More than four in ten births in this country are now caesarean births. In the latest figures, caesarean has overtaken unassisted vaginal birth — it's now the single most common way babies are born. And about one in nine more babies arrive with the help of forceps or a ventouse.
If you're getting ready for your partner's birth, this isn't the side room. It's the main room.
First, the word. You'll hear "natural birth" and hear caesarean spoken about as though a caesarean isn't. At its root, the word natural comes from the Latin for being born — genesis, generate, native, all one family. Natural means born. A caesarean birth is a birth. The same trick works on "normal birth": a birth is a birth, and the only abnormal thing in that room would be pretending otherwise.
What actually happens. She'll have an epidural or a spinal block, so she's awake but feels no pain — just pressure. A screen goes up, so neither of you watches the surgery itself. The whole thing takes about forty-five minutes to an hour, and the baby is usually out within the first few minutes. You'll be given scrubs. You'll sit at her head, holding her hand, watching her face — not the screen.
Your job. Everyone behind that screen has a job: the surgeon, the anaesthetist, the midwife. Yours is the only job that matters to her — you're the person in the room who is there for her, not for the operation. That's not nothing. That's the whole thing.
I remember being in theatre myself, years ago — the hustle and bustle, the bright light, the bleeps, feeling disorientated. And I remember thinking: my job here is not to be a spare part. Later, when my oldest daughter had a caesarean birth and wanted me with her because she had no partner, I experienced it from the other side of the fence — and I didn't cover myself in glory in that theatre. The point is this: even the bloke who wrote this book gets it wrong in there. But she needed someone in that room. And that, in the end, was the whole of it.
What to say. If the caesarean is unplanned — and often even when it's planned — she may have complicated feelings: relief, but also disappointment, a sense of failure, grief for the birth she'd pictured. You don't get to tell her which feelings are allowed. They're all allowed. "This wasn't how you wanted it to go, was it?" goes further than "but you did amazing!" — say both, but lead with the first.
Know the standard. NICE, the body that sets standards for the NHS, says she should have you with her in theatre, and the baby should go skin-to-skin as soon as it's safe — right there in the operating room. That's the standard, not a special request. So "can she have the baby on her chest now?" is a completely reasonable sentence, and you're allowed to say it more than once. And if she can't hold the baby straight away — shivering, or sick from the drugs — then it's you. The baby goes on your chest until she can. That's not a consolation prize. The baby doesn't care whose chest it is, just that it's warm and there's a heartbeat.
And when the team speak in vagueness — and under pressure, they will — ask for the specifics. "Can you explain what you mean by that? What are the immediate steps?" You're not being difficult. You're being her witness: the person who makes sure nothing happens to her that she hasn't understood.
This piece draws on the caesarean and instrumental birth chapter of Men, Love & Birth (2nd edition).