I'd appreciate any wisdom on type of birth...

OK, I know ultimately this is a decision only I and my husband can make.
I have a vague recollection from after I last gave birth that even
some of the natural minded amongst you were pretty surprised I'd not
ended up with a c-section.

The list of diagnoses of damage done at that delivery are as follows :-
labral tear in the left hip resulting from hip dislocation or subluxation
grade 2 rectocele
"broken" coccyx (it's a bone that's already in pieces, but historically
it was throught to be only one and the word broken when it really means
disruption seems to have persisted)
disruption of sacroiliac joints
probable rupture of symphysis pubis ligament
tear to the lower sling of pelvic floor muscles that remains separated
damage to the upper sling that was still swollen 2 years after delivery

With that list, I sometimes wonder if I am even nuts to consider a
vaginal birth, then I think back to my first birth and if it were that
easy again, I'd be nuts to consider anything else. The thing is though,
he was an IUGR baby and thus had enlarged fontanelles, they were about 3
inches across, when 1 inch is normal for a full term baby, about the
size of a quarter. Another IUGR baby wouldn't be great and may not have
such extreme fontanelles.

Another consideration is timing of delivery, with DD I was in horrific
pain the final month, the obsetric community tends towards symphysis
pubis pain not being a condition where damage is occuring, the
orthopedic community pretty much seem to say that is rubbish and any
time there is dysfunction of a joint there is going to be swelling and
often other mess as well and if they do end up doing surgery, the first
thing they have to do is a thorough clean up. Based on that, the
obstetric community see no difference in delivery at 37 weeks and 42
weeks, whereas there's a possibility that this extra month could make
quite a difference in terms of the amount of inflammation that needs to
calm down. In the UK at that time there was a big drive to do elective
c-sections at 39 weeks or later, whereas I get the impression here that
most doctors are more open to doing amnio for lung maturity and
delivering earlier if that comes back ok. That could be a significant
benefit to us.

I also wonder how I'm going to cope emotionally with the unknowns of
planning a normal delivery, it could go fine, I think it would be
unlikely to be as bad as last time, but it could easily be somewhere in
the middle. With the amount of pelvic floor damage I have any
gynaecologist would be recommending c-section, but would also admit that
worsening of things isn't guaranteed. One of the problems for me is that
as soon as I start considering emotions I start to think that I should
not be driven by them, in my book emotions are the wrong reason to
choose a c-section.

There is another big fear too, I'm really not very good with wounds, I'm
not sure how I'd cope with a wound across my tummy, I wouldn't exactly
be able to avoid looking at it! Also I have a quirky reaction to local
and regional anesthetics, it's entirely possible that they wouldn't be
able to numb me up enough and even if they did, I'm one of the worst
people at coping with feeling wierd tugging and pulling, I'd probably be
a quivering wreck.

Does anyone have any suggestions? Any questions I need to ask myself or
ask other people? Thanks for listening.

Anne