Intervention: What thought disturbs you more.

[Inertia]

Ok, so ignoring the unwanted and unnecessary interventions that we all disagree with, I am thinking more in a case where your options are slim. Something has to be done quickly because (X justified reason).

Which one would you choose - or more to the point, which method would you be more comfortable with?

1: Ventouse (Vacc delivery)
2: Forceps
3: Cesarean

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Personally I would probably go straight for the C. Sad but true, but tbh a botched episiotomy is not something I would be willing to risk. Also the whole idea of someone grabbing hold of my babies head (be it with a big salad fork or godfreys bowling ball style) and basically yanking it out of my body in what is already a tight and no doubt difficult path is just horrifying.

What about you guys. No doubt it is something everyone has looked up - but if push came to shove, what intervention would you be more scared of your doctor/mw telling you they want to try next?


ETA: Just add, I had been giving this a bit of thought with regards to my birth preferences because previously I just winged it and was lucky I was an extremely difficult case to get several intervention attempts thumped on the head with my utter refusal to rush my babies. But now I am writing this stuff down, making the most of my last stint in a delivery room, it is really striking me that if push came to shove, I am so glad now I am informed enough to have a conscious - painfree thought on how I would want it handled.

[myson]

I think the scariest thing would be forceps... mainly because not many Docs are using them anymore I have been told. I have also heard from some ladies that ventouse is sometimes possible without episiotomy.

Cesarean itself doesnt scare me... the recovery from having my belly cut open is a very daunting thought.

But then Ive never had anyone one of these things, yet!

[mrsmac]

I had forceps with my 1st baby so it doesn't scare me at all. My obs was older and very skilled with them, she didn't have a mark on her, when I was having DD2 I kept begging them to get some forceps to make it easier LOL

[OceanPrincess]

With DD, I was facing these three options... except my Obs hadn't mentioned c-sect, but it was in the back of my mind.

She said she wouldn't try forceps without an epidural so we went with vacuum. I'd never go for c-sect unless it was absolutely necessary. My recovery from the vacuum and episiotomy has been straight forward, give me that over major abdominal surgery any day.

Oh and the Obs tried the vacuum without an episiotomy first - so I think it is possible.

Also my recovery from the episiotomy has been better and cleaner than my sister who had a few tears and grazes from a delivery without an epi.

[amberj]

I would go for the vac first, then probably c-sect over forcepts- those things scare the willies out of me!!

I had the vac with Peter and I had a big episiotomy and some nasty tearing, so the recovery was NOT great (and lots of complications)- my dr said it was on par, pain wise and limiting of movement wise- with a c-sect.

BUT, the really cool thing was- I got to push, even with the vac! I had an epi so I was feeling pretty left out of my labour, and I couldn't really feel the pushing and probably did a crap job- but I got to push! I actively helped get my baby out, and that was awesome. So from that perspective, I would def go vac over c-sect. I suppose you could argue the same with forcepts, but as I previously said....those things scare the willies out of me!!!

[Willow]

I would avoid a c/s at all costs so would go with either forceps or vaccum first.

[Toomanytoomany]

The idea of forceps makes me want to vomit. I can't cope with a pap smear or internals... the idea of forceps just... ugh I'd rather die. So I'd go for a c-section, I guess.

[Jakabella]

I didnt get a choice and had an emerg C-sect...
TBH it was not a bad experiance.. I was up the next day and the pain only lasted a day or so and then it was just tender.. I was up and about on day 2 and didnt look back. Obviously I wanted to do it all vaginally but it didnt happen and I really think my c sect was not so bad under the circumstances.

I hope you get the birth you want and dont have to decide on any of the options!!

Kate xox

[Janie]

I personally would avoid a c-section if there was something else that could be done first, either forceps or ventouse. I had forceps (after ventouse failed), and like Mrsmac, my Ob is older and very skilled with them, so it was no biggie.

I've heard too many scary stories about ventouse, especially those done without an episiotomy, to make me ever want to go down that route. Obviously it's safer for bub, but I don't think I'd consider it without an episiotomy.

[BellyBelly]

The thing is with c/s and while the risk is slim, you set yourself up for a risk of rupture next time around (although you do that just by having an induction and yes, also during a c/s), a repeat c/s, infection, hysterectomy, haemorrage and not to mention anaesthetic complications. Its not just that birth, but the impact on future births women need to think about. Most Obs put the most stringent conditions on VBAC women which may result in you not having the birth you want, ever... I'd choose c/s last because they wont bat an eyelid if you want a normal birth next time around and you wont have any birthing conditions.

[Snowy Love]

I'd choose c/s last because they wont bat an eyelid if you want a normal birth next time around and you wont have any birthing conditions.

:yeahthat: Wot she said!

