SITTING in the mother and baby group with her infant son Jaxon, Rachael Creswell listened in awkward silence as the other mums swapped stories of epidurals and episiotomies.
“One of them asked about my labour, and I explained I’d had a caesarean. I was so stunned when she called it an ‘unnatural birth’ – as opposed to her ‘natural’ one – that I didn’t know how to respond,” says Rachael, 41, a mum of five from Paignton, Devon.
“After that, they all turned away from me and didn’t include me in their conversation any more. In their eyes, I wasn’t a ‘real mum’ who had rejected painkillers and panted for hours on all-fours – even though I had, before Jaxon’s head got stuck in the birth canal and I needed an emergency C-section to save his life.
“But it was evident they thought I’d taken the easy way out,” she adds.
Last month, a damning report laid bare the catastrophic cost of this obsession with “natural” birth. The inquiry by senior midwife Donna Ockenden lifted the lid on a litany of devastating errors at the Shrewsbury and Telford Hospital NHS Trust (SaTH), revealing that at least 201 babies and nine mums could have been saved in two decades of medical failures at scandal-hit hospitals, where desperate attempts were made to keep their C-section levels low.
It found that maternity units were short-staffed for years, and bosses refused to take responsibility for mistakes, while target numbers for vaginal births meant women were denied C-sections or had them delayed. In 2011, one woman who was in agony was told that it was “nothing”, while staff were dismissive and made her feel “pathetic”. One obstetrician even called her “lazy”.
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The events at SaTH are the biggest maternity scandal in NHS history, and consultant obstetrician and gynaecologist Clive Spence-Jones agrees that the findings make for difficult reading for women planning or expecting a baby.
“Of course, anyone who has been following this case would be alarmed, but we hope it is a unique event,” he tells Fabulous. “The national numbers of mothers suffering harm or dying are still low and staying low.
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'Normal birth movement'
"And it’s the same for the numbers of babies being harmed or dying – they’re low and staying low. This is not a national problem. But we have to stand back and ask how this could have happened.”
Rachael’s experience has its roots in a campaign that started more than 30 years ago. The “normal birth movement” was launched in the 1980s, amid disquiet over the medicalised nature of childbirth.
Organisations like the Natural Childbirth Association, now the National Childbirth Trust (NCT), called for fewer interventions – and were listened to by the NHS and the UK’s medical chiefs.
In 1985, the World Health Organisation said a country’s C-section rate should be between 10-15%, and so by the early 2000s, the NHS, the Royal College of Midwives, the Royal College Of Obstetricians And Gynaecologists and the NCT were pushing vaginal births.
David Harding, a consultant neonatologist who retired after 25 years in the NHS in 2019, told The Sunday Times that women were being “brainwashed into having a natural birth at all costs.”
Clive Spence-Jones agrees that some women do feel under pressure to attempt a “natural” delivery. “Women’s health is full of individuals who are evangelists, who say: ‘What I’ve done is right for you,’ and that’s simply not true,” he says.
Women are being influenced both by other women and by healthcare professionals, which creates a pressure to make a decision about how they give birth, and a stigma around C-sections.
“Women are being influenced both by other women and by healthcare professionals, which creates a pressure to make a decision about how they give birth, and a stigma around C-sections, when really the way we look after people has to be completely individualised. All that should matter is achieving the safest outcome for the woman and for her baby.”
Despite emergency, planned and elective caesareans accounting for 31% of all births in England for 2019-20 – an increase of 4.7% from 2014* – they are still seen by many as an easy option compared to a so-called “natural” birth.
Recently, a woman went viral on TikTok after shaming women for having C-sections, claiming: “It’s not a birth, it’s an extraction,” prompting a mass response from other mums who revealed they had been similarly shamed. Even celebrities aren’t immune, with Rochelle Humes being trolled after having her third C-section last year.
“I’ve been in situations where people have said: ‘Oh, are you too posh to push?’” she said. “I remember feeling really offended. Almost like I’d failed, like I couldn’t do it properly.”
Rather than being the easy way out, C-sections can, in fact, be even more gruelling, says Lesley Gilchrist, registered midwife and co-founder of the antenatal resources provider My Expert Midwife.
“A C-section is both major abdominal surgery and birthing a baby on the same day. Therefore, it can be a much more challenging path to take, especially as the recovery can be more difficult than after a vaginal birth,” she explains.
'I was too weak'
“Many mums who have had C-sections hesitate to use language around having given birth. They talk of ‘having had their C-section’ rather than ‘having given birth to their baby’, and this can lead to feelings of disappointment about the birth.”
