No, it’s not a typo. I am talking about why you might plan for something that you don’t think will happen, just in case it does.

In my last blog post, I explored how you might avoid having an unnecessary caesarean. While this is useful information to know, I ended it by stressing that my courses are not actually about avoiding caesareans, or getting any specific ‘perfect’ birth. My courses are all about empowering women and birthing people so that they come away from birth feeling like they were listened to, respected, and made their own decisions. If the plan to give birth at home changes and becomes a caesarean birth at hospital, I want my clients to have the tools to navigate this and experience it without freaking out. I want them to look back and consider the experience positive. I know that hypnobirthing allows this to happen.

First, let’s discuss the contentious issue of whether or not you should plan for something you don’t actually want! There are two sides to this…

Only focusing on what you do want makes it more likely to happen

I do think this argument has some merit. Hypnobirthing is all about unlearning negative and often incorrect ideas about birth and trying to re-programme your brain to think of birth as normal and entirely possible. We spend a lot of time on the course focusing on the mind-body connection and helping you to change your outlook on birth, particularly if you have some fear about birth. Using tried and tested techniques such as positive affirmations, visualisations, positive birth stories and relaxation exercises, we work on building a bubble of positivity to help your unconscious mind start to trust that birth will be ok. The point of this is not so that you have a ‘nice time’ during labour! It’s so that you do actually go into labour, and stay in labour! The birth hormones you need to trigger and keep labour moving are only produced when you feel safe and relaxed. (The fact that hypnobirthing mums tend to feel better during labour is a bonus!)

So, if we are aiming for a happy, relaxed mum with a really positive attitude to birth, wouldn’t it be better to only consider the really good things that you want to happen, and try to block out the bad?

To a certain extent, yes. Politely refusing to listen to friends’ negative birth stories and avoiding overly dramatised birth on T.V. is sensible as it’s unrealistic and damaging to your mental preparation for birth. And only picturing the birth you want may make it more likely that you’ll get it. The mind-body connection is powerful. But I’m not going to tell you that it’s powerful enough to overcome anything. For some reason, sometimes birth doesn’t ‘work’ all on it’s own. Sometimes we do need some help. And isn’t it wonderful that when we do, we have highly qualified and skilled obstetricians with extremely safe procedures such as caesareans available to us? If you’ve fixated on one type of birth and haven’t read up on or explored any other possibilities, how would you feel if things didn’t go to plan and you felt you needed to opt for something you knew very little about?

Planning for a range of scenarios means you’re more likely to get a positive birth, regardless of how you birth

I know when I was pregnant I wanted to know how to avoid an unnecessary caesarean. To be honest I didn’t want to know much else about caesareans (during my first pregnancy, at least) because I didn’t want one. But from my own experience (nearly having an ‘unplanned caesarean’ – I signed the form then birthed her vaginally with the help of forceps) and from reading all of the caesarean birth stories that my friends were kind enough to send me, I now believe that some planning for the possibility of a caesarean makes sense.

In 2022, 19% of births in the UK were unplanned caesareans, meaning there was a decision made during labour to switch from a vaginal birth to a caesarean birth (see data here). So, whilst it’s by no means the most common way of birthing a baby, you may not feel it’s rare enough to ignore as a possibility.

When I asked my friends about their unplanned caesareans, most admitted that they didn’t really know what to expect and that this made the experience less positive. Below are their stories. Please note that I haven’t included any negative birth details as I’m not here to add to the already enormous amount of negativity around birth that is out there. However, the stories do include how they felt at the moment they decided to have a caesarean and how they made their decision. Some of these experiences are negative, so I want to be up front and suggest you skim past them if you don’t want to hear that sort of thing.

Natalie:

Trigger warning: Natalie talks about how the decision to have an unplanned caesarean was stressful, rushed and traumatic. Her story doesn’t detail her birth, but the way she felt about this part of the birth when she was offered a caesarean.

As I personally had no intention of having a section, I never even looked into any information about caesarean sections or what to expect if you have to have one before I went into labour.  

My first birth with Jacob was a very straight forward birth in a very relaxed environment (in the birthing centre with not a single drug- not even gas and air!). So, I was hoping that my second one was going to be somewhere along the same lines (even though everyone knows you don’t get two births the same), as the last one.  However, they couldn’t have been more different!

So, I wasn’t prepared in any shape or form of what to expect. 

After 12 hours of trying to have a natural birth with various forms of pain-relief the on-call Doctor advised me that a section was, ‘the best option for me and my baby’. 

The decision to do this was very rushed as, once you agree to having a section, they proceed to ply you with information about what the process is, where it’s going to take place and what’s going to happen and when.  You also have to sign (I don’t know how many) types of paperwork to say that you’re happy to go ahead with the procedure before they can begin.  However, as I’d been on a lot of pain-relief over the 12 hours, I don’t remember any of the conversation, what was said to me, nor signing any paperwork. 

The whole experience for me was very traumatic and the furthest thing from how I wanted the birth to go.  This is actually one of the main reasons I decided not do it again. 

