We recognise and respect women’s informed choice of how they give birth however it is important to find out the cause and reasons for anxieties or fears. This will enable us to provide the best care and support during pregnancy and after you have had your baby.
If it is your first baby reasons for increased anxiety and birth fears include:
For women who have already had a baby, anxiety and birth fears are generally related to a previous poor experience. In this case we will refer you to the birth reflections clinic. This is a clinic which is led by an experienced senior team of midwives and doctors. At this appointment you will be able to discuss your previous experience of birth and ask questions.
History of Anxiety or Depression
We know that a history of anxiety or depression can increase anxiety and lead to birth fears during pregnancy. Please let your midwives know as soon as possible so that we can support you.
Tell the midwife as soon as possible if an elective Caesarean Section is a choice of birth that you would like to make. This is referred to as a maternal request caesarean section.
Depending upon your reason for an elective Caesarean Section you will join the pathway which could include the following:
Before making any decision we ask that you attend antenatal education session at the hospital. This will help you make a fully informed decision and provide you with the opportunity to ask lots of questions. The final decision is discussed with you at your birth planning meeting with your midwife at 34 weeks. If you decide that you would still like a C/S you will be referred to a consultant obstetrician who will confirm that you are aware of all of the risk factors involved. This leaflet outlines some of the common risks.
Having a planned caesarean section may make you feel more in control and avoid the anxieties and uncertainties of going into labour naturally. However, it is surgery and can have complications. It will also affect your future pregnancies (see below).
Although you should not feel any pain during the caesarean section (because you will have an anaesthetic),the wound will be sore for the first few days. One in 10 women will experience discomfort for the first few months.
The main risks when having a caesarean section include:
These risks are increased if you are overweight.
Serious complications are rare if it is your first caesarean section and it is planned in advance, as long as you are fit and healthy and are not overweight.
However, serious complications become more common if you have repeated caesarean sections.
If you develop any complications, your recovery and stay in hospital will be longer.
The most common problem affecting babies born by caesarean section is temporary breathing difficulty.
Your baby is more likely to need care on the neonatal unit than a baby born vaginally.
There is a small risk of your baby being cut during the operation. This is usually a small cut that isn’t deep. This happens in 1 to 2 out of every 100 babies delivered by caesarean section, but usually heals without any further harm. Thin adhesive strips may be needed to seal the wound while it heals.
Babies born by caesarean section are more likely to develop asthma in childhood and to become overweight.
If you choose to have a caesarean section, any future births are more likely to be by caesarean section as well. You should consider the size of the family you want because the risks increase with the number of caesarean sections you have. Two caesarean sections do not appear to have a higher complication rate, but three or more carry serious risks which include the following:
Having a vaginal birth is usually straightforward, particularly if you have had a vaginal birth before. It is normal for the area between your vagina and anus (perineum) to feel sore and uncomfortable for a while after you have given birth. This is because this area will have stretched as your baby is born and you may have stitches.
Complications can also happen, especially with first births. These include the need for forceps or ventouse to help deliver your baby (for more information, see RCOG patient information
Heavy bleeding in the first few days is more likely with a vaginal birth than with a caesarean section.
However, there is generally more blood lost with a caesarean section overall.
What are the benefits of having a vaginal birth?
If you do have a vaginal birth, it is worth remembering that: