Caesarean vs vaginal birth nowadays

[Bikergran]

I just heard on the radio that this year in the UK, caesarean births have outnumbered vaginal births. Can I ask why you had a caesarean, if this was an option before labour commenced, or was it an emergency, and did you regret it? Or did you want a caesarean and were refused?

For full transparency, I am well beyond childbearing age now, had 3 children vaginally, one with forceps, another very traumatic psychologically. My DIL had an emergency caesarean after being in strong labour over 24 hours. My mother had 2 classic caesareans (where they cut you vertically from breastbone to pubis) in 1941 and 1953, the first one being performed by her family GP as the consultant couldn't get through due to wartime restrictions.

I was just surprised by the statistic, why do you think there has been such a massive rise in numbers?

I was very strongly advised, at my first consultant appointment, that attempting a vaginal birth given my medical history would be unwise and that a c-section would be my safest option. The consultant even sent me to see an anaethetist who further exorted me to opt for a c-section, she was so obviously relieved when I told her I was opting for a c-section that I can only imagine the consultant had given her the impression that I was pushing for a vaginal birth, which was definitely not the case! It did not occur to me to question medical advice and my c-section was planned for 38 weeks. I had an extremely straightforward, uncomplicated birthing experience, very calm and relaxed and I recovered very quickly afterwards. Most importantly, our perfect baby girl was born healthy and in a peaceful and chilled environment. I definitely think this was largely down to the scheduled c-section reducing some of the anxiety of the unknown that usually surrounds birth since we were fully aware of the plan and had some concrete idea of how and when our baby would arrive.
I would not have pushed for a vaginal delivery against all medical advice but, in the event, even had I been determined to attempt a natural labour it would not have been possible as our baby was remaining determinedly in a transverse position making a c-section essential. Fortunately this was not an issue since my delivery was already planned.

I have a family member with brain damage from a birth gone wrong. Cord around neck. Mum was dismissed by callous midwives for far too long.

It's heartbreaking seeing the lifelong issues they're struggling with.

If I had kids, it would have to be C section, 100%

I had a planned C-section. My mental health was atrocious in pregnancy, I was supported by the perinatal MH team throughout but I still needed a telephone assessment and two psychiatrists to sign off on the fact that I had severe tokophobia. I knew when I got pregnant that I could not have continued with it had I been forced to go into labour and I am forever thankful that I was listened to, because my birth was joyful and the best thing for DD as she got to come into the world surrounded by happiness not fear. It certainly wasn’t the case that I just asked for it and got one.

I was young, healthy weight, had a perfect pregnancy when I went into labour and ended up with a fourth degree tear. I was told that any future births would be by c section as further damage had to be avoided. I was dreading it but it was a great experience and recovery was much easier.

First time I had a vaginal delivery: I had a traumatic induction- no pain relief, tears, broken coccyx. Second time round was twins and my consultant was not keen on vaginal delivery for twins and said he couldn't guarantee I wouldn't rebreak coccyx! Opted for csection.

First was an emergency. I got induced and baby’s heart rate dropped so had to have emergency c section and baby had to be resuscitated when born. Second was elective due to traumatic first birth. 3rd I had no choice had to have c section due to second and third birth being a year apart

The 1:5 isn't a blanket risk for all VBAC's, rather it was a personal VBAC risk calculated from a series of factors including age, weight, progress of natural labour in previous pregnancy, etc. I'll see if I can find the exact details as it was a while ago now.

I felt it was too high a risk, but risk is very personal. The factors which upped my risk, and my level of risk aversion, won't necessarily be the same for others and so I wouldn't expect others to make the same choice I did.

First c section was at fully dilated. Laboured for 12 hours, pushed for 1.5hours- huge foetal distress and not descending. They tried ventouse in theatre it but she didn’t come down. So i unfortunately had a c section after all that.
second emergency c section- I had obstetric cholestasis and my liver was struggling. Baby wasn’t doing well so It was all rather quick. I had planned vaginal delivery as I had got to fully previously and it was the position. And distress that caused c section. Sadly at second c section I bled a lot,
both of them totally out of my control
if I had another I’m keen for vaginal but I am unsure if they would go for it

My one and only was born via maternal request c-section, though some medical considerations did play a part.

Above all I had zero confidence in the care I might receive during labour. Pain relief, support if things not progressing, recognising signs of distress. Maternity care is so poor in this country currently that I was not willing to risk mine and my baby’s health in the unknown, versus the controlled environment of theatre and the proper attention of medical staff.

I suspect many women who have been paying attention feel the same and chose accordingly.

OK thank you. I had a CS due to failed induction (cord compression, it was around her leg in the end), and I'd love to experience a positive natural birth but that stat would put me off too

Crazy the risks we go through.

I think a lot of women have lost faith in maternity care. We are more open when talking about poor experiences and with maternal request caesarians it feels like a valid option.

The increase in inductions doesn't help either. Loads of the horror stories I hear are about inductions that didn't work or were done without appropriate pain relief. I think we also need to look at the antenatal wards that they take place on. Whilst I wasn't induced I had to stay on antenatal in early labour and my cervix didn't dilate during that time, I think because it felt like such a public place. It really put me off induction for my next pregnancy.

I do find that interesting. My daughter-in-law and friends who had C-sections all had a lot of pain and long recovery times, much more so than I had with vaginal delivery. However, my births were 50, 48 and 35 years ago, and the midwives were wonderful, plus there were more of them, so you got a very personalised service.

I have a relative who works on a maternity ward and has said that they have more first-time mothers requesting c-sections than ever before.

I have had 3 vaginal delivered, the last being twins, and would not have entertained the idea of a cesarean unless absolutely necessary. I dislike hospitals and never had any surgery, so it creates a lot of anxiety when pregnant with the twins and being pushed for a cesarean.