I never planned to have a section with my first. I never planned for anything. If I’m honest I didn’t think about how or what would happen I just presumed I’d have a vaginal delivery. 

I remember people saying “too posh to push” “c section is the easy option” 

I laboured for over 30 hours having been induced. I never wanted to be induced! I was frightened.

Having laboured for so long I was tired. I was in fact exhausted. I’d not slept for days! All I wanted was for my baby to be out and ultimately to be alive. 

I was young, it was my first I didn’t know what to expect. 

And then a consultant and many other medics came in. I remember thinking this is serious now. I was asked to sign a consent form. If I’m honest I don’t know what I signed, I just wanted the baby out. 

I was prepped for theatre. It’s all a bit of a daze, still. I was drugged up. Emotional. Tired. 

After 3 weeks I was driving. I was good as new!

Lauren

I have had three C-sections. 2 emergency, 1 planned. 

I would say I still feel a bit awkward admitting it to people as there is still the misconception that you’re lazy or too posh to push. Or that you didn’t try hard enough.

My first was an emergency after being in labour for hours and pushing for hour and a half. Rose developed an infection inside me and I was rushed to theatre. At this stage I was just happy to have her out and I didn’t care how it happened. My recovery was great the first time. I don’t know whether it was because I was younger, or because it was my first time, or whether I was trying to prove a point that I was strong and not weak. I remember the next day I was walking to the hospital canteen and carrying my own tray of food etc. 

The surgery itself seems very calm (even though 2 of them were emergencies) and professional. There are loads or drs and nurses in the room with you and you do feel very looked after. I was physically sick after surgery with both the boys which noone warned me about. 

What stands out to me from these stories is that my friends don’t talk negatively about the caesarean itself, in fact, Lauren even describes how calm it was and how well-looked after she felt. But both Natalie and Gemma describe feeling overwhelmed and stressed about the decision to switch plans and accept the offer of a caesarean. Reassuringly, that is definitely something that you can change yourself by being prepared for this possibility.

On my courses, we look at what happens during a caesarean birth, reasons why an unplanned caesarean may be offered, and what birth choices you have if you choose to accept the offer of a caesarean during labour. Many people assume that once you agree to a caesarean, any birth plan or preferences go out of the window. But that is absolutely not the case. There are lots of things you can still ask for if you need to have an unplanned caesarean. You may want to think about whether or not you’d like the curtain lowered so you can see you baby being born, what music you’d like them to enter the world to, how long you’d like to wait before your baby’s cord is cut, who you’d like to cut their cord, how you’d like the sex of your baby to be revealed, and loads more things that you can choose to help you feel positive about your birth.

Isn’t it all a bit rushed for all this nice but non-essential stuff?

Possibly, but probably not. It depends on the reason for the offer of a caesarean and whether it’s ‘unplanned’ or an actual ’emergency’. The two terms are often used interchangeably, but in actual fact, there are a number of different types of caesarean. Let’s look at how your caregivers classify them:

Type of caesarean	What this is and why you might need one
Category 1 – Emergency caesarean	Immediate threat to the life of mum or baby. The aim is to complete the caesarean within 30 minutes of the decision being made. There is time to discuss birth choices though it is likely to feel rushed. You may be put under a general anaesthetic instead of a local one (meaning you are not awake for the birth) in order to save time so they can do the operation as soon as possible (the general one is quicker to do).
Category 2	Labour isn’t going to plan. The aim is to have baby out within 75 minutes of making the decision. Though it may not feel like it, there is time to discuss birth choices. You’ll more than likely be awake for the birth.
Category 3	This is where a scheduled caesarean is brought forward for some reason, such as the mum going into labour early. The aim is to get baby out within 12 hours. There is time to discuss birth choices.
Category 4	A scheduled caesarean, on schedule! You’ll have plenty of time to discuss birth choices.

As you can imagine, the level of ‘calm’ that is likely to be achieved depends somewhat on the category of caesarean. But for category 2-4, which are most common, there is certainly time to discuss options, ask questions, and then focus on relaxing and getting into a positive frame of mind to birth your baby. I don’t think it always feels like this, which is a shame. But on a hypnobirthing course, you’ll get the information and techniques you need to make your unplanned caesarean as calm and positive as possible.

To plan, or not to plan, that is the question

So, what do you think? Do you want to focus your energy on visualising the birth you want, and blocking out any negative alternatives? Or do you want to plan for a range of eventualities?

There’s no correct answer. It’s definitely personal.

Personally, whether you write a separate unplanned caesarean birth plan, or you just use your main birth plan and ask ‘which parts of this plan can be kept?’ if an unplanned caesarean becomes a possibility, I think it’s a good idea to spend a small amount of time preparing for a caesarean birth. But, that’s not for everyone. It’s your call! My courses equip you with the knowledge and techniques you need to make decisions that are right for you, and that includes deciding for yourself how many, if any, birth plans you want to write.

If you’d like to know more about the hypnobirthing courses I offer, click here.

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