Caesarean birth
A Caesarean birth is usually performed when a vaginal birth could put mum or unborn baby at risk. This is a huge topic and there are whole books written about the subject. The World Health Organisation says the Caesarean rate should be 10-15% in order to make a difference and save lives. The national average in the UK is nearly 30%, with some hospitals having an even higher rate.

Ina May Gaskin has a Caesarean rate of 1.4%. This suggests that some Caesareans are happening when they could have been avoided, perhaps as the end of a cascade of intervention.

There are three types of Caesareans:

Planned or elective
The operation is scheduled before the mother goes into labour.
This can be because of maternal choice, multiple birth, position of the baby (i.e. breech – bottom or feet first or transverse – lying across) which makes it difficult for the baby to fit through the pelvis, maternal infection such as genital herpes or placenta praevia (blocking the exit of the womb).

Unplanned or emergency
The decision to perform a Caesarean happens once labour has started, most commonly done because of foetal distress or lack of labour progression.
Despite the name, it is NOT an actual emergency although it can be very frightening if you hear that word.

Crash or category 1
This is when the situation is life threatening and baby needs to be born immediately (this is the real emergency).
This will be done under general anaesthetic and partners will not be allowed into the room.

The way birth is presented many women feel having a Caesarean is easier than giving birth vaginally. They feel it takes away any uncertainty about when the baby will be born and for many, it is the less frightening option with the bonus that no damage needs to happen anywhere near the vagina.

Physiological birth is not meant to be frightening or damaging, the chances of real problems occurring are low and much more likely to happen if the birth is interfered with. Recovery from a physiological birth will be at a pace that is right for you.

Recovery from a Caesarean can take many months. You have undergone major abdominal surgery.  Your 6 week check is an opportunity for you to ask questions.
When booking this book a double appointment one for you and one for baby.

Babies born via caesarean may experience breathing difficulties because they have not experienced the intense contractions that happen at the end of labour which help squeeze fluid out of their lungs and prepare them for life on the outside (although most of these issues are slightly more of a concern with an elective caesarean because labour may not have officially started before the baby was born).

A Caesarean birth is much ‘cleaner’ than vaginal birth. When a baby is born vaginally they come into contact with the good bacteria in the vagina which contributes to seeding the microbiome i.e. preparing the baby’s very sterile immune system for contact with a very un-sterile world. There is a lot of research on this currently going on.
A baby born by Caesarean misses out on all of that.

Some research evidence suggests that babies born by caesarean who miss out on these important elements are going to have a higher chance of contracting illnesses and health conditions (Dietert R. and Dietert J., 2012), however more research is needed.

Having a caesarean may impact on your future fertility.
Breastfeeding and bonding may be delayed because those all-important, hormones were not produced in the quantities required because the birth process was  ‘interrupted’.
There may be lack of skin to skin contact or, because of being in theatre, and/or, depending on the circumstances necessitating the procedure, there may be separation of mother and baby for an extended period of time.
The mother and baby are likely to have high levels of stress hormones during and immediately after birth, because there has not been the huge surge of Oxytocin at birth which calms everybody down.
Please be aware the these risks are rare but it is important to know all the information when making your decisions.

If you are separated from your baby for any reason please don’t think you won’t be able to feed or bond.  As soon as you are able to, do skin to skin to give the hormones the opportunity to do their magic.  (This applies to all births).
In theatre do skin to skin. Make sure your gown is is open at the front to facilitate skin to skin.

Request skin to skin in theatre – skin to skin regulates body temperature so they don’t need to be bundled up in a towel because the theatre is cold.
Catheters can be sited in your non-dominant hand and any heart monitor pads can be attached to your back.  The leads can be passed under the table. You can also ask for the screen to be lowered slightly at the point of birth, so you can see your baby being born.

Caesarean birth can be where your birth ends up, it can become a necessity or it can be a choice – it is still the birth of your baby and you can still use hypnobirthing!!
All the principles about remaining calm are just as relevant and a lot of the affirmations can be adapted to suit an abdominal birth. If you know well in advance that you’re having a caesarean let your hypnobirthing practitioner know.  You could also do some research on Gentle Caesareans, as pioneered by Professor Phillip Bennet, Consultant Obstetrician to Imperial Healthcare NHS Trust at Queen Charlottes and Hammersmith Hospitals. Check out the Caesarean Options lesson. Listen to one of the Ripple Mamas who negotiated the first Gentle Caesarean in Northampton under Mrs Dexter at NGH.

The aim is to replicate a vaginal birth and the pressure on the baby’s lungs as much as possible by facilitating the baby to slowly push/manouver themselves through the abdominal incision.