I want a C section
July 21, 2012 7:26 AM   Subscribe

Pregnant and interested in elective C section - looking for anecdotes/resources?

I am pregnant and I still have a ways to go before delivery, but I am thinking a lot about elective C-section (if my OB will accommodate this). I would do this at full term, not early. I am very well acquainted with the medical world and I have been in the operating room for many a C-section, seen many post-operative C-section patients, and also seen many vaginal births. I am well aware that this is abdominal surgery and I'm not afraid of that. I have never had any interest in experiencing childbirth and don't need to prove to myself I can do it - I know I could do it if I needed to. I already struggle with urinary incontinence and I don't want to make that any worse, and I am not interested in anything that could cause trauma to my vagina. I love sex. I've read many studies already and don't want to argue the health risks of one way versus another. I was just wondering if anyone knows of good books or discussion forums about this subject where I could talk about it without getting steamrollered? Or if there are any anecdotes you could share about having an elective C section with no medical indication other than preferences like mine? If I bring this up to family or friends, they can't really handle the idea of it because "who would want surgery??" This is anonymous because of the controversial nature of elective C section.

throwaway email: dontwannapush@gmail.com
posted by anonymous to Health & Fitness (21 answers total) 3 users marked this as a favorite
if my OB will accommodate this

That's very key; I would think you'd want to make inquiries before bothering to go further with this line of thinking. It's quite possible there are no practitioners where you live that will do this, if where you live is like where I live. Not the most inspiring anecdata, sorry...
posted by kmennie at 7:39 AM on July 21, 2012 [2 favorites]

Our experience was quite a bit different, as we were already in the delivery room with a baby who'd been measuring small all pregnany, a labor that wasn't going anywhere, water that had broken unbeknowst to us up to 18 hours before, and some slightly worrisome fetal readings on the monitor -- but when we said "we'd like to just skip ahead to the C-section" they were perfectly happy, even eager, to accommodate us. (And good thing too - there'd been a knot in the cord! It might have tightened if we'd gone further.)

I think if you talk to your OB about your concerns you may find him or her accommodating. I get the sense that some OBs prefer a non-emergency C-section as they can control the variables much more directly that way.
posted by gerryblog at 7:56 AM on July 21, 2012

I ended up c-section because a) baby was breech and b) I have an eye condition that would not be helped by pushing. In your shoes I would approach the doc with your concerns about worsening your urinary incontinence. You may find your OB is sympathetic to your concerns.
posted by PorcineWithMe at 7:59 AM on July 21, 2012 [1 favorite]

I wanted an elective C-section, too. I asked my then-doctor and she responded very negatively. She told me that maybe I could find someone who would do one but implied that that practitioner would have to be shady or only in it for the money. Not her exact words, but that was the idea.

I didn't like my overall experience with that doctor and I switched to another one. I didn't bother asking the new and much better doctor about the C-section because, for some reason, I took the previous doctor at her word.

I ended up needing a C-section because I had pre-eclampsia and my son flipped over at the last minute. I said something like, "Thank goodness. That's what I wanted anyway."

My doctor said, "Oh, you should have said so!" So, yes, keep asking doctors. You're supposed to get to choose what, if anything, goes into your vagina and you should be able to choose what comes out of it, too.
posted by gentian at 8:00 AM on July 21, 2012

I have been in the operating room for many a C-section

That's good. But I'll still give you this advice. That shiny lamp hanging above you on the table? Don't look up at it. Seeing the reflection of your own insides does nothing good for your already stressed state of mind.
posted by MonkeyToes at 8:01 AM on July 21, 2012 [4 favorites]

I had a c-section because my son was pretty much breech my entire pregnancy. Prior to giving birth, my preference was to have a vaginal birth but knowing that was unlikely (the stubborn bugger wouldn't budge), I was fine with the idea of a c-section.

