Delivery
In this section
Caesarean: everything you need to know
A caesarean section (c-section) may be planned or unplanned.
A caesarean section (c-section) is an operation to deliver your baby. A doctor makes a cut just below your bikini line, through your abdomen and womb, and lifts your baby out through it.
You may have a planned (elective) c-section if you know you will need a c-section before you go into labour.
You may have an unplanned (emergency) c-section if this is the safest way to deliver your baby.
About 1 in 4 who give birth in the UK have a c-section. Most of these are emergency c-sections.
What is a planned c-section?
Sometimes, a c-section may be safer for you or your baby than a vaginal birth. For example, your doctor or midwife may offer you a planned c-section if:
There are problems with the placenta, such as a low-lying placenta (placenta praevia)
Your baby is lying in a difficult position for labour, such as bottom down (breech)
You are expecting twins who share a placenta or if either baby is lying in a difficult position for labour
You are expecting more than 2 babies.
If you have HIV or genital herpes, your doctor will explain your birth options. Some women may need a c-section to reduce the risk of passing the virus to the baby.
If you are offered a c-section because of medical reasons, it is your choice whether to have one or not. You do not have to have one if you don’t want one.
If you decide to have a planned c-section, you will see an obstetrician. This is a doctor who specialises in care during pregnancy, labour and after birth. They will explain the benefits and risks of a c-section and your other birth options. You will also see a midwife at your antenatal appointments where you can discuss your options.
You will usually have a planned c-section at 39 weeks of pregnancy. The aim is to do the c-section before you go into labour. Babies born earlier than 39 weeks are more likely to need help with their breathing. Sometimes there’s a medical reason for delivering the baby earlier than this. For example, if you’re expecting more than 1 baby.
What is an emergency c-section?
You may have an unplanned emergency c-section if your baby needs to be delivered quickly. This may happen if your labour is not progressing or there’s any concern about your or your baby’s wellbeing.
The word ‘emergency’ makes it sound rushed, but there’s often time to decide whether you want a c-section. Your doctor and midwife will explain what your options are. If your or your baby’s health is at risk, you may need to have a c-section more quickly.
C-section myths
There’s no strong evidence that any of these things affect your chances of needing a c-section:
Walking around during labour
Not lying on your back during labour
Being in water during labour
Drinking raspberry leaf tea
The midwife or doctor breaking your waters early
Having an epidural.
There is no evidence that your height or the size of your baby can predict whether you will need a c-section. Being short or having a small pelvis or small feet does not affect whether you can have a vaginal birth. But you may be more likely to have a c-section if you’re overweight or over the age of 40.
Pain relief in labour and birth
Labour pain can be difficult to manage, but there are pain relief options available that can help. It’s good to know what they are before you go into labour.
It's helpful to know which pain relief options are available before the birth. If you know what you can have, you may find it easier to stay calm and try to relax as much as you can, which can mean an easier birth. If you are stressed and tense, your contractions may feel more painful and become less effective.
You may also find it helpful to:
Talk to your midwife about what pain relief will be available to you so you can decide what’s best for you
Write down your wishes in your birth plan
Learn as much as you can about labour – you could try talking to your midwife and going to some antenatal classes
Keep moving and try different positions during labour
Arrange to have a birth partner who can support you, if you can.
You may have very clear ideas about the pain relief you want or don’t want. This is helpful but try to keep an open mind. You may find that, for whatever reason, some methods just don’t work for you on the day. Don't feel bad about this, just do whatever is best for you at the time.
You may find that you are in the latent stage of labour for a long time before things really get going. Things can help include:
Warm baths
Back massages
Paracetamol
A TENS machine
Moving around.
Try not to worry about how you’ll manage when labour gets going. When it happens, every woman deals with it in her own way. Some find an inner calmness, some swear and shout, and others want to have all the pain relief they can. All these reactions are fine and normal, and your healthcare professionals have seen it all before!
Breathing and relaxation during labour
Slow rhythmic breathing will help you get into a relaxed state that should help you cope better with labour pains. Being able to relax rather than tense up during a contraction helps your body manage labour better. Many antenatal classes cover relaxation and breathing techniques. It's good to find out about these, whatever you decide to do when you go into labour.
Breathing and relaxation doesn’t affect your baby. You can use breathing techniques and also have pain relief.
