All the things I've learnt from having two caesareans
No one wants to say 'vaginal'
April is caesarean awareness month - which rather ironically I wasn't aware of, despite having had two myself.
Ironic but not all that surprising; although caesarean births are increasingly common - the latest NHS stats showed 42% of all deliveries in 2023/24 were via caesarean - they remain greatly under discussed.
Bar snarky headlines relating to various celebrities being ‘too posh to push’, I can't say I'd heard much about caesareans before having kids.
During my prenatal course, no more than five minutes was dedicated to talking about them, as opposed to the three days spent focused on vaginal births. I'm not convinced they would have been brought up at all had one of the group not been pregnant with twins and advised to deliver via ‘sun roof’. To be honest, that episode of Love Island when Dr Alex stood next to the fire pit in his swimmers and explained how C-sections are performed was more informative. Which is bonkers considering three out of eight of us in the class ended up having one, whether planned or emergency.
It’s no wonder when you consider that from 2005 the Royal College of Midwives ran a campaign promoting vaginal births as preferable. The initiative also encouraged expectant mothers to give birth without medical interventions including epidurals and inductions.
Although the campaign ended in 2017, the judgemental attitude towards birth is still evident. At the start of 2023, six weeks before giving birth to my daughter, I wrote a feature in response to the temporary ban on gas and air several NHS trusts had implemented. It was feared that prolonged exposure to nitrous oxide was harmful for medical staff. However, rather than invest in the necessary equipment to ensure safe usage, the solution decided on was to deny birthing women pain relief instead.
It was only three years ago that hospitals in England were told to abandon targets aimed at limiting the number of caesarean sections carried out to below 20%, over fears for the safety of mothers and babies.
The societal narrative around caesareans births has long been that they're a cop out of the real deal. Something to be ashamed of. I couldn't disagree more.
My first C-section took place unexpectedly in the middle of the night one Sunday in November. It was eight months into the Pandemic so an already nervy experience felt even more intense. The hospital was eerily quiet. My husband had to sit on a small plastic chair in the corridor. I wasn't allowed to take my face mask off.
After a stressful couple of hours being monitored (was the baby moving? All I can feel is contractions… Yes, he's moving!) I was moved to a private room, hooked up to another monitor and introduced to my midwife, whose name I didn't catch as her gentle, delivery room-appropriate voice was entirely absorbed by her face mask.
My husband joined armed with the mandatory four-pack of Lucozade and we set to work waiting it out for the arrival of the baby, him sat in the shabby grey leather recliner, me heaving myself into various ‘active’ positions as per NCT instruction.
To cut a long story short, several hours and a few complications later, I was being measured up for compression socks, hurriedly talked through a waiver form and told “there's more chance of being hit by a bus than something going wrong”, which I suppose was meant to be reassuring.
At 1.20am I was fumbling off my chain necklaces and handing them to a somewhat pale looking Ben (thank goodness he had the Lucozade to hand). By 2.15am I was holding a baby having discussed red wine preferences with an anaesthetist called Eric.
Aside from the trainee midwife pointing out that the overhead surgical lamp was reflective enough to see what was going on the other side of the fabric barrier - and then said barrier partially falling down - everything went ok. Untill my husband was ejected from the recovery room after 40 minutes (Covid rules) and I was left by myself with a newborn and no feeling below my ribcage.
If my first caesarean was wild in its unexpectedness, my second was surreal in its routine.
It was elective; I figured I had the scar anyway and it would be easier to sort childcare for my now toddler. During a mid-pregnancy consultation I was told the week it would happen and given a choice between the Monday or the Tuesday. The latter half of the week was already booked up - first come, first served.
We arrived at the hospital at 7am on the scheduled date, went to the maternity ward and were shown to a bed where a tiny see-through bassinet was already waiting. The midwife told us to lie a nappy and hat in the cot in preparation, which felt completely bizarre. Despite knowing otherwise, it was hard to relate to the fact that a baby was about to come out.
Sat on the bed - me in a gown, my husband in scrubs - we watched the first couple in the queue get taken through to theatre. An hour or so later the next went in. Neither of us can remember what we talked about but we took a selfie and a little after 10am it was our turn.
Here we are!
Without going into details that may not be helpful to hear, even a planned caesarean doesn't always go to plan. Having major surgery really isn't all that easy and whoever says otherwise has obviously never been through it. It certainly isn't the blow-dry and champagne affair the media might suggest… perhaps when you go private?
It's been almost four and a half years since I had my first, a little over two years since my second. While I’d won’t pretend I’m totally unbothered about the scar across my bikini line, I am at peace with how my kids came into this world. Were their births the magical experiences I thought I would/should be having? No. But they arrived safely, which is ultimately what matters.