But here is my anecdotal story as to why after the c-section, I really regret not having a vaginal birth. The operating room is super sterile and my husband was not allowed in until right before the doctor started cutting. For most people this might have been 5-10 minutes while they administered the spinal anesthesia but I did not respond at all to 2 spinals and it took a long time before I responded to the epidural. Yes, I was VERY unique but I was in there waiting to get numb for at least 45 minutes before my husband could come in. But this was not the part I hated the most.

I hated the fact that once Baby Murrey arrived, they held my son up to my cheek for 20 seconds and then whisked him away with my husband immediately thereafter. I was again alone while I was being stitched up and carted off to the recovery room. My OB and his nurses were amazingly kind and warm to me, but being alone and not having the chance to really see or hold my son for a couple hours after the birth was super lonely.

I am not trying to talk you out of any decision, but to give you an idea of how I felt immediately post-birth. I have spoken to other mothers who agree that it is a super-lonely feeling. But perhaps we are romanticizing the vaginal birth experience because we never had it. I can't say.

Perhaps you can talk to your OB as to how to avoid having your baby whisked away so fast so you can bond right away and avoid the loneliness. I shared my experience with a woman who wanted a c-section with my same OB and after she signed 80 waivers and releases, she was allowed to hold her daughter in the operating room.
posted by murrey at 8:30 AM on July 21, 2012 [8 favorites]

They took my baby for tests after a vaginal birth and I sent his dad to retrieve him in a fit of new mom rage. A lot depends on hospital policy.

Incontinence is a valid medical concern and you should play that up when you ask.

I had some psychological issues that made vaginal birth frightening for me as a concept, and my OB would've been fine with an elective C but he did refer me to a psychiatrist for a consultation as a mandatory part of that, so be prepared for something similar.

FWIW I went with the vaginal birth and vaginal intercourse is better now. I've heard this from numerous women. Not to argue with your choice, just some anecdata.
posted by the young rope-rider at 9:22 AM on July 21, 2012 [2 favorites]

First c section was because they thought my baby was over 10 pounds (she wasn't). Second was elective.... I loved both of them. I had to be stuck 7 times to make the epidural for the second one "take" .... that was terrible. And I think they gave me too much juice, it took almost 4 hours for it to wear off...... but I had my baby with me.... I recovered easily from both. But, my husband was able to stay home and help. You do need help to recover, for at least 2 weeks. If you have help, I say go for it. Congrats on the little one!!
posted by pearlybob at 11:14 AM on July 21, 2012

Fwiw, my first kid was an emergency c section, the second a vbac. My wife's recovery time was much much faster with the vbac kid, and she was much more comfortable afterwards. I'd suggest talking about the post-op recovery process and timeframe with your OB when you discuss the options, as it can be significant.

Congratulations on your impending baby!
posted by jenkinsEar at 12:49 PM on July 21, 2012 [1 favorite]

Vaginal delivery is generally better for you and your baby. I tend to not trust doctors wo will allow you to choose the surgical opiton over the safer non-surgical option.

I'm biased; I had a surgical delivery, and a post-surgical infection. So not fun. The catheter caused numbness on 1 side of my vagina that resolved over about a year. Managing a 10 lb. infant while healing from abdominal surgery was not fun. Do not recommend.
posted by theora55 at 1:15 PM on July 21, 2012 [3 favorites]

I had a vaginal delivery 17 days ago (and more "natural" than I planned; epidural was late, then the tubing fell out at some point during pushing which no one noticed til afterwards so no wonder I didn't "think" it was working, Jesus).

I will only say this - as much as I love my daughter and am so happy she's here....if I were ever to have another kid, I would do an elective C or not have a baby at all, that simple. I would find a doc who would respect that choice if it took me going to a hospital in another state, I swear to god.
posted by tristeza at 2:41 PM on July 21, 2012 [2 favorites]

will your doctor be on-call? Assuming your OB will accommodate it, for example, if you start labor prior to your scheduled c/s and are going to get it done then, will your OB come in? or do they work in a practice that would send someone else? will all the doctors accommodate the surgery?

