The information in this section was compiled by Kristina Bennert with clinical advice from Rona McCandlish (Midwife and Epidemiologist) and Roshni Patel (Specialist Registrar in Obstetrics & Gynaecology). 

After caesarean birth

1. I am not sure why I had a caesarean. How can I find out?

2. Does a caesarean require me to give written consent?

3. What are common physical effects of a caesarean?

4. How active can and should I be after having had a caesarean?

5. How soon after a caesarean can I drive?

6. What impact does having a caesarean have on breastfeeding?

7. How can bonding with the baby best be supported after a caesarean?

8. How long after a caesarean should I wait before having another baby?

9. Are women who have a caesarean birth more likely to get postnatal depression?

10. Can a having a caesarean lead to post traumatic stress disorder (PTSD)?

11. I had a caesarean due to pre-eclampsia. How will this affect my next pregnancy?

1. I am not sure why I had a caesarean. How can I find out?

Every woman who has had a caesarean should be offered the opportunity to discuss the reason(s) for the caesarean and what it might mean for future pregnancies as part of their care from the obstetrician who carried out the operation, and from the midwives who offer them care during the postnatal period. However, if you have not had such a discussion or cannot recall the details, your first hospital appointment with a consultant obstetrician (usually around 20 weeks) will be another opportunity to review the hospital notes from your caesarean and discuss how likely it is for any problems you may have experienced the first time to happen again. Books and websites can help to give you further information about common complications, but they cannot replace the discussion you can have with a consultant obstetrician about your experiences and individual medical history you can have with a consultant. You can also contact the Head of Midwifery in the hospital where you had your caesarean to ask for her help to talk though what happened and understand what is written in your hospital notes.

2. Does a caesarean require me to give written consent?

Obtaining consent for a medical intervention is required by law; however it is a process rather than a single moment in time. Written consent is usually needed for a surgical operation (such as a caesarean) but may not be possible to achieve in an emergency. In this situation, if the woman is considered to be competent to give her consent, her verbal consent must be obtained before the operation is started. Clinical guidelines state that “Your healthcare team should give you information about birth and caesarean section before they ask you to consent to the operation. They should do this in a way that respects your dignity, privacy, views and culture, while taking into account your medical circumstances. You have the right to decline a caesarean section even if this will harm you or your baby's health”.


3. What are common physical effects of a caesarean?

The answer to the question can be found by following the link to askbaby.com: www.askbaby.com/caesarean-recovery.htm

4. How active can and should I be after having had a caesarean?

The prospect of walking about after the operation may seem daunting at first, but many women feel able to get out of bed after about six hours rest. Midwives will often encourage women to move around relatively soon after the birth to aid circulation and avoid the forming of blood clots in the legs. (The risk of blood clots can also be reduced with ankle-moving exercises.) One very good reason to get moving is to go to the toilet.  You will have had a tube put into your bladder to empty the urine when you had your operation and this is usually taken out sometime in the first few hours after you go to the postnatal ward.  It's a lot easier to pass urine if you get out of bed and go in the toilet.  Also, you'll have to try it sometime - and once you've got out of bed once, next time will be easier. However, be careful not to overdo it. A hormonal high triggered by the experience of birth might lead some women to be active too quickly after birth. It is important not to exhaust yourself as initial over-exertion can slow down overall recovery time and also affect the supply of breast milk, if you are breastfeeding. Talk to your midwife about what would be a reasonable level of activity for you.

