Women’s experiences of their previous caesarean (C-section) birth

Women’s first experience of caesarean birth was strongly influenced by the hopes and expectations they had held beforehand. (See ‘Women’s expectations for their previous birth‘). For all but one of the women who were interviewed, their experience of caesarean was also their first experience of childbirth. All of them had opted to give birth at hospital and many felt anxious about what lay ahead. Looking back, some women wished they had been more confident to question some of the decisions made about their care.

With her first birth, she went along with whatever the medical team recommended. In her second…

Age at interview 37

Gender Female

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The majority of women in the study experienced an ’emergency caesarean’, that is, the decision to perform a caesarean had been made after they had gone into labour. The most common reasons for having an emergency caesarean were problems getting fully dilated or the baby starting to show signs of distress. A few women went on from induction of labour post term to having an emergency caesarean without experiencing contractions and dilating only minimally. Two women experienced life-threatening complications due to pre-eclampsia and had to have their babies delivered prematurely.

She had trouble dilating and had a caesarean when her son’s heart rate started dropping. She was…

Age at interview 40

Gender Female

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She was admitted to hospital with pre-eclampsia at 30 weeks and went on to have a caesarean under…

Age at interview 33

Gender Female

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A minority of women had a planned caesarean – that is, a caesarean that was scheduled to take place before their labour started. Reasons for a planned caesarean included being pregnant with twins, a large baby, a baby in breech position and a difficult previous birth. Women who had a planned caesarean did not necessarily feel less anxious about the operation than those who had emergency caesareans (see ‘Women’s expectations for their previous birth‘). However, they’d had more time to adjust their expectations of what the birth would be like. Most of them felt satisfied with their birth experience. One who woman who had chosen to have a caesarean felt particularly pleased with her decision. However, a couple of women regretted missing out on labour and vaginal birth. One woman felt angry initially when she found out that doctors had misjudged the size of her baby and she could have had a vaginal delivery after all (Interview 06).

Her delivery of twins by planned caesarean was a very positive and stress-free experience. Played…

Age at interview 32

Gender Female

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The majority of women had epidural caesareans, so they were conscious during the operation, though several felt quite hazy due to the painkillers they had received. Some women had an epidural earlier on in their labour so they were ready to move on to the operating theatre as soon as the decision for a caesarean was made. Others received a spinal block specifically for the operation. Several women felt quite nervous about receiving the epidural and a few women also felt anxious about being operated on without a general anaesthetic. Generally, women found it very reassuring when medical staff kept them informed about what was happening to them at each step. Friendly words providing some distraction were also much appreciated.

She was nervous about being awake during her planned caesarean, but it made a big difference that…

Age at interview 38

Gender Female

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There was wide variation in how quickly the decision to perform an emergency caesarean had been reached and how involved women had felt in the decision-making process. For some women, the decision was a gradual process reached in consultation with hospital staff and did not have an ’emergency’ feel to it. For others, it happened very abruptly and they were rushed into the operating theatre with little time for discussion.

Her previous caesarean happened very quickly, but it did not feel stressful. She can’t recall…

Age at interview 40

Gender Female

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She was fully involved in the decision to have a caesarean and was able to play her CD in the…

Age at interview 38

Gender Female

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The decision to deliver her twins by caesarean was made in consultation with her. It did not feel…

Age at interview 33

Gender Female

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When it was found that her baby was in distress there was no time to discuss options. She was…

Age at interview 31

Gender Female

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Women need to consent to the operation, but depending on circumstances consent might be taken verbally rather than in written form. Not all women could recall a formal consent procedure or signing anything. Several woman said they felt far too stressed or too hazy from painkillers to take in the information provided to them at the time. The women who had a planned caesarean had more opportunity to find information and talk to health professionals beforehand, but this did not necessarily mean that they felt more involved in the decision-making. Some women hadn’t felt the need to be given much information or be involved in decisions as they trusted the medical staff to do whatever was necessary. Several women also said they did not feel there had been much of a choice and caesarean had been the only safe way to deliver their baby. Few women were aware what having a caesarean might mean for future pregnancies at the time of the operation. However, a couple of women had much more positive experiences of information provision and felt very happy with the way their views were taken into account.

She felt treated unsympathetically by the consultant and was annoyed to find out she had been…

Age at interview 42

Gender Female

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The doctor consulted her about whether she wanted to labour for a while longer and she was able…

Age at interview 31

Gender Female

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She would have liked to be more involved in decisions about her care, but once she experienced…

Age at interview 30

Gender Female

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Several of the women who had difficulty dilating described a gradual loss of control during their labour. Once they had one intervention, others seemed to follow. Similarly, as time went on and pain became more intense, they found themselves agreeing to forms of pain relief they had originally wanted to avoid. Looking back, some women wondered whether the way in which their care was managed at hospital had the effect of slowing labour down. For example, one woman felt that perhaps she had got into the birthing pool too early and got too relaxed. Others wondered about the effect of drugs such as pethidine, which made them feel too confused or sleepy to move around. (See ‘Women’s feelings about their previous caesarean’).

She felt left alone during the first stage of labour, then received several unwanted…

Age at interview 30

Gender Female

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She had wanted as natural a birth as possible, but after her labour slowed down she felt she lost…

Age at interview 32

Gender Female

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A few women felt so exhausted from having laboured for many hours that they were relieved when a caesarean was eventually offered to them. Others who went through a long and painful labour would have liked to have been offered a caesarean earlier on and found it difficult to understand that medical staff waited until their baby showed signs of distress. However, a few women felt they should have been given more time to try and give birth vaginally.

She didn’t care what was done to her as long as her son would be alright. The thought of…

Age at interview 26

Gender Female

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At some stage during their labour, many women had been connected to a fetal heart rate monitor. This restricted their movement and a few women felt that this made it more difficult for them to get comfortable and maybe even contributed to slowing down their labour. Several women also found it very upsetting to witness irregularities in their baby’s heartbeat via the monitor.