Practice 10-Minute Consultation

Birth options after a caesarean section

BMJ 2018; 360 doi: (Published 11 January 2018) Cite this as: BMJ 2018;360:j5737

No place for giving birth in fear in 21st Century Britain

When dealing with women making birth option choices after a caesarean section, we find the overwhelming question to be asked when making decisions are the events and circumstances around the caesarean section.

Consider the example given of a woman who had a caesarean section for a breech presentation diagnosed in early labour. Contrast it with a woman who had a long labour, with multiple fetal scalp pH samples taken, who then has a failed instrumental delivery followed by a caesarean section and the baby is born in poor condition. This woman would be highly likely to opt for an elective caesarean section.

It is our experience that women with previous traumatic delivery approach subsequent pregnancies with great trepidation. We believe there is no place in the 21st century for women giving birth in fear. And if this means the woman requires an elective section then it should be offered with good grace and done with kindness. There may be no evidence base to support this, but we feel that Gaia, or mother earth, would agree.

Competing interests: No competing interests

12 January 2018
Malcolm John Dickson
Consultant Obstetrician & Gynaecologist
Angus P Conacher, Christi Brasted
Morley Green, Cheshire