Q: I’M expecting my first baby and I’m really scared about giving birth. Can I have a caesarean just because I’m scared of the pain?
Dr Shazia Malik, a consultant gynaecologist and obstetrician at The Portland Hospital in London, part of HCA Healthcare UK, says: “About one in four women in the UK have a c-section to deliver their baby. For women with a complicated pregnancy, a c-section may be recommended or necessary for the health of the mother or baby. However, some women choose to have a caesarean even when there’s no medical need.
“In addition, women sometimes opt for an elective caesarean for fear of the pain of giving birth. Some mothers-to-be may feel guilty or worried about asking for an elective c-section, but their healthcare teams will never judge them for their choice and just want them to have the best birth experience possible.
“Some women may have suffered previous traumatic experiences related to their sexual health, or a previous birth experience, or have a real fear of giving birth vaginally (called tocophobia). It’s important to discuss this with a trusted healthcare professional, ideally before you even become pregnant, so you can have counselling and psychological support, not only to help overcome your issues, but to make the right choice for you.
“It’s important to remember that having a caesarean isn’t risk-free, as it’s major abdominal surgery. It can take longer to recover after giving birth and there may still be some pain and discomfort in the following weeks. I’d recommend that any woman who’s nervous about giving birth speaks to a member of their healthcare team about their concerns, as they should be able to help put their mind to rest.
“If a woman is considering having a caesarean for non-medical reasons, such as anxiety about childbirth, their doctor should explain the benefits and risks of the procedure, compared to a vaginal birth. Following this, they’ll usually be offered an elective caesarean. If their obstetrician is unwilling to perform the operation, they should refer them to another obstetrician who’s willing to do it.
“There are many ways of your team looking after you during your labour to help alleviate any pain, such as gas and air, injections and an epidural injection. So if fear of pain is your main concern, discuss this with your midwife and obstetrician. They can also arrange an appointment with an anaesthetist – with modern ‘mobile’ epidurals you can remain mobile and pain-free in labour and during the birth.
“I often find that learning hypnobirthing during the pregnancy can be helpful if you feel anxious about the birth, and many women find it reduces their need for injections or epidurals. Discussing your worries in good time also helps to make a clear plan for whatever birth you choose, which helps you feel more confident and enjoy the experience of welcoming your baby.”
