The majority of women in the UK will give birth vaginally, have a healthy baby and recover well with no long-term complications.
However, if you are not sure whether a vaginal birth is right for you, you can request an appointment with an obstetrician during your pregnancy to discuss the pros and cons of choosing an elective caesarean section.
Around 1 in 4 babies are born by caesarean with the majority of these being performed as an urgent or emergency procedure due to concerns over the mother or baby’s wellbeing. Some women are recommended to have an elective caesarean section during their pregnancy by their obstetrician and any woman in the UK, can choose to have a caesarean when there isn’t a medical reason for this, and this is called a maternal request caesarean section.
Generally, a vaginal delivery is considered safer for you and your baby than a caesarean Section because of the associated risks in the short and long term, therefore doctors do not usually recommend the operation unless they feel it is absolutely necessary. There are many reasons why some women feel a maternal request caesarean birth is right for them and it is important to recognise that everyone is different and what might be right for someone else might not be right for you. The most common reasons include anxiety or fear of vaginal birth and a previous history of a complicated or traumatic birth or experience. Some women wonder if it is safer to have a caesarean or are worried about damage to their pelvic floor or about the timing of the birth of their baby. If any of these apply, you will be referred to the antenatal clinic to discuss your request and personal situation with an obstetrician to help you make an informed choice.
During this appointment you will be encouraged to discuss your rationale and any specific concerns you have and given a full explanation of the pros and cons of both elective caesarean section and vaginal birth. You will be offered an opportunity to discuss any questions you have and some written information to take away with you to read. If you have specific concerns, such as fear or anxiety, and would like support to overcome these, you may be referred to a specialist to help manage and control your anxiety and treatment to overcome any fears. If you have had a previous traumatic birth your obstetrician may discuss your previous labour and the likeliness of a similar situation occurring again and suggest plans that can be put in place this time to help you feel safe during labour. If after the consultation you are certain a caesarean section is the right option for you, this should be arranged for around 39 weeks of pregnancy for you. Some obstetricians or some maternity units do not offer maternal request caesarean sections however, if this is the case in your area, you will be referred to a different obstetrician or a different maternity unit that will support your request.
Most women who have a planned caesarean section will recover well and have healthy babies and no long term complications however, the recovery is longer to get back to normal and it does make future pregnancies and births more complicated so it is important to consider both of these factors when making a decision.
The important thing is to be honest about your feelings and concerns throughout your pregnancy and recognise that these feelings may change along the way and that your decision over your birth preference may change to. Your midwife and obstetrician are there to support you to make an informed decision on whichever mode of birth is right for you and your family based on your personal situation.
If you would like any further information, please see the Royal College of Obstetricians and Gynaecologists Patient leaflet on ‘Choosing a Caesarean Section’.
Dr Ellie Rayner
Obstetrician and Gynaecologist and founder of The Maternity Collective.
The Maternity Collective offer expert-led antenatal classes and support all birth preferences, including offering a dedicated Elective Caesarean Section Course for parents planning a caesarean birth.