Benefits of labor if you are having a c- section?

[BeachBum]

I've got to have a c-section because of a breech baby. I'm just trying to decide if it is worth it to just wait and go into labor, or if I should schedule it. I have enough friends and family around that child care either way shouldn't be an issue for my DS.

37 weeks is considered full term for twins and I'm 37 weeks 3 days now. I do have a section scheduled for 37 weeks 6 days, but my Doc said he would gladly let me go a few days past that if I wanted to.

I'm trying to determine if there are any real benefits for the babies or for me for actually going into labor. Does being in labor change anything about how the section goes?

Anything else I should think about?

[o_mom]

I think the biggest benefit is that you know the babies are ready to come.

[hillview]

So pros to waiting:
- the babies are "ready" to come out
- I expect your body starts to do some natural things if you wait to go into labor (eg hormone releases and other things I am sure someone here is smarter about)
- could the breach change last minute?

Pros to scheduling
- would you get to have YOUR doctor vs someone on call (this would be big for me)
- would it be easier with your home/DP life to have it scheduled (sounded like no but worth really thinking through)
- would it make you less stressed to have it scheduled?

GOOD LUCK and congrats!
/hillary

[Melaine]

If it were me, I think I would schedule, honestly. I've heard there is a signicant difference in scheduled v. emergency. I was really dissapointed that the dr. that performed my C I had never heard of, let alone met. The fact that you have made it to 37 weeks is PHENOMENAL for twins! (Congratulations!)
Agreeing with hillary, I would've been WAY less stressed to have it scheduled. I went into labor at 33 weeks so I had four days in the hospital followed by an emergency c-section because of complications (even though I had expected a C because of breech babies).
My advice would be different for a singleton, because there is a bigger chance of v-delivery (if baby turned), but that is unlikely with twins. And the fact that you have made it so far, those babies will be ready to make an appearance and I am assuming you are ready to deliver! (I was miserable from about week 28 on so...) Let us know what goes on!
Yay for twins!

[bubbaray]

According to my Peri, OB and Anesthesiologist, the risk of post-op infection after a scheduled c/s (and no labour) is less than after an emergency c/s after labour.

[kijip]

Just want to chime in and say that going into labor prior to a c-section does not make it an emergency c-section with all of the risks incumbent to an emergency c-section vs. a scheduled one. It is still pretty much like a scheduled one except your doctor might not be the one doing the procedure. An emergency c-section would be medically indicated as urgent with either or both the mother's or baby's life/health at risk and the surgery would be performed as quickly as possible, perhaps with a classical incision or general anesthesia instead of an epidural. Whereas waiting till contractions start alone (with no other medical issue at play) is really planning for c-section to happen at an uncertain time---if you live close to the hospital you could likely be in surgery 30 minutes after you called/arrived. Or they could wait a bit to deliver (a friend of mine did this, waited for her doctor to arrive, I think they gave her something to stop labor).

I don't have an opinion as to scheduled vs. unscheduled, just that unscheduled does not default mean the risk of an emergency section.

[citymama]

Originally Posted by bubbaray

According to my Peri, OB and Anesthesiologist, the risk of post-op infection after a scheduled c/s (and no labour) is less than after an emergency c/s after labour.

Going through labor doesn't nec. mean you have to have an emergency c/s. I can speak from experience with a singleton, and not a planned c/s (i.e., we didn't think I'd have to have a c/s, whereas in your case you know you do). Baby was breech in my case, had a manual version to turn her, she was breech again during labor. Anyway, the pediatrician who saw her at the hospital (and turned out to be our long-term pedi. who we love) said there is a difference bw babies who have experienced labor versus those who haven't - generally all the squeezing and shifting and other mechanics of labor are healthy for the baby to go through, even if not vaginally delivered. He even sent us some links to medical articles about this, but I can't find them right now. Will post if I do.

Nonetheless, with twins, and potentially complicating factors, your considerations are different. I'm not sure that if I knew I'd have to have a c/s anyway, I would have gone through extended labor as I did - or would have been allowed to, given the higher risks if it does become an emergency c/s. So you should take all those into consideration, rather than just the benefits of going through labor. Writing this quickly, hope it makes sense!

[cono0507]

Just want to add in here that there are physiologic benefits of labor on the baby. I had a scheduled c-section at term with my second and she still ended up in the NICU for a day due to breathing difficulty/fluid in her lungs/etc. In talking with the neonatologist, I learned that not only do baby's lungs benefit from getting squeezed through the birth canal, there are also physiologic and hormonal changes that prepare the lungs for the transition.

All that said, I'd still schedule a c/s. Many people have scheduled term sections without any lung issues. I just thought I'd throw that info out there.

[bubbaray]

Originally Posted by citymama

Going through labor doesn't nec. mean you have to have an emergency c/s.

I realize that -- clearly, there are different levels of "emergency" (crash vs non-progression). I was merely stating what the various dr's told me during the planning stages for DD#2's delivery (actually, before I was even PG with her). I can't recall the reasons they gave at the time, but they were all on the same page that performing a c/s on a non-labouring uterus had significantly lower infection risks. I'm not disputing that there are/might be other benefits to starting labour prior to a c/s, but I'm just passing along what I was told re the infection stats.

[Melbel]

With my scheduled C-sections (3), I was required to fast. This would be far less likely to happen if you waited to go into labor. I personally liked the controlled environment of a scheduled CS, with the OR ready, my doctors of choice on duty, all the instruments and sponges counted, etc. I would still carefully consider any research you find regarding risks/benefits of waiting to go into labor, particularly as applied to twins, the distance to the hospital, any complications during the pregnancy, etc. before making a decision.