Written by Shirin Fardi, childbirth educator. Last reviewed September 2026.
Most birth preparation prepares you for one kind of birth.
In England, which publishes the fullest UK figures, close to half of babies are now born the other way. In Portugal it is nearly four in ten. In Germany and the United States, about one in three. In France, about one in five. In the Netherlands, closer to one in six.
If you have spent months learning to breathe through contractions, and nothing you have read has given a caesarean more than a paragraph, then you have prepared for a little over half of what might happen.
A caesarean is also a birth you can still make decisions inside. Not one or two decisions. Fourteen, and a UK national guideline that tells your team to accommodate them where they can.
Around 45% of deliveries in England were caesarean births in 2024 to 2025, roughly 20% of them planned and roughly 24% unplanned. The rate is different wherever you are giving birth.
Your own hospital will have its own rate, and your midwife can tell you what it is. It is a reasonable thing to ask and nobody will mind you asking.
What none of these numbers tell you is which one you will be. That is the part worth preparing for.
The word caesarean covers three different situations. They feel nothing alike, and which one you are in changes what you can ask for.
A planned caesarean, also called elective, is booked in advance. Usually for a medical reason found earlier in pregnancy, such as a placenta lying low across the cervix, or a baby who stays breech. Some women choose one.
It is normally scheduled for the morning. You can usually eat until midnight the night before and drink water until two hours before you leave for the hospital, though your own hospital will tell you its rule. Several couples are often asked to come in together, and the consultant gives you your order for the day. Expect to wait, because anything urgent takes the theatre first. Bring something for that time. Breathing practice, a hand massage, a film downloaded onto a tablet. It is a strange few hours, knowing you are about to meet your baby. The waiting is what surprises people, not the surgery.
An emergency caesarean is decided during labour, when labour has stopped progressing or an induction or assisted birth has not worked. You go when a slot opens, which might be ten minutes or half an hour. There is a short separation while your partner is taken to change into scrubs and you are prepared for theatre. Knowing the separation is procedure and not alarm makes it a great deal easier to sit through.
A crash caesarean is the rare one, where a baby needs to be born within minutes. It is the only situation where a general anaesthetic is likely, because it is faster, and it is the only one where your partner cannot be with you. You are reunited in the recovery room.
That last point is worth holding onto. Most caesareans, including most emergency ones, are done with a spinal or an epidural. You are awake. You hear your baby. Your partner is next to you.
There is also a gentler surgical approach, sometimes called a gentle or natural caesarean, developed for planned births. Ask whether your hospital offers it.
You are given something to settle your stomach, something for sickness, and antibiotics. A spinal or an epidural goes in, or a combination of both, and a cold spray is used to check that you are numb from your toes to the top of your uterus.
Then the monitoring. An oxygen monitor clips onto your finger like a peg, so leave gel nail varnish off, because it is difficult to remove. A blood pressure cuff goes on your upper arm and stays there. A cannula goes into the back of your hand and a blood sample is taken. Compression stockings go on and stay on until you are told otherwise. A pad goes across your legs, which earths the device used to seal blood vessels. The trolley is tilted slightly to the left, so that nothing presses on the large vein returning blood to your heart.
Two small things to ask for and one to leave at home. Ask for the heart-rate pads to go on your neck and shoulders rather than your chest, so nothing is in the way when your baby is put on you. Ask what the incision will be, which is usually ten to twenty centimetres, low, under the bikini line. And leave make-up, contact lenses and jewellery at home, because all three come off anyway.
More people than you expect. Around ten to twelve for one baby, and about fifteen for twins.
A midwife to check your baby. A consultant obstetrician or registrar, who does the surgery, and their assistant. An anaesthetist. A paediatrician, and a paediatric resuscitation team in case your baby needs help straight away. An anaesthetic nurse or operating department assistant. A scrub nurse. One or two theatre nurses. Sometimes medical or midwifery students, with your permission.
They should each introduce themselves to you and to your partner before anything starts. If they do not, you can ask.
From the first incision to your baby being born is usually three to five minutes. The whole operation takes around fifty, and most of that is after the birth.
You feel pressure and pulling, and no pain. Sometimes there is pressure on the top of your uterus to help your baby out. Women describe it as someone doing the washing up inside them. Strange rather than frightening, and quick.
Your baby is lifted out, shown to you, and taken a few steps away for a short check under a heat lamp. Babies born by caesarean go from fluid to air in a moment, without the squeeze of a vaginal birth, so they often need a little suction and sometimes some oxygen. Theatres are kept cold to lower infection risk, which is what the heat lamp is for.
That trolley has wheels. You can ask for it to be brought where you can see it, and most teams will.
Then, in most cases, your baby comes to your chest.
One thing to agree with your partner beforehand, because nobody wants to decide it on the day. If your baby needs to go to the special care unit for extra observation, does your partner go with the baby or stay with you? There is no right answer. There is only the answer you have already had the conversation about.
No, and the reasoning matters more than the reassurance.
