Roles of partners and others in decision-making

The decision about how to give birth after a previous caesarean can be a very personal choice, and several women we spoke to felt strongly that it was down to each woman to choose the method of birth that felt right to her. Nevertheless, most women said that in reaching a decision, they had been influenced at least to some extent by other people. For many women, advice and information received from health professionals played an important role, but they also considered the views of their partners, family and other women. (See also 'Women's experience of making the decision' and 'Roles of health professionals in decision-making'.)

All women we talked to were with the father of the child they were expecting and all said their partner or husband would accompany them into hospital. Most women had discussed the decision of how to give birth with their partner and a couple of women who felt uncertain which way to go said they had 'talked about it a lot'. We asked women how their partners felt about their birth preference and whether they had reached the decision jointly or by themselves. We did not speak to women's partners directly, so the views represented here are women's perceptions of their partners' views.

Her partner was very supportive of her preferences, but felt the decision was totally up to her.

Some women said their partners did not have any strong opinions about how they should give birth and were just happy to support them in whichever decision they made. Several women were quite happy for their partners to take a backseat in the decision-making process and make up their mind by themselves, but a few others hinted that they would have liked their partner to take on a more active role. A few women thought it was 'a typical male thing' not to become too involved in the details of giving birth. However, one woman acknowledged that she did not really know how her partner felt about things and described him as 'a bit of a closed book'.

Her husband thought a caesarean would be safer, but he left the decision up to her. Once she had decided to attempt VBAC, he was supportive of that choice. Played by an actor.

Some other women said their decision about how to give birth had been altered or influenced by their partners' views and concerns. A couple of women who had considered a vaginal birth at home agreed to go into hospital because their husbands were worried that a home birth after caesarean would be too risky. Several women empathised with the emotional challenge men faced during birth: worrying about the risks to their partner and baby while being limited to playing a rather passive role for most of the process - something that can be “distressing and boring at the same time”, as one woman put it. A few other women said their partners had wanted them to have a caesarean because they perceived it as a safer option than a vaginal birth involving a lengthy labour. One woman said 'the thought of me going through all that again just terrifies him'. A couple of woman also hinted that a caesarean would be more convenient for their husbands because they would not have to spend long stretches of time in hospital with them and would be able to plan for the day. 

She had considered a home birth, but her husband wanted her to have the baby in hospital, because he was concerned about the risk. Played by an actor.

Her husband is keen for her to have a VBAC because he thinks she will recover more quickly and it would be difficult if she could not drive.

A couple of women said their partners wanted them to have a vaginal birth because they hoped that they would recover more quickly than after a caesarean. One woman who had been advised by her consultant to have a repeat caesarean said her partner would have liked her to have a water birth and thought that having a caesarean was 'cheating'. 

Her partner wanted her to have a water birth with their second child. He thinks having a caesarean is 'cheating'.

Besides their partners' views, some women's decisions were also influenced by consideration for other family members. One woman whose family lived abroad was pleased that her caesarean would allow them to time their visit for the birth of the baby. Another woman worried whether she would have her baby in time to be a bridesmaid at her sister's wedding. One woman, who had been very ill after her first vaginal birth and had felt much better after the birth of her second child by caesarean said booking another caesarean had helped to reassure her family. Other women thought vaginal birth might be better, because they were concerned that after a caesarean they might not be able to cuddle and lift their toddlers. (See also 'Reasons for wanting vaginal birth after caesarean' and 'Reasons for wanting a planned caesarean'.)

A few women mentioned that talking to other women had helped them in reaching a decision. A couple of women who had decided to attempt vaginal delivery said they had been encouraged by hearing about the experiences of friends who had gone through VBAC. Similarly, one woman who was considering a planned caesarean had felt reassured when friends who had experienced both emergency and planned caesarean told her that the difference was 'like night and day'.

Being able to talk to friends who had faced the same decision was helpful in making up her mind. She thinks women would benefit from having access to other women's experiences of VBAC.

However, a couple of women felt that the views of friends and acquaintances could put women under pressure sometimes or make them doubt their decisions. One woman who was very keen to attempt vaginal delivery, said her friends thought her 'mad', though that hadn't put her off. Another young woman who had decided on a planned caesarean thought that the people who were criticising her decision did not really know all the facts.

Other women's reactions to her decision to attempt vaginal birth made her reconsider for a short time, but she decided to give it a go anyway.

She thinks women should not let themselves be influenced too much by the opinions of other people. It is more important to have accurate information.

A couple of women who had decided to have a planned caesarean said they found some of the media coverage on women's birth preferences unhelpful and ill-informed. They thought it was wrong for people without medical background to write judgmental opinion pieces that were likely to make many women feel guilty about their birth choices. However, negative press coverage of planned caesarean had not made them change their minds about what they thought was right for them.

She thinks negative media coverage of women who have a caesarean is unhelpful and could sway women in their decision when they might have very good reasons for wanting a caesarean.

Last reviewed November 2010.