Making decisions about birth after caesarean

Comparing birth experiences and recovery

In making the decision about how to give birth to their next child, women are influenced by their previous birth experiences and their expectations of what other ways of giving birth might be like (see 'Women's expectations for their next birth', 'Reasons for wanting a planned caesarean' and 'Reasons for wanting a vaginal birth after caesarean').

Many of the women who took part in this study agreed to be interviewed again 6 to 12 weeks after they had given birth to their next child. This allowed us to explore how women's views about different ways of giving birth might have been influenced by their next birth experience and how they felt about the decision they had made after actually going through vaginal birth after caesarean (VBAC), repeat planned caesarean, or, in the case of one woman, a second emergency caesarean. We asked women whether their next birth had matched their expectations, and how they thought their recent birth experience compared to the previous one. (See also 'Women's experiences of their next caesarean' and 'Women's experiences of vaginal birth after caesarean'.)

A few women who had experienced a sense of failure after their previous caesarean, felt very proud to have achieved vaginal birth and said the experience had made up for some of the things they had missed out on with their first birth. For some, it meant that the thought of further pregnancies no longer scared them, and a few said they definitely wanted to repeat what had been 'one of the most amazing experiences' of their lives.

One woman thought being in better physical shape than with her previous birth had helped her labour and recovery. During her previous labour, she had tensed up a lot but this time she used breathing techniques which she thought made her cope much better with the pain of the contractions.

Not all women were as enthusiastic about their experience of vaginal birth. One woman, who had experienced painful contractions for more than 60 hours before giving birth to her baby thought her previous caesarean had been quicker and overall, possibly less painful.

A couple of women said they had felt self-conscious about losing control over their bodily functions during and after birth. One woman described the experience as 'pretty undignified'. However, these drawbacks were not enough to make them regret their decision to have a vaginal birth.

Most women who experienced vaginal birth after caesarean said their recovery had been a lot quicker than after their caesarean. While most of them found going through labour very painful, they said the discomfort they had experienced after the birth was minor by comparison. They were pleased to be back on their feet again quickly because it meant they could look after their families as normal. 

However, a few women said the recovery after their vaginal birth had not been as quick as they had expected. Several women had experienced a tear during delivery - either because the birth had been assisted by a suction cup (ventouse) or forceps, or because of the way the baby had come out - and needed stitches after the birth. Some said their tears had healed very quickly, but others were surprised by for how long they felt quite sore. 

One woman who had thought her difficulty in feeding her first child had been caused by her caesarean, was disappointed to experience the same problems with her second child after a vaginal birth. Nevertheless, she felt that VBAC had been a much better experience emotionally for her and her daughter.

A few women said that vaginal birth had given them a more immediate bonding experience with their newborn.

However, a couple of women who'd had a planned caesarean also said their bonding experience with their next child had been more immediate. They thought this was because they had felt much better in themselves this time round.

Most women who chose to have a planned caesarean for their next birth had an emergency section previously. Some of them were quite frightened by their previous experience: they had witnessed their baby getting distressed, or things had happened very fast without giving them time to adjust. Some had also gone through a long and exhausting labour before having the operation. This time round, women said they had felt calmer, more refreshed and more mentally prepared for having a caesarean and this had made their experience much more positive.

A couple of women who had wanted to attempt VBAC had a planned caesarean when they went several days overdue without going into labour. Even though it wasn't the birth they had wanted originally, they were pleased with their birth experience. One woman said that despite not being in control she had felt 'empowered' by the process.

Several women commented on the relaxed atmosphere in theatre during their operation. A few women described how staff had chatted to them throughout the operation and made jokes to put them at ease. For one woman, who had gone to a private consultant for her planned caesarean, knowing that she was in the hands of experts and was kept fully informed about her care made all the difference.

However, not all women experienced their second caesarean more positively than their first. One woman said the birth of her second child had felt like a 'job to be done'. She remembered her first emergency caesarean more positively, though she thought having been under the effects of gas and air might have affected how she felt. Another woman, who had booked a planned caesarean for 3 days before her due date went into labour early and had to be delivered by emergency caesarean instead. She didn't feel mentally ready for the baby and experienced much worse pain than she'd had with her first, planned, caesarean.

Last reviewed April 2015.

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