What Does a Positive Caesarean Birth Look Like after Birth Trauma?

Written by Dr Rosie Pajak - Perinatal Psychologist and Founder of The Birth Healing Collective

April is Caesarean Awareness Month, a powerful opportunity for families to share their experiences and broaden our understanding of the complexity of caesarean birth.  

When we speak about positive birth experiences, caesarean births are often left out of the conversation. Yet for some women - especially those preparing for birth after a previously traumatic experience - a planned caesarean can offer a sense of safety, reducing the challenging unpredictability of birth.

At the same time, there are many families whose caesarean births involved deep feelings of grief or trauma, for whom the idea of a "positive caesarean" can feel like a contradiction.

In my work as a perinatal psychologist supporting women to give birth again after trauma, I hear many distressing caesarean birth stories. But I also see many families go on to have genuinely positive, deeply healing births via caesarean.

I think it’s important to know that a positive caesarean is entirely possible, even after a previously traumatic caesarean birth.

Caesarean birth can be soft. It can be slow. It can be sacred.

A positive birth experience is about so much more than the way our babies physically enter the world. It’s about how mothers are held and heard through the experience. What I hear in my work time and time again is that caesarean birth can be healing if mothers are supported to feel safe and involved in the process.

For most of my clients, a positive caesarean starts with informed choices and a genuine sense of involvement in their birth. Understanding that you still have many options when it comes to caesarean birth can make a world of difference, helping you reclaim the experience as your own. The operating theatre can feel like the obstetrician’s domain, but a good team will want to support you to feel as safe and in control of your birth as possible.

Whether you are planning to give birth via caesarean or want to be more prepared in case the birth goes that way, it’s always worth asking your care team what’s possible. It might be that you would like to prioritise skin-to-skin in theatre, or want to ensure a calmer, more soothing environment with gentler lighting and music. (If you’re not sure what kinds of things you can ask, there’s a downloadable list of questions available on my website).

The other half of birth preparation is less practical and more emotional. Before heading into another birth, it’s important to make space for the story of your last one.

If your previous birth left you feeling unseen, powerless, or confused, those feelings don’t just disappear. They might get put aside for a while, but they linger in the body, heart, and the decisions you make moving forward.

It’s okay for your last birth to inform the choices you make - it’s incredibly important – as long as those decisions aren’t made solely from fear.

Taking time to gently revisit your birth and process what happened can help you understand what you needed then, and what you are likely to need now. Reflecting on your last birth isn’t about reactivating past distress, it’s about clearing some space for a new and different experience this time around.

Seeking out some additional support can help you reflect on what happened if it feels difficult to revisit, whether that’s via therapy with a trauma-informed clinician or a birth debrief with your midwife. Talking through your experience with another might help you view it with a different perspective, new understandings and more compassion.

Revisiting your last birth in this way means your decisions can come from a place of clarity, strength and hope. It’s an important shift, to believe that a better birth is possible (for you, not just for other women!) It feels quite different to go through your pregnancy knowing that you are doing all you can to prepare, both practically and emotionally.

When caesarean birth is approached with intention, personalisation and emotional support, it really can be a beautiful, powerful and healing birth experience.

About Dr Rosie 

Dr Rosie Pajak is a perinatal clinical psychologist and founder of The Birth Healing Collective. She has a range of resources and supportive programs for parents preparing to give birth again after traumatic birth experiences available here. You can follow her @birth_healing_collective.