I think trying to investigate hospital and provider policies is key here. Some hospitals (very few) are testing out the "natural cesareans" (uh, so few that I can't remember if that's the right term) that allow mom to see more (but not the guts - I think they replace the sheet to close up) and hold the baby more. Some hospitals are more or less sucky about the whole process.

I have not had a cesarean. However, I have scrubbed in on my patients' c-sections.
Talking with patients, what I gather to be one of the more difficult things is basically what murrey says - the baby comes out, she sees the baby for < 30 seconds, then the baby goes off with pediatrics somewhere else.

I think a lot of women are surprised by the post-operative limitations, so that would be something to plan. So identify and have a good support network in place (because no driving the first 2 weeks, no lifting anything heavier than your baby for at least 2 weeks, etc) because that will help recovery.

if there's any way that you can keep your baby with you or even just in the same room or something, do it -- I really think that early time is critically important, when the baby's having it's very first period of awake/alertness.

I admit that I'm really, really not in favor of elective primary cesarean sections, so I'm not going to rehash that, but, I want to say that I respect the fact that you already intend to wait until you're at term. Those last few weeks are so important for development. Honestly, that's probably a good way to weed out a shady OB, if they're willing to section you before 39 completed weeks.
posted by circle_b at 2:42 PM on July 21, 2012 [4 favorites]

Nothing to add specifically about c-section choice except to say make sure you have a strong support network at home immediately after (but then, you should have that really whatever the baby comes out of!), but:

I am not interested in anything that could cause trauma to my vagina. I love sex.

Though it can certainly feel like it "trauma", is really a sub-optimal way to think about giving birth. That's what vaginas are made for, and pushing out a baby - painful as it can be - is not really "trauma" in a meaningful and certainly not a permanent sense.

Despite what movies and others may portray, vaginal birth will not "ruin" your vagina, or cause you to dislike it, or sex, etc by any means. To be honest, for my partner and I, the demands of a baby and associated lack of sleep was far more of a deciding factor in post-birth relations than anything whatsoever that was going on downstairs. Downstairs was fine; we were just so frigging tired we were practically hallucinating, and sex was absolutely not high up on the priority list.

Indeed, you may find that c-section, physically, is more of an inhibitor of sex after birth than a vaginal delivery. Mentally, it may be a different story, but if that is your prime motivator for having a c-section I really urge you to speak to some more people and explore your feelings about your desirability and your body etc - because your body will be different after birth no matter what. Not better or worse, just different; if that's a source of anxiety for you, better to take steps now before you're running on no sleep with a crying baby etc when it will be exponentially harder, and things that merely bother you now may feel catastrophic.
posted by smoke at 4:14 PM on July 21, 2012 [2 favorites]

My ob seems to be one of the few who will fight to get you a vaginal birth, or c-section on request. He supported my vaginal birth, even though any number of other obs wouldn't have (high blood pressure, surprise gestational diabetes, 37 weeks, first-timer) but he was also the one you called if you wanted the c-section. So talk to your ob. A friend of mine just had an elective c-section and she was very happy with it.

(and to add to the vagina/incontinence thing - pregnancy does as much/more 'damage' than vaginal birth, unless something goes spectacularly wrong during the birth)
posted by geek anachronism at 6:14 PM on July 21, 2012

I think the trauma vs. not trauma thing really depends on he birth. Saying every vaginal birth causes trauma/damage is wrong but saying that a vaginal birth won't cause trauma/damage is also wrong. 4% of people get 3rd or 4th degree tears which can cause anal incontinence (!), which is definitely a major problem no matter how you look at it.

Even less severe tears can be a problem. This is TMI, and if you know me in real life you have to forget that I wrote this, but objectively my vagina is damaged. My stitches ripped out before my second-degree tear was healed so I have, for lack of a better term, a notch in my vagina. When I try to do kegels, it hurts quite a bit, so thankfully I don't have incontinence or prolapse issues that would make kegels necessary. I will have to get surgery if I ever feel like fixing it. It isn't mental or me having the wrong attitude towards birth or whatever, it's a real actual injury.

