You have chosen to have your baby at the Elizabeth Garrett Anderson Maternity Unit.
We want to provide you with the highest quality care we can, that is safe and ensures that you birth your baby in the way that is most appropriate for you and your baby.
There is a lot of evidence to support the widely-held view that pregnancy ending in vaginal delivery is a normal process which is safe and appropriate for women with a low predicted risk of complication in the UK.
There has been an increase in the proportion of women delivering by caesarean section across the UK, giving rise to questions about whether all caesarean sections are necessary. The cause for this concern is that caesarean section is major abdominal surgery that is associated with a number of risks when compared to vaginal birth. These risks can be categorized into 3 groups:
Risks for you:
- Higher risk of uterine (womb) infection
- Higher risk of severe bleeding (haemorrhage)
- Higher risk of developing a blood clot in your legs or lungs
- Risk of accidental surgical damage to your bladder or bowel
- Longer stay in hospital
Risks for baby:
- Higher risk of your baby developing breathing problems following birth requiring hospital admission
- Problems breastfeeding
Risks for future pregnancies:
- Higher chance of developing low lying placenta (placenta praevia)
- Higher chance of developing a placenta (accreta) which grows abnormally into the uterine wall and sometimes beyond; these are rare complications but are serious enough to endanger your life and that of your baby
- More chance of infertility following first caesarean section
- More chance of stillbirth
It is important to emphasize that for many of these risks the increase related to caesarean section is small and most women having a cesarean section will not be affected by them.
In addition there are a number of situations where you and your doctor or midwife may feel that the risks of vaginal delivery are increased and outweigh those of caesarean section; such indications can be identified before labour (e.g. if the placenta covers the neck of the womb (cervix) or if the womb has been weakened by previous surgery) or during labour e.g if the fetal heart rate monitoring suggests that the fetus is not getting enough oxygen.
In these cases, where it is clearly safer for you and the baby to be delivered by caesarean section, the doctor/midwife will discuss the risks with you and arrange for a caesarean section if this is what you want.
If there are no identifiable factors that increase the risk of vaginal delivery then caesarean section will not be offered routinely as a birthing option. You might still think that a caesarean section remains the best choice for you and your baby, particularly if you have had a previous negative birthing experience, have complications during the pregnancy or are worried about delivering vaginally.
If this is the case then you will be referred to a senior doctor or midwife with extensive experience of caesarean section and vaginal delivery. You will have the opportunity to discuss your anxieties about vaginal delivery and they will provide you with information about the relative risks and benefits of both methods of delivery. In addition, you might find it helpful to have regular meetings with a healthcare professional trained to provide psychological support during pregnancy and childbirth.
Ultimately we wish to make sure that your delivery is as safe as possible for you and your baby and that you have a positive birthing experience.
Your midwife will help plan your birth with you and offer you:
- Small group birth preparation classes
- Infant feeding workshops
- Choice of the place of birth: Birth Centre, Home or Labour Ward
- Choice of birth companions present at the birth
- Choice of pain relief
- Water birth
- Support to feed your baby
- Support with caring for the baby after birth