Choosing an Elective C-Section: Maree Shares Her Story

Hey Māmā sat down with Maree, owner of the NZ maternity wear label Close to the Heart, to talk about her elective c-section experiences – in support of C-Section Awareness Month this April.

The Decision

Can you walk us through what led you to choose an elective c-section for your first birth? Was it a straightforward decision, or did it take time to reach?

For me, this was a straightforward decision, led by my mental health. I have significant anxiety, and this centres around the unknown. Unfortunately, labour comes with a huge amount of unknowns – when will I go into labour, how long will it take, will I need any interventions, how will I cope with the pain – and this freaked me out beyond words, to the point of panic attacks. Induction could have given me some of that control by way of answering the “when”, but there were still so many unknowns. By planning a caesarean, it felt like I was bringing back that control to my life and my body. I’d know when it was, and I could research the actual process to know what to expect. Caesareans don’t generally differ so much each time in the actual mechanics, compared to labour which is always different!

Were there medical, personal, or emotional reasons behind your choice, and how much did each factor in?

My decision was 100% based on my mental health and what gave me peace. Later in my pregnancy I developed gestational diabetes, which in my area usually results in induction at 38–39 weeks due to babies tending to run on the larger side. But by this point I had already decided that a caesarean was the best option for me.

Did you feel fully supported by your lead maternity carer (LMC) or medical team in that decision?

More than I expected! I live in a small rural area with a maternity ward and the most incredible midwives, but it is a rural hospital under the guidance of a larger city hospital, about an hour and a half away. When I first spoke to my midwife about the decision I was considering, she pointed me towards some resources that talked through the mechanics of what a caesarean involved, giving me the power to make my decision as informed as possible. She referred me to the larger hospital under the care of their obstetrics team – and this is where I was most nervous.

I had read so many stories online about elective caesareans being denied in NZ as a “waste of non-essential medical resources”, or that you had to pay for them (which was not an option for us), and I expected a fight to get what I wanted. But I am stubborn, and I knew this was the right choice for me. I met the obstetrician with my arguments organised in my head. By this point, induction was on the table due to the gestational diabetes. I (very incorrectly) judged him and expected major pushback. He brought up induction, and I said, “Actually I don’t want an induction – I want an elective caesarean.” He asked me why, I explained my reasoning, and his response was not what I was expecting. He simply agreed, saying he supports the philosophy of “my body, my choice” and can’t in good conscience do otherwise. He asked what research I’d done, then discussed the full process and associated risks to ensure my decision was fully informed. Then we booked a date, signed the consents, and I burst into tears of relief.

Did anyone in your life question or push back on your choice? How did you handle that?

Yes – some of those closest to me tried to convince me that it wasn’t the “easy way out” they thought I was looking for, and that recovery would be harder than I expected. But as part of my research I had spoken to nearly everyone I knew who had had a caesarean and asked about their experience. This showed me that not everyone has a horror story – there were some really positive experiences out there. Some of the feedback I received lined up so closely with my own fears, and reassured me I was making the right call.

The Experience Itself

What surprised you most about having a planned c-section, compared to what you expected?

I went into it with so much research that I knew the mechanics well. It was the little things that surprised me – things I hadn’t thought of or that no one had mentioned – like the fact that you still bleed for weeks afterwards. The spinal block also surprised me in terms of sensations. I was lying on the table waiting to feel numb and tingly like at the dentist, but I just felt completely normal except that my legs didn’t work. The anaesthesiologist asked me to lift my legs – the signals left my brain but nothing happened! They then told me they had been testing my legs with ice spray and sharp objects, to which I had not felt a thing. Regaining feeling after the spinal was also not what I expected. I anticipated it fading evenly, but I regained sensation in one leg faster than the other. With my second caesarean, I felt one leg go numb and tingly but the other stayed normal – just goes to show it really can be different each time!

Can you describe what the day of your surgery felt like, from arriving at the hospital through to meeting your baby?

If I had to pick one word, it would be “calm”. From the minute you walk in, it feels controlled and routine for the hospital staff, which was incredibly reassuring. There were moments when I felt uncertain thinking about the next step, but nothing happened without it being explained to me first. The team in the theatre were incredible – particularly an anaesthetic technician who learned I had bad anxiety, and sat beside me talking me through every little step before it happened. Things like: “You are about to hear a lot of fluid being suctioned, but don’t worry – it is not blood, just them breaking your waters.”

With my first, the situation turned into a minor emergency as my son was stuck under my ribs – but even then, everyone remained so calm. Even when the obstetrician was kneeling on the edge of the bed to get better access and asked the NICU team to call in their senior staff, it was done so calmly that we didn’t fully realise the severity until much later. Everyone who entered that theatre (and suddenly there were a lot of people) did so quietly and without panic.

What was recovery like in those first days and weeks? What helped, and what was harder than you anticipated?