So even if you have the right attitude towards it or whatever, yeah, vaginal birth can cause trauma/damage to the vagina and the surrounding tissues and it seems to be largely a matter of luck.
posted by the young rope-rider at 6:31 PM on July 21, 2012 [5 favorites]

I had a scheduled C. There was a medical indication for it. (MeMail me for details.)

I thought it was fine. Don't assume that you'll mourn a fantasy birth experience that you didn't have.

Here are some things to think about:
- How do you feel about being on opioid pain meds? Some people hate them. Some people feel uncomfortably out of it while on them. I don't think it's possible to have a C without two (ideally three) weeks on them. I don't feel like being on serious pain meds inhibited my delivery/birth experience at all. I feel okay on viocodin, though. Not everyone agrees.
- You will never ever ever ever be able to explain your decision away to a lot of people in your life. I had a (medically indicated) scheduled C, and a lot of (otherwise) lovely people in my life took the opportunity to tell me that there's nothing like pushing a baby out of your vagina, implying that I should be super-sad about my surgery. If you decide to have a non-medically-indicated C, I strongly suggest telling people it was necessary. People are jerks, man.
- I was fine in the (maybe 45?) minutes between the delivery of my baby (in which we had a weird cheek-to-cheek encounter, and I was all, "Uh, so, it's you.") and when we were reunited in the recovery room. It was not very long for us, but that's because I delivered at a rad hospital. I understand it's not always like this. We have had plenty of time since then to bond, and I do not, personally, believe that humans are like geese, requiring bonding in the first few minutes. Again, this is a topic you'll get a hard time about. Because some people are jerks.
- I had zero trouble with breastfeeding. In my experience, you'll get a lot of information to the contrary, but my milk came in right on time.
- Having a good night's sleep before you go in for a C-section is really the best possible start. I have heard tons of stories of people who had to deal with 30+ hour inductions leading to their C, and it's no wonder for me that the surgery kicked their asses. It was much easier to deal with knowing it was coming and being able to rest up and prepare.
- I don't think your concerns about incontinence are crazy. My mother is 61, and after two C-sections, she has no incontinence problems at all. Her friends (some of whom are the "You can't imagine how amazing pushing a baby out is" people) do have such problems. This is obviously anecdotal.

Listen, this is a fraught topic. You're not likely to find any internet community that's like, "Yeah, C-sections!" I wasn't opposed to a vaginal birth; it just wasn't in the cards for me. I do know a couple of doctors who had Cs on purpose because they felt like it was more civilized. You're not wrong for feeling this way.

On the other hand, lots of folks have had super-crappy C-section experiences. And you have to understand that you might have one of those too. Are you the type of person who will mourn your birth experience? You know yourself best. I've thought about this a lot, both about the cultural expectations of birth and the medical stuff, so please MeMail me if you'd like to chat.
posted by purpleclover at 9:57 PM on July 21, 2012 [4 favorites]

I just wanted to share my experience, because I had such a phenomenal csection with my daughter. Immediately after she was born, they brought her to me to hold on my chest while they stitched me up. She did not leave my side except to get suctioned out. I also had her with me the entire time in recovery, unless I asked the nurse or my husband to take her. They had me start breastfeedng as soon as they wheeled me out of the OR. It was wonderful! I elected to have her via section due to previous preeclampsia, and I am so so glad that I did. Besides being horribly sore after surgery, it was quick and relatively easy and my doc was wonderful. You can have a birth plan for a csection, and you might have more options than you think. Once you find a doc who is willing to do the elective surgery, ask about how post op stuff will go. I was surprised with how awesome it was!
posted by Happydaz at 10:40 PM on July 21, 2012

Assuming you get the go-ahead, schedule your post-birth OB follow-up appointments ahead of time. I have this dim memory of being in a 4 a.m. drugged-out post C-section haze and someone walking in to my hospital room and saying, "Can you make such-and-such date for an appointment? Great!" and then getting yelled at by the office for forgetting. That will also let you arrange driving duties, because you probably won't be able to drive.

