Looking back- caesarean birth
Several of the women we interviewed had caesarean births, some as emergencies and some planned or 'elective'.
Planned caesareans were done for various reasons, including the position of the baby or babies (see 'Twins and breech presentation'). One mother was advised she might need a caesarean because the baby was large compared to the size of her pelvis, and she and her partner decided the safety of the baby was the most important thing. Another mother had an elective caesarean so surgeons could be standing by ready to repair her baby's heart defect.
The baby was quite large compared to her pelvis size. She decided on a planned caesarean and was...
Did you always see the same consultant?
Yes, I always saw the same consultant. Unless he happened to be on holiday which was only once, but I always saw the same consultant, and he was the consultant who made the final, well, the final discussion with, he gave me the final discussion as to the possibility that the baby I was carrying was big in proportion to my hip size and pelvic size and general wellbeing.
My sugar, blood sugar level started to rise very much towards the end of my pregnancy. It didn't develop into pregnancy diabetes but it was beginning to rise. The baby was growing very rapidly and appeared to be engaged very early on. She was engaged probably a good seven weeks, eight weeks, before I was due, my due date was end of January. And he then started to talk to me about the size of my baby, which I became very concerned about and I was a bit concerned that it might be too much, get stuck and cause brain damage or anything like that, which has happened in our family, sadly. And he advised me to think about the possibilities of having a caesarean and the possibility also of trying natural labour, but in any event that there was any difficulty at all, a caesarean section would be given. But, at that stage, having had a scare, all I wanted was the safe arrival of the baby, and having gone through lots of discussions with my husband, very difficult decision, we did decide to go for an elective caesarean, 14 days before she was, sorry, 21 days before she was due, but I was actually given a caesarean section 14 days after that date.
So, my baby was born at 39 weeks, and that was fine, no problems at all. I could say to anyone, have no fear, it's a happy time. The hospital were wonderful, you go in, it's all done on the day, the baby arrives safely, very calm, very contented. I was absolutely fine.
Women who had already had one caesarean could choose whether to try a vaginal birth next time or have an elective caesarean (see 'Thinking about where and how to give birth' and 'Looking back - vaginal birth'). One mother felt traumatised by her first emergency caesarean after an induction and long labour; her baby needed 3 days in special care. A planned caesarean next time helped her overcome her fear, and she recovered quickly.
An elective caesarean for her second baby was a happier experience than the emergency caesarean...
What were the reasons that you were given for not having an elective caesarean?
They said they, they didn't want to give me a second elective caesarean because, you know, obviously, obviously it's healthier to give birth naturally. The recovery is better, there's less of a risk, it's less expensive on the NHS, presumably, was, would be an issue. You know, and, and obviously, it's the natural way and it's major surgery, obviously, which they'd like to avoid. But weighing up the risks in my own mind, of going through what I went through before and of, of possibly losing my child like I nearly did the first time, I wasn't prepared to risk that. I wouldn't be able to cope with that so my midwife thought it was the best thing for me to have an elective caesarean but the consultants wanted me to go for a natural delivery. But I am glad I stuck to my guns because my second child, the birth was fantastic. I actually had an elective caesarean for - you know, I've known people that are really worried about it. It's the most amazing experience. |It was, it was lovely and I can't praise the people enough. It was such a good experience.
Tell me more about what happened and why it was so good?
Well, I, going in for my caesarean that was, was elective, I knew, I knew the date to go in and I turned up and everyone was very casual. I had, at the time, actually, I have a very bad needle phobia, which is not good when you're going to have a needle this long in your back. So I went in and they, they were very relaxing, they were so kind and they, once, once they'd, you know, once it was planned that I was going to have a caesarean, there was no more talk of, should I or shouldn't I? It was just, "That's what you're going to do" and they were great about helping me overcome my fear. And you, and I went into the theatre and everyone was laughing and joking and talking about the baby and it took away from my fear completely. And they, they were just fantastic and you felt like you knew them really well because they were, they were just so lovely and you wouldn't want a nicer bunch to be with you when your baby was born. And the experience of, of being there and seeing the baby lifted out, it was amazing because I was knocked out for my first pregnancy so it was the first time I'd seen one of my children being born and it was lovely. And I would, I don't know, to anyone I would say, just, you know, it's not something to worry about. It w
Other women took longer to recover from the operation, and some would have liked to be told more beforehand about what to expect. Some welcomed having a few extra days in hospital and getting midwives' help with feeding and caring for the baby, but others were keen to get home.
