How unlucky was I?

@nodu Yes, 4 hours seems ridiculously long. Everything happened essentially the same for me up until even d in OPs series of events. When I got to 2 hours of pushing, they started talking about a c section. It was the last thing that I wanted and I was seriously convinced that it would negatively affect my child's health (because of microbiome colonisation from the birth canal) if I has one.

As soon as I realized what the doctors/nurses were discussing I was like "LETS DO IT". At that point I'd had 2 nights of back labour contractions and it felt like the baby was never gonna come out. C section recovery was rough.

All that to say, glad I'm not alone in asking for a c section after pushing and getting nowhere.
 
@nodu I used to feel guilty about planning my second c-section, like maybe I should just try to have a natural birth, but I failed to progress during my first born last year and had the choice of c-section or inducing labor.

I had read up tons on inducing labor and I was already overdue, most inductions ended in c-section anyway which swayed me toward getting one, along with my baby not dripping and not being dilated despite my doctor probing me to have my water break about an hour later. I’m SO glad I went this route and plan to do it again in a few weeks.

I already suffer from depression (before babies and marriage and PMDD as well—that shit is hell) and I can’t bear doing anything that’ll make me go into PPD or worse, which is a huge reason why I just want to ensure my body can handle recovery and I don’t have a horrible birth and recovery from interventions or tearing.

Glad to hear it’s okay to just do what you need to do for you and I hope all works out well for you.
 
@nodu I had my baby via planned c-section because she was breech. It wasn’t what I had wanted originally, but it went great and I am 95% decided that if we have another I would choose it again over attempting a VBAC.
 
@daphne1 I didn’t have a) f) or ppd, BUT I can very much relate to the rest of your post, except ultimately my first wasn’t pulled out with forceps, but with the vacuum.

The baby wasn’t ‘sunny side up’ (as another response mentioned could have been why you had all these issues!), but her head was sideways.

My second baby was also born with his head sideways, but all of the issues that happened with my first were much less severe and much more manageable. He didn’t need to be vacuumed out, I pushed him out, labour was shorter, pushing shorter, breastfeeding was issue-less (in fact, I was an EXPERT and felt like I got it all right because the first experience was so heartbreaking). I tore the same, but it didn’t seem like as big of a deal.

It actually felt like a redemption in a lot of ways, I definitely wouldn’t let your first experience dissuade you from having more kids if you want more kids.

I felt really humbled and crappy about the first birth, second one I felt like I ‘got it’ a bit better.
 
@jaketmores I second this. They are there for so so much more than just emotional support. My doula was also able to suggest different pushing positions depending on where baby was in my pelvis and how she was descending. I can’t speak highly enough of her support and knowledge at the most vulnerable times I have ever experienced.
 
@jaketmores Third. In my 1st birth I had the vacuum , 4th degree tear, episiotomy, retained placenta (OB had to reach up and pull it out - twice), induced overdue, etc. My second birth was really just fantastic and bright and happy which was not how I felt after my 1st birth. The data on both doulas, second births, subsistent perineal tearing, etc is all very reassuring and I experienced that thankfully.

I can’t speak to prolapse/PROM but in terms of connecting… it took me awhile to bond with both my kids. Even parents with non-traumatic births sometimes feel duped by the “love at first sight!” bullsh*t. It takes many many moms and dads time to build up their love.
 
@cocoon87 I hear this, but it’s been a year and I still feel like my kid’s babysitter. I feel like it should have improved by now and that at this point it’s unlikely to happen on its own 😕
 
@daphne1 I would consider therapy too then. If you feel you still haven’t connected properly you definitely could still have some PPD or PTSD from a traumatic labor. I did therapy when pregnant with my second and she had me focus a lot on my “automatic negative thoughts” (you can google that). It was helpful for me to stop spiraling and not stress about the birth.
 
@daphne1 Every pregnancy and birth stands alone for the most part. If you reach a point you sincerely want a second but the prospect of birth is still traumatic, you do also have the option of discussing a voluntary c section with your OB. I would use a different medical team for subsequent birth.
 
@kevin76 Yeah, the birth part of having a kid was giving me deep anxiety and making me hesitate about having a kid at all. But I easily found an OB who listened to me and agreed to a voluntary c section. She said that she had more than a few patients who had such a bad first birth that they wanted a c section for their next kid and were happier after the c section. For me recovery from that was a breeze and I’m now considering a second when the timing is right.
 
@daphne1 So, I actually encountered some of the same issues. I had PROM, although my contractions didn't start until I got on pitocin about 24 h after rupture. I pushed for four hours, although I didn't have the tearing/prolapse issues you encountered. I did have the milk supply issue though! I've tried everything and it has always fallen short.

So, in terms of how likely these things are to happen in the future, I have no idea about PROM. But, pushing times are very often shorter for subsequent babies, so you're unlikely to be pushing for four hours!