All my births have been wonderful. No complications and immediate recovery.

Birth trauma is valid and rife at the moment. A lot of it is down to far too much intervention that results in emergency c-secrions. I think maternity care needs a complete overhaul, and antenatal classes should focus on birthing processes so the fear of the unknown is lessened.

I would not criticise anyone who chooses a cesarean as choice is very important. But informed choices can only be made when the whole process is transparent, including the implications of interventions like inductions.

During my first pregnancy, 50 years ago, this was actually advised by medical staff, to get baby into a good position and also to ease sciatic pain due to baby pressing on the sciatic nerve. One of my friends had hyperemesis, and after hearing of the thalidomide tragedy refused all medication, and she told me she scrubbed the floor with 2 buckets, one for hot water, and one to throw up into!

During my first pregnancy, 50 years ago, this was actually advised by medical staff, to get baby into a good position and also to ease sciatic pain due to baby pressing on the sciatic nerve. One of my friends had hyperemesis, and after hearing of the thalidomide tragedy refused all medication, and she told me she scrubbed the floor with 2 buckets, one for hot water, and one to throw up into!

It may be coincidence but I can’t recall a single woman I know who’s had an average straight forward birth.

Could it be a sign of the care now being offered or not enough staff?

I in know way think that a C section will be the easy way out and I fully understand it’s a tough recovery however it outweighs a vaginal birth for me due to previous medical anxiety and panic attacks that stem from being in situations that I can’t control and don’t know the outcome of.

The medicalisation vaginal birth, leading to interventions, leading to emergency C-sections. The atrocious care during and after birth. With the current state of the NHS maternity services, a controlled C-section seems/is the safest option. (As in, the C-section is generally a controlled and predictable procedure).

I had 2 vaginal births, not in the UK, but I totally understand why almost half of women are going for C-sections.

Also - this is not an individual issue, it's a societal issue. Each individual woman can only make decisions within the framework that exists

That, plus also the women they were looking after were on average younger, lighter and less likely to be primips. I don't doubt the 1975 staffing rates on the 2025 population would give us better care and outcomes, but it's a two sided thing really.

Your poor friend! I can understand why she didn’t want to take any medication. I wouldn’t even take a paracetamol just in case!

I would never have chosen a caesarean unless it was an emergency. I’ve had two natural births, second a home birth and had no problems.

I was fit, healthy and late 20s so encouraged to go natural, hypnobirthing. But baby was finally born 16 days over due date following sweep, induction, manual breaking of waters and finally EMCS as all of the above put the baby in distress and it was getting very late.

Second one was Elective as had to be born in a hospital with the correct PICU due to known health issues.

I would say that the increase is due to choice, insistence on on time deliveries, better medical understanding, earlier detection of medical issues in unborn children. As still birth rates appear to be decreasing (though not as quickly as they should) it is not a bad thing.

I do wonder at the number of 'failure to progress' though. I suspect that this may be due to horrible medicalized birthing suites in hospitals interrupting the natural rhythm of birth.

I had a vaginal without pain relief for DC1 - back home 3 hours later.

And a planned ELCS for DC2 for maternal request (i.e., no official medical reason) because my very straightforward VB caused unknown damage to my pelvic floor (lots of private pelvic rehab required as NHS couldn't give a shit) and triggered a bowel related issue that I still have to medicate 9yrs later. So.... no, I wasn't doing it again thanks. NHS didn't think any of these issues merited a medical-reasons ELCS so I pushed for maternal request and quoted NICE guidelines at them, along with requesting this went to head consultant for discussion if they were to reject. (Totally unlike me as I never do confrontation or advocate well for myself!)

FWIW, ELCS was absolutely fine - and that was during Covid days when things were tough in L&D wards. Home in 24hrs. Recovery was stiff and a bit sore but totally totally manageable and relatively back to normal by day10 and ran a 5k at 12wks PP. It took me 2.5yrs to run after having DC1. No worsening of bowel issue, and pelvic floor had no changes at all.

I recently had a planned C-section due to a low lying placenta and a breech baby. Hated every moment of it, lost a lot of blood, had a few panic attacks, recovery has been hard and ended up with an infection in the wound. My previous DC was born vaginally and I had a beautiful hypno style birth which I loved. Feel like I’ve missed out on that this time round, but I’m just glad baby is here safe and currently snuggled up in my arms.

My 1st was a 38 hour labour with induction and an emergency c-section. I'd had awful PGP and was on crutches. The combination of the c-section, and barely being able to walk afterwards and a post partum haemorrage was pretty awful. I don't know why I had the haemorrhage (I didn't even realised I'd haemorrhaged until I was back at home - nurses just said I'd lost a lot of blood and I didn't quite understand what that meant). I guess it could have been to do with the section or maybe because it was a long labour.

The 2nd was a vaginal delivery after a 20 hour labour. The PGP was not quite as bad as the 1st time but the vaginal delivery with legs in stirrips (plus episiotomy) finished my pelvis off and I had back problems for a long time afterwards. I was better prepared when I got home though and my partner had a month off work to help.

Honestly, I would never want to do either pregnancies or births again but, if the haemorrhage was to do with the long labour, I'd probably skip that part completely and opt for a c-section.

It's absolutely insane what we're expected to go through.

1. Just didn’t like the look of it. This was the biggest reason.
2. multiple miscarriages so didn’t want additional risk at the end, just wanted baby out
3. 37 week delivery and for my specific risk factors, age, BMI etc had a 40% chance of induction ending in emcs
4. clotting issue so emcs carried a bigger risk
5. I just didn’t want to and that’s enough.