More than 1 in 5 babies born in the UK are now born by caesarean. A caesarean is an operation where an obstetrician makes a cut in your abdomen and womb, just above your bikini line, and lifts your baby out through this opening.
If you’ve had a previous caesarean, you might be feeling unsure about your birth options. There’s lots of myths and misinformation around vaginal birth after caesarean (also known as VBAC).
You might be sure that you want a VBAC this time, or anxious about the idea of it. You might feel that you don’t want to try a VBAC at all.
Whether a VBAC will be recommended will depend on lots of factors. Women have caesareans for all sorts of reasons – some of these are unlikely to recur in future pregnancies, while in others the team may think it’s safest for you to have another caesarean. The obstetric team will help you to understand the circumstances around your previous caesarean, why it was necessary, and whether your caesarean needs to be considered for your current pregnancy birth options.
For example, if you had a caesarean because your baby was breech, it’s unlikely that you will need another caesarean. Women who’ve had one previous caesarean and are having a straightforward pregnancy have a 75% chance of a successful vaginal birth. If you had a vaginal birth before your caesarean, you have an even higher chance of success – about 80-90% of women in this situation are able to have a vaginal birth.
There’s lots to think about when considering your options for your next birth. Your booking appointment is a good opportunity to discuss these issues. If you feel you need further information and support, your midwife can refer you to the Birth Choices clinic at the hospital where you plan to give birth.
Elective caesareans (sometimes called planned caesareans) are usually performed after 39 weeks of pregnancy, to ensure that your baby has had time for their organs to fully develop. Elective caesareans are recommended for various reasons, such as having a low-lying placenta, or babies that are presenting in certain breech positions (i.e. bottom first first). In some cases a caesarean may be planned before 39 weeks of pregnancy if there are concerns for mum or the baby; the risks and benefits of delivering your baby early or continuing with the pregnancy will always be explained and discussed with you to help you make the right decision for you and your baby.
*Please note this video discusses covid restrictions - however these often change, please check your local trust website for the most up to date information.*
Caesareans that are not planned are called emergency caesareans. These are usually performed when problems occur during labour – it might be that labour isn’t progressing, you start bleeding, or your baby isn’t responding well to contractions. In some cases, such as when a baby has restricted growth or reduced movements, an emergency caesarean may be done before labour has started.
Emergency caesareans are not always done straight away but there will usually be some degree of urgency. When they need to be done quickly, your midwife needs help to prepare you for theatre, so try not to worry too much if several members of the maternity team come into your room to help.