that on day 5 with #2, I had the piles lanced and drained as there were clots in them. After #4, the dr was quite helpful in commenting how bad they were, but no advice on how to deal with them. Needless to say, I am aware of the excruciating pain of haemorrhoids. In addition, i got 2nd degree tears with both #2 and #3. Despite the terrible pain I was in after those VBACs, I would never, ever choose to have another c/s.
For me, those first few days/weeks were very painful after a VBAC but nothing compared to the weeks/months of discomfort of the c/s.
Posted 07 November 2012 - 12:50 AM
I had a fast natural birth for my first it didnt go well for me I had a fair bit of damage and suffered post traumatic stress the recovery was close to 6 months. I opted for an elective csection with my second and it went perfectly. For me it was an excellent choice and for our 3rd theres no question of elective again
In saying that dont take the decision lightly (I know you are and can fully understand what you went through the first time with birth and recovery) but it is still major surgery the recovery is still hard and painful (although not compared to my first!) and has all the risks that go along with surgery.
Have a talk to your OB about everything. Its a very personal choice and im sure you will make the right decision for yourself
Posted 08 November 2012 - 01:25 PM
I had a caesar for my first and a fairly epic VBAC with 2nd degree tearing for my second.
FWIW, I had far more complications after the CS than I did after the VBAC. I had fissure issues that developed post CS and went on for months, I suspect due to the painkillers (codeine?). So if you opt for a CS, be aware of that and stay well hydrated etc.
Posted 10 November 2012 - 02:34 PM
I've never had a VB, but I physically healed from my elective C/S really quickly and had no complications. I was walking (with pain) the next day, I had an afternoon C/S, but I don't for one moment think it would be any easier to walk with stitches or a wound in my perineum. I imagine it would be harder? My friend who had a VB had bad haemorrhoids and grazes and found it extremely difficult to walk and go to the toilet.
I would be asking my care provider about what the possibility of another episiotomy is. Also I would be asking about what healing time is expected if you were to tear along your scar tissue. It's maybe questions that can't be answered because of the nature of everyone's bodies being vastly different and recovery times etc being different, but IMO is important to ask. I was certainly asking all of these questions before I signed the consent for my C/S.
I'm not sure what I'll do next time around honestly. I did have a traumatic C/S (go figure!) so it's for me a case of trying to decide to VBAC and risk all the complications that could happen there, considering it will be my first labour also, or go a C/S knowing what I'm in for already and knowing that my body did heal really well and quickly from the first one.
Posted 10 November 2012 - 03:01 PM
I've had two episiotomies and each time I was sitting cross legged in bed the next day. I think you were just really unfortunate the first time.
Posted 10 November 2012 - 06:06 PM
Cinnabubble- Sitting cross legged???? OMG! I couldn't sit ON A COUCH for about 3 weeks. I had to sit on a hard chair as the soft couch shifting underneath me was agony.
I remember I went to a physio info session on how to fix my abdominal muscles. We had to sit on the floor. I couldn't get down there and had to sit on a chair and this was about 10 days post birth.
Does this sound normal for an episiotomy?
Posted 14 November 2012 - 12:08 PM
I had a scheduled c/s with #1
Emergency c/s with #2
VBA2C with #3, which involved tearing that was stitched.
Overall, I would choose the VBAC.
The differences ...
With the c/s, sitting was fine. I would be perfectly comfortable once I sat down. It was just the getting up and down that was hard. With my first c/s, it was about 5 weeks before I really felt completely normal, and even then there were occasional twinges.
With the vba2c (so tear and stitches), sitting was horrible. I was getting a lot of pain, not just from the stitches, but I had a LOT of bruising which made sitting really painful. I bruise REALLY easily. The first week was terrible. And then I worked out the best to sit, and it wasn't a problem after that. I think the worst of the bruising was going down by then.
Suprisingly, crosslegged was actually good for me
Or with my legs under me somehow. It was all a matter of how I positioned myself, and sitting with one leg folded up underneath me was comfy.
Posted 14 November 2012 - 12:32 PM
mine was like your first-I went on to have two more vaginal births and yes I tore but nothing like the forceps and cut fissures etc I had with DD
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