Has anyone been 'advised' to choose an elective C-Section?

[Eternal_Howl]

I plan to give birth vaginally, but after meeting my midwife on Tuesday, it's been recommended that I may want to consider an elective c-section. I'm not down with this, but I must admit that it has made me wonder if I should. The risks seem pretty big.

My midwife has concerns that I may end up with problems with my anal sphincter if I birth vaginally. Yeah, I know it's lovely to think about and I've been as polite as I could be without giving up too much info :)

When she initially told me the concerns and that apparently my issue isn't as common as I thought (actuallly quite rare...allegedly), I did entertain the concept of a C-section that evening. And then I kind of got annoyed. I realize that my health is as important as my baby's, but I hear a lot about how c-sections are often over 'prescribed', when they should be for those mothers and babes that are in a medical emergency. I do feel pretty comfortable in New Zealand's health care. It's not like the US where everyone is trying to win another malpractice suit. But the whole thing left me a bit stunned. The way I see it (and I really am no expert) is that whatever issue has presented itself has been caused by the pregnancy. If I've been 'damaged', the damage is done already. I don't see how a C-section will improve things. (But again, it doesn't mean I"m not still wondering which is the better course of action. This is my first pregnancy.)

Has anyone else been 'advised' or 'recommended' to choose a c-section? Have you decided to go with the medical advice?

[jbk21]

Well.... Without knowing what the issue is, it's a hard one to answer!  What exactly are the risks?  What are the odds of those things actually happening?  Would other pushing positions help the situation (say, if you were on all 4's and not on your back?)  or is it the act of pushing itself?

Were you planning to birth in the hospital?  With a CNM?  I have never been advised to choose a c-section, and I'm not yet sure what I'd do in your situation....

[Jaimee]

Agreed... I would get more information about the risks involved and probably seek a second opinion from a specialist in the area.  Like J mentioned, if it's the pushing that is of concern, women are able to birth babies with minimal pushing if conditions allow.  Position (both baby's and mom's) and support are paramount. 

[crazykittymomma]

I'm confused about where your midwife is keeping her crystal ball...I mean, how in the world can she be recommending MAJOR abdominal surgery on the CHANCE that you MIGHT have an issue?
Hell, after going through a hellish c/s already, I would rather have a fourth degree tear than be cut in half again.
I would get a second opinion for sure.

[APToddlerMama]

DDCC.  I'm due the first week of December and actually just updated a post on this same topic earlier today.  Maybe you don't want to share, but what reasons does she have for suggesting a c-section and thinking you'll tear so badly?  I'm assuming from your signature that this is your first...?

I had a third degree tear with my first (who was a 6.5 pound baby born at 35 weeks) so was offered a c-section this time by my OB (who has had two c-sections). I was also annoyed at first, but then when I started doing a little research, it seemed like a more reasonable option that I had been thinking.  Anyhow, my care has just been switched over to a perinatologist, for reasons totally unrelated to tearing, and I asked her what she thought about the c-section in my case and she claimed to be "crunchy" and not think a prior third degree tear was reason for c-section.  However, after taking a look at my perineum, she said it was pretty short, and also my first tear was jagged and not repaired well which would cause another repair to be more difficult.  Also with the short perineum, I'd be at greater risk of tearing badly again...and this baby is measuring big too.  So, if I am lucky enough to go towards full term with this baby, I am going to do the c-section.  Perinatologist does not benefit from me having a c-section as she won't be delivering my baby and does not work with my OB, so I was more inclined to listen to her opinion than my OB's. 

Anyhow, I would definitely want an answer on *why* she thinks you'll tear so badly.  3rd degree tears are uncommon.  I think something like 5% of women will have a 3rd or 4th degree tear and they are notoriously hard to predict.  I'd get a second opinion.... That said, I don't know how a midwife would benefit from telling you to have a c-section so that would definitely give me pause to think. 

[Eternal_Howl]

Originally Posted by crazykittymomma 

I'm confused about where your midwife is keeping her crystal ball...I mean, how in the world can she be recommending MAJOR abdominal surgery on the CHANCE that you MIGHT have an issue?
Hell, after going through a hellish c/s already, I would rather have a fourth degree tear than be cut in half again.
I would get a second opinion for sure.

It's based on the fact that I'm already starting to experiencing an issue now. (Fecal incontinence - yuck.) It's not really bad, but I figured it's just that baby is pushing on all the wrong things and all the wrong places. I think I will get a second opinion. She did offer to send me to the OB before I asked. But I'm still inclined to want to birth vaginally. One can't know for sure that what's happened already won't rectify in time with some exercise and a few less pounds pushing on various spots, right?

[APToddlerMama]

Originally Posted by Eternal_Howl 

It's based on the fact that I'm already starting to experiencing an issue now. (Fecal incontinence - yuck.) It's not really bad, but I figured it's just that baby is pushing on all the wrong things and all the wrong places. I think I will get a second opinion. She did offer to send me to the OB before I asked. But I'm still inclined to want to birth vaginally. One can't know for sure that what's happened already won't rectify in time with some exercise and a few less pounds pushing on various spots, right?

You might want to think about getting a referral to a physical therapist as well.  I believe they can use biofeedback to work on strengthening and retraining the muscles.  I worked with a PT on pelvic floor dysfunction after my pregnancy and found myself peeing a lot less when I sneezed, etc. 
 

[Eternal_Howl]

Because we're discussing the same thing, it's probably better to continue in the thread you started APToddlerMama.

http://www.mothering.com/community/t/1328104/offered-a-c-section-updated