Caesarean Awareness Month: Understanding the Realities of Caesarean Birth

Each April, we mark Caesarean Awareness Month, a time to open up honest, compassionate conversations around this common, often misunderstood mode of birth.

In the UK, roughly 1 in 4 babies are born via caesarean section. These births are as powerful, meaningful, and important as any other, yet many parents still experience stigma, judgement, or feel their experience is diminished.

Behind every caesarean birth is a story. Some are planned, some unfold in emergencies, and others are shaped by previous trauma, complex health needs, or deeply personal choices. In this article, we aim to explore some of the types of caesarean section and debunk fear and judgment surrounding this birth process. 

Elective Caesarean: An Informed and Empowering Choice

For some women, the decision to plan a caesarean birth is not taken lightly and comes after reflection, conversations with care providers, and often in the context of:

• A previous traumatic birth experience

• Diagnosed post-traumatic stress disorder (PTSD)

• Tokophobia (a severe fear of childbirth)

• Ongoing mental health challenges

• Pre-existing medical conditions or complications in pregnancy

In these situations, a planned caesarean can offer something invaluable: a sense of safety, control, and emotional readiness. As midwives, we’re seeing and celebrating more women empowered by choice, where the right support allows them to reclaim their birth story and that matters!

Emergency Caesarean: When Birth Takes a Different Turn

An emergency caesarean, on the other hand, can feel very different.

When the original plan shifts suddenly, often due to concerns for the baby's wellbeing, stalled labour, or unexpected complications, families can be left reeling. The urgency, clinical setting, and loss of autonomy can lead to feelings of trauma, helplessness, or grief for the birth they imagined.

For some parents, particularly partners, the pace and medicalisation of emergency caesarean birth can be equally distressing. It's vital we acknowledge this, and that birth debriefing and emotional support are made accessible to both parents. 

There are many charities and organisations available online to support parents who are experiencing trauma following caesarean section such as The Birth Trauma Association, PANDAS foundation UK, National Voices and Maternal Mental Health Alliance. 

Health Impacts: Balancing the Risks and Benefits

No birth is without risk, and caesarean section is no exception. It’s important we offer families honest, evidence-based information so they can make informed decisions.

For mothers, short-term considerations may include:

• A longer recovery time

• Increased risk of infection, bleeding or clots

• Pain and discomfort that may impact early bonding or infant feeding

Long-term, there may be:

• Increased risk of placental complications in future pregnancies

• The possibility of adhesions or scar tissue

• Limitations on the number of future caesarean births (depending on individual circumstances)

For babies, research suggests:

• A slightly higher chance of breathing difficulties at birth

• Potential differences in gut microbiome development

• A higher likelihood of NICU admission in some cases

However, it’s essential to remember: a caesarean birth can prevent far greater risks to mother, baby, or both. In many cases, it is the safest and most compassionate choice but must be correctly explored and risk and benefit explored with care providers when possible. 

When considering caesarean section, use the B.R.A.I.N. method to help guide your decision-making process:

• Benefits – What are the potential benefits of this decision?

• Risks – What risks are associated with this decision?

• Alternatives – Are there any alternatives?

• Intuition – How do I feel about this? What does my intuition tell me?

• Nothing – What happens if I choose to do nothing or wait to see how things progress?

Supporting Mental & Emotional Wellbeing

One of the most overlooked benefits of planned caesarean birth is the way it can support mental health, particularly for women with:

• Pre-existing anxiety or PTSD

• Fear of childbirth or tokophobia

• Past trauma, including sexual abuse

• Experiences of loss or medical trauma

For these women, control, clarity, and compassionate care can make all the difference. A positive caesarean experience can lay the foundations for confident parenting, reduce the risk of postnatal mental health difficulties, and allow the birthing person to feel seen, heard, and respected.

Let’s Change the Conversation!

It’s time we challenge outdated ideas of what a “real” or "natural" birth is. Caesarean birth is not a failure. It is not less than. It is birth.

Every woman deserves respect for her choices, support through her experience, and the right to feel informed and empowered, however her baby comes into the world.

If you’ve had a caesarean birth and need to process your experience, know that you are not alone. Gentle support, debriefing, and midwifery care is available.

Let’s keep talking. Let’s keep listening. Let’s keep holding space for all birth stories — without judgement, without shame. 🤍