Hypnobirthing
Hypnobirthing is a method of pain management that can be used during labour and birth. It involves using a mixture of visualisation, relaxation and deep breathing techniques.
Breathing exercises have been part of antenatal classes for a long time. Hypnobirthing also includes relaxation, visualisation and mindfulness techniques to help you concentrate on your body and the birth of your baby.
Hypnobirthing can be used with all other types of pain relief and can be added to your birth plan.
Alternative methods of pain relief
Some women may choose alternative treatments (complementary therapies) such as acupuncture, aromatherapy and reflexology.
Your midwife or doctor may offer these therapies to you, although most of them aren’t proven to provide effective pain relief.
It’s important to talk to your doctor or midwife about this before you go into labour. Also make sure any practitioner you use is properly trained, experienced and insured.
Using a birthing ball
A birthing ball is an inflatable, burst-resistant ball – similar to an exercise ball. Gently bouncing or rocking on it may help you relax and ease pain.
Ask your midwife whether birthing balls will be available on your delivery ward or you could buy or borrow one before the birth. Just make sure you try before you buy because birthing balls come in different sizes.
Having a water birth
Some women find that being in the water helps them cope better with labour pain and feel more relaxed. The water also provides support for your body so you can move more freely.
You can hire a birth pool to use at home or there may be one available at your hospital or birth centre. A birth pool is larger and deeper than a bath so there is space to move in the water. Your midwife will check your temperature every hour to make sure you are not getting too hot.
Tell your midwife as early in your pregnancy as possible if you'd like a water birth. If you're planning a home birth, your midwife may be able to recommend places to hire a pool.
Pros
Being in water doesn't affect your baby
You stay in control of it because you can get out at any time
You can also use gas and air (Entonox).
Cons
You can't stay in the water if you want to use a TENS machine
You won’t be able to have any drugs for pain relief, such as pethidine or an epidural
The birth pool may not be available if the hospital or birth centre is busy
Birth pools take time to fill, so if things happen quickly you might not have time to use it.
TENS (transcutaneous electrical nerve stimulation) and labour
A TENS machine is a small machine that is attached to your back with sticky pads. It sends out tiny electrical impulses to block pain signals sent from your body to your brain. This means you are less aware of the pain. It can also trigger the release of endorphins, which are your body's pain-relieving chemicals.
You can hire or buy a TENS machine, so you have it ready at the start of labour. Try it out before you go into labour (after you reach 37 weeks) so you can learn how it works. For the best results, start using it early in your labour.
Pros
A TENS machine doesn't affect your baby
You stay in control of it yourself
You can use other pain relief at the same time.
Cons
If you only start using a TENS machine when you’re in established labour, it will not help with pain
It may not work for all women
You can't use it in a birthing pool, bath or shower as there is a danger of electrocution
You may need other pain relief methods as well.
Gas and air (Entonox) in labour
This is a mixture of oxygen and nitrous oxide gas. You breathe this in just as a contraction begins using a mask or mouthpiece, which you hold yourself. It works best if you take slow, deep breaths.
You can have it while you’re having a water birth. If you're planning to have a home birth, talk to your midwife before the baby is due about using gas and air at home.
Pros
It takes the edge off the labour pain
It works quickly
It can be used at any time during labour
It can be used with other forms of pain relief
You are in control of how often and when to use it
Gas and air doesn’t affect the baby
It's easy to use
You can stop using it at any point and the effects go away quickly.
Cons
It doesn't get rid of all the pain
It might make your mouth feel dry (sipping water or sucking ice cubes will help)
It may make you feel sick or lightheaded
You may need to use other pain relief methods as well.
Pain relief using drugs
Diamorphine, pethidine and similar drugs (called opioids) can be given as injections for pain relief. Each one works slightly differently.
Find out in advance what injections your hospital offers. Talk to your birth partner and midwife about the side effects, which are different for each drug.
Pros
They may help you cope better with contractions
You may be able to sleep through contractions
They can help you to relax.
Cons (these will vary depending on which drug you’ve been given)
They can cause nausea and vomiting (although you can be given other medication to help with this)
They can make you drowsy
They may affect you baby’s breathing after the birth and they may be drowsy (which could affect breastfeeding)
You won’t be able to use the birthing pool for at least 2 hours after you’ve had an injection.
