Hi Becky,

I haven't had a c-sect so i only have anecdotals i'm afraid.

My mum had 5 vaginal deliveries and 2 c-sections. The 1st c-section was an emergency for placenta praevia and the 2nd was elective (or rather, because they didn't allow VBAC then and she'd already had one section). She said she recovered much faster with the vaginal births (1st resulted in 2nd degree tear, no tearing to speak of for the rest, no stitches anyway) but that the c-sections weren't so bad. SHe also said the elective c-section led to MUCH faster recovery than the emergency - she thinks they were very rough as they were literally working to save her and my brothers lives by then - she had a general as there was no time for spinal. She said her scarline and just her guts generally felt badly bruised and painful for about 2 months after the emergency, but nothing like that after my birth, i was the last, the elective c-section, during which she had a spinal and watched the whole thing in the mirrors behind the bulbs in the surgical lamp. SHe said she felt fit and well a few weeks after my birth though she was a nurse so she did take it easy for the prescribed 6 weeks. My brother was nearly 4 and had been told about mummy not being able to pick him up etc. so i think it wasn't too bad.

My cousin is a doctor and during her training she watched lots of deliveries of all kinds including on where during the incision-making to get to the baby the Ob cut a 4" long bone-deep slit in the baby's scalp/face which needed stitching immediately and through which he lost a fair bit of blood and ended up in SCBU. This IS NOT the norm, but it can happen.

I think the instrument-damage risk is something which exists whenever instruments are used and you can maybe ask your ob to try to get the baby with his hands rather than using forceps, unless it is an emergency?

Maybe you could look into ways to avoid tearing (as others have said, perineal massage during 3rd tri, no pushing from crowning, have the midwife support your perineum, maybe deliver on your hands and knees as this can relieve pressure from the perineum etc.) and also work out your preferences for a c-section in case you decide to have one (ie no instruments if poss etc.), then write down all your pros and cons (recovery time, risks, etc.) and see which one you're leaning towards.

You've plenty of time to think about it at least.

In my opinion (and that's all it is) i'd look into a vaginal birth. I know women who did NOTHING different and still tore FAR less with 2nd and subsequent babies, and there are lots of ways to avoid stitches in the hoohaa - having stitches in your uterus, muscles and belly seems the least attractive.

Hana