Birth / 8 April, 2026 / Ellie Thompson
When preparing for birth, many women focus on achieving a natural, straightforward labour — but what happens when things don’t go to plan?
According to Midwife Pip, an NHS Midwifery Sister, MSc, author of Midwife Pip’s Guide to a Positive Birth, and founder of the Midwife Pip Podcast, too many women are going into Caesarean birth feeling unprepared, both physically and emotionally.
Having supported hundreds of births, Pip has seen first-hand how a lack of balanced antenatal education can leave new mums feeling overwhelmed, confused and even disappointed when a Caesarean becomes necessary. In this article, she shares why better preparation for all types of birth — including Caesarean — is essential for a more positive and empowered experience.
Midwife Pip will also be sharing her expertise at The Baby Show, returning to Birmingham NEC from 8th–10th May. For more information, visit www.thebabyshow.co.uk/nec
visit www.thebabyshow.co.uk/nec.
I have stood beside hundreds of women as they have brought their babies into the world. Some births have been calm and predictable, others fast and chaotic, and many have not gone to plan at all. One thing that has become increasingly clear over the years is this. More and more new mums are going into Caesarean sections completely unprepared, not just physically but emotionally and mentally too.
This is not about blaming women. It is about recognising the gap between expectation and reality. It is a gap in how we talk about birth, how we educate women, and how we prepare them for all possible outcomes, not just the ones we hope for.
Over the past couple of decades, there has been a powerful shift toward promoting physiological birth. As a midwife, I support this wholeheartedly. Birth is a normal biological process, and for many women, it can unfold beautifully without intervention. However, somewhere along the way, the messaging has become a little too one-sided.
Many women enter pregnancy surrounded by phrases about trusting their bodies and believing birth will unfold naturally. These messages are empowering, but they can also create a very fixed expectation of what a good birth should look like. When a Caesarean becomes necessary, whether planned or unplanned, it can feel like something has gone wrong or that they have somehow failed.
The reality is that if you spend nine months preparing only for one type of birth, you are not given the tools to process or cope with a different outcome. That is where the first major gap lies.
Another important issue is how antenatal education is delivered. In many classes, Caesarean birth is covered briefly or sometimes, not at all. Compare that to the amount of time spent discussing labour techniques, breathing, and birth preferences. Yet in the United Kingdom, around one in three births are by Caesarean section. That is not rare. That is a significant proportion of births.
Despite this, many women arrive at the point of needing a Caesarean with very little understanding of what will actually happen. In practice, I regularly hear women say they had no idea what to expect. They are often surprised by the sensations during surgery, the intensity of recovery, and the emotional impact afterwards.
One of the most common things women tell me is that they did not realise they would be awake. Most Caesareans are performed under spinal or epidural anaesthesia, meaning the mother is conscious and aware of everything happening. For some, this is a beautiful experience, but for others, it can feel overwhelming if they were not prepared for it.
Another surprise is the physical sensation during the procedure. While there should not be pain, there is often a feeling of pressure, pulling, and movement. Without prior knowledge, this can feel frightening and disorienting. It is not widely discussed, yet it is entirely normal.
Recovery is another area where expectations and reality often clash. A Caesarean is a major abdominal surgery. It is not simply an alternative way of giving birth. In the days following surgery, mobility can be limited and even simple movements like sitting up, laughing, or coughing can be uncomfortable. Many women are shocked by how long it takes to feel like themselves again.
Emotionally, the experience can be just as significant. Even when a Caesarean is the safest option for mother and baby, it can still bring unexpected feelings. Some women feel disappointment or grief for the birth they had imagined. Others feel a loss of control or question whether their bodies let them down. Without preparation or reassurance, these emotions can feel isolating.
It is also important to understand why Caesarean rates have increased. This is not due to a single cause but rather a combination of factors. Women are having babies later in life, which can bring additional complexities. There are higher rates of certain medical conditions such as gestational diabetes and high blood pressure. Monitoring during labour has become more advanced, which means potential concerns are identified earlier. Inductions of labour are more common, and these can increase the likelihood of a Caesarean.