Something to consider is that babies that are occiput posterior (sunny side up) can be associated with longer, more painful labor and longer pushing time. In future labors, it might be worth actively trying to change positions to encourage baby to move into a posterior position, which tends to make passage through the pelvis easier.

With milk supply: milk supply is often better with subsequent babies! The alveolar tissue in the breasts increases with each pregnancy, so supply issues this time around might not happen again! It does depend on the cause of low supply though - this can range from IGT to thyroid issues to PCOS to issues with baby's transfer.
 
@jdvelez This is helpful! I was never told that my baby was sunny side up, but it may have been the case.

From my reading, I think that PROM can have a lot in common with induction (regardless of the use of pitocin in PROM labours), and so could be seen as similar in terms of the beginning of the “cascade of interventions”.

I also don’t know whether PROM has the same likelihood to occur in subsequent pregnancies, or whether it’s more likely.
 
@daphne1 This is all just my understanding/ recollection from my own research on the subjects, though I don't have the studies/references on hand.

a. PROM (but contractions started pretty soon after).

Slight increase in chance of PROM above the average (avg is 8-10%), so not even close to guaranteed.

b. “Active labor”-type contractions (lasting about a minute, happening every 2-3 minutes) from the beginning, so for about 23 hours. I think this can happen with PROM, but I'm not sure if it happens every time.

I had similar and was informed it's actually fairly common, but yes, if you had this

c. Unsatisfactory progress during labor, necessitating augmentation with pitocin. (I needed a lot of pitocin, and at this point, I got an epidural, which may influence some of the other things.)

Again, it's not uncommon, but I believe this is less common in subsequent labor, as your body gets "better" at it.

d. Extended pushing - pushed for nearly four hours.

Same as above.

e. Third degree tear.

Yes, I believe tearing is more common in subsequent births. But not guaranteed.

f. Prolapse of bladder and urethra.

Same as above.

g. “True” low supply when breastfeeding (tried literally everything to increase supply, under the care of IBCLC and doctors, over the course of 6 months, and still never had a full supply).

From my discussions with my LC, true low supply is usually caused by insufficient glandular tissue (nothing to do with breast size, small breasts can have enough glandular tissue, large breasts can have not enough). And glandular tissue can not be increased. I would recommend planning to combo feed or do formula only for your own mental health.

h. PPD and, I think, PTSD (from threatened forceps during pushing). Subsequent lack of bonding with baby (still not really dealt with).

Yes, having PPD once means more likely to have PPD for subsequent pregnancies, but not guaranteed. There are lots of influencing factors into the severity of PPD such as sleep, support, and baby temperament (and I'm sure the PTSD and supply issues didn't help).

So somethings are likely to be better, some the same, and some worse, purely on a dice roll. But you really never know.

Personally, I had a bad labor, and it was likely to have similar issues the 2nd time, so I opted for a scheduled csection.

I also had PPD with our 1st (who also had colic) and made sure we had extra support for our 2nd (who is much more chill). For the most part, my PPD was less to start with as we had extra support. Then that support left, and my husband went back to work, and my PPD got worse than with my 1st. Then, we got more support and rented a snoo, and it got better again much quicker.
 
@daphne1 Anecdote: a friend recently gave birth to her second following a traumatic first. I don’t know all of her details, but I think she had preeclampsia and delivered at 32 weeks the first time. The next time around she was a high-risk pregnancy because of that and had closer monitoring and a month or two ago she successfully delivered her second child without any complications at 39+ weeks.

A different friend had a traumatic four hours of pushing that resulted in an emergency C-section with her first, and she and her birth team scheduled a C-section for her second and she felt very positively about that decision.
 
@dojusnider If I wanted a second, I would also schedule a c-section. I remember thinking at the time, “why would anyone choose this?” And after many months, the last thing I remember about my delivery was the surgery and recovery. I remember the PROM at midnight, followed by 3 hours of being evaluated for admission, followed by 4 hours of pitocin and no progress, followed by much more pitocin, then manually rupturing a tiny water sac that was left, which led to very intense contractions because the pitocin had been up’d so much. Then I had an epidural that failed and had as least 4 hours of back labor before then gave me another epidural. After a few more hours I had a c-section, just after midnight. I couldn’t sleep at this point because I had to meet my baby and breastfeed every two hours so I went 60 hours without sleep and then another two months or more before I got more than 3 hours of consecutive sleep. If I did it again, I’d just schedule the c-section for noon so I wouldn’t have any lack of sleep because that was literally the worst part about all of it! And honestly, if breastfeeding is hard, do formula and get more sleep that way! There’s actually a link between breastfeeding and PPD and I think it’s because lack of sleep and stress (sorry I’m not looking up a link right now).
 
@untilthewholeworldhears I had an elective C for first/only baby because I have seen way too many friends not even consider anything but a vaginal delivery and it goes down so, so badly. I was thrilled with my elective C.
 
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