Epidurals
An epidural is a local anaesthetic that is injected into the spine and topped up as needed. You can only have an epidural if you are in an obstetric unit (labour ward), so if you are at home or in a midwife-led unit you will need to be transferred.
If you choose to have an epidural, you and your baby will need to be monitored more closely. Your blood pressure will be checked more often, and you will be put on a drip. Your baby's heartbeat will also need to be monitored using a machine (electronic monitoring) for the first 30 minutes after you have the epidural, and after each top‑up.
Once started, your epidural should continue until after your baby is born, your placenta is delivered and any stitching you need has been done.
Pros
You should be able to have an epidural at any point
It is better at relieving pain than opioids
It is not linked to a longer first stage of labour or an increased chance of having a caesarean section
It is not linked to long‑term backache
You may be able to have a type of epidural that you can top up yourself.
Cons
You may not be able to move around as much after you’ve had a few top-ups
Epidurals are linked to a longer second stage of labour and an increased chance of an assisted birth
You can only have it in hospital, because it needs to be given by an anaesthetist
You will need to be monitored more closely in labour
There can be side effects, including low blood pressure, loss of bladder control, itchy skin, feeling sick, headaches, infection and nerve damage.
Water births
Water birth is the process of giving birth in water using a deep bath or birthing pool. Being in water during labour is shown to help with pain as well as being more relaxing and soothing than being out of water. The water can help to support your weight, making it easier to move around and feel more in control during labour.
Can I have a water birth?
Having a water birth is an option for you if you have had a low risk pregnancy and your midwife or obstetric doctor believes it is safe for you and your baby. You can talk to them about it at any of your antenatal appointments.
You may not be able to have a water birth if:
Your baby is breech
You are having twins or triplets
Your baby is pre-term (under 37 weeks)
Your baby has passed meconium before or during labour
You have active Herpes
You have pre-eclampsia
You have an infection
You have a high temperature in labour
You are bleeding
Your baby needs continuous monitoring via CTG machine
Your waters have been broken for over 24 hours
You have had a previous caesarean section
Your labour is induced
You are at high risk of having birth difficulties.
You will probably be advised not to have a water birth if you have any of the risk factors above because it may be difficult to get you out of the pool safely in an emergency. If you have an infection, you may be at risk of passing it onto your baby in the water.
If you are at high risk of bleeding, being in the pool can be dangerous because it is difficult to measure how much blood has been lost in the water.
What are the advantages of water birth?
The warm water can help to relax, soothe and comfort you
The support of the water means you can try different positions and move more freely
When upright in the water, gravity will help move the baby down towards the birth canal
Being in water can lower your blood pressure and reduce feelings of anxiety, making your body more able to release endorphins, which can help ease pain
The water can help to improve back pain and the feeling of pressure, especially when you are fully dilated
Being in the pool during labour and birth can be a “cosy” experience, making you feel safe
The water can help your perineum stretch gradually as the baby’s head is being born, reducing the risk of injury.
Are there any disadvantages of having a water birth?
You will not be able to have some pain-relief options. For example, you cannot have any opiates, such as pethidine, for at least six hours before you get into the pool, and you cannot have an epidural
You will be unable to use a Tens machine
Your contractions may slow down or get weaker, especially if you go in the pool too soon
If the pool water is too cool at birth, your baby is at risk of hypothermia. But your midwife will check the water temperature regularly. If your baby’s temperature is low, skin to skin contact with you and warm towels will help
You might need to leave the pool if there is a complication.
Can my baby drown if I give birth in water?
Many women wonder whether there is a risk of their baby drowning if they give birth in water but it is very unlikely to happen.
Babies do not need to breathe when they are in the womb because they get oxygen from the blood that comes from their mum through the placenta. When they are born in water, their body behaves as if they are still in the womb until they take their first breath of air, at which point their lungs open up. As a baby comes from water (in the womb) into water (in the birth pool), the lungs are not open and no water can enter.
After your baby is born in the water, you and your midwife will bring them to the surface slowly. Your baby will only be underwater for a short time and won’t take a breath until they are out of the water.
Your baby is only at risk:
If their head is brought above the water and brought down again
If their oxygen supply from the placenta is affected
If their temperature changes suddenly.
Your midwife will be careful to make sure this does not happen.
What should I wear for my water birth?