An emergency caesarean is decided late, by people watching things you cannot see, on information that did not exist an hour earlier. That is precisely why it lands as a shock. Nothing was wrong with your preparation. Nothing was wrong with your body. The situation changed and somebody acted on it.
An obstetrician writing for ACOG put it plainly, about her own two caesareans: it is not your fault, and it is not a failure, if you need one.
What women tell us afterwards is that the surgery was rarely the hard part. The hard part was the gap between the birth they had trained for and the birth they had, and the private sense that they should have been able to close it.
They could not have. Nobody can.
One of the women in our community said it in four words and we have not improved on them since. No one fails at birth.
"Before the retreat, I was so scared about giving birth that I'd completely blocked it all out. I am so much more relaxed." Ruth, momz.eu reviews
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You can write a birth plan for a caesarean, and most women are never told so. They arrive believing the only decision left is to lie still and let it happen.
The UK's national guideline is explicit about it. It asks teams to accommodate a woman's preferences for her caesarean birth wherever possible, and it names examples: music in theatre, lowering the screen so she sees her baby born, silence so that her voice is the first the baby hears.
This is the list we teach. Write down the ones that matter to you and show them to your midwife or consultant before the day.
Not all of it is possible in every theatre, and almost none of it is possible in a crash caesarean. That is worth saying plainly rather than promising otherwise.
But a planned caesarean can usually accommodate most of this list, and a calm emergency one a good part of it. The point is not that you get all fourteen. The point is that you walk in already knowing which two or three matter most to you, so your team knows without you having to find the words on the day.
"I gained a lot of knowledge about pregnancy and birth, which confirmed what I want and what I don't want." Yasmine, momz.eu reviews
You use six questions instead of research. We teach them as BRAINS, and they work for any decision in birth, an induction, an epidural, a caesarean. They work outside birth too.
B, Benefits. What is the benefit of doing this?
R, Risks. What are the risks, and how likely are they?
A, Alternatives. What else could we do?
I, Intuition. What is my gut telling me?
N, Nothing. What happens if we wait, or change nothing for now?
S, Support, space and smile. Do I want another opinion? Can I have two minutes alone with my partner? And ask warmly. A question asked as a question gets a better answer than a question asked as a challenge.
Before the birth you have all the time in the world to work through this. In the room you will have about thirty seconds. That is the whole argument for practising it now, on something small, so the shape of it is already familiar when it counts.
"I now have a deeper appreciation for myself, more trust in my body, and newfound confidence to advocate for my birth plan." Janel, momz.eu reviews
A caesarean is abdominal surgery, so your recovery follows surgical rules rather than birth rules.
You will be encouraged to get up and move sooner than seems reasonable, and there is a good reason for it. Lifting is limited to your baby. Driving usually waits around six weeks, because an emergency stop uses your stomach muscles. Your own midwife will tell you what applies to you, and the NHS keeps a plain guide to recovery that is worth reading before rather than after.
One more thing, because it tends to go unsaid.
Some women cannot look at their scar for weeks. They feel they ought to be able to, and they cannot, and they take that to mean something is wrong with them. It is common and it passes, and it is a completely normal thing to say out loud to your midwife or health visitor.
Here is the question underneath all of this. If the birth went the other way, was the preparation wasted?
The women who write to us after an unplanned caesarean answer it the same way, in different words: the preparation was what let them meet the change without losing themselves inside it.
You are not preparing in order to guarantee one outcome. Nobody can sell you that, and you should be careful of anyone who implies it. You are preparing to know what is going on. To know what you can still ask for. To be able to answer while somebody is waiting.
That holds whichever way your baby is born.
On a mom'z Solo Babymoon, birth preparation covers every kind of birth, taught across five days by childbirth educators. Retreats currently run near Barcelona, near Lisbon and in Somerset, for women from week 14 to week 35.
Yes, and it is one of the questions we are asked most. If your date is already set, the caesarean session applies to you directly, and so does everything about the fourth trimester, which is the same for everyone. There are usually several women in each group preparing for one.
In most cases, yes, and UK guidance asks teams to offer and facilitate it. Ask for the heart-rate pads to go on your neck and shoulders rather than your chest. Babies can latch from almost any angle, including over your shoulder while you are lying flat.
No. Early skin-to-skin and an early first feed help, which is one of the reasons they are worth putting in writing beforehand. Ask for feeding support in the recovery room, before you go back to the ward.
Often, yes. It is called VBAC and it is a conversation to have with your consultant, based on your own history. The RCOG publishes patient guidance on it.
Almost certainly. Most caesareans, planned and emergency, are done with a spinal or an epidural. A general anaesthetic is mainly used when a baby needs to be born within minutes.
This article is for preparation and information. It is not a substitute for advice from your own midwife or doctor.
Sources: NHS England Digital, NHS Maternity Statistics 2024-25. NPEU University of Oxford, international comparison of caesarean birth rates. Statistisches Bundesamt. CDC/NCHS. Entidade Reguladora da Saude. DREES. Perined and RIVM. NHS, Caesarean section and Caesarean section recovery. ACOG. NICE NG192, Caesarean birth. RCOG, Birth after previous caesarean.
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