CLAIRE COLMAN: It’s time we stopped fetishising so-called ‘normal’ births

At a children’s birthday party recently, a woman I had never met before asked me about my experience of giving birth to my first son, now two.

She looked shocked when I told her I chose to have a C-section, explaining it was probably as stress-free and painless as a birth could have been.

In fact, out of the ten women in my antenatal class, the only ones who considered their birth a positive experience were those who had a planned – or elective – caesarean.

Some others were so traumatised by what happened, they had flashbacks and physical reactions to TV programs about birth and labour.

Figures published on Monday show a record one in four babies born between April 2023 and March 2024 were delivered by elective caesarean – up more than 10 per cent in the past decade.

The figure includes my younger son (figures from two years ago would have included my older one) and I have absolutely no regrets.

That’s despite women like me being made to feel like failures if they can’t – for whatever reason – give birth “naturally”.

The phrase “too posh to push” may no longer be in use, but that doesn’t stop some believing a woman who can’t, or simply doesn’t want to, put themselves through the pain and potential risks of a vaginal birth is somehow less of a woman, or mother.

Even the experts heading up the latest NHS data – which showed that, of the 398,675 deliveries in England in the year to the end of March 2024, 25 per cent were by planned C-section – sounded disparaging.

I’ve spoken to other women who had to undergo therapy courses before being allowed to have the birth they wanted.

Dr Ranee Thakar, the president of the Royal College of Obstetricians and Gynaecologists (RCOG), put the increase down to higher rates of obesity “and people choosing to have children later . . . both of which can increase the chance of complications”.

This sounds a lot like mother-blaming to me.

All these ancient or fat women deciding they want to have kids, how diabolical!

Yes, one of the major reasons I chose to have a C-section for both my first son, born in March 2022, and my second, in March this year, was because of my age.

I was 44 when I first gave birth and knew full well being older meant a vaginal birth was more likely to have complications.

But the idea I chose to have children at a later stage in my life is laughable.

Like many, I didn’t end up having children until my 40s because I wasn’t in the right relationship until then.

It’s not like 20-something men are begging to settle down.

And these days, even if you are lucky enough to meet someone in your 20s and decide you want a family, it’s not that straightforward.

The staggering cost of housing and childcare – two children in childcare full-time will cost more than our mortgage – are both very good reasons responsible, would-be parents might feel they can’t have children until they’re older.

More to the point, shouldn’t healthcare provisions progress with the needs of a society?

It’s all very well Dr Thakar insisting “the RCOG does not promote one form of birth over another”, but in my experience there is huge pressure on women to opt for a vaginal – I deliberately use that word instead of “natural” – birth over a caesarean.

I had to repeatedly explain why I wanted a C-section to midwife after doctor after midwife, and though they were sympathetic and understanding and didn’t try to persuade me otherwise, I still had to jump through the hoops.

I’ve spoken to other women who had to undergo therapy courses before being “allowed” to have the birth they wanted.

Friends who had done antenatal classes with the National Childbirth Trust (NCT), the largest provider of antenatal education in the UK, told me the emphasis was very much on having what it calls a “normal” birth.

This despite the fact their website states: “We are not here to promote one way over another, but to ensure parents have access to evidence-based information.”

This shaming affects thousands of women.

Because, according to the latest data, in addition to the one in four having an elective caesarean, a further 18.7 per cent of deliveries in 2023-2024 – almost 100,000 – were emergency C-sections.

The same set of statistics also shows less than half (42 per cent) of women go into labour spontaneously — the rest are induced or have a C-section — and once in labour, only 46 per cent deliver the baby without instrumental intervention, be that forceps, ventouse or an emergency C-section.

You might like to claim it’s because we’ve “over-medicalised” birth, but that’s like saying we’ve over-medicalised dentistry because we now use anaesthetic when extracting teeth, or cancer is over-medicalised because we don’t let people die from it.

In 1920, in England and Wales, the maternal death rate – or number of women per 100,000 who died during pregnancy, birth or just after – was 433.

In 2020, excluding deaths from COVID, it was 11.54. Medicine has moved on and I’d argue it should move on even further.

I’m not suggesting C-sections are risk-free.

They’re major abdominal surgery – of course they carry risks.

There has been limited academic research which suggests children delivered by C-section have an increased risk of asthma up to the age of 12, and obesity up to the age of five.

This shouldn’t be ignored.

But the academic research I studied when making my decision to have both my children by C-section showed it was, I believe, the safest way to deliver my babies, even if it meant the risks for me were marginally higher.

And while I know it’s not always the case, I feel those risks are overblown. I was up and about a day after my first C-section.

I walked half a mile to and from the GP for my son’s five-day check-up.

There’s often an argument made that a vaginal birth is cheaper and less staff intensive. That may be true, but what happens when you take into account complications that can accompany it?

The data shows 147,144 incidents of “perineal laceration during delivery”, that’s a tear that can result in pain, urinary or anal incontinence; 111,416 woman whose labour and delivery were “complicated by fetal stress”, the baby being in trouble; and 105,485 women who had postpartum haemorrhage, or severe bleeding.

While I had been subjected to scare stories about how a C-section might incapacitate me for weeks, and make breastfeeding and bonding with my baby difficult, nobody warned a friend that a vaginal birth might result in her being in such pain she couldn’t sit comfortably for six weeks, or that her post-partum haemorrhage might hamper her ability to feed and bond with her baby — let alone the psychological distress it put her husband through.

This is so common most hospitals now offer new mothers the chance to debrief after their birth, allowing them to talk through what happened during the process in a bid to resolve the trauma.

There is something very wrong – barbaric, even – with a society that encourages millions to go through something with the potential to cause serious physical and psychological damage.

When it comes to birth, it should be the health of the mother and baby that is paramount, not an ideology that fetishises a romantic ideal most women can’t achieve – and many just don’t want to.