Someone noted up-thread that scheduled C-sections let the docs arrange their time more efficiently, and that's true. Talk with your doc. "Where do you stand on full-term elective C-sections?" is a question you need to ask, and *do* mention your concerns with urinary incontinence. (But in the immediate period after, you might still experience the old sneeze-and-pee thing.) If you present your case reasonably and calmly, there's a good chance that you'll be heard. And asking sooner rather than later would be a good thing, in case you get an answer that sends you packing for another practice.

Good luck.
posted by MonkeyToes at 6:06 AM on July 22, 2012

I'll share my unplanned c-section experience, in case it helps. I had a c-section after more than two days of (horrible) back labor. I had planned for a completely "natural" birth and had gone through childbirth classes. But my labor was progressing very slowly, even with pitocin, and on the morning of my son's birth, I just couldn't take another minute (the epidural wasn't even helping enough), so I asked for a c-section. I think one would have been suggested earlier if I wasn't delivering with midwives rather than an OB/gyn.

A few things about my surgery:

-Recovery was very difficult. During the first few days, getting out of bed, turning over in bed, and walking felt almost impossible. There were restrictions afterward, like not driving for a while, and avoiding stairs and lifting as much as possible. Sleeping was difficult after getting home (without that nice adjustable hospital bed) and I had to send my husband out to buy a triangular/wedge pillow so that I could sleep on my back propped up. That's the only way I could sleep for a while. On the first day home, my husband went out to buy diapers and I ended up sobbing by myself, trying to change my son's onesie and failing -- it hurt too much to bend down to do it. There was also a big list of medications to take after I got home (painkillers, anti-inflammatories, stool softener, etc.).

-It was upsetting for me not to be able to hold my son right away when he was born. I was just kind of trapped lying down on the table. They took him away to do tests, and because of the way the operating room was set up, I couldn't even see where he was. I could hear him crying/screaming, though, so I sent my husband over to be with him. My husband wanted to stay with me, but I didn't want my son to be alone. That was very difficult -- to hear him crying and not be able to even see him.

-I had a weird experience with the anesthesia -- my arms felt very numb/floppy afterward, and I could barely control them. It made me pretty anxious, but none of the hospital staff really seemed to care when I told them. It made my son's first attempt at nursing difficult because I couldn't really hold him properly.

-My scar healed very well, and two years later it looks really good. I asked for stitches (which dissolve over time) rather than staples (which I think are standard, i.e. easier for the doctor), because I had read that they make for better healing. Plus, you don't have to have anything removed. This is something you might want to look into.

Even after a somewhat traumatic experience, I don't regret having a c-section. I think one reason I had such a long labor (50+ hours) is that deep down, I was very scared of labor and childbirth (even thought I had felt prepared). Plus, the back labor was nothing I had expected. One positive thing about a c-section is that you avoid any chance of an episiotomy or tearing, one of the things I was most worried about. Still, it's major surgery, so it's certainly a good idea to do a lot of research and to know your preferences for things that you can control (e.g., stitches vs. staples). Good luck!
posted by trillian at 11:33 AM on July 22, 2012

Oh, and the "sneeze-and-pee thing" that MonkeyToes just referred to -- two years later I have this problem sometimes, even without the vaginal delivery. So unfortunately, as people have said already, it isn't a guarantee.
posted by trillian at 11:37 AM on July 22, 2012

I am confused here... how would a vaginal birth ruin your orgasms? Birth does not ruin your clitoris (as far as I know). We've all heard the "hotdog down a hallway" jokes about women who've given birth, but those are just stupid jokes, not reality for most of us.

My personal experience is that vaginal birth did not "ruin" me. Sex is...actually better (and it was great before). My vagina is not a canyon, my husband is happy. I love sex too. I am sure that most of us women who have had vaginal births love sex just as much as you do.

If you struggle with urinary incontinence, then I'm sure you've had a visit or two with your doctor. I hope you have - no woman should feel ashamed about this. Please talk to your OBGYN about this problem.
posted by lotus-eater at 1:38 PM on July 22, 2012

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