Why do women fear a caesarean birth?

From the contact I have had with mums-to-be over the years, it is safe to say there are many different reasons why women fear caesarean birth. For many it stems from an overall fear of the unknown – both the surgery itself and the possible outcome. But then there are those women whose fear is based on previous experiences – experiences which may be birth related, but which could also derive from other surgical and hospital experiences. While still others experience fear because of the stories they have heard friends tell or clips they have seen in the media.

Researchers have often documented birth dissatisfaction as higher in women who have given birth by caesarean than those who deliver vaginally. ‘Loss of control’ being long established as a significant factor in the poor satisfaction ratings associated with unplanned caesareans in particular. A study in 2016 attempted to quantify this a bit more.

The top 4 reasons given by the women in the study were:

  • Poor communication – not so much in terms of what they were told, but rather the extent to which they felt listened to by those caring for them
  • Fear of the operating room
  • Distrust of the medical team – again relating to not being listened to and feeling something was being ‘done to them’ without due consideration
  • Loss of control

In this study, many women expressed the wish that they had been given more information about caesarean birth, both its likelihood and the procedure, prior to giving birth.

The study recommended for any birth, proceeding towards a caesarean delivery, a ‘collaborative plan’ should be negotiated and that such a plan must involve discussion beyond the relaying of the medical facts. Failure to do so would increase the likelihood of all the fears highlighted above.

‘Informed consent’ is a formal procedure, one which is carried out in all caesareans, unless the mother is unconscious and a caesarean deemed time critical. However, this study revealed that the process of ‘informed consent’ was all too often a formality where the mother was simply expected to agree, without time allocated for a more ‘robust exchange’.

What this all points towards is the importance of antenatal education in providing a rounded and balanced approach to modes of birth, where caesarean birth are given as much time and respect as vaginal birth, where myths and fears can be openly addressed. Being informed well before the event that a caesarean might be a possibility, what will happen and how means women can participate in their birth and this could go a long way to reducing the feeling of loss of control and fear so often unnecessarily tied up with caesarean birth.