There is also the reality that once a woman has had a Caesarean, she is more likely to have another in future pregnancies. All of these factors contribute to the overall picture.
One thing that often surprises women is that many so called emergency Caesareans are not dramatic, life or death situations. They are urgent decisions made in response to how labour is progressing or how the baby is coping. This nuance is rarely explained in advance, which can make the experience feel sudden and overwhelming.
Birth plans are another area worth reflecting on. While it is helpful to think about preferences, rigid plans can sometimes set women up for disappointment. Birth is inherently unpredictable. A more flexible approach allows women to hold onto what matters most, such as feeling informed and supported, while remaining open to different outcomes.
Reframing expectations can be powerful. Instead of focusing on achieving a specific type of birth, the focus can shift to having a positive experience regardless of how the baby arrives. This includes understanding options, being part of decision-making, and feeling respected throughout the process.
Language also plays a significant role in how women experience birth. Clinical terms can sometimes sound harsh or personal, even when they are not intended that way. Words that suggest failure can leave a lasting impression and contribute to negative feelings. As healthcare professionals, we need to be mindful of how we communicate and ensure that women feel supported rather than judged.
Better preparation does not mean frightening women or expecting the worst. It means providing balanced, honest, evidence-based information about all types of birth. It means explaining what a Caesarean involves, what it might feel like, and what recovery looks like. It also means acknowledging the emotional side of birth and normalising a wide range of feelings.
Practical preparation is equally important. Many women are not told simple but essential things about recovering from surgery, such as how to move comfortably, how to care for their wound, or what kind of support they may need at home. These details can make a huge difference in how confident and capable a woman feels after birth.
As a midwife, one of the most important truths I have learned is that a Caesarean can still be a positive and empowering experience. I have seen women feel strong, informed, and deeply connected to their babies, even when birth did not go as they had imagined.
The difference is not the type of birth. It is the level of preparation and support. When women understand what is happening and why, they are more likely to feel in control. That sense of control is a key factor in how birth is experienced and remembered.
We need to move away from the idea that Caesareans are simply a backup plan that does not require attention. For many women, it is their reality. Every woman deserves to approach birth with a full understanding of all possibilities, not just the ideal scenario.
If you are pregnant, it is worth taking the time to learn about all birth options. Not because something will go wrong, but because knowledge gives you confidence and choice. It allows you to navigate whatever path your birth takes with greater understanding and less fear.
Prepared women do not just cope better. They experience birth differently. They are better able to process what is happening in the moment and reflect on their experience afterwards with clarity rather than confusion.
Birth is not about getting it right or wrong. It is about bringing your baby into the world safely and feeling supported along the way. When we broaden the conversation and fully prepare women, we give them the best possible chance of a positive, empowering experience, whatever form their birth takes.
Article by Midwife Pip
Pip is an experienced practising NHS Midwifery Sister, MSc, author of Midwife Pip’s Guide to a Positive Birth, KGH hypnobirthing diploma, founder of the Midwife Pip Podcast, pelvic health specialist, pre and postnatal trainer and, importantly, a mum. Pip is an enthusiast of all things women’s health and wellness. Having worked with many families for many years, Pip sees every day the void of high-quality information. Pip is on a mission to change this and to make sure that all women can access the information they deserve and need to be empowered and supported through their pregnancy, birth and postpartum journeys.
Step into party season with Linzi’s gorgeous collection of occasion-ready footwear. From sparkling heels and statement platforms to elegant courts and chic ballet flats, there’s something for every festive celebration. Whether you’re dressing up for a Christmas party, heading out for cocktails or planning your New Year’s Eve look, Linzi has the finishing touches covered. Think eye-catching details, flattering silhouettes and plenty of sparkle, all at prices that won’t blow the party budget.
Christmas Gifting / 15 November, 2026
Christmas Gifting / 14 November, 2026
Christmas Gifting / 13 November, 2026