You can wear what feels comfortable for you, keeping in mind that you will be in what is essentially a large bath. Many women choose to wear a bikini or tankini. Others choose to just wear a bra. You can wear a t-shirt or vest top if you want to be a little more covered. It can be twisted up and tucked into the neck if it’s very long. Some women prefer to be naked.
What other pain relief can I have in the water?
Water is sometimes referred to as ‘nature’s epidural’ or ‘aquadural’, because of the support and pressure it gives you. However, if you need a little extra, it is common to use gas and air (Entonox) while you are in the birth pool.
The Entonox tubing is waterproof so this can be used in the pool too.
How do I deliver the placenta if I have a water birth?
Your midwife is likely to ask you to get out of the pool to deliver the placenta because gravity can be helpful in the third stage of labour. It also makes it easier to help you in case of an emergency, as some new mums can feel faint after birth, or during the third stage of labour. If you do suddenly feel lightheaded, it may be difficult to get you out of the pool quickly and safely.
When might I need to get out of the pool?
If the midwife sees meconium (when the baby does a poo whilst still inside)
If you start to bleed heavily from the vagina
Your labour becomes abnormal, changes in your temperature or blood pressure for example
If the baby’s heart rate changes
To go to the toilet (you can leave and return)
For your midwife to examine you to check your progress
If your labour slows down or if your contractions get weaker
To deliver the placenta.
Forceps or vacuum delivery
An assisted vaginal birth is where the doctor uses special instruments to help deliver the baby during the last stage of labour.
Why might I need help to delivery my baby?
There are several reasons you may need help, including if:
Your baby is not moving out of the birth canal as expected
There are concerns about your baby’s wellbeing
You can’t, or have been advised not to, push during birth.
The purpose of an assisted birth is to mimic a normal birth with minimum risk. Forceps or ventouse will only be used if they are the safest way to give birth for you and your baby.
How common is an assisted birth?
Assisted birth is quite common, although you’re much less likely to need help if you’ve had a vaginal birth before.
Will I be asked for consent?
Yes. Your doctor or midwife will ask for your permission to use forceps or ventouse to help deliver your baby. They will also explain:
Why they think you need an assisted birth
What instrument they want to use
The potential risks to you and your baby.
After your baby is born, you should also have a chance to talk to your doctor or midwife about why you needed an assisted birth.
Can I avoid an assisted birth?
Women who have someone supporting them during labour are less likely to need an assisted birth, particularly if the support comes from someone you know (a birth partner as well as a midwife).
Using upright positions or lying on your side and not having an epidural may also help. Find out more about movement and positions during labour.
If this is your first baby and you have an epidural, you may be able to reduce the need for an assisted birth by waiting until you have a strong urge to push or by delaying when you start pushing. The length of time that you delay pushing will depend on your individual situation and your wishes but is usually 1–2 hours after the cervix (neck of your womb) is fully open. Starting a hormone drip may also reduce the need for an assisted birth.
Try not to worry too much about this and how to do it. You can talk to your midwife about how to avoid an assisted birth before labour and a professional will be there to help you on the day.
What is a ventouse birth?
A ventouse (vacuum extractor) uses suction to attach a soft or hard plastic or metal cup on to your baby’s head. The doctor will wait until you are having a contraction and then ask you to push while they gently pull to help deliver your baby. They may need to pull more than once.
What is a forceps birth?
Forceps are smooth metal instruments that look like large spoons or tongs. They are curved to fit around your baby’s head. The doctor will carefully put them around your baby’s head, wait until you have a contraction and then ask you to push while they gently pull to help deliver your baby. They may need to pull more than once.
Which instrument will be used?
Ventouse and forceps are both safe and effective. Your doctor will choose the type of instrument most suitable for you, your baby and your situation.
There are many different types of ventouse and forceps, some of which are specifically designed to turn the baby around, if needed. Forceps are more successful in delivering the baby, but a ventouse is less likely to cause vaginal tearing.
The ventouse is not suitable if you are less than 34 weeks pregnant as the baby’s head is softer, which can increase the risk of bruising, brain haemorrhage and jaundice.
What happens during a forceps or ventouse assisted birth?
Your doctor will examine your stomach and do an internal examination to confirm that an assisted delivery is best for you. Your bladder will be emptied by passing a small tube (catheter) into it.
They may use a local anaesthetic injection inside the vagina (pudendal block) or a regional anaesthetic injection given into the space around the nerves in your back (an epidural) to block any pain.