5. How soon after a caesarean can I drive?

The answer to the question can be found by following the link to caesarean org: www.caesarean.org.uk/FAQ.html#driving

6. What impact does a caesarean have on breastfeeding? 

Most women go on to breastfeed after a caesarean without problems. Statistics show that women who give birth by caesarean are slightly less likely to start breastfeeding but those who do are as likely as those who give birth vaginally to go on breastfeeding. This may at least in part be due to mothers' own preferences as some women may feel too tired or unwell after the operation and decide against breast-feeding. Other contributing factors include when there is a delay between birth and the mother and baby being able to be together for the first feed, or the baby being drowsy from pain killers given during labour.  In these situations it can be harder to get the baby latched onto the breast.  It is really important that if you want to breastfeed your baby after a caesarean you have help and support from your midwife or to deal with these issues.  It can be difficult to find a comfortable position to breastfeed with a caesarean scar and many mothers find it helpful to have assistance so they can get comfortable before putting the baby to the breast. Further information and advice about breastfeeding after a caesarean can be found at: www.plus-size-pregnancy.org/CSANDVBAC/bfaftercesarean.htm

A list of relevant organisations and support groups can be found in the 'Resources' section of the Healthtalkonline website on breastfeeding: www.healthtalkonline.org/Pregnancy_children/Breastfeeding

7. How can bonding with the baby best be supported after a caesarean? 

Separation of a baby and mother should be minimised in the first hour after birth if at all possible. Bonding opportunities should take precedence over hospital or theatre routines.  Early and prolonged skin-to-skin contact between mother and baby allows their relationship to develop and promotes hormonal changes needed to initiate and maintain breast milk production.  Hospital units should provide facilities for 24 hour rooming-in, so that a mother and her baby can be together throughout their stay.

8. How long after a caesarean should I wait before having another baby?

The decision about how much time to allow before trying for another baby is a very personal one and will be influenced by a multitude of factors. Your age, how easily you are likely to conceive, your general level of health, and how ready you feel to start another pregnancy, are all likely to be important to you in making that decision. For a medical point of view, there is evidence to show that the uterine scar becomes stronger as time goes on. Research has looked at different gaps between pregnancies from those grouped as "less than 6 months" up to those grouped as "longer than 2 years". The risk of uterine rupture or of the scar separating remains small even with small intervals, but gaps of less than 6 months had the highest risk.

9.  Are women who have had a caesarean birth more likely to get postnatal depression?

Around 1 in 10 mothers will experience postnatal depression. It is different from the 'Baby Blues' a period of low mood immediately after the birth which is experienced by around half of all women but which will lift again after a couple of weeks. Postnatal depression sometimes only occurs a few months after the birth and it can be quite severe in its effects. There is no evidence that having a caesarean makes women more likely to experience postnatal depression. 

Further information about symptoms of postnatal depression and sources of support can be found following these links:

Information booklet published by MIND, the mental health charity: www.mind.org.uk/help/diagnoses_and_conditions/post-natal_depression

Website of MAMA, the Meet-A-Mum-Association. Offers information about postnatal depression and local groups and the option of joining an online support group: www.mama.co.uk

The National Institute for Clinical Excellence (NICE) has published a booklet on mental health problems during pregnancy and after giving birth that describes the care and treatment options that should be available in the NHS: http://guidance.nice.org.uk/page.aspx?o=409693

10. Can having a caesarean lead to post traumatic stress disorder (PTSD)?

Giving birth can be a traumatic experience and some women may find it hard to cope in the aftermath of a birth that was very different from what they had expected. While very few women who have had a caesarean are likely to meet the diagnostic criteria for PTSD, a small study of 30 women who had an unexpected caesarean found that around half of them experienced some of the symptoms associated with PTSD, such as intrusive thoughts and worries for a period of time after the birth.* If you think you might be experiencing symptoms of PTSD, the website of the Birth Trauma Association offers further information and support: www.birthtraumaassociation.org.uk/index.htm

* Ryding, Wijma, K., & Wijma, B. (1998) Predisposing psychological factors fo9r post-traumatic stress reactions after emergency caesarean section. Acta Obstetricia et Gynecologica Scandinavica, 77, 351-352.

11. I had a caesarean due to pre-eclampsia. How will this affect my next pregnancy?

Women who have had pre-eclampsia previously will be offered more frequent appointments and monitoring in their next pregnancy, as there is a risk that complications might happen again. However, many mothers will not experience any problems in their next pregnancy. Action on Pre-eclampsia provides further information on the condition and how women will be monitored in a next pregnancy: www.apec.org.uk

Last reviewed November 2010.