Midwife vs C Section

I just had a c-section 6 weeks ago for my second child. The first one was too big and wouldn't engage, so I had to have an emergency c-section. I have to say that if you have a large baby that may not fit or if you might need a c-section, then schedule it!! Recovery was so much better when I didn't go into labor before hand. I needed a lot less drugs afterward, bleeding was not terrible, and recovery was just a whole lat easier. I haven't had a vaginal birth to compare it with, but from what I have read what you went through and are going through is much worse than a c-section. Good luck!

You can also continue with an obstetrician and plan a vaginal birth- discuss in advance how likely an episiotomy will be. Many MDs are now avoiding episiotomies (with exceptions) as vaginal tears may heal as well or better in many cases.

Since I'm a nurse midwife, I just have to clear up one misconception. Midwives do perform episiotomies, but are less likely to do them routinely. I've had a few patients over the years who actually needed an episiotomy to preserve the health of the baby. I've performed an episiotomy for 2 reasons: to speed up delivery when fetal distress is evident, and shoulder dystocia (when shoulders are lodged behind the pubic bone). Vaginal tearing is somewhat dependent on birthing technique (allowing the perineum to stretch, maternal position at birth being upright instead of lying down, and less forceful pushing help prevent both pelvic floor damage and tearing of the vagina) but it also depends on the mother's skin integrity. Hereditary factors and nutrition (low protein diets lend to more tearing at birth and slower healing) also play a part in whether a women will suffer a large vaginal tear regardless of size of her baby.
Pelvic floor problems like rectoceles and cystoceles (bulging of bladder into vagina) are often blamed on vaginal birth, but research tells us that just being pregnant puts one at risk. Hereditary factors, obesity, straining with chronic constipation and chronic coughing also can cause these disorders.
C-sections are major surgeries with major risks especially if one desires to have more children. Please research this topic thoroughly before making a decision. I'd recommend you make a consultation appt with a midwife and see what you think. We tend to spend more time with women explaining things during the prenatal period and during the labor/delivery and postpartum period.
There are no 2 births alike. My first birth was a nightmare: 30 hour induction with horrible pain, shoulder dystocia, 3rd degree vaginal laceration, and hemorrhage. Recovery took more than a month. The baby weighed 8# 13 oz. Then my next 2 births were WONDERFUL! I had 5 hour labors, no epidural, small vaginal tear and easy recovery. All 3 were delivered by MDs because that's what our insurance covered. My second and third babies weighed 9# 1 oz and 9# 5oz. And yes, I do have a cystocele and rectocele just like my mother and sister both developed with childbearing but I consider them just one of many inevitable body changes I assumed with I decided to have children.
Hope this helps you explore your options. Congrats and best wishes!

My first (normal 7lb 11oz) was born with a midwife in a hospital, I had a small/medium tear. Got sewed up and was pretty sore for a little over a week. Four months later I was still having this shooting pain "there", went to a family doctor and found that my body was rejecting the healing site and I had what was like a small skin tag that was a bundle of super sensitive nerves. As you can imagine, this was affecting our bedroom life in a very negative way! I had to have the skin tag burned off - yikes! - and the doctor told me I had a lot of thick scar tissue from the tear and would have a heck of a delivery next time around.
Fast foward three years; I went into labor at midnight (after contracting and dilating for two weeks, but not active labor), and my daughter was born at 2:30am. I was actually told NOT to push, and had nurses holding her head in while shouting for the doctor. Without so much as one push, she came flying into this world giving me a super small tear (7obs 12oz). I was home the next day playing trucks on the cement with my son.
I dreaded that labor and delivery like you wouldn't believe, having it in my head that it was going to be a "heck of a delivery" - I left that hospital a firm believer that a non medicated, vaginal delivery was the best thing that God ever invented! HAHA
Get more than one, or even two, opinions from various sources - doctors, midwives, maybe even doulas (they aren't medical professionals, but they see LOTS of births). Weigh your options and choose what you would like to see happen, it still doesn't guarantee how your birth and recovery will go.

Part of me agrees with Laeh, and part of me agrees with Marla.

