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Planning the Birth of Your Child

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Imagine you’re planning a big event –say your wedding. When you sort out the arrangements you try to think of everything - the invitations, your dress, the venue, it can be like that when you are planning what kind of birth you want.

You can still think through what you’d like to happen: where to give birth, ways of coping with the pain, and who you want to have with you. It may be, though, that you haven’t thought about how it would be if your baby was born by caesarean section.

Caesarean birth

It can be difficult to believe it might happen to you, yet more than 1 in 5 babies in the UK are born by caesarean. Sometimes women know in advance that their baby is going to be born this way, but often the decision isn’t made until late in pregnancy or during labour. Even though antenatal classes cover caesarean birth, a lot of the information available is about what will happen to the woman and her baby rather than what options may be available. As a result, women often feel very unprepared for a caesarean and may end up feeling they have lost control over their baby’s birth.

Most caesareans are not rushed emergencies, even if they occur while you’re in labour. Only 1 in 20 caesareans are urgent, where the operation needs to be done quickly to prevent damage to the mother or baby.

If you have had a caesarean before, you will need to decide how any other babies you have will be born either by another caesarean or a vaginal birth after a caesarean (VBAC). There are many occasions where VBAC is an option. Many women wanting a VBAC feel that their choices - in terms of where they give birth, how active they are during labour, who they choose to support them, and so on -can improve their chances of a successful VBAC. Even without additional support and information more than 6 in 10 women in the UK who decide to have a VBAC succeed.

If medical staff advise a caesarean you should be given time to ask questions, including what would happen if you waited longer before deciding, or if you chose not to have a caesarean. If you agree to a caesarean then, in most cases, some time will be taken in preparing you for surgery and getting the team ready to deliver your baby. Often you will have a midwife looking after you and you should have time to ask questions about what is going to happen, ; discuss your preferences and how your wishes can be best achieved.

Few caesareans are now done under general anaesthetic, as regional anaesthetic (epidural or spinal) carries less risk for mother and baby. At most caesarean births the mother is awake, and the father and/or other birth supporter is present. Even if a caesarean needs to be carried out quickly often a spinal is possible. This is similar to an epidural, but involves a single injection into your spine. Being awake during the birth often worries women, as it means being awake during surgery. Most women are surprised at how well they cope. Babies are usually born quickly, so you can be holding your newborn soon after he or she is born while the longer repair part of the operation takes place.

So what birth choices can you make?

Seeing their baby as soon as he or she is born is important to most parents. During a caesarean you will see your baby more quickly if the screen is lowered, or if the baby is lifted above the screen as soon as he or she is born and before the cord is cut (if it is long enough), or by having a mirror positioned so you can see your baby born.

Skin-to-skin contact between you and your baby helps bonding and breastfeeding, so is generally encouraged by hospital staff at all births. You may need more help with this at a caesarean birth, as the gown you’ll be wearing may restrict skin-to-skin contact, and positioning a baby while lying on an operating table requires help. Some mothers like to breastfeed while still in theatre, others prefer to wait until they are able to move to a better position once they are back in the ward.

Some women need time to adjust and may want to greet their baby in their own way, in their own time. You can explain what you would prefer as your wishes are likely to be respected.

Many parents now have pictures of their baby being born or soon afterwards, and in most cases this is possible at a caesarean as well. Women who have had a general anaesthetic can often find them particularly helpful due to not having been awake to greet their baby.

Other factors that may be included in a birth plan may still be possible for a caesarean - your choice of music, being the first voice your baby hears, discovering the sex of your baby yourself. Washing and dressing your baby does not have to be done straightaway, it can wait until you are back on the ward and able to be involved.

Many of these things can easily be organised, and may help to improve your birth experience. In most cases women find hospital staff is pleased to be able to help, but in a busy hospital environment it can be difficult for staff to offer what is important to each parent if they are not asked.

Category: Pregnancy
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