She was surprised how long it took to recover from the caesarean, and thought women should be...
Were you disappointed at all not to be able to have a natural labour?
I was disappointed not to have a natural labour, but on the other hand, at the time, you're only thinking of the safety of your baby. I had no idea of the consequences to my health of having a caesarean, and it's a long recovery. It's not a quick snip and, you know, you're out and you're about. It's months of rehabilitation to build up your strength again and your stamina.
Tell me about that. What were you told before the caesarean about what it would be like for you getting over it?
Before I had the caesarean I was given very little information about my after care, my - sorry, what can I say? - recovery. I was given very little information about my recovery, what to expect, what it would be like. I was given every book under the sun, every bit of information about the baby, how it had happened, and the risks and the benefits. But what no-one tells you is, once you're home, quite how difficult it is physically to cope, even though I had 100 per cent support from my family. For three weeks I had constant support, after those three weeks it was still very difficult physically lifting, bending down, putting the washing on, running up the stairs, and you think you can do something, you go to do it, and you just feel a little bit of, ow, no, that's a bit early. In terms of looking after the baby there's no problem; the only difficulty was bathing. But there's very little information still, I believe, in this country, on how you as the mother heal, what happens internally. You have a check at six weeks after the midwives have checked at home, you have a check at six weeks by your local GP and that is it, after major surgery, no-one else has even looked at my scar, felt my internal muscles or anything.
What do you think people need to be told before they have caesareans?
Before women have caesareans they must be given more information. They must be given more information from people like myself and other mothers who can collate an information pack, what to expect when you get home, the benefits of having a caesarean, the downers of having a caesarean. And in the long run it's fine, it really is no problem, but people need to be a little more prepared just how difficult it is for the body to knit. It's a big operation, it is underestimated. Yes, you have a positive result at the end, but if anyone else was having a similar operation such as a hysterectomy, you wouldn't be sent out to work two weeks later, two days later, or anything; you'd have time to heal and mend. I would like to see, myself, alternative therapy given on the NHS for people who've had such operations. I would like to see a choice of massage to tone the muscles again, therapy classes for post-caesarean women. There must be enough women to make a class to strengthen the abdomen and doing things like that, and just to really get people together who've had the same experience and to get your strength back far, far quicker than perhaps if you were unaware of quite how much work is needed.
Women had emergency caesareans for a variety of reasons, including a long, exhausting labour, a breech baby, concerns that the baby was distressed or unusual complications such as vasa praevia (see 'Rarer complications').
Views about emergency caesareans were mixed. After a long and tiring labour, some people felt calm and relieved to make the decision.
After a long, tiring labour, she felt calm and relieved making the decision to have a caesarean.
So you went straight ahead?
Straight into theatre, yeah. Straight into theatre.
So what was the experience of the actual section like?
It wasn't too bad. Everybody seemed fairly calm, and I was, because we were tired, we were quite calm as well. I just remember there being lots of people in the operating theatre, which I wasn't expecting. The porter wheeled me in, he stayed in, he was gowned up. My husband was gowned up, stood next to me. I had the anaesthetist behind me, and then there was about four other people. There was like the surgeon and maybe three nurses or something. There just seemed to be this whole crowd of people in this small operating theatre [laughs]. And they were very good, they all talked to me, what they were doing, and even when though they were busy setting up. And the anaesthetist was, you know, checking and checking again that I was, you know, that I couldn't feel anything before the operation started.
One mother felt relieved at the time, but wondered afterwards whether labour might have been easier and more relaxed if she had stayed at home longer. She felt demoralised to be told she was in labour only once she got to three centimetres dilated, when she had already been having contractions for thirty hours.
She was so exhausted she wanted an emergency caesarean, but wondered if labour might have been...
Okay, so who first broached the idea of a caesarean? Was that you?
Because you were so shattered?