I had been well educated prior to my births about natural birth. My sister was a homebirther, and she was also a child birth educator, so I got to learn a lot of things, whether I wanted to or not (hehe!). I still didn't fully get it until I became pregnant and decided I had to research it to see if my sister was a little crazy or if there was something to what she was saying. Turns out there's so much EVIDENCE that birthing with a midwife has way better results (main way to truly have a natural birth since many doctors don't know how). So, I chose a midwife at a birth center.

That was a long and hard birth. Baby was in the birth canal for close to three hours (pushed for three hours). It did a lot of damage that took a LONG time to heal from. I also had some bleeding issues (lost 2 liters) and overall it wasn't the birth I was expecting at all...though, I did L. it. It just wasn't that birth I hear people talk about when they talk about natural birth!

My next baby, I felt like the hospital was the way to go. (my first had to be transferred for open heart surgery, which was very stressful!) He was huge. 10 lbs 11oz. The doctor I chose was very natural birth friendly. I had him vaginally. I tore - she didn't do an episiotomy but provided perinneal support instead. He was in the birth canal for about 45 minutes. That made me really, really sore after.

Next baby, back at birth center. Besides the fact that she felt like a spiked bowling ball on her way out, she shot right out (10 minutes?) and healing was MUCH faster (finally!).

My last baby had to be a c-section due to a complete placenta previa. I was very scared of having a c-section. Who wants major surgery?! But I knew in my case, there was no question as to whether it was needed. Not only did I have placenta previa, but when the doctor got the baby, she said there was a knot in her cord, the cord was wrapped around her neck, and it was a short cord. Individually those things usually aren't big deals. But put them all together and that would have been a bad vaginal birth...

So, guess which birth was the easiest to recover from?! The c-section! The other births (minus #3), I was still sore at 6 weeks. And after my vaginal births, the pain could easily be described as excruciating for a while afterwards. I was so swollen and sore.

What you've gone through isn't normal. The doctor very, very, very likely caused all that damage DUE to the episiotomy. It's so dumb they do them! But since he did, it could very likely mean more tearing in the future. And some women do tear easily. A c-section is not awful. What you have gone through is. Healing with my c-section was amazing. I couldnt' stop telling me mom how awesome it was to not have a sore bottom. I could actually SIT. I could walk almost NORMAL. The pain didn't compare.

I always hear how c-section makes it harder to take care of your baby afterwards. Not true with me. It was SO much easier to care for baby after my c-section. I don't have typical vaginal birth recoveries. I could hardly walk for days. I couldn't pee from being so swollen. I couldn't stand and shower. Most other women I know heal MUCH faster after their vaginal births than I have...but you are in the same boat as me. You didn't have an easy vaginal birth recovery. There is nothing wrong with choosing something that will damage you less. So many people get stuck on hating c-sections, but sometimes they really are helpful. Who wants to be damaged down there like that?

So basically, decide what you want. I loved my natural/vaginal births. They changed me as a person, and I am forever grateful for them. But I loved the healing from my c-section more than I loved the healing from my vaginals! And I NEVER EVER thought I would think that. I was so anti-csection (for me) prior to that...I had a similar view to most of these anti-csection ladies. But after experiencing it myself, I see huge benefits of them. What you went through with your tearing was way more painful and worse than the typical c-section. The question is whether you would tear without an episiotomy. A little tear (that naturally occurs), like i had with my giant baby, heals better typically and is less of a tear (by far) than an episiotomy. But some natural birthers have horrible tears, it's just QUITE rare comparatively. You've gone through something that has taken years to heal from. You have to decide what you want. There is nothing wrong with either choice. I loved all my births - none were a "dream" birth - even loved the c-section, ESPECIALLY the healing part.

I'm not a big "c-section fan" but given your continued problems, I would have one. If you have another big baby with tearing and aggravation to the problems you already experience, you're going to wind up having reconstructive surgery anyway that can take longer to heal from and leave you with lingering problems forever. I have a friend who had to have some reconstructive surgery immediately after her first birth and has always had to have scheduled c-sections subsequently because basically any other vaginal births would completely ruin her. Be thankful for modern medicine on this account. I would go with being pro-active and controlling the situation from the start instead of having to worry about it and possibly have more surgery later. I doubt you'll be able to have a relaxed and anxiety-free birth experience if you're worried about this the whole time.