[Snacks]

I'd probably still go vag, either way (vac or forceps). I could never have surgery unless it was my only option.

[2CheekyMonkeys]

i'd go vaccuum, forcepts c-sect. i had a vaccum first time round with no episiotomy, i did tear though.

[paradise lost]

Bearing in mind that the reasons for needing any of those 3 can either be seen well in advance or completely avoided during labour i doubt i would find yself in a snap-decision type situation.

The part of me that is rational would like to know what the sudden need for immediate deliver actually IS, because i seriously can't think of one. Sudden foetal distress - why? I wouldn't let them augment me, or have an epidural, or other drugs, so why is the baby distressed suddenly? In unaugmented natural labours one usually can tell something which might later cause distress (usually poor foetal positioning) is afoot because the labour is slow and doesn't progress much - babies drive labour in normal circumstances and will not do so to the point that they are struggling. If the cord is so tangled inside that the baby can't descend without distress then we NEED a c-section. If there is a prolapsed cord but i am fully dilated and pushing, if i need any assistance at all from forceps or ventouse then my baby is very probably going to die or be severely damaged because you have only a few moments to get the baby fully born in that situation. If there is deep transverse arrest - why? I wouldn't have an epidural and in the absence of them DTA is incredibly rare.

I know i'm not really answering the question, but that's the key issue for me. Not the intervention itself but the reason for it. If you NEED a c-section there is no decision to make. Michael Odent never used forceps and he never needed to, their major popularity grew to a fever pitch in the middle of the 20th century when labouring women were given general anaesthetic and hadthe baby dragged out of them while they slept. Odent states that he used c-section when needed, which was about 11% of the time overall, and didn't offer forceps, or anything else that required the supine position.

Inertia it may interest you to know that in almost all emergency c-sections where the baby has descended into the pelvis (i.e. was "engaged") the Ob uses forceps to drag the head back up and out of the incision, an incision which is as small as possible to minimise damage to the uterus. The baby is fundamentally physiologically designed to be pushed out of the vagina, however tight the fit, and the vagina is designed to massage the baby into life as it emerges. C-sections are (theoretically) used ONLY when there is no alternative but damage or death, and it would be a mistake to think that choosing one over an assisted vaginal delivery would save the baby trauma.

Bx

[Lolli]

OK, I'll be honest- I go for the vac or the forceps before the c-sect, but only if there was no epidural involved. The thought of having a needle shoved in my spine scares me more than the other options put together.

[mrsmac]

Epidurals scare me more than anything! I know its irrational but I had a friend whose whole body shut down after one and she had to be revived so they have always scared the life out of me.

[Inertia]

see, I knew there was a reason to ask this. The extra eyes looking at it from all angles is always helpful!

I figured for me I would be in a good position to not worry about a C-S seeing how I don't plan on having any more kids. But the only way I could possibly be sure of that is to never have sex again - and that just doesn't sound like much fun - so certainly I would have to consider that I would want to vbac. But add that on top of everything else (grand multiparity, prior uterine atony) and I would be hard pressed to find someone willing to let me vbac - not to mention, would I want to risk my baby under all those circumstances.

I don't anticipate that I would need to consider anything regarding this. The last time my labour stalled and they were "discussing my options" without me, I went through a MFER and then my body shut down, causing the PPH. But that is where my problem starts mentally. To put it gently as possible - I have a serious aversion to medicos sticking their hands and god knows what else wherever they please like its open season. I understand for sure that at the time it was a medical emergency - but that really does not undo how it made me feel. As it is I have since left going in as late as possible to minimise the amount of times they decide to check to see how far I have dialated. I'd personally prefer they didn't at all.

I am extremely lucky to have never torn - and the idea of asking for it to be done for me by someone who I don't want down there in the first place is already bad - but then they'd have to stitch it up.

Really - all the options are bad no matter how I look at it. I am just trying to decide for me which is less worse than the others. So much to consider and all the input is very welcome. I just will continue to sit here and tell myself that it wont come to it and it will all just be a discussion on a forum - but at least I will have planned for it anyway.

[paradise lost]

Inertia you are perfectly within your rights to decline vaginal examinations, they are not necessary - checking labour doesn't make it happen betteror faster!

DD gave me a 2nd degree tear with her shoulder on the way out which i didn't have stitched (my choice) and it healed beautifully without any of the painful scar tissue some of the women i know who WERE stitched have. I know a woman who had a 3rd degree tear after her planned unassisted homebirth. She didn't have it stitched either, just kept her legs together for 10 days (tied her knees together loosely when she was asleep so she wouldn't part them too much) and she too healed up fine. Tears are generally not volunteered for but unless you tear through the rectal mucosa stitches are a choice.

Bx