How to plan for a C-section

Distinguished consultant obstetrician and gynaecologist Dr Shazia Malik discusses what to consider before a C-section, and what to discuss with your gynaecologist before making a decision about the procedure.  

What are the latest developments regarding maternity care in the UK?

According to the latest NHS data, around one-third of babies in the UK are delivered by caesarean section, with about half of these procedures being planned. Despite this, a significant stigma persists around elective C-sections, and it is not uncommon for women to be denied the procedure even when they request it.

However, there is now a glimmer of hope. A recent parliamentary inquiry into birth trauma has called for a national plan to improve maternity care. The inquiry highlights that women are often "treated as an inconvenience" and emphasises the importance of respecting women's choices regarding childbirth.

The current questions on everyone’s mind are why is choosing to have a caesarean still frowned upon in some circles, and how can expectant mothers advocate for themselves if they prefer an elective caesarean?

What should be considered before a C-section?

Every pregnant woman is unique, and their individual needs and preferences should be prioritised in planning the birth of their baby.

If someone is considering a caesarean birth or has questions or concerns about childbirth, they should inform their healthcare provider as early as possible. Personal feelings and opinions are crucial and should be respected by healthcare professionals when discussing birth plans. A planned caesarean is a surgical procedure, and its benefits and risks should be thoroughly discussed alongside those of a planned vaginal birth.

The Royal College of Obstetricians and Gynaecologists (RCOG) firmly believes that a woman's choice to have a caesarean birth should be respected and supported. In the UK, most women recover well and have healthy babies regardless of whether they have a vaginal or caesarean birth.

Historically, there has been a stigma around elective caesarean sections, often driven by the outdated notion of being 'too posh to push.' However, this perspective overlooks the many valid reasons a woman might need or choose a planned C-section.

The National Institute for Health and Care Excellence (NICE) guidelines affirm that women should have a choice in how they deliver their baby. Reasons for choosing a caesarean can include a previous traumatic birth, certain medical conditions that make vaginal delivery riskier, or psychological factors such as anxiety or depression that could be worsened by labour.

Every pregnancy is different, and various medical and personal factors can make an elective C-section the safest or most appropriate option for both mother and baby. The ultimate goal is a safe and positive birth experience. Pregnant women should openly discuss their hopes, fears, and preferences about delivery with their medical team as early as possible. It's crucial that women feel empowered to have these conversations without judgment. Obstetricians aim to work in partnership with expectant mothers, providing the necessary support so they can make fully informed decisions about the birth.

Some women may feel pressured to deliver vaginally even when it compromises their or their baby's safety. A safe, healthy mother and baby should be the top priority, and no one should feel ashamed of their delivery method. We need to move beyond outdated perspectives and guarantee that all mothers feel empowered, with access to respectful and inclusive antenatal and postnatal care that supports their choices.

No decisions about pregnancy and birth should be made without the woman's informed consent, based on the best available evidence. Discussions should always cover the benefits, risks, alternatives, and personal feelings about the options.

Unfortunately, not all women are listened to or supported, and they may not always be able to ask questions and access the support needed to make the best choice for their birth. Societal pressure and unrealistic ideals, such as 'the best way to give birth' or the perception of being 'too posh to push,' fail to consider the complex needs of pregnant women, especially those with previous traumatic experiences. Those who do not feel heard should seek a second opinion if necessary.

How should I approach a consultant regarding C-section?

Before speaking to a gynaecologist about a C-section, you should write down any questions you have and don't hesitate to ask them. If you don't understand the answers, ask for clarification until it makes sense to you, and you feel confident in making the right decision for yourself.

Contrary to what some people may think, emergency caesareans are not always life or death situations and often result from failure to progress. A common misconception is that C-sections are an easy way out, avoiding bleeding and preserving the vagina. However, this isn't true. You still bleed after birth, and recovery is very challenging. It's major abdominal surgery and definitely not an easy way out.

If you would like to book a consultation with Dr Malik, do not hesitate to do so by visiting her Top Doctors profile today.