Yeah, yeah. Yeah and, you know, they said, “Oh, you know, you don't have to do that,” blah, blah, blah. The doctor was like quite happy to do it, the doctor who was on duty. He said, “Well, you know, it seems like a sensible idea.” So I mean, so it's difficult, really. I think, I think it was more me that sort of was happy to go with that option really. I mean, and I'm quite happy because, in a way because I sort of feel I was so exhausted, and the thing is you can go for like hours in your birth, but then you've got the next day to face. You, it's not like you've got the next day of just, like, lying in bed and relaxing eating chocolates. You've got actually a baby there. So for me I can sort of see, “Well, he's come out healthy”, and yeah - but then I sort of think, “Oh, maybe I should have gone through the whole birth thing.” But I don't know if there's something in me that would have found that even worse [laughs] to go through or not, and so that's the thing as well. And I think maybe again, maybe being in a hospital - maybe in, if I think about it in hindsight, it was not, probably not the most comfortable atmosphere for me to be in. Maybe being, as I say, being at home for longer, longer would have been better for me in the long run, rather than being in hospital. Even though they were very nice. Because I think I'd have just been more relaxed. As a person, I think I feel more relaxed in my own surroundings, and around strangers and stuff I don't feel like so relaxed. I think maybe, again in a sort of subconscious way for me, that might have affected how I felt in my birth. That might have made it take longer. I don't know if that can happen.
Hmm. Or if these things happen on the, you know what I mean? Does a birth take a long time or are there problems because that's what's going to happen anyway? Or is there stuff that might be sort of happening - subconsciously that might make things sort of a bit more complicated or whatever?
It was demoralising to be told she was only just in established labour when she had been having...
Well, I mean, my waters broke about 9 o'clock on the Thursday evening, and then I was in hospital from that night, all day Friday and it was like, I went down to the labour suite probably about one in the morning on the Saturday morning, and then I was there all day [laughs]. I was there, I was there all day. So it was like, I mean, he wasn't born until about five to six on the Saturday, and I had a caesarean section then. But I just dilated one centimetre. And I wasn't sure, I think I felt a bit demoral-, I think I would have felt happier, because from my perspective I was like in labour from the minute my waters broke, but I don't really, you're not in labour until you're three centimetres dilated, which they didn't tell me till, like, you know, five in the morning on the Friday.
So - because I had all these contractions for like well over twenty-four hours - so I thought, “Oh well, I'm in labour now”, you know. And they said, “You're in labour now”. And I think that demoralised me a little bit, because I sort of felt like, “Oh my God, I'm only just now in labour. How much longer am I going to have to go on for? I've been in, having contractions for like, you know, thirty hours.” And then, you know, then I was in there for like another twelve hours, and they said, “ Oh, you've dilated by one centimetre - actually it might be slightly less than that,” and like, “How much longer are you going to be here for?” you know. So I think, I mean I do feel now I should have carried on for longer, rather than having the caesarean. And they did say, “Oh, have an epidural and go to sleep” and then things like that, and then sort of, I just thought, “Well, what's the point of having an epidural?” I mean, I don't know. I just, I was so tired, I was sleeping through all the contractions and stuff like that. So a bit of me now feels maybe I should have, like, had the epidural and gone to sleep, and then woken up and seen if I was more progressed.
And I was worried about the risk of infection. They say after eighteen hours of your waters being broken you have a higher infection risk than if you, than if you have the baby sooner. So that worried me as well, like thinking, “If I have an epidural what would happen there? Go on for another twenty-four hours? Surely this infection risk they keep telling me about, you know, is going to be worse?” and things like that. So I sort of was happy to have a caesarean section.
For others, the decision was more sudden and dramatic, for example when the baby was getting distressed, but this mother was sure it was the right decision.
The decision to have an emergency caesarean happened very quickly when the baby became distressed...
Mmm. How did that, how did that feel to suddenly have your labour taken over by all these people?
It was, it was very strange having labour taken over by other people. It was a bit like something out of ER. Something, you know, you were lying in the room with just yourself and a midwife and then suddenly she pressed a button and I think they could read the tracing in the doctors' office and about fifteen people rushed into the room. You know, several doctors and several midwives and then you were just being rushed on the trolley down to theatre. And it happened so incredibly quickly. I think, I knew it was a possibility because the - earlier on in the day they'd been watching the heart beat going down and I'd, I'd had, I'd had an epidural earlier on and the anaesthetist said, you know, "I might be seeing you later on" because, you know, he'd seen the tracing as well. So there was some suggestion that it might have to happen, so it wasn't completely a surprise. But it was, the speed at which it happened was, was quite a surprise really.
Did, were you disappointed to have a caesarean rather than a natural delivery?
Yes, I think I was slightly disappointed. I think I'd hoped to have a normal, natural delivery and - really because I hadn't managed to get pregnant myself, and I hadn't managed to go into labour myself, so I thought it would be quite nice to do something normally, but it wasn't to be. And in the end it, it wasn't a big issue, I don't think, for me, because, you know, we had a healthy baby which, you know, at one stage we didn't think we would have. And that was the main thing. And I think in the end, you know, several months later how I delivered wasn't a feature at all. It was the end result was by far the most important thing for me.
