Making decisions about birth after caesarean

The decision about how to give birth after a previous caesarean can be a very personal choice, and several women we spoke to felt strongly that it was down to each woman to choose the method of birth that felt right to her. Nevertheless, most women said that they had been influenced, at least to some extent, by other people. For many women, advice and information received from health professionals played an important role, but they also considered the views of their partners, family and other women when making the decision.

All women we talked to were with the father of the child they were expecting and all said their partner or husband would accompany them into hospital. Most women had discussed the decision of how to give birth with their partner and a couple of women who felt uncertain which way to go said they had 'talked about it a lot'. We asked women how their partners felt about their birth preference and whether they had reached the decision jointly or by themselves. We did not speak to women's partners directly, so the views represented here are women's perceptions of their partners' views.

Some women said their partners did not have any strong opinions about how they should give birth and were just happy to support them in whichever decision they made. Several women were quite happy for their partners to take a backseat in the decision-making process and make up their mind by themselves, but a few others hinted that they would have liked their partner to take on a more active role. A few women thought it was 'a typical male thing' not to become too involved in the details of giving birth. However, one woman acknowledged that she didn't really know how her partner felt about things and described him as 'a bit of a closed book'.

Some other women said their decision about how to give birth had been altered or influenced by their partners' views and concerns. A couple of women who had considered a vaginal birth at home agreed to go into hospital because their husbands were worried that a home birth after caesarean would be too risky*. Several women empathised with the emotional challenge men faced during birth: worrying about the risks to their partner and baby while being limited to playing a rather passive role for most of the process - something that can be “distressing and boring at the same time”, as one woman put it. A few other women said their partners had wanted them to have a caesarean because they perceived it as a safer option than a vaginal birth involving a lengthy labour. One woman said 'the thought of me going through all that again just terrifies him'. A couple of women also hinted that a caesarean would be more convenient for their husbands because they wouldn't have to spend long stretches of time in hospital with them and would be able to plan for the day. 

A couple of women said their partners wanted them to have a vaginal birth because they hoped that they would recover more quickly than after a caesarean. One woman had been advised by her consultant to have a repeat caesarean. She said her partner would have liked her to have a water birth and thought that having a caesarean was 'cheating'. 

Besides their partners' views, some women's decisions were also influenced by consideration for other family members. One woman, whose family lived abroad, was pleased that her having a planned caesarean meant that her family would be able to time their visit for the birth of the baby. Another woman worried whether she would have her baby in time to be a bridesmaid at her sister's wedding. One woman, who had been very ill after her first vaginal birth, felt much better after the birth of her second child by caesarean. She said booking another caesarean had helped to reassure her family. Other women thought vaginal birth might be better, because they were concerned that after a caesarean they might not be able to cuddle and lift their toddlers. (See also 'Reasons for wanting vaginal birth after caesarean' and 'Reasons for wanting a planned caesarean'.)

A few women mentioned that talking to other women had helped them in reaching a decision. A couple of women who had decided to attempt vaginal delivery said they had been encouraged by hearing about the experiences of friends who had gone through VBAC. Similarly, one woman who was considering a planned caesarean had felt reassured when friends who had experienced both emergency and planned caesarean told her that the difference was 'like night and day'.

However, a couple of women felt that the views of friends and acquaintances could put women under pressure sometimes or make them doubt their decisions. One woman was very keen to attempt vaginal delivery and her friends thought she was 'mad', but it hadn't put her off. Another young woman, who had decided on a planned caesarean, thought that the people who were criticising her decision didn't really know all the facts.

A couple of women who had decided to have a planned caesarean said they found some of the media coverage on women's birth preferences unhelpful and ill-informed. They thought it was wrong for people without medical background to write judgmental opinion pieces that were likely to make many women feel guilty about their birth choices. However, negative press coverage of planned caesarean hadn't made them change their minds about what they thought was right for them.

*National Institute of Clinical Excellence - NICE had advised that women who wish to have a VBAC should have ‘care during labour in a unit where there is immediate access to CS and on-site blood transfusion services. [2011]

Last reviewed August 2018.