Caesarean gets another push

The controversial issue of Caesareans has resurfaced once again following the high-profile birth of Liz Hurley's son Damian.

Whether Hurley, who had a Caesarean, has joined the "too posh to push" brigade is not known, but the Portland is the hospital of choice for A-list mothers who want elective Caesareans rather than give to birth naturally. This is a trend that has been condemned by the natural-childbirth lobby, but for some women, a Caesarean is the easiest - and safest - way of giving birth.

Karen Patterson, 38, works as a policy adviser for the Health Development Agency. An NHS patient, she chose to have her second child, Ross, delivered by Caesarean section at the Chelsea and Westminster Hospital, on Fulham Road. She lives in Battersea with her husband Gordon and 20-month-old daughter Lara.

'Sitting on the edge of the operating table, waiting for my elective Caesarean, I found I was shaking like mad. I was absolutely terrified, to put it bluntly. I had known all along that this was how I wanted my son to be born, I had booked the date weeks before, and I wasn't having any second thoughts about having the Caesarean itself.

But it had suddenly come home to me that I was going to have my stomach cut open, and all of a sudden I was scared. It's a major operation, and I was worried it was going to hurt, despite the epidural and the spinal block, and I knew it was going to hurt afterwards.

My husband Gordon was with me, so he was able to hold my hand and reassure me. He was very cool about the whole thing, though he was nervous, too, because he was worried that he'd be able to see what was going on.

I had had to push quite hard to get this section. I knew I wanted one - as far as I was concerned it was the safest and most convenient way of giving birth. I'd chosen the Chelsea and Westminster Hospital, because their Caesarean rates are higher than most, and I reasoned that it would be easier to get an elective section there than at other hospitals in the area. For all that you read about the rocketing rate of Caesareans, the midwives were very keen for me to try to have the baby naturally. At every ante-natal appointment, I had to explain what I wanted all over again to a different person, and each time they pressed me to think about a normal birth. Up to a point, I agreed with them, because I don't think that women should put themselves through unnecessary operations - and however popular Caesareans seem to be, they remain a serious operation - but for anyone who had been through the pain that I had been through during my first labour, an elective Caesarean makes sense.

Also, planning a birth in this way meant I knew precisely when I would need childcare. I picked the date five weeks in advance, which gave me plenty of time to get my arrangements in place. If I hadn't known the timing, I'd have been worried about how I would manage to get my mother up from Chichester in time to look after Lara if I was having to rush off to hospital, but as it was, I could sort that all out beforehand. My husband knew when he needed to take paternity leave, so that was a happy little spin-off.

Of course, I would have liked to have had the experience of a natural birth. If there's anything I feel I've missed out on by having a Caesarean, it's that euphoric feeling of having managed to push a baby out, which I would have loved to feel. When Ross was delivered, it wasn't as emotional a moment as it would have been if I'd given birth naturally because there's so much going on in the theatre, all the people and all the clanging noises. The main emotion I felt was relief.

And when it was all over, I felt huge relief too, not least because of the speed with which my body repaired itself. Not for me the stretchmarks and other post-birth body blues. There's always the scar of course - it's not the prettiest one you'll ever see - but I'm not remotely bothered by that. I'm not much of a bikini woman and at least by avoiding pushing the baby out, I'm otherwise intact.

It was very different 20 months ago when I went through the most horrendous 71-hour labour with my first child, Lara. Twelve hours of that were complete agony, and it really scarred me, emotionally. Eventually, I was given an epidural before the emergency Caesarean, but I was left feeling absolutely traumatised by the pain.

When I became pregnant again, just 10 months later, this awful pain was still fresh in my mind. It could have been because my hormones were raging, thanks to the pregnancy, but every time I thought about having to give birth, I burst into tears. I felt I couldn't do it. The prospect was too scary.

I was certain why I wanted a Caesarean, but the midwives brought enough emotional pressure to bear that I did, briefly, consider whether I ought to go for what they call a trial of labour, to see if I could give birth naturally.

Each midwife I saw pointed out that I wouldn't be able to hold Lara much in the six weeks after I'd had the Caesarean and, even worse, they said I should make sure I got used to not holding her before I had the operation, so she didn't expect to be held so much, which was awful.

I hated the thought of not being able to hold Lara, or put her to bed, or lift her in and out of the bath, simply because of my decision. I didn't want my having a Caesarean to affect Lara, and yet I knew I couldn't go through that pain again. And, yes, it did make me feel doubly guilty about Lara, because I already felt guilty for having another baby while she was still so young - and now I wouldn't be able to give her proper attention either.

The idea that natural birth is best is so ingrained in our way of thinking that I was embarrassed to tell my friends that I had planned to have a Caesarean because it smacks of rich women who can't be botheredto go through the whole birthing process.

But in the end my friends were all incredibly supportive and I was the one making feeble jokes about myself being "too posh to push", just because I was a bit self-conscious about the whole thing. I haven't felt judged in any way by any of them for what I decided to do, which is a relief. But then what other people think doesn't really bother me. I don't feel I have to give birth naturally to prove myself as a woman.

I'd certainly recommend an elective Caesarean to anyone in my situation. I wouldn't recommend it over a natural birth, simply because it's not good to have an operation unnecessarily, but if you'd gone through what I'd gone through the first time, you'd definitely choose one, too.

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