Who Decides? Your Rights When Birthing After a Caesarean

Lizzy Lewis
May 14
5 min read

You’ve probably heard it (or maybe even said it yourself):

“They wouldn’t let me…

”“I wasn’t allowed…"

“I had to…”

These phrases echo across maternity care- But here’s the truth:

When it comes to your pregnancy and birth, you decide. You are the decision-maker. Not your doctor. Not the hospital. Not a policy or a protocol. You.

Human Rights in Childbirth: The Basics

In the UK, every adult has the legal right to decide what happens to their body. That right does not disappear when you're pregnant.

You have the right to bodily autonomy, which means the freedom to make decisions about your body, your care, and your birth. This is protected by both the Human Rights Act 1998 (which is protected by the European Convention on Human Rights) as well as UK Common Law.

Consent Matters

No one can give you medical treatment without your permission. This is the legal and ethical principle of consent. Your consent must be:

Informed – You understand the risks, benefits and alternatives
Voluntary – You're free from pressure, coercion, or manipulation
Ongoing – You must be asked whether you agree to every medical procedure. You can change your mind at any time

And yes, this means you can decline treatment when:

Your doctor disagrees
It goes against hospital policy
You’re told it’s risky

You can refuse any intervention, at any time, for any reason.

Your Rights After a Caesarean

Having had a previous caesarean changes your history, but it doesn’t take away your rights. Here are four of the most important rights to know if you’re planning a birth after caesarean:

1. You Have the Right to Plan a VBAC or Choose an Elective Repeat Caesarean

You have the right to choose HOW you give birth- whether that’s a Vaginal Birth After Caesarean (VBAC) or an Elective Repeat Caesarean Section (ERCS)

You shouldn’t be pressured into choosing one choice over the other. While some women might feel pressured to attempt a VBAC, more often many feel they’re being steered toward another caesarean.

According to NICE guidelines: “If a pregnant woman or pregnant person chooses to plan a vaginal birth after they have previously had a caesarean birth, they should be fully supported in their choice.”

You can also define your own boundaries. For example:

Planning a VBAC with boundaries (e.g. only if labour begins spontaneously by a date you choose)
Starting labour with VBAC in mind, but changing your mind mid-way.
Agreeing to an induction based on favourability
You do not need to attend a VBAC choices clinic if you know you want an Elective Repeat Caesarean (likewise, even if you know you want a VBAC you don’t have to attend!)

It’s your right to choose and to change your mind.

2. You Have the Right to Choose Where You Give Birth

Whether you plan to give birth at home or in hospital- that decision is yours.

Home Birth After Caesarean (HBAC)

Yes, you can have a home birth after a caesarean- even though this goes against the NICE and RCOG guidelines. No one can make you give birth in a hospital. Ideally, you would be supported in your choice on where to birth, but it is worth knowing that you don’t need permission from a consultant obstetrician (typically referred to as having your birth plan ‘signed off’) and you don’t need to justify your decision. Realistically, it is unlikely you will find a doctor supportive of HBAC as it goes against their professional guidelines, so it is usually wise to discuss this with someone like a consultant midwife or head of midwifery.

Accessing a Birth Centre

Birth centres often use “admissions criteria” that can exclude those labelled high-risk. But these are not legal rules- they’re internal policies, and they must be applied case by case.

VBAC alone is not a valid reason to exclude you automatically. If a birth centre cannot accommodate your care, they must explain why clearly and with evidence. Many women with straightforward histories after caesarean have birthed safely in birth centres with supportive teams. If you are getting nowhere with a consultant (who probably has little say over their day to day running of a birth centre anyway!) try instead contacting:

The birth centre manager
A VBAC specialist midwife
The consultant midwife

3. You Have the Right to Make Informed Choices About Your Care

Standard VBAC care often follows a predefined pathway- for example, insertion of a cannula and CTG. But these are guidelines, not laws.

You have the right to balance up the risks, benefits and evidence and decline and accept any offer of treatment. You have the right to:

Accept or decline any part of offered care
Make choices based on your values, not just hospital routine

If you are birthing outside of guidelines, you may find it useful to create an individualised care plan so it is signed off and in your notes ahead of birth, so you aren’t having to stress the importance of your choices in the moment. You can usually arrange this with either a consultant midwife or The head of midwifery

4. You Have the Right to Choose Who Cares for You

After a caesarean, you're usually placed on a consultant-led pathway. However, You don’t have to:

Attend a VBAC clinic (unless you want to)
Be under consultant-led care
Have your care plan “signed off” by an obstetrician

Midwifery-led care is still an option, even after caesarean. You can ask to remain with a community midwife team, or work with a consultant midwife to make a plan that supports your choices. This includes both antenatally and during labour by giving birth either in a midwife led unit or at home.

5. The right to choose pain relief

Ultimately, its your choice as to what pain relief you choose when going for a VBAC. In some parts of the world, an epidural is advised to be placed ‘just in case’, but this is your choice and something that shouldn’t be encouraged here in the UK based on both NICE and RCOG guidelines.

NICE guidelines also say that women with a previous caesarean can have a water birth, but barriers exist in hospitals due to the reality of amount of pools on delivery suites and the recommendation of CTG which can make it harder.

Final Thoughts

When you’ve had a caesarean before, it can feel like your choices are being taken away from you. But the truth is: your rights don’t go anywhere.

You still get to decide. You still get to ask questions. You still have the power to shape your birth—on your terms.

And if anyone tells you otherwise?

It’s time to ask them: “Is that a legal requirement—or just hospital policy?”

Because knowing your rights is the first step to reclaiming your birth.

Further Resources:

Birthrights - your human rights during pregnancy and maternity care