If your baby’s head needs turning, you’ll probably be advised to have an epidural for pain relief during the birth.
Are assisted births always successful?
Not always. If your doctor has tried using a ventouse or forceps and they do not think your baby can be born safely vaginally, they may recommend that you have an emergency caesarean. The word ‘emergency’ makes it sound last minute and rushed, but this is just a medical term.
Assisted vaginal birth is less likely to be successful if:
You are overweight with a body mass index (BMI) over 30
Your baby is large
Your baby is lying with its back to your back
Your baby’s head is not low down in the birth canal.
What are the risks of having an assisted birth?
Bleeding
Bleeding after having a baby is normal. Immediately after an assisted birth, you may have some heavier bleeding. This should become like bleeding after a normal birth in the days afterwards.
Use sanitary towels, not tampons for the first 6 weeks after birth because tampons can increase your chance of getting an infection.
Tell your midwife or health visitor if you’re losing blood in large clots because you may need some treatment.
Vaginal tears or episiotomy
You may have a vaginal tear or an episiotomy. This is a cut made in the area between your vagina and anus, called the perineum. Even without the forceps or ventouse the perineum may tear during delivery. If you have a vaginal tear or episiotomy, this will be repaired with dissolvable stitches.
If you have an assisted birth, you’re more likely to have a third- or fourth-degree tear. This is a vaginal tear that involves the muscle or the wall of the anus or rectum.
This type of tear affects:
1 in 100 women having a normal vaginal birth
up to 4 in 100 having a ventouse delivery
8–12 in 100 having a forceps delivery.
Bowel and bladder problems
Urinary incontinence (leaking wee) can happen after childbirth and it can be common after a ventouse or forceps delivery. You should be told about ways to prevent this, including advice on pelvic floor exercises.
Anal incontinence (leaking wind or poo) can happen after birth, particularly if you had a third- or fourth-degree tear.
If you have any concerns about incontinence, you can ask your GP to refer you to a women’s health physiotherapist.
Blood clots
Pregnancy increases the risk of blood clots forming in the veins in your legs and pelvis (deep vein thrombosis) and this risk is higher after an assisted birth. You can help reduce this risk by staying as mobile as possible after you give birth. You may also be advised to wear special stockings and to have daily injections of heparin, which makes the blood less likely to clot.
Are there any risks for the baby?
If you have a ventouse delivery, the suction cup can:
Leave a mark on the baby’s head, which should disappear after a day or two
Commonly cause a bruise on a baby’s head called a cephalohematoma – this occurs in between 1–12 in 100 babies who are born by the ventouse and disappears with time. It rarely causes any problems with babies except for a slight increase in jaundice in the first few days.
Forceps can:
Leave a mark on the baby’s face – this is very common and usually small, and usually disappears within 24–48 hours
Commonly leave small cuts on the baby’s face or scalp, which will heal quickly.
How will I feel after I leave hospital?
Much like after any birth, you may feel a little bruised and sore. Any stitches will heal within a few weeks and pain relief will help.
Will I need an assisted birth next time?
Not necessarily. Most women who have an assisted birth deliver their baby without help next time.
Vaginal birth after c-section
Getting pregnant after a c-section
It usually takes longer to recover from a c-section than a vaginal birth, even if the birth was straightforward. It’s important to give your body time to recover before you start trying to get pregnant again.
It’s particularly important to make sure your scar has completely healed if you want to try for a vaginal birth next time. This is because it is possible that the scar may open slightly. This is known as uterine dehiscence. It may not cause any serious issues, but it may increase the chance of a uterine rupture (a tear in the wall of the uterus), which can cause serious problems for both the mum and baby. The chances of a uterine rupture is higher if you have a vaginal birth next time, but it is still rare.
It may help to think about how long it took you to recover after your last c-section, your current physical health now and if you’re feeling emotionally ready. There are lots of positive things you can do to prepare for a healthy pregnancy and baby. Find out more about planning a pregnancy.
Of course, pregnancy isn’t always planned. Or you may want to get pregnant sooner for your own reasons. If you have become pregnant within a year of having a c-section, you may still be able to give birth vaginally if you want to. Your doctor or midwife will explain your best options for giving birth.
Birth options after a c-section
If you’ve had a c-section before, you can have a vaginal birth after a c-section (VBAC) or an elective repeat c-section (ERCS). If you are fit and healthy, both are safe choices with very small risks.