One woman had been booked for an elective section after a previous emergency one, but labour started early and was long and distressing, eventually ending with another emergency caesarean. The baby needed special care. She was unhappy with her care and the lack of communication with staff. Her partner feared she might die and they later decided to have no more children.
Her second labour was long and stressful and communication with staff was poor. She had an...
And it started on the Friday night, went into the hospital on the Friday night, they said I wasn't dilating enough, sent me home. Went back in on the Saturday, that was in the early hours of Friday morning, Saturday, early Saturday. They broke my waters and then I eventually had, at 4 o'clock on the Sunday I had an emergency section again. But in the meantime I'd had, I'd had a failed ventouse, a failed suction and a failed manual and the worst thing about it was that I was actually booked in for an elective section on the Monday, so why didn't they just give me a section? But the actual surgeon did not speak English so I didn't know what he was saying. I'd had 3 lots of diamorphine over the 3 days, I'd had gas and air, pethidine, so I was quite, you know, away with the fairies.
But he didn't speak English so he just kept indicating that I had to point at something and it was a, my Mum was with me and she took the piece of paper off me and she read it and it was a consent form that if anything was to happen, the hospital wasn't under any obligation, blah, blah, blah, blah. And eventually I sort of, I think I did scribble my name somewhere but I can't, you know, couldn't tell you what it was. And then I remember being in the theatre and he said - I remember screaming or something, and I remember my husband appearing next to me and the doctor saying, telling them, indicating to the midwife to tell the midwife to tell him, to tell me to push, which was quite, really quite strange. And I remember him saying this to me and I just looked at him and I thought, are you kidding? Because I was really, really, by 3 days later I was absolutely shattered and eventually I ended up getting an emergency section. And he came out and he was 5lbs 12 and he had to go into special care because he was that stressed through the labour. And out of the whole thing, he ended up having a hernia operation when he was 3 months old because he ripped his stomach lining and got a hernia from his stomach down to his testicles. So it was quite a, my second was quite a, horrendous for the two of us, really.
Her husband could not find out what was happening and was afraid she might die. They decided not...
Was your husband trying to sort of talk to them or get them to do anything?
Yeah, yeah, he was, he kept asking them, you know, what was going on, why was it taking so long, why was I so drugged up? Because I really was a lot of the time drugged up. But he just kept saying that he got no answers, he just really thought that I was going to die, because no-one ever actually explained to him. And it was only when, that, when I, obviously had had him and the paediatrician came out and said to my husband, “Oh, you've got a boy.” And he said, “Oh, that's fine, but what about my wife?” You know, and she went, “Oh, she'll be fine.” But that was the first time he knew that I would be okay, after I'd had him, and so for a day and a half he actually didn't know what was happening to me. So that was quite scary for him, it was, because, as I said to you, there's a lot I can't remember so it, it doesn't seem that scary to me. But obviously to him, it definitely was, because, as I say, 2 weeks later he went and booked himself in for the snip. And that was it, no more children.
She would have liked a caesarean earlier but thought staff were reluctant because they were...
The midwife asked Jen if she was cold, she was shaking so much before her caesarian. She wasn’t told what was happening.
And, obviously, you were upset about this, did they explain to you what would happen, what the steps would be?
No, I weren’t explained nothing but I saw someone about three days before I had the caesarean and they just went through a consent form really quickly and then I signed that but I didn’t understand what I was signing and then they said, “You have to take this tablet the day before.” And I said, “What’s that for?” And they didn’t explain what the tablet was for or the caesarean procedure or anything so I was just clueless.
Yeah. So can you remember how you felt the day before you were about to give birth then.
Really frightened and I was really frightened on the day as well. I was like, I mean I was that frightened, I was shaking that much and the midwife said, “Are you cold?” And I went, “No, I’m that scared, I’m shaking.”
And what, did she try to reassure you at that point?
No, I didn’t have any reassurance or nothing I, I was just shaking all the way through the caesarean, you know. Before the caesarean and all the way through the caesarean I was just shaking really badly because I was that scared because I just didn’t know what was happening.
As with vaginal birth, people's feelings about whether a caesarean was the right choice for them were affected by how well they felt supported and informed by staff they trusted, and whether they felt they had control over the decision.
Last reviewed May 2017.
Last updated May 2017.