Women have told us that giving birth, even if it goes as smoothly as it can, is something that takes time to process mentally. Having a caesarean section (c-section), in particular, can cause lots of emotions that you may not feel prepared for. Talking about it can help. For example, you can talk to your midwife, health visitor, friends, family or parent groups.
If you had an emergency c-section or if there were complications, you can talk to your doctor or midwife about your experience. If you don’t feel ready, you can ask to speak to someone after you have left hospital.
Most maternity units have a ‘birth reflections’ or ‘birth after thoughts’ service, where you can go through your maternity notes and talk about what happened. You can ask your midwife or GP to refer you to this service, or you can ask to be referred for counselling.
‘I had a difficult and long labour, which resulted in an emergency c-section. It wasn’t until a year later that I wanted help to understand what had happened.’
Where can I get support?
Your midwife will visit you the day after you get home. Ask them how often they will visit and who you should contact if you need help in between visits. Your health visitor will also visit you at home at least once. After this visit, you will usually see the health visitor in a clinic at key points in your baby’s development.
Each time you see your midwife or health visitor, they should ask you how you are coping and what help you have at home. Being honest about how you’re feeling will help them to support you.
Many women feel tearful, anxious or sad after having a baby. This is called ‘baby blues’ and should not last longer than two weeks. Tell your midwife, health visitor or GP if you feel this way for more than a couple of weeks after your c-section. They can refer you to a counselling or support service, which can help you cope with your feelings. It doesn’t matter how long ago you had your baby – it’s never too late to ask for support.
What else can help?
There are some things you can try yourself, such as:
- having lots of skin-to-skin contact with your baby – there is evidence that this can help women feel happier about the birth
- meeting other parents and babies – your midwife or health visitor can tell you about baby groups and breastfeeding support groups in your area
- speaking to one of Tommy’s midwives.
Pregnancy and childbirth change the way your body looks and feels. After a c-section, your wound will heal and leave a scar.
The scar will be 10-20cm long and will be at the top of your pubic area. Over time, the scar will fade to a thin line and your pubic hair may cover it. Some women find that the skin above the scar sticks out slightly.
It is natural to feel sad or upset about the changes to your body. Talking to other women who have had c-sections can help to reassure you you’re not alone and may help you come to terms with these changes. You may want to join a mother and baby group or an online support group.
Many women feel happy with their decision to have a c-section. But others may feel guilty or disappointed about not giving birth vaginally. Some women feel under pressure to give birth vaginally and find it difficult to deal with people’s comments about having a c-section.
If you had a general anaesthetic, you may feel that you missed out on experiencing the birth.
If the birth didn’t go the way you expected, you may feel that you weren’t in control of what was happening or that you didn’t ‘do it right’. Maybe you feel that you have let your baby down.
Although it can be difficult to ignore these feelings, they will fade with time. It can be hard to ignore comments from other people. But they haven’t been through your experience – only you know what was best for you and your baby. Talking to other parents who have had c-sections can be helpful and may even give you some ideas for how to respond to unhelpful comments.
‘To start with, I found that I was justifying my decision to have a c-section, even though it was needed for health reasons. I have since come to terms with the fact I made the right decision for me and my babies and that is all that matters.’
Postnatal depression affects more than one in ten women in the first year after giving birth. There is limited evidence that having a c-section may increase this risk.
If you had depression during your pregnancy, you may have a higher risk of postnatal depression. There is some suggestion that breastfeeding might help reduce the risk of postnatal depression in women who had depression during pregnancy, and who feel positive about breastfeeding.
It is natural to feel sad or tearful after having a baby. This is caused by changes in hormone levels and is called ‘baby blues’. But if you continue to have negative feelings, or if you get new symptoms after the first two weeks, talk to your health visitor or GP. Symptoms of postnatal depression may include:
- low mood
- not getting pleasure from activities you usually enjoy
- lack of confidence in yourself
- blaming yourself or having strong feelings of guilt
- not being able to concentrate on anything
- not sleeping or eating properly
- thinking about harming yourself or your baby.
If you are diagnosed with depression after having your baby, your doctor may offer you counselling or psychological therapy, such as cognitive behavioural therapy (CBT). If you have had depression in the past, or if other therapies aren’t helping, your doctor may give you medicines, such as anti-depressants. If you are breastfeeding, you will only be offered medicines if the benefits are greater than the risks to your baby.
Most women with postnatal depression recover after three to six months.
Post-traumatic stress after a c-section
Post-traumatic stress disorder (PTSD) is a type of anxiety that affects some people after a traumatic event. It affects up to 7 in 100 women after giving birth.
Having an emergency c-section increases your risk of getting PTSD. You may also be more at risk if you found the birth frightening or if you didn’t get the right support during and after the birth.
Many women have negative feelings after giving birth, but if you have the following symptoms for more than a month, you may have PTSD:
- Flashbacks or dreams about traumatic parts of the birth.