Your midwife or obstetrician will talk to you about your birth options soon after your fetal anomaly scan at 18–21 weeks. An obstetrician is a doctor who specialises in care during pregnancy, labour and after birth.
They can help you decide how to give birth by talking to you about:
Why you had a c-section last time
Whether you have had a vaginal birth
Any complications during your last c-section or during your recovery
The type of cut that was made in your womb – horizontal or vertical
How you feel about your most recent birth experience
How your current pregnancy is progressing and if there have been any issues or complications
How many more babies you are hoping to have in the future – the risks increase with each c-section, so you may want to avoid another c-section if possible.
Vaginal birth after a c-section (VBAC)
If you have only had one c-section before, you should be able to give birth vaginally if you’re carrying one baby and you go into labour after 37 weeks.
You’re more likely to have a successful vaginal birth if:
You’ve had a vaginal birth before, especially if it was after a previous c-section
Labour starts naturally
You were at a healthy weight when you got pregnant.
What are the advantages of a VBAC?
If vaginal birth is successful, you’re less likely to have complications than if you have an elective repeat c-section (ERCS).
Your recovery is likely to be quicker
Your stay in hospital may be shorter
You will avoid the risks of an operation
You’re more likely to have a successful vaginal birth in future pregnancies
Your baby will have less chance of breathing problems in the days after birth.
What are the disadvantages of a VBAC?
On average, about 1 in 4 women will need an emergency c-section during labour. This carries a higher risk of complications than an elective repeat c-section (ERCS). For women who have had a vaginal birth before, about 1 in 10 will need an emergency c-section.
There’s a higher chance of the scar in your womb tearing (uterine rupture). This happens in about 1 in 200 women. The chance of this happening is lower if you have had a vaginal birth before but it is more likely if your labour is induced (started artificially). If it looks like that may happen, you’ll be offered an emergency c-section.
You have a slightly higher chance of needing a blood transfusion compared with women who choose a planned caesarean section.
Where can I give birth?
You may need to give birth in hospital, where you have quick access to more facilities if you need them. For example, in case you need an emergency c-section or a blood transfusion, or if your baby needs help to breathe.
This is especially important if you’re more likely to have complications, such as uterine rupture. This may be the case if your labour is induced or you have had more than one c-section before. Your doctor or midwife can help you decide what is best for you.
Can I have a vaginal birth if I have had more than one c-section?
If you have had more than one c-section, you should have the chance to talk to a senior obstetrician about the risks and benefits of a vaginal birth. Speak to your midwife as soon as possible to arrange a consultation with an obstetrician.
Going into labour before a VBAC
During your pregnancy, your doctor will explain what to do if you do or don’t go into labour before your VBAC. If you go into labour or your waters break, contact the hospital straight away. Once you start having regular contractions, the midwife will track your baby’s heartbeat.
You can choose your preferred type of pain relief during labour, including an epidural if you would like one.
Elective repeat c-section (ERCS)
If you choose to have another c-section, you will usually have it after 39 weeks of pregnancy. Your obstetrician may suggest you have another c-section if you have:
A vertical scar in your womb
Placenta praevia
Had a uterine rupture
Had uterine surgery.
What are the advantages of an ERCS?
There’s a smaller risk of the c-section scar separating or tearing (1 in 1000)
You will know the date of planned birth. But you may go into labour before this date or your healthcare team may need to change the date
The risk to your baby of brain injury or stillbirth is lower than for VBAC.
What are the disadvantages of an ERCS?
A repeat c-section usually takes longer than the first operation. This is because you will have scar tissue, which can make the operation more difficult. Scar tissue might also damage your bowel or bladder
You have a slightly higher risk of placenta praevia and/or placenta accreta in future pregnancies
You’re more likely to need a c-section in future pregnancies
Your baby has a slightly higher risk of breathing problems after birth if you have an ERCS before 39 weeks – you may have steroid injections before the birth to reduce this risk.
What happens if I have an elective c-section planned but I go into labour?
Your doctor or midwife will help you plan what will happen if you go into labour before your elective c-section.
Tell your maternity team straight away if you start going into labour. They will help you decide on the safest option for you and your baby. This may be an emergency c-section, or if labour is very advanced it may be safer for you to have a vaginal birth.