Recovery was hard – it is major abdominal surgery! But I found it hardest in terms of the restrictions. Things like not being able to lift anything or do anything that strained the incision. I didn’t have a huge amount of pain, but I stuck to the pain medication schedule so I stayed on top of it and never let the pain take hold. Sitting up from lying down was the worst, because you can’t just sit up – you have to roll onto your side first, then push up using your arms. Try remembering that in the depths of those first few nights waking up what felt like a million times to a newborn! Pro tip: hold a pillow or cushion firmly against your tummy every time you sit up, particularly in the car. I also struggled with holding back because I felt pretty okay – I pushed my body too far and vacuumed too early, which didn’t hurt at the time, but ached later. I never made that mistake again.

Were there aspects of the birth experience that you found unexpectedly meaningful, despite it being a surgical birth?

There was such priority given to me as the mother. It wasn’t just about the impending arrival of the baby – it was also about me becoming a mother (and my husband becoming a dad). We were referred to as “Mum and Dad” by the whole team, which feels a little strange if you’ve never heard it before. And comments to the baby like “happy birthday, little one” and “let’s meet your mama” really touched me in those moments.

Having a Second Elective C-Section

What made you choose an elective c-section again for your second birth? Did anything change in your thinking between the two?

I had a really positive experience the first time, with none of the fears I had anticipated coming true. It ticked the box in my brain, and the sense of control I felt was exactly what I had been seeking – so having a second caesarean was a no-brainer.

How did the two experiences compare? Was the second time easier to navigate, or did it bring its own challenges?

They ended up being vastly different in ways I didn’t expect – both hugely positive, just different. Different teams, and we had a much better understanding of the finer details the second time around. But my second birth was healing in ways I never knew I had needed until it happened. With my first, my son was stuck under my ribs and needed help establishing his breathing, so it became an emergency situation even though it hadn’t started that way.

With my second, opportunities arose that hadn’t been available the first time – including dropping the drapes so I could see my baby being born and be the first to see the gender. I wasn’t sure during the pre-op discussion, as I had never considered it as an option, so the team gave me right up until the moment to decide. It was a spur-of-the-moment choice, but one I would never take back. The drapes are positioned carefully so you don’t see anything you wouldn’t want to – and your attention is so completely on your baby that nothing else registers. The memories of my baby in those very first seconds in the world are some of the most treasured of my life. The team also asked if I’d like music playing, so my baby was born with some of my favourite songs in the background, with everyone singing along. It gave the room such a joyful atmosphere.

The healing was a little harder the second time – I felt I had to take it slower knowing what happened if I pushed too far, and having a toddler to look after made it harder to rest and recover. But in other ways it was easier, because I knew what to expect and what I could do to support my own recovery.

For Māmā Considering an Elective C-Section

What do you wish someone had told you before your first elective c-section?

That it is not all horror stories and pain! For me, it was the best way to meet my babies, with no negative memories taking priority in my brain. It was peaceful, calm, and even fun – and it left me with some incredible memories that bring me joy in a way nothing else could have provided.

Is there anything you’d want māmā to know who are weighing up their birth options, or who have made a similar decision and are second-guessing themselves?

A lot of the difficult or negative stories you hear about caesareans are actually from emergency caesareans, not elective ones – and there is quite a difference between the two. With an emergency, the choice is often taken away from you, leaving you feeling on the back foot from the start. If labour has already begun, your body and baby are starting at a very different place. Think of the difference as starting to renovate your house immediately after running a marathon, versus having just got off the couch. With an emergency, speed is the highest priority. With an elective, there is far less rush and no panic.

At the end of the day, it is you who lives inside your brain. The memories stay with you, and you need to feel at peace with your choice. Don’t let others dissuade you from making the decision that is right for your brain, your heart, and your body – they don’t have to live with the outcomes of your choices.

What helped you feel at peace with your choice, and has that feeling stayed with you?

I spoke to a close friend who had a mentally traumatic birth with her second child, and went on to have an elective caesarean with her third. Her experience aligned so closely with what I was afraid of, and her elective gave her exactly what I was seeking. She explained the whole process, answered all of my questions – even the silly ones – and I felt so aligned with her story and her outcome that it reassured me I was making the right choice. She was the first person to tell me that a caesarean wasn’t going to be a frenzied bloodbath, and that it was a calm, peaceful, and controlled experience. It gave me the confidence to pursue what I knew in my heart was best for me. And I am so glad I did.

A Personal Note

Is there anything about your experience that you haven’t often felt able to talk about openly, that you’d like to share here?

Not really, because I tell everyone all of the details – I want people to be informed. I want people to know there are so many more stories like mine out there, because it seems we only ever hear the difficult ones. There is such a negative perception around caesareans – “too posh to push”, “the easy way out” – but think about what it actually involves. They cut you open while you are awake and talking to them, hand you a baby to take care of, then send you home to both recover from major surgery and keep this little person alive, who is themselves just learning to exist. Caesarean māmā are every bit the superheroes that any other birthing māmā are.

Maree is the owner of Close to the Heart, a beautiful NZ maternity and breastfeeding wear label designed by māmā, for māmā. If you are looking for stylish, practical clothing that supports you through pregnancy and beyond, they are well worth a look.