In England and Wales women have the right to decide how they gives birth. While there isn’t a legal “right” to a caesarean on demand, healthcare professionals are obligated to discuss all available options, including vaginal birth and caesarean sections (c-sections), outlining the associated risks and benefits. A decision can then be made on the basis that the person understands all options available fully and can make an informed decision.
This emphasis on informed consent empowers women to make decisions aligned with their individual circumstances and preferences. Healthcare providers are expected to respect these choices, even if they differ from their own professional opinions, provided the woman has received comprehensive information and support. If a woman’s request for a specific birth method is refused, she should be referred to another healthcare professional who can accommodate her wishes.
When are caesareans encouraged?
Caesarean sections are performed either as planned, elective procedures, typically from the 39th week of pregnancy, or as urgent, emergency interventions when vaginal birth poses significant risks.
Planned caesareans might be recommended if the baby is breech and attempts to turn them have been unsuccessful or declined. They may also be recommended if the mother has placenta praevia, pre-eclampsia, certain infections like late-stage genital herpes or untreated HIV, or if the baby is experiencing oxygen or nutrient deprivation.
Emergency caesareans are necessary when labour fails to progress, there’s excessive vaginal bleeding, or if immediate delivery is crucial for the baby’s wellbeing.
Why are they not always suggested?
There are many cases, where even though there is no particular medical reason like the ones we mentioned above a woman may choose they still want to deliver through a c-section. Having experienced a previous difficult birth or fearing possible complications linked to one’s personal or family medical history are all reasons women may have for wanting to avoid a vaginal birth.
C-section is classified as a major surgery. This means it carries all the risks surgeries do including the risk of infection and of causing damage to internal organs. It also means that not all birthing units are equipped to carry it out as it needs to take place in hospitals able to deal with possible complications. Finally, the cost of c-sections to the NHS is higher compared to vaginal births. Some of the reasons for that include that they need to be carried out by a consultant gynaecologist instead of a midwife, they require using an operating theatre, the need the prolonged involvement of an anaesthetist and often result in longer hospital stays.
Our experience
It’s important that women feel listened to when discussing their options for delivery. We often hear that whilst C-sections are discussed and would have been a reasonable choice, women are persuaded to proceed with a vaginal delivery instead which may include the use of instruments such as forceps. Women often report that they do not feel able to say no, and that they felt pressured to proceed as advised.
Forceps delivery can increase the risk of serious vaginal tears including 3rd/4th degree tears (which involve the anal sphincter muscle) resulting in long term consequences. Whilst we are not promoting the use of C-sections in all cases and it is appreciated that in emergency situations decisions need to be made quickly, it is still reasonable to expect the risks and benefits of each option available to be discussed. Too often we support women whose opportunity to make an informed decision regarding their delivery options was taken away.
How we can help in birth injury claims
If you or your baby have suffered physical harm because a medical professional did not listen to your concerns or did not present you with all information to empower you to make a decision that was right for how you want to give birth we can help you. At Enable Law we have a dedicated team of solicitors investigating and bringing birth injury claims on behalf of mothers and children. To have a free, confidential discussion with a member of our team call us on 0800 044 8488 or fill in our contact form so we can call you back at a time convenient to you.