If I was already 'messed up" down there the LAST thing I would want would be another baby to come out of "there". Don't you think you really do stand a much better chance of making your matters worse? It seems like it would just stand to reason and it wouldn't be something that I would want to risk. I vote you liesten to your doctor and have the C. I had 2 and they were fine. And the good thing is I am not messed up down there in the least.

If you do use a midwife I would do it in a hospital so you have backup in case something happens to you or the baby.

I have not had a midwife but I have had 3 children. First was vaginal and was a large baby. I labored for a long time and pushed for almost 3 hours ended up with a huge episiotomy. When she was born she wasnt breathing and was rushed out of my room for treatment. The next day I was so sore everywhere from such a long labor (started Sunday she was born early Thursday not all of that was terrible but by mid monday I was crying during contractions)
By the time I was pregnant with #2 I switched OB's and at 34 weeks was told that I should have a c-section due to the size of this baby and the issues I had birthing my last. I have to admit I cryed while being told this I was crushed. I ended up having the c-section and it was the best birthing experince ever.
I would interview OBs and Midwifes to find the right fit for you and your family. It makes a big difference. My 3rd was also a c-section and for me it was an easy choice to make. I am not pro-section but I am not against it either.

This is my opinion, and obviously this is your decision to make, but I think you should listen to your doctor and have the c-section. (I had a very rough delivery, and 3rd degree tear with my first- and c-sections for the 3 that followed). Either way there is a recovery period, but having a baby vaginally certainly won't improve things "down there". It would make sense that it will likely aggravate the condition.

Best wishes with whatever you decide to do!!!!

Congratulations!!! =o)

I would rather have a midwife than ever get a C-section. Doctors are just maniacs with knives. How many women get C-Sections they did not need to have. About 38%.
If you think you had complications I will tell you your doctor is an incompetent jerk who did not know what he was doing. An episiotomy should not have done that to you. Episiotomy's in hospital deliverys are very common which they should not be.
I've been to upwards of 600 births and what you describe happened in none of them.

go with the midwife, the doctor is more likely to drug you and do a c section simply because its what he wants you to do, not necessarily what is going to be whats best for you, or your baby. alot of doctors these days are trying to sell c sections simply because they claim they want to help you with your "vaginal integrity", doctors words, not mine.and i am sorry, but, its a little late for a doctor to worry about my "vaginal integrity" if i remember correctly what i told my doctor when he tried telling me he was concerned about my "vaginal integrity" was, DO I LOOK LIKE A VIRGIN TO YOU ??
now wipe off the screen, cause i gotta go check on my toddler, tell the doctor, no
K. h. my other half was my mid wife, when our baby was born in our bathroom

I'm a huge fan of midwives and would recommend one in almost all situations. But please know that going to a midwife at a birthing center or having a homebirth with a midwife is not the same as using a midwife in most hospitals. If you're in a hospital, you're still subject to the same "rules" as if you use a doctor. A friend of mine who's a doctor at a local hospital here told me the midwives have more freedom than nurses, but ultimately, they work under the direction of a doctor and have to call the doctor if certain things happen. I wonder if your scarring and problems due to the first episotomy will lead to a hospital midwife having to call in the doctor during labor.

If you do go the hospital midwife route - just ask questions in advance so you know what to expect. I'd hate for you to plan for a natural birth attended by a midwife (in the hospital) and find out during labor that the midwife will only work with you up to 8 centimeters or whatever.

For your 'education' in which you are wanting - I think you need to be more specific in your question. You want to know how many women had used a Midwife (which they should also include whether it was at a Birthing Center, At Home or Hospital Midwife - for not all are created equal) and the outcome of their births.

Ex: had a birthing center/home midwife, baby was 9#6oz, no tearing or episotomy, and gave birth in the hands and knees position. (this is not a real example, tho I hope it's how my home birth in July turns out!)

All you Moms who had 'great' experiences with cesareans... lucky you - LITERALLY. She's already got 'cesarean is a breeze' responses from her other posts - so this time let the more normal birthing experiences be shared PUH-LEASE!

Yes, I've already shared my traumatic cesarean birth experience in her prior posts too - and I strongly urge her to google and research cesarean complications.

I definitely would recommend the midwife route. They are excellent and helping you deliver without tearing. They use oils and ointments, all sorts of things to help your body deliver as intended. A good one will also be able to advise you on whether or not the scarring will cause a problem for tearing. Doctors just have little care about these things. They are trained to cut, so they do (episiotomy/C-section).