I do however wish I’d known a few things going into it all:
It feels like someone is doing dishes: I remember a celebrity on TV saying a caesarean feels like someone is doing the washing up inside your stomach. I think it was Olivia Colman on Graham Norton. She was spot on.
You can pick your playlist: There will be music on in the theatre, so if you have an elective caesarean you can take your choice of tunes. I was told about one couple who even stipulated which song they wanted playing at the point the baby was brought out. It was The Circle of Life. Lol.
It's ok to ask about the scar: In the moments before my first surgery, I felt too embarrassed to ask how the scar was going to look. Whether it would be horizontal or vertical (typically vertical). How high up it would be (typically bikini-line level). The second time around, I was too embarrassed to ask whether they would go through the same scar or make a new one. I think I felt too silly. And like it was a shallow question. Which it wasn’t. For subsequent caesarean sections the surgeon will try and go through the same scar – unless the scar tissue is too thick then a new cut is made. I currently have one scar about four inches long that you can't see when I have a pants/ bikini bottoms on.
I posted this 11 weeks after my first caesarean after Amy Schumer put a pic of her scar on Instagram. She liked my post which I am thrilled about.
A night dress is essential: I packed a pair of pyjamas in my hospital bag instead, figuring I'd easily be able to slip an elastic waistband on. Wrong. After a caesarean you literally cannot lift your legs, so I had to spend the first few hours bottomless. Mortifying. For my second go, I took a night dress.
Stock up on big pants just in case: Otherwise, like me, you could be panic buying whatever ginormous knickers Amazon Prime has to offer from your hospital bed. For the first few days these disposable ones are comfortable and convenient. Then you’ll want soft cotton or tencel pants with an incredibly high waistband and in black.
Have someone stay with you overnight: After my second caesarean, we decided my husband should go home to be with our son for bedtime and when he woke up. A great decision for my son (consistency!) and my husband as he got a solid eight hours in a proper bed, but it was lot less great for me. The midwives were so busy that I was left without much help. Inching my way to the breakfast station the following morning carrying my catheter was an extreme low point. This is one of life’s moments where you need to put yourself first.
You will pick up something heavier than your newborn: Even though you get repeatedly told not to. But - life! Especially if you already have a child. I found an abdominal support band helpful for making it feel less like my insides were going to fall out.
It's normal to have numbness around your scar: And it can last anywhere between a month and forever. I couldn't feel the area above mine at all for months and it still feels a bit like it's not part of my body.
It's worth bothering with massage: Everyone I spoke to after my second caesarean recommended doing daily massages on my scar to loosen the tissue which was tight and making the skin over the top hang over. Massaging also increases blood flow to help with healing and can flatten bumpy scars. DIY it after your shower from 6 weeks onwards.
People will be unintentionally insensitive by referring to non-caesarean births as ‘normal’ or ‘natural’: The language used, even by the medical profession, has been wrong for so long. But in my experience most people aren't being judgemental, they just don't want to say ‘vaginal birth’. No one wants to say vaginal. VAGINAL.
The post-caesarean edit
Soft-waist trousers for when you get home to wear with a big T-shirt or shirt, £57
Slip-on shoes, because bending down isn't the one, £40
One more thing…
The latest John Lewis x A.W.A.K.E Mode collection has just launched and includes a reissue of the curve trousers (£159). I got a pair in the last drop and they’re such a great cut that looks smart but cool and won't make you feel like you’re in school uniform. Wear them to the office with a tee and loafers! Or out to dinner with a sexy shirt!
This is what they look like on a model...
And this is that they look like on me…
That's all for now. You're doing great, Frankie x
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Thank you so much for your message! Gosh those visiting hours were madness and so, so tough. 💔Xx
Great article. I’d add:
- prepare for the birth you don’t want, not the ideal one. My emergency section was a million times better because I had the enormous pants, the nightie and the peppermint tea bags in my suitcase;
- take all the pain relief and outsource the pain relief scheduling to your partner (my husband was brilliant at just bringing whatever pill it was that hour, unprompted);
- get up and walk (slowly) as soon as you are able. I thought my hospital was sadistic in making me do this but mobility was critical to recovery and I was walking (slowly) a mile each way to the park within a week;
- LACTULOSE;
- no one told me about the blood-thinning injections beforehand. I curse the bloody antenatal class teacher who told us to pack fairy lights (I did not) but didn’t bother to mention blood thinners are routine after the operation and I had to have six weeks’ worth. This wouldn’t have changed anything but it would have nice for this not to have been a surprise on top of everything else.