Making decisions about birth after caesarean

A range of common and more specialist medical terms are available to talk about caesarean and birth after caesarean. Many of these words might be perceived as negative or judgmental by some people.  For example, an unassisted vaginal birth is sometimes referred to as a 'normal birth', even though over one third (42.5%)*of babies in the UK are now born by instrumental or operative delivery (forceps, ventouse or caesarean). Similarly, vaginal birth is often referred to as 'natural delivery', even though it may involve various medical interventions such as induction or an epidural.

In writing the different sections for this module, we have tried to use words that are sensitive to women's experiences and reflect their perspectives rather than those of clinicians.

We have used 'planned caesarean' instead of 'elective caesarean' to refer to a caesarean that is scheduled to take place before the onset of labour, because the word 'elective' suggests a level of personal choice that some women did not experience. As one woman said, “I didn't 'elect' to have it … it was the only conclusion”. 

Clinicians will sometimes distinguish between a 'laboured caesarean' and an 'emergency caesarean' but we have used 'emergency' for any caesarean that was not planned, regardless of whether women went through labour beforehand. We have used caesarean throughout (sometimes abbreviated to CS) rather than 'caesarean section' or 'c-section' because this is the term women themselves most commonly used. We have used 'birth' and 'delivery' interchangeably, as do women themselves. When talking about vaginal birth after caesarean, we have used 'VBAC' rather than 'trial of labour' or 'trial of scar'. Some women were happy to use these terms to describe their plan to have a vaginal birth with their next child, but others felt that they sounded too negative, medicalised and discouraging.

Some women also told us they found the language used by clinicians to describe why a caesarean had become necessary (e.g. 'failure to progress') contributed to their feelings that somehow they were to blame for what had happened, so we have avoided these terms in the summaries themselves, though they have been included in the glossary where no commonly used alternatives were available.

* Office of National Statistics - Hospital Episode Statistics: NHS Maternity Statistics 2016-17

Last reviewed August 2018.
Laast updated August 2018.