- Avoiding situations that remind you of your experience, such as going back to the hospital where you gave birth or having conversations about birth.
- Feeling irritable or anxious.
- Struggling with daily life, such as work or social situations.
If your doctor diagnoses you with PTSD, they should offer you psychological therapy. Some women find it helpful to ask for a referral to the maternity unit, to talk about the birth.
‘I had a difficult first birth and developed postnatal depression afterwards. Before I had my second baby by c-section, I was referred to a specialist midwife who went through my first birth with me and diagnosed PTSD. I was reviewed by the mental health team and supported completely. It was a very difficult time for me but having the support from the right people helped me greatly.’
- Ayers S (2014) Editorial: Fear of childbirth, postnatal post-traumatic stress disorder and midwifery care. Midwifery 30(2): 145–148.
- Dias CC, Figueiredo B (2015) Breastfeeding and depression: A systematic review of the literature. Journal of Affective Disorders 171: 142–154.
- Di Florio A, Jones I (2017) Postnatal depression. BMJ Best Practice.
- Lopez U et al. (2017) Post-traumatic stress disorder in parturients delivering by caesarean section and the implication of anaesthesia: a prospective cohort study. Health and Quality of Life Outcomes 15:118.
- NICE (2014, updated 2017) Antenatal and postnatal mental health: clinical management and service guidance. Clinical guideline 192. London National Institute for Health and Care Excellence.
- NICE (2013) Caesarean section. Quality standard 32, National Institute for Health and Care Excellence.
- NICE (2006, updated 2015) Postnatal care up to 8 weeks after birth. Clinical guideline 37, London National Institute for Health and Care Excellence.
- Schneider LW, Crenshaw JT, Gilder RE (2017) Influence of Immediate Skin-to-Skin Contact During Cesarean Surgery on Rate of Transfer of Newborns to NICU for Observation. Nurs Womens Health 21(1): 28-33.
- Xu H et al. (2017) Cesarean section and risk of postpartum depression: A meta-analysis. Journal of Psychosomatic Research 97: 118 – 126.
ℹLast reviewed on April 24th, 2018. Next review date April 24th, 2021.
By Dorothy (not verified) on 7 Jan 2019 - 20:56
More than 37 years after my son's birth, I hate everything about my cesarian--the feeling of him being pulled from my body, the cold temperature of the operating room, not being able to touch or hold him when he was born, being left in a bright room for 5 1/2 hours with no way to call for help and no one checking on me after he was born while I was shaking so hard and was so cold I couldn't sleep, excruciating pain beginning 8 hours after surgery because pain medication was withheld since the baby was "sleepy," not being able to hold or pick up my baby for five days because of the pain. It took weeks for my situation to improve once we got home--it was tremendously painful to lift him out of low cradle we had in order to care for him and there was nowhere else for him to sleep, and I was on my own since my husband had to go back to work the day after I left the hospital. Today I still hate my scar and can't stand to have my husband see or touch it. The cesarian has done terrible damage to our marriage: I haven't felt emotionally connected to my husband since our son was born and physical intimacy is never pleasurable. I have been in therapy four times, currently for three years, and am now on my 9th medication for depression. I can't stop thinking about our son's birth and I relive the experience multiple times a day. Even the subsequent vaginal births of our two daughters never did anything to relieve the distress of the cesarian. After all these years and countless hours of cognitive therapy, prayer, and years of medication that have left me with permanent side effects, at the age of 62 I am trying to accept that I will never recover from the cesarian.
By Midwife @Tommys on 8 Jan 2019 - 14:13
Thank you so much for your message and sharing your thoughts with us. The impact of a traumatic birth is far reaching and as you have highlighted can have long term effects on all involved. If you haven't already, the Birth Trauma Association may be of help to you.
By Olesha (not verified) on 17 Jan 2019 - 07:29
I completely feel your pain , I had a 72 hour labour followed by an emergency c section. It completely destroyed me .. I was freezing cold and shaking as you where ... traumatized by having my arms bound to the table
By Midwife @Tommys on 17 Jan 2019 - 09:41
Dear Olesha - So sorry to hear you had such a traumatic birth experience. If you would like to discuss this in more detail, please feel free to contact us on our pregnancy information line (Mon-Fri, 9-5) 08000147800 or email us at [email protected]
By Midwife @Tommys on 30 Aug 2018 - 16:25
Hi, Thank you for your comment.
It can be possible to have a vaginal birth after a C-section but you would need to discuss this with your midwife and the obstetricians at the hospital, they will discuss the benefits and the risks and then you can make an inform decision. If you are pregnant at the moment then you should start to discuss this with your midwife or Dr so that you are fully aware of what the risks are but you should feel supported in your decision and the Drs will advice you on what is the safest option for you and your baby. Hope this helps, Take Care, Tommy's Midwives x
By Anonymous (not verified) on 30 Aug 2018 - 15:20
CAN I HAVE A VIRGINAL BIRTH AFTER 2 CSECTION