DEFINITELY a midwife. they are much better trained in dealing with normal birth. even in hospitals episiotomies are much less practiced compared to 50 years ago. they are considered unnecessary, obsolete and outdated. but i have no doubt that your experience with a midwife, whether in a hospital, birth center, or at home, will be more positive. midwives are and always have been the "birth experts!"

and c-sections should only be for emergencies. there are serious risks for you and your baby when dealing with anesthesia and major abdominal surgery, not to mention the recovery time and how it affects your ability to care for your newborn. it is only for when the baby is in serious distress and may die if not removed immediately.

no matter where you birth, if there is an emergency you will be given appropriate treatment. don't create an emergency unless one exists. it's not fair to your baby, your body, or yourself.

good luck with your decision.

Talk to a midwife. They are the experts in the range of normal birth....and what requires medical intervention. A midwife will give you pretty clear information about the risks either way.

Keep in mind that C-section is major surgery. The risks of "messing up your body down there" should be pretty significant to warrant a C-section.

Keep in mind that since you had an episiotomy with the first, there probably a higher chance that you will tear with a later, especially if it also a big baby. Tearing may not be as bad as episiotomy, but with all the issues you've had it can still compound it all. (And not all doctors routinely cut, or require the traditional on your back pushing, etc).
If you do go with a midwife, choose one who works with OBs. Make sure she understands the problems you had with the first and what is going on down there now. A good midwife will try to follow your wishes, but will still put your overall well-being, and the baby's, ahead of a "no cut, no C-section" agenda.
And remember, a c-section is not the worst thing to happen. More risk of complications, longer recovery, etc, are true in general, but it may still be better than further injury to your lady parts :\

I think you have to make the ultimate decision based on lots of research and your comfort level. I had both of my babies with a midwife and would do the same in a heartbeat. I tore a little with both, but I'd take that over an episiotomy any day. If I were you, I'd probably find a good midwife in your area and have a consultation with them to see how they might approach the birth differently before you decide. I might also find one or two other obs as well, as you may find that there is a huge difference of option between them. I think researching the risks of c-sections and vaginal births post episiotomy would be in your bests interests too. Hope this helps and you are able to make the best decision for you.

I got a c-section & now when I sneeze I pee. I would go for the midwife. If you have Netflix you can instantly watch the movie "The Business of Being Born" produced by Ricki Lake. A lot of great information for pregnant women in this movie. Consider a doula too.

I would suggest getting a midwife AND talking with her. See what her recommendation would be. And ALSO talk to another doctor. Get feedback and then make the best informed decision that you are comfortable with.

I've had one c-section after 12 hours of labor and 3 hours of pushing and 2 hours of waiting for the anesthesiologist, one vaginal-vbac- (didn't go well because my pelvis isn't shaped right, baby got stuck), and another planned c-section however my water broke 3 weeks early at 3 am so I did endure a small amount of labor before everyone who needed to be there arrived. To be honest, NONE of my deliveries OR recoveries were easy.......

Everyone has a different experience so there truly is no "right" answer. You just have to keep gathering info and do what's right for you! Good luck.

I had a great vaginal birth for my first child with some tearing. She was 9lbs 6oz and I had a midwife. In my search to find a hospital I only wanted to go to one that had a low episiotomy rate and would allow me a midwife the whole time. This brought me to St Joseph in Nashua. I am not suggesting you switch hospitals but when things start to get complicated the hospital is going to do what they normally do so if your hospital has a high episiotomy rate and you have the same Dr or Hospital as before you will most likely have another one. Only you can decide what is best for you. I have no idea of the pain you have had for the last two years but I would go for vaginal delivery over c-section any day.

I would rather have a midwife than ever get a C-section. Doctors are just maniacs with knives. How many women get C-Sections they did not need to have. About 38%.
If you think you had complications I will tell you your doctor is an incompetent jerk who did not know what he was doing. An episiotomy should not have done that to you. Episiotomy's in hospital deliverys are very common which they should not be.
I've been to upwards of 600 births and what you describe happened in none of them.

As others said, a c-section (even an uncomplicated one) is still major surgery. Interview a couple care providers (midwive, certified nurse midwife, ob) and then make an educated decision.