Rachael knows this disappointment only too well. She had her first C-section with Jaxon, now eight, in February 2014 – followed by four more with Noah, six, Cole, five, Bodhi, two, and 13-week-old baby Leif. She shares her children with husband Dan, 38, a fisheries enforcement officer.
“I went through 22 hours of labour with Jaxon before I was raced for an emergency C-section,” she says. “With me bleeding internally, it was Dan who was first to hold him, as I was too weak, which was heartbreaking. It took several months to recover physically. However, mentally, the scars lingered.
"I felt robbed of my birth experience – I’d wanted my ‘warrior woman’ moment and the early moments with my baby boy, but they’d been snatched from me. The judgement from other mums just compounded that sadness.”
Because of the complication with Jaxon’s birth, Rachael was told she couldn’t give birth vaginally with any of her subsequent pregnancies.
“I’ve experienced negative reactions to this even within the medical community – staff telling me during check-ups and even during labour that I shouldn’t have fallen pregnant so many times,” she says.
“It was mentioned each time by the male consultants. It made me feel like an inconvenience. We’re not planning any more – we have enough happy chaos to keep us busy!”
Rachael says she has made her peace with Jaxon’s traumatic birth by going on to have more positive experiences with his brothers. “When my second child Noah was born, it was amazing to have a calm experience of a planned C-section.
Despite all the medical intervention, it felt extremely natural and generally perfect.
“Despite all the medical intervention, it felt extremely natural and generally perfect. Having such a positive birth only 14 months after Jaxon’s helped me focus on the bigger picture and move past any previous disappointment.
"Now I’m a strong advocate for mothers having choices in birth – and being able to be proud of their birth story no matter how their baby arrived.”
Like Rachael, mum-of-one Sera also found herself shamed for having a C-section. It was only a matter of weeks following the birth of her son Taylor, on December 19, 2017, that an acquaintance told her she “hadn’t really given birth”.
“She claimed that I’d taken the easy way out, which was devastating. It made me feel like I wasn’t a real woman,” says 48-year-old Sera from Stevenage, Hertfordshire.
The criticism was particularly painful for Sera, a professional assessor of engineers, as she had struggled so hard to conceive Taylor, now two, in the first place.
“I was desperate for a baby. After trying for 12 years, my husband and I turned to IVF and, thankfully, conceived after the fourth try. But at 44, I was warned by medics I was unlikely to have a natural birth – something I desperately wanted,” she says. “I was told the risks associated with labour at my age were higher than in younger women.
"In the end, I developed pre-eclampsia, high blood pressure, my placenta started to fail and Taylor was at risk.”
'The right choice'
After 15 hours of labour and at 10cm dilated, Sera was rushed for a C-section and, thankfully, Taylor arrived safely, weighing 7lb 11oz.
“The C-section was the right choice. My son’s life was my primary concern and I adored him, but deep down I was also hugely disappointed,” she says. “Society had conditioned me to believe vaginal labour was the ‘natural way’ and it was something I had been desperate to achieve.”
Immediately after giving birth, having already been perimenopausal when she conceived Taylor, Sera went into the menopause – which meant there would never be another chance for the birth she wanted.
“Knowing I would never birth a child vaginally devastated me. Physically I was in pain from the C-section, and those unkind comments didn’t help,” she adds.
The stigma around having a C-section can be hugely damaging for new mums, according to Dr Rachael Molitor, a psychology lecturer at Coventry University who specialises in parent and child emotionality. “The safety of mother and child is paramount.
"No one should ever be made to feel guilty for following medical advice for the health and wellbeing of themselves and their child. A C-section is major surgery and not something that should ever be considered the easy way out.”
To help shift the stigma, experts say the words we use to describe caesarean births are paramount. “Referring to having a C-section as ‘giving birth abdominally’ can start to reframe this and help towards giving women who have an abdominal birth the credit they deserve,” says Lesley Gilchrist.
Meanwhile, Dr Edward Morris, president of the Royal College Of Obstetricians And Gynaecologists, says it recommends using the term “vaginal” birth instead of “normal” birth.
Two years on from her C-section, Sera has made her peace with her birth experience.
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“Now I realise that the acquaintance who told me I hadn’t given birth was wrong. What are women supposed to do if they are being told by qualified medical professionals their baby must come out now and it’s a matter of life or death? Ignore those instructions? Of course not,” she says.
“Taylor is a toddler now – a cheeky, smiley little boy who loves singing and dancing – and I know that I did give birth to him